Understanding Paradigms For Nursing Research

Question 0

What paradigms are used in nursing research?

Answer 0

Quantitative: positivism (empiricism) and post-positivism.
Qualitative: interpretive, constructivism, critical social theory.

Question 1

What is a paradigm?

Answer 1

Paradigms are patterns of belief and general assumptions.
Sets of philosophical underpinnings from which research approaches follow.
Often called research traditions or world views or methodologies.
They provide the ‘view point’, process and principles through which an investigation is conducted and interpreted.

Question 2

Quantitative paradigm - positivist (empiricist) viewpoint

Answer 2

This is a quantitative view. We accept something if it can be objectively measured.

Question 3

Positivist paradigm - contributions

Answer 3

Generalisable.
Verifiable - others can confirm findings.
Objective.
Description and prediction.

Question 4

Positivist paradigm - limitations

Answer 4

Context stripping.
Explanation needed as well.
Value free observations needed as well.
Absolute truth rarely established.

Question 5

Qualitative paradigm - constructivism/interpretivism

Answer 5

The subjective view is legitimate. I.e. You may wish to know what the colour red means to people regardless of an objective definition.

Question 6

Interpretivist/constructivist paradigm - contributions

Answer 6

Articulates voices of research participants.
Deliberately subjective.
Multiple realities.
Seeks understanding and shared meaning.

Question 7

Key features of quantitative research

Answer 7

1. Measurable
2. Aims, objectives and hypotheses are pre-stated
3. Procedure must be standardised
4. Outcome measures must be reliable and valid
5. Results must be presented statistically
6. Results should be aimed at falsification (hypothesis testing), establishing causal relationships, establishing association between variables

Question 8

Aims

Answer 8

Broad statement of intentions

Question 9

Objectives

Answer 9

Specific detail of intentions. What is the research question?

Question 10

Hypothesis

Answer 10

Statement of relationship between variables (piece of data)

Question 11

Validity

Answer 11

Must measure what it intends to measure

Question 12

Reliability

Answer 12

Must be repeatable

Question 13

Expert opinion

Answer 13

Lowest level of evidence as this is subjective.
High chance of bias/errors.
Only possible source of evidence.
Can be considered as research.
But has some gravity.
In some areas of study there is very little objective evidence.

Question 14

Case series - case reports

Answer 14

Descriptive studies
Small - fewer than 10 cases
Performed because of rarity of cases, few resources, conducted in real clinical conditions/practice
Time constraints
Case series is the same as case report but has more than 10 cases.
Aims to measure the course/progression of disease so is mainly used in medicine.
Benefits include speed of deployment and it provides useful initial data.
Problems include insufficient numbers for meaningful analysis and it only involves single groups so there is no independent control group.

Question 15

Case control studies

Answer 15

This is a type of observational study. 
It is conducted with retrospect. 
It starts with the condition (the case). 
It is matched with a control. 
Unable to attribute causation.

Question 16

The Bradford-Hill criteria

Answer 16

1. Temporal relationship
2. Strength
3. Dose-response relationship
4. Consistency
5. Plausibility
6. Consideration of alternate explanations
7. Experiment
8. Specificity
9. Coherence

Question 17

Cohort studies

Answer 17

Looks at associations between one entity and another e.g. Smokers vs non-smokers.

Question 18

Difference between cohort studies and case-control studies

Answer 18

Dats is collected prospectively in cohort studies (it is retrospective in case-control).
You collect the data that you want - more accurate.
Provides greater precision.