Critique of Quantitative and Qualitative Health Research


Each of the two critiqued articles describes a study related to the issues of cultural competence and cultural self-efficacy in health care. Hendson, Reis, and Nicholas (2015) present a qualitative study exploring health care providers’ perception of culturally competent care. Data in it are collected in focus groups and analyzed through conceptual and thematic analyses. Miskin, Matthews, Wallace, and Fox (2015) present a quantitative study measuring the level of perceived cultural self-efficacy among nursing students. Data in it are collected through surveying and analyzed within the Cultural Self-Efficacy Scale (CSES) framework. Comparing the studies’ research designs, research questions, sampling, data analysis methods, ethical standards, and indicators of validity and generalizability will allow describing important differences between qualitative and quantitative studies in general and revealing strengths and weaknesses of these studies in particular.

Research Design

Research design is the general framework of a scientific study that includes justification of the use of certain research methods to answer research questions and confirm or disconfirm hypothesis. Research design evaluation is assessing whether or not selected methods are appropriate for attaining research purposes.

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The study by Miskin et al. (2015) is quantitative, descriptive, and non-experimental. The addressed issues had been repeatedly explored in various similar studies, which created certain common perspectives and points of reference, allowing the researchers to operate within an established research framework. Surveying was the selected research method. The results were analyzed based on the CASES to produce quantitative data and evaluate the levels of perceived cultural self-efficacy.

The study by Hendson et al. (2015), on the contrary, dealt with phenomena that had been studied less thoroughly, which is why there had been a lack of comprehensive research frameworks and the need for more innovative research. This study was explorative and employed a ground theory approach, i.e. its results were to be used for developing a new theoretical concept. The data collection method was focus groups intentionally designed to include participants from different disciplines, which enabled in-depth and multifaceted discussions. The content was later analyzed for concepts and themes to identify what health care providers’ understanding of culturally competent care was.

Research Questions

Formulating a research question is a pivotal component of a scientific study. The research question determines the entire research design. Evaluating research questions includes following considerations: Is answering the question important and why? Is the question’s wording optimal for addressing the studied phenomena? Can the question be answered through a reproducible and verifiable study?

The research question addressed by Hendson et al. (2015) can be put as follows: What are the experiences and perceptions of health care providers caring for new immigrant families in the neonatal intensive care unit” (p. 17)? Regarded more broadly, the study pursues understanding what culturally competent care means to heath care providers. Such a question invites qualitative research because the phenomena of interest are perceptions and understandings, which are hard to quantify.

Miskin et al. (2015), on the contrary, employ a quantitative method (surveying), although their subject, in a way, is perception, too. The research question of this study can be formulated as follows: What are “the levels of perceived cultural self-efficacy of senior students in second-degree pre-licensure nursing programs in the provision of culturally appropriate care to immigrants” (Miskin et al., 2015, p. 155)? To answer the question, the authors used an established scoring system—the CSES. In other words, an additional research question can be put as follows: How much will the participants score on the CSES? As a quantitative study, the given research involves calculations, unlike the qualitative study described above, which involves interpretations and theme analysis.

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Sampling Process and Sample Size

The appropriateness of sampling is one of the main criteria for establishing the validity of a study and the reliability of its results. To be considered adequate and appropriate, sampling should be carried out in a way that allows the data collected from given samples to effectively address the research question. Apart from sampling criteria, analysis of sampling should also examine the sample size, which is a crucial indicator of generalizability.

For their qualitative study, Hendson et al. (2015) used purposive sampling, i.e. they selected participants intentionally. Heath care providers had been invited by several media, and the selection process among those who were willing to take part in the study was based on the study’s purpose to explore views from all disciplines. Age, gender, cultural background, or experience were not among the criteria for selecting participants. A total of 58 health care providers participated in focus groups. The sample size can be considered sufficient, as it allowed conducting seven focus groups, which produced a considerable amount of data for addressing the research question.

Normally, quantitative studies require larger samples because statistical phenomena are observed on large scales. Miskin et al. (2015) conducted their study among 117 participants. All the participants were senior pre-licensure nursing students. In order to be defined as such, a student had to meet two inclusion criteria: to be enrolled in an accelerated bachelor of sciences (or entry-level master of sciences) program in nursing and to be taking at that time a nursing course of the term three level or above. The sampling was convenience-based, i.e. guided by the considerations of participants’ accessibility and proximity to researchers. All the participants were students of the same university in California. Convenience sampling is a somewhat debatable technique for qualitative studies because it can be argued that such a technique undermines generalizability (see Generalizability and Transferability of Findings). Overall, the choice of sampling makes it hard to apply the study’s results to students from different universities and states.

Methods for Data Analysis

Scientific studies often include several steps of working with data. After data collection, there is data analysis, which determines the meaning of collected data and their relevance to the research purposes. Data analysis if often different in qualitative and quantitative studies, too.

After obtaining large amounts of text from transcribing focus group discussions, Hendson et al. (2015) applied relevant software to collected data for “line-by-line coding, categorization of codes, concept saturation, and theme generation” (p. 20). This analysis allowed identifying important concepts referred to by the participants, the connections between those concepts, and their meaning within the theoretical framework of the study.

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Data analysis in the study by Miskin et al. (2015) was processing the questionnaires and scoring the participants according to the CSES. Complicated calculations were performed through the use of statistical analysis software. Also, additional information about participants that had not been used in sampling, such as gender, age, and cultural background, was analyzed to reveal possible correlations between demographic characteristics and the level of perceived cultural self-efficacy.

Ethical Standards

Any scientific study should have ethical considerations in order to ensure that participants are not hurt and their rights are not violated. Research institutions have established procedures for assessing the ethics of studies before the latter are conducted, i.e. at the proposal stage. Qualitative and quantitative studies may have differences in terms of ethical standards due to the differences in approaching participants.

Both the study by Hendson et al. (2015) and the study by Miskin et al. (2015) faced particular ethical considerations during the data analysis stage of research. In the qualitative study (the former), the personal information of participants needed to be eliminated from focus groups transcripts before their conceptual and thematic analyses. In the quantitative study (the latter), the personal information had to be removed from questionnaires, too, but it had to be done along with preserving certain demographic data. In both cases, it was done to protect the confidentiality of respondents and to prevent a situation where their personalities or identities could affect the results of data analysis. Also, Hendson et al. (2015) mention that their study had been approved by a research ethics authority. The participants had provided their written consents to researchers before the conduction of focus groups.

Reliability and Validity

Reliability and validity of an academic study are confirmed and supported by strong research design and appropriate conduction. Both critiqued studies appear reliable. Their methodologies are duly described and explained, and the use of selected methods is justified. Another important aspect of reliability and validity is a theoretical framework. Studies should be given a conceptual context, within which their results can be evaluated and interpreted. Miskin et al. (2015) have such a context, as they use an existing system (CSES). Hendson et al. (2015) are in a more difficult position, as they conduct conceptual and thematic analyses outside of an established framework for assessing culturally competent care, i.e. they need to develop criteria for such assessment along with conducting the study. However, their justification manages to make their results appear reliable and valid.

Generalizability and Transferability of Findings

Generalizability and transferability of findings largely depend on sampling techniques and data collection methods employed in a given study. As it was previously assessed (see Sampling Process and Sample Size), Hendson et al. (2015) use adequate sampling that makes their findings transferable, i.e. applicable to all NICU health care providers from similar facilities. Concerning the study by Miskin et al. (2015), their convenience sampling is questionable. The choice of participants makes the findings only applicable to the students of the certain university where the study was conducted. However, even such narrow generalizability can be questioned. For example, if there are more than 1,000 nursing students at the university, the sample size of 117 people is not representative, even if it had been random sampling.

Summarization

I strongly believe that qualitative change is only possible through qualitative research. I think the two critiqued studies illustrate my idea. The quantitative study by Miskin et al. (2015) was to provide statistical data about the level of perceived cultural self-efficacy among nursing students. The data analysis consisted of calculations and assessment within an existing framework (CSES). However, this framework had been previously developed as a result of qualitative studies, where it had been suggested how perceived cultural self-efficacy can be quantified. Therefore, quantitative studies are enabled by qualitative efforts toward understanding how something can be counted and measured. That is why I believe that significant change can be brought by in-depth qualitative research only.

References

Hendson, L., Reis, M. D., & Nicholas, D. B. (2015). Health care providers’ perspectives of providing culturally competent care in the NICU. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 44(1), 17-27.

Miskin, P., Matthews, E., Wallace, L. A., & Fox, S. (2015). Cultural self-efficacy of second-degree nursing students in providing care to immigrants. Journal of Cultural Diversity, 22(4), 155-162.

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