Practice-Based Evidence and Qualitative Inquiry

University of North Carolina at Chapel Hill School of Nursing, Chapel Hill, NC, USA.
Journal of Nursing Scholarship (Impact Factor: 1.64). 05/2012; 44(2):171-9. DOI: 10.1111/j.1547-5069.2012.01449.x
Source: PubMed


Nurses and other healthcare providers continue to underuse interventions demonstrated to be effective at improving health outcomes. We propose in this article that if more evidence-based practice is wanted, greater use must be made of qualitative inquiry to obtain practice-based evidence derived from the experiences and practices of healthcare providers and the contexts of healthcare provision.
We present a framework for the use of qualitative methods to contribute to the following categories of practice-based evidence: (a) practice-based interventions and implementation strategies, (b) causal mechanisms, (c) approaches to adaptation, (d) how-to guidance, (e) unanticipated effects, and (f) relevant contextual factors.
Qualitative inquiry has an essential role to play in incorporating more practice-based evidence into the evidence base for nursing practice.
This framework can be used by clinicians to plan for the implementation of interventions in practice, by researchers to discuss the practice implications of their findings, and by researchers to launch qualitative studies explicitly designed to capture practice-based evidence.

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    • "Practice-relevant models informed by both patients' and health professionals' experiential knowledge that goes beyond purely providing information are needed to meet these demands. Important here too are establishing procedures to make practice-based evidence more transparent (Morse et al., 2000) and providing tools supporting knowledge translation for implementation of research (Leeman & Sandelowski, 2012). This would improve conditions for patient safety (Martin et al., 2013) and assure a stringent discussion about practicebased ethics related to person-centered information and communication (Redman, 2013). "
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    No preview · Article · Aug 2015 · Palliative and Supportive Care
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    • "Qualitative research from singular empirical studies is often referred to as first level research or primary studies. However, the findings in these qualitative studies may involve small numbers of participants, be scattered, conflicting or in need of systematising (Leeman & Sandelowski, 2012). Qualitative metasynthesis is secondary level research that interprets available primary qualitative studies within a field of inquiry by bringing together and breaking down the findings, elucidating the key features, and combining the findings from primary studies into a transformed whole, i. e. to a single description of the findings (Zimmer, 2006; Sandelowski & Barroso, 2007). "
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    ABSTRACT: The debate about the "right" methods and designs for nursing research is on-going. According to international surveys, studies on the effectiveness and safety of nursing interventions are rare. Since nursing practice deals daily with interventions, nurses ostensibly expose hospital patients and nursing home residents frequently to unproven therapeutic and preventive nursing interventions. Nursing interventions are predominately of a complex nature, consisting of several components depending on and interacting with each other and their complex contextual factors. Thus, evaluation studies are often challenging and need especially careful development, ambitious designs and systematic evaluations. The UK Medical Research Council (MRC) has proposed a framework, where qualitative and quantitative research rely on each other in order to develop theory-based complex interventions, prepare and conduct their optimal delivery, explain how the interventions work and which conditions contributed in case they did not work. The present essay outlines the points where qualitative research contributes towards the development and evaluation of complex interventions. First, the UK MRC framework is introduced, and secondly it is illustrated where qualitative research should necessarily be located using examples from a handful of qualitative studies. Future clinically meaningful and implementable nursing interventions should best be developed by research groups with both excellent qualitative and quantitative research skills.
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