Advance Nursing Research – Critiquing a Qualitative Research Paper

Advance Nursing Research – Critiquing a Qualitative Research Paper

Instructions/Descriptions

Advance Nursing Research – Critiquing a Qualitative Research Paper

Critiquing a Qualitative Research Study

For this assignment, you will be writing your own QUALITATIVE study critique (similar to what you did for me last week for the quantitative study critique, only this time critiquing a QUALITATIVE research study) on one of the studies provided to you.

Choose one qualitative journal article from this list:

Biezen, R., Grando, D., Mazza, D., & Brijnath, B. (2019). Visibility and transmission: complexities around promoting hand hygiene in young children: A qualitative study . BMC Public Health, 19(1), no pages.

da Silva Lins, H. N., Macêdo Paiva, L. K., Gonçalves de Souza, M., Cassimiro Lima, R. M., & Albuquerque, N. L. A. (2019). Experiences in women’s care: Doulas’ perception . Journal of Nursing UFPE / Revista de Enfermagem UFPE, 13(5), 1264–1269.

Mele, B., Goodarzi, Z., Hanson, H. M., & Holroyd-Leduc, J. (2019). Barriers and facilitators to diagnosing and managing apathy in Parkinson’s disease: A qualitative study . BMC Neurology, 19(1), no pages.

Assignment Instructions

– Read your selected journal article entirely.

– Analyze the journal article and use the specific questions that are outlined in Gray, Grove, and Sutherland (2017) found on the attachment section to construct your analysis of your chosen QUALITATIVE research study. (See Word Attachment)

These are the main headers of your paper:

1- Identifying the Steps of the Qualitative Research Process

2- Determination of Strengths and Weaknesses of Qualitative Studies

3- Evaluating a Qualitative Study

You have many questions to address in your assignment. They should be in complete sentences (i.e., bullet point responses are not acceptable!).

– APA format is required in your assignment Word document.

– Page length, excluding the title and references list, is between five and seven pages.

– Minimun Two (2) references.

– Free of plagiarism (Turnitin Assignment)

Critical Appraisal Process for Qualitative Studies

Critical appraisal of qualitative studies requires different detailed guidelines than those used when appraising a quantitative study (Marshall & Rossman, 2016; Sandelowski, 2008), because the different qualitative approaches have different standards of quality than do quantitative approaches. However, appraisals of quantitative and qualitative studies follow the same three major steps in the appraisal process (see Box 18-1) and have a common purpose—determining the credibility and trustworthiness of the findings.

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The integrity of the design and methods affects the credibility and meaningfulness of qualitative findings and their usefulness in clinical practice (Melnyk & Fineout-Overholt, 2015; Pickler & Butz, 2007). Burns (1989) first described the standards for rigorous qualitative research almost 30 years ago. Since that time, other criteria have been published (Cesario, Morin, & Santa-Donato, 2002; Clissett,

2008; Melnyk & Fineout-Overholt, 2015; Morse, 2012; Pickler & Butz, 2007), including one book on evaluating qualitative research (Roller & Lavrakas, 2015). The standards by which qualitative research should be appraised have been the source of considerable debate (Cohen & Crabtree, 2008; Hannes, 2011; Liamputtong, 2013; Mackey, 2012; Nelson, 2008; Roller & Lavrakas, 2015; Stige,

Malterud, & Midtgarden, 2009; Whittemore, Chase, & Mandle, 2001). Nurses critically appraising qualitative studies need three prerequisite characteristics in applying rigorous appraisal standards. Without these prerequisites, nurses may miss potential valuable contributions qualitative studies might make to the knowledge base of nursing. These required prerequisite characteristics are

addressed in the following section.

Prerequisites for Critical Appraisal of Qualitative Studies

The first prerequisite for appraising qualitative studies is an appreciation for the philosophical foundation of qualitative research (Melnyk & Fineout-Overholt, 2015) (Box 18-3). Qualitative researchers design their studies to be congruent with one of a wide range of philosophies, such as phenomenology, symbolic interactionism, and hermeneutics, each of which espouses slightly different methods and approaches to gaining new knowledge (Charmaz, 2014; Corbin & Strauss, 2015; Kaestle, 1992; Marshall & Rossman, 2016; Munhall, 2012; Norlyk & Harder, 2010).

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Without an appreciation for the philosophical perspective supporting the study being critically appraised, the appraiser may not appropriately apply standards of rigor that are congruent with that perspective

(Melnyk & Fineout-Overholt, 2015). Although unique, the qualitative philosophies are similar in their views of the uniqueness of the individual and the value of the individual’s perspective. Chapter 4 contains more information on the different philosophies that are foundational to qualitative research.

Box 18-3

Prerequisites for Critically Appraising Qualitative Research

• Appreciation for the philosophical foundation of qualitative research
• Basic knowledge of different qualitative approaches
• Respect for the participant’s perspective

Guided by an appreciation of qualitative philosophical perspectives, nurses appraising a qualitative study can evaluate the approach used to gather, analyze, and interpret the data (Miles et al., 2014). A basic knowledge of different qualitative approaches is as essential for appraisal of qualitative studies as knowledge of quantitative research designs is for appraising

quantitative studies (see Box 18-3; Munhall, 2012). Spending an extended time in the culture, organization, or setting that is the focus of the study is an expectation for ethnography studies but would not be expected for a phenomenological study. A researcher using a grounded theory approach is expected to analyze data to extract social processes and construct connections among emerging concepts (Charmaz, 2014).

Phenomenological researchers are expected to produce a rich, detailed description of a lived experience. Knowing these distinctions is a prerequisite to fair and objective critical appraisal of qualitative studies. What one expects to find in a qualitative research report may be the primary determinant of one’s appraisal of the quality of that study

(Morse, 2012; Sandelowski & Barroso, 2007).

Box 18-3 outlines the prerequisites of philosophical foundation, type of qualitative study, and openness to study participants that direct the implementation of the following guidelines for critically appraising qualitative studies. Appreciating philosophical perspectives and knowing qualitative approaches are superficial, however, without respect for the participant’s

perspective. Qualitative philosophers are similar in their views of the uniqueness of the individual and the value of the individuals’ perspective. That basic valuing creates an openness to hearing a participant’s story and perceiving the person’s life, in context. This openness allows qualitative researchers and nurses using the findings to perceive different truths and to

acknowledge the depth, richness, and complexity inherent in the lives of all the patients we serve.

Step I: Identifying the Steps of the Qualitative Research Process in Studies

As with quantitative research, you will start by reviewing the title and abstract. Reading the article completely is essential when critically appraising a study, because you need to use all of the information that the researchers provided. If you are unfamiliar with the qualitative approach that was used, this is a good time to look it up in Chapter 4 of this book or in other qualitative research sources listed in the references of this chapter.

Guidelines for Identifying the Steps of the Qualitative Research Process

QUESTIONS:

The following questions are provided to help you identify the key elements of the study.

1. Introduction
2. Describe the researchers’ qualifications. Take note of their employers, professions, levels of educational preparation, clinical expertise, and research experience. Have the researchers conducted previous studies on this topic or with this population? Not all of this information will be available in the article, so you will need to search for additional information about the researchers online (Fothergill & Lipp, 2014).
3. Does the title give you a clear indication of the concepts studied and the population? Can you determine from the title which qualitative approach was used?
4. Is the abstract inclusive of the purpose of the study, qualitative approach, and sample (Fothergill & Lipp, 2014)? The abstract should also contain key findings.
5. Research problem
6. Is the significance of the study established? In other words, why should you care about the problem that inspired the researcher to conduct this study (Liamputtong, 2013)?
7. Identify the problem statement. Is the research problem explicitly stated?
8. Does the researcher identify a personal connection or motivation for selecting this topic to study? For example, the researcher may choose to study the lived experience of men undergoing radiation for prostate cancer after the researcher’s father underwent the same treatment. Acknowledging motives and potential biases is an expectation for qualitative researchers, but the researcher may not include this information in the article (Marshall & Rossman, 2016; Munhall, 2012).

III. Purpose and research questions

1. Identify the purpose of the study. Is the purpose a logical approach to addressing the research problem

of the study (Fawcett & Garity, 2009; Munhall, 2012)? Does the purpose have an intuitive fit with the problem?

1. List research questions that the study was designed to answer.
2. Are the research questions related to the problem and purpose?
3. Are qualitative methods appropriate to answer the research questions?
4. Literature review
5. Are quantitative and qualitative studies cited that are relevant to the focus of the study? What other types of

literature are included?

1. Were the references current at the time the research was published? For qualitative studies, the author may have included studies older than the 5-year limit typically used for quantitative studies. Findings of older qualitative studies may be relevant to a

qualitative study that involves human processes, such as grieving or coping, that transcend time.

1. Identify the disciplines of the authors of studies cited in the article. Does it appear that the researcher

searched databases outside the Cumulative Index to Nursing and Allied Health Literature (CINAHL) for relevant studies? Research publications in other disciplines as well as literary works in the humanities may have relevance for some qualitative studies.

1. Were the cited studies evaluated and their limitations noted?
2. Did the literature review include adequate synthesized information to build a logical argument (Marshall & Rossman, 2016; Wakefield, 2014)? Another way to ask the question: Does the author provide enough evidence to support the assertion that

the study was needed?

1. Philosophical foundation or theoretical perspective

The methods used by qualitative researchers are determined by the philosophical foundation of their work. The researcher may or may not state the philosophical stance on which the study is based. Despite this omission, you as a knowledgeable reader can recognize the philosophy through the description of the problem, formulation of the research questions, and selection of the methods to address the research questions.

1. Was a specific perspective (philosophy or theory) described from which the study was developed? If so, what was that perspective?
2. If a broad philosophy, such as phenomenology, was identified, was the specific philosopher, such as Husserl or Heidegger, also identified?
3. Did the researcher cite a primary source for the philosophical foundation or theory (see Chapter 4)?
4. Qualitative approach
5. Identify the stated or implied research approach used for the study.
6. Provide a paraphrased description of the research approach used. In addition to reviewing Chapter 4, refer to Charmaz (2014), Corbin and Strauss (2015), Creswell (2013), and Munhall (2012) for descriptions of the different qualitative research perspectives or

traditions.

VII. Sampling and sample

1. Identify how study participants were selected.
2. Identify the types of sites where participants were recruited for the study.
3. Describe the inclusion and exclusion criteria of the sample.
4. Discuss the sample size. How was the sample size determined (theoretical saturation, no new themes generated, researcher understanding of the essences of the phenomenon, etcetera)?

VIII. Data collection

1. Describe the data collection method.
2. Identify the period of time during which data collection occurred, and also the duration of any interviews.
3. Describe the sequence of data collection events for a participant. For example, were data collected from one interview or a series of interviews? Were focus group participants given an opportunity to provide additional data or review the preliminary conclusions of the researcher?
4. Describe any changes in the methods in response to the context and early data collection (Marshall & Rossman, 2016; Miles et al., 2014; Roller & Lavrakas, 2015).
5. Protection of human study participants
6. Identify the benefits and risks of participation. Are there benefits or risks the researchers do not identify?
7. Are recruitment and consent techniques adjusted to accommodate the sensitivity of the subject matter and psychological distress of potential participants?
8. Describe the data collection and management techniques that acknowledge participant sensitivity and vulnerability. These might include how potential participants are identified or what resources are available if the participant becomes upset (McCosker, Barnard, & Gerber, 2001; Munhall, 2012).
9. Data management and analysis
10. Describe the data management and analysis methods used in the study, by name if possible (Marshall &

Rossman, 2016; Miles et al. 2014; Munhall, 2012).

1. Is an audit trail mentioned? An audit trail is a record of critical decisions that were made during the development and implementation of the study (see Chapter 4).
2. Does the researcher describe other strategies used to minimize or allow for the effects of researcher bias (Miles et al., 2014; Patton, 2015)? For example, did two researchers analyze the data independently and compare their analyses?
3. Findings
4. What are the findings of the study?
5. Does the researcher include participants’ quotes to support themes or other processes identified as the findings (Corbin & Strauss, 2015; Patton, 2015)?
6. Do the findings “ring true” to the reader? This resonation, this believing on the part of the reader, in relation to something already experienced in private or professional life, supports the study’s veracity.

XII. Discussion

1. Describe the limitations of the study.
2. Identify whether the findings are compared to the findings of other studies or other relevant literature (Fawcett & Garity, 2009; Munhall, 2012).
3. Did the results offer new information about the phenomenon?
4. What clinical, policy, theoretical, and other types of implications are identified?

Step 2: Determining the Strengths and Weaknesses of the Study

Nurses prepared at the graduate level will compare each component of qualitative studies to the writings of qualitative experts, such as Charmaz (2014), Corbin and Strauss (2015), Creswell (2013), Maxwell (2013), Miles et al. (2014), Morse (2012), Munhall (2012), Roller and Lavrakas (2015), and Sandelowski and Barroso (2007). See also Chapters 4 and 12 in this text to review the processes considered appropriate for qualitative studies. By doing this comparison, you can determine the strengths and weaknesses of the study.

Guidelines for Determining the Strengths and Weaknesses of Qualitative Studies

1. Research report
2. Are you able to identify easily the elements of the research report?
3. Are readers able to hear the voice of the participants and gain an understanding of the phenomenon studied?
4. Does the overall presentation of the study fit its purpose, method, and findings (Fawcett & Garity, 2009; Marshall & Rossman, 2016; Munhall, 2012; Sandelowski & Barroso, 2007)?
5. Research problem, purpose, and questions
6. Is the purpose a logical approach to addressing the research problem of the study (Fawcett & Garity, 2009; Munhall, 2012)?
7. Does the purpose have an intuitive fit with the problem?
8. Are the research questions related to the problem and purpose?

III. Literature review

1. Is the study based on a broad review of the literature? Does it appear that the author searched databases outside CINAHL for relevant studies?
2. Is the review of the literature adequately synthesized and presented in a way that builds a logical argument? Another way to ask the question: Do the researchers provide enough evidence to support the conclusion that the study is needed?
3. Methods
4. Are the qualitative methods appropriate for the study purpose (Sandelowski & Barroso, 2007)?
5. Are the methods consistent with the philosophical tradition and qualitative approach that was used? Determining whether there is methodological congruence among the elements of the study is key to the quality of the study (Hannes, 2011).
6. Were the selected participants able to provide data relevant to the study purpose and research questions?
7. Were the methods of data collection effective in obtaining data to address the study purpose?
8. Were resources available to support participants who may have become upset? What resources did the researcher cite? Topics of qualitative studies may be sensitive topics that are difficult to talk about (Cowles, 1988; McCosker et al., 2001). Researchers concerned for their participants ensure that a mental health professional and other resources are available, should

the participant become distressed.

1. Was the rationale provided for the selection of the particular data collection method used?
2. Were the data collection procedures proscriptively applied or allowed to emerge with some flexibility? Flexibility within parameters of the method is considered appropriate for qualitative studies (Patton, 2015).
3. Did the data management and analysis methods fit the research purposes and data?
4. Were the data analyzed sufficiently to allow new insights to occur?
5. Were the methods used to ensure rigor adequate for eliciting the reader’s confidence in the findings (Miles et al., 2014)? For example, were participants given the opportunity to validate their data after transcription and initial analysis? Did quotes support the themes or descriptions?
6. Findings
7. Do the findings address the purpose of the study (Marshall & Rossman, 2016; Munhall, 2012)?
8. Are the findings of the study consistent with the qualitative approach? For example, findings of a

grounded theory study are presented as a description of concepts and social processes and the findings of an ethnography study are a description of a culture.

1. Is there a coherent logic to the presentation of findings (Corbin & Strauss, 2015; Sandelowski & Barroso, 2007?
2. Are the interpretations of data congruent with data collected (Miles et al., 2014)?
3. Did the researcher address variation in the findings by relevant sample characteristics (Corbin & Strauss, 2015)?
4. Discussion
5. Did the researcher acknowledge the study limitations? Could any of these limitations been corrected before the end of the study?
6. Did the researcher identify implications of the study that are consistent with the data and findings?
7. What new insights or knowledge were gained from the study?

Step 3: Evaluating a Study

“The sense of rightness and feeling of comfort readers experience reading the report of a study constitute the very judgments they make about the validity or trustworthiness of the study itself” (Sandelowski & Barroso, 2007, p. xix). Critical appraisal of research is not complete without making judgments about the validity of the study, or in the case of qualitative studies, making judgments about the trustworthiness.

Balancing the strengths against the researcher- identified limitations and other weaknesses of the study, you determine the value or trustworthiness of study findings. Figure 18-1 demonstrates that trustworthiness in qualitative research involves transparency, time, truth, and transformation, leading to transferability. Transparency, time, truth, and transformation are displayed as different aspects or facets of trustworthiness.

Each of them plays a key role in whether the findings of a study are trustworthy. The arrow leading from trustworthiness indicates that trustworthy studies can potentially be transferable. Transferability of the findings to other populations is appropriate only if you determine that the findings are trustworthy. These characteristics of high quality qualitative studies were synthesized from sets of criteria that included terms such as credibility, reflexivity, confirmability, and dependability (Hannes, 2011; Lietz & Zayas, 2010; Marshall & Rossman, 2016: Maxwell, 2013; Miles et al., 2014; Morse, 2012; Munhall, 2012; Roller & Lavrakas, 2015; Stige et al., 2009). By examining transparency, truth, time, and transformation, you can make a judgment about the trustworthiness of the study findings. Although they will be described separately, the four characteristics overlap.

FIGURE

FIGURE 18-1 Criteria for evaluating trustworthiness of qualitative findings.

Guidelines for Evaluating a Qualitative Study

1. Transparency

Transparency is the extent to which the researcher provided details about the study processes such as decisions made during data collection and analysis, ethical concerns that were noted, and personal perspectives that may bias the findings (Maxwell, 2013; Roller & Lavrakas, 2015). The researcher may indicate that field notes were written immediately after each interview. For examples, such field notes may include thoughts on what worked or did not work in getting participants to talk freely as well as insights from the researcher’s self-reflection of his or her response to the data.

The openness of the researcher about how personal bias was managed increases your confidence in the findings. Terms used in assessing qualitative research that have similar meanings as transparency are confirmability, dependability, and rich or thick descriptions (Liamputtong, 2013). The questions are prompts to help you evaluate transparency.

1. Were the researchers’ assumptions made explicit about “sample population, data-gathering techniques, and expected outcomes” (Roller & Lavrakas, 2015, p.93)?
2. Did the researcher describe how personal biases and preconceived ideas were identified and managed (Charmaz, 2014; Lietz & Zayas, 2010; Miles et al., 2014)?
3. Did the researcher indicate the use of journals, field notes, memos, and other forms of documentation written during the study?
4. Were any ethical issues discussed that arose during the study?
5. Were the characteristics of the participants described adequately for you to determine the relevance of the findings?
6. Was the rationale provided for any changes in the study methods?
7. Were the stages of data analysis from raw data to findings described (Miles et al, 2014)?
8. Were quotations or other participant data provided as exemplars of codes, themes, and patterns (Patton, 2015)?
9. Truth

Truth as a characteristic of qualitative studies is not absolute. Your evaluation is influenced by your confidence that the findings can be confirmed by reviewing the audit trail, field notes, or transcripts (note the overlap with transparency). Strategies implemented to increase rigor, such as comparing transcripts to audio recordings, sharing the findings with participants and writing memos, also increase your confidence in the truth of the findings.

Truth also includes the conceptual and experiential fit of the findings with your view of the phenomenon. Your view of the phenomenon also may expand as you empathize with the thoughts, feelings, and experiences of the participants. Some describe this as intuition or new insights that emerge as you read the article.

1. What strategies did the researcher use to confirm the accuracy and logic of the findings?
2. How do the findings fit with your previous views related to the phenomenon?
3. Are the findings believable?

III. Time

In qualitative research, the researcher is the instrument (Marshall & Rossman, 2016). Time must be spent in gathering data, developing relationships with participants and key informants, interviewing additional participants based on initial data analysis, and being immersed in the data during analysis and interpretation. These activities take time. Some qualitative experts have described this study characteristic as “prolonged engagement” and “persistent observation” (Roller & Lavrakas, 2015, p. 21).

As a researcher, you need time to reflect and analyze your own responses to the data as well as thoroughly analyze the data. One indication of the amount of time spent engaged in the study is the depth and comprehensiveness of the descriptions (note the overlap with transparency).

1. How long did interviews last, how much time was spent in the field, and/or how much time was spent in observation (Sandelowski & Barroso, 2007)?
2. Does the time spent collecting and analyzing data seem adequate based on the size of the sample, complexity of the design, and scope of the phenomenon?
3. Transformation

Data analysis and interpretation transform the words of participants, the observations of the ethnographer, and the text of a document into findings (Liamputtong, 2013). Qualitative researchers who analyze the data at a superficial level will report the data as the findings, without evidence of synthesis, comparison across participants, or creation of abstract themes or categories.

To transform data, the researcher must organize, interpret, compare, and reorganize phrases and themes until the meaning of the data begins to emerge (Miles et al., 2014). Data analysis is “the heart of qualitative inquiry” (Streubert & Carpenter, 2011, p. 51). As you might expect, for transformation of the data to occur, the researcher must spend time to become focused and immersed in the data. Immersion requires persistent engagement with the data (note overlap with time).

1. Do the findings go beyond reporting facts and words to describing experiences with depth and insight?
2. Are there other possible interpretations of the data?
3. How do the meaning and interpretation of the data match or contrast with previous research findings?
4. What contributions do the findings of the study make to what is known about the phenomenon?
5. Has the researcher taken the time to hone the writing —to transform the stories of the participants to a narrative that exhibits both thoroughness and eloquence?
6. Transferability

Trustworthiness is a necessary, but not sufficient, condition for transferability. Transferability is the applicability of the findings to another population or phenomenon or stated another way the “ability to do something of value with the outcomes” (Roller & Lavrakas, 2015, p. 23). To be transferable, the findings must have meaning for similar groups or settings.

The reader or user of the findings is the one who makes the determination of transferability (Streubert & Carpenter, 2011). If you have answered the previous questions and concluded the study is trustworthy, proceed with answering the following questions to determine the transferability of the findings to your practice.

1. How similar were the study participants to the persons or groups with whom you interact? Are there general truths that emerged from the research that might be used with similar populations, or with people in similar circumstances?
2. What implications may the findings have for your practice?
3. What actions could be taken that are consistent with the findings?
4. How does the study move research, theory, knowledge, education, and practice forward?

Key Points

• Critical appraisal of research involves carefully examining all aspects of a study to judge its strengths, weaknesses, meaning, credibility, and significance in light of previous research experience, knowledge of the topic, and clinical

expertise.

• Critical appraisals of research are conducted (1) to summarize evidence for practice, (2) to provide a basis for future research, (3) to evaluate presentations and publications of studies, (4) to select abstracts for a conference, (5) to evaluate whether a manuscript should be published, and (6) to evaluate research proposals for funding and implementation in clinical agencies.
• Nurses’ levels of expertise in conducting critical appraisals depend on their educational preparation and experiences; nurses with baccalaureate, masters, doctorate, and postdoctorate preparation all have a role in examining the quality of research.
• The critical appraisal process for research includes the following steps: identifying the steps of the research process in a study; determining the study strengths and weaknesses; and evaluating the credibility, trustworthiness, and meaning of a study to nursing knowledge and practice (see Box 18-1).
• The identification step involves understanding the terms and concepts in the report and identifying the study steps.
• The second step of determining study strengths and weaknesses involves comparing what each step of the research process should be like with how the steps of the study were conducted. The logical development and

implementation of the study steps also need to be examined for strengths and weaknesses.

• Study strengths and weaknesses need to be clearly identified, supported with a rationale, and documented with current research sources.
• The evaluation step involves examining the credibility, trustworthiness, and meaning of the study according to set criteria.
• To perform fair critical appraisals of qualitative studies, nurses need the prerequisites of an appreciation for the philosophical foundations of qualitative research, knowledge of different qualitative approaches, and respect for the study participant’s perspective (see Box 18-3).
• Each aspect of a qualitative study, such as problem, purpose, research questions, sample, data collection and analysis, and findings, needs to be examined for strengths and weaknesses.
• The trustworthiness of a qualitative study’s findings is the extent to which the researcher demonstrated transparency, provided true findings, expended adequate time, and transformed the data into meaningful findings. Transparency, truth, time, and transformation are essential elements or aspects that determine whether a study’s findings are trustworthy (see Figure 18-1).
• Trustworthiness of a qualitative study is a necessary, but not sufficient, condition for transferability, the application of the findings to similar groups or settings. A study’s findings may be trustworthy, but the sample, setting, or focus of the study may not be similar enough for transferring the findings to your population.

Advance Nursing Research – Critiquing a Qualitative Research Paper

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