Snowball or Chain How big should a sample be? Sample size is an important consideration in qualitative research. Typically, researchers want to continue sampling until having achieved informational redundancy or saturation -- the point at which no new information or themes are emerging from the data.
This is an open-access article distributed under the terms of the Creative Commons Attribution License http: This article has been cited by other articles in PMC. Abstract Background Quantitative studies are becoming more recognized as important to understanding health care with all of its richness and complexities.
The purpose of this descriptive survey was to provide a quantitative evaluation of the qualitative studies published in core clinical journals for Methods All identified studies that used qualitative methods were reviewed to ascertain which clinical journals publish qualitative studies and to extract research methods, content persons and health care issues studiedand whether mixed methods quantitative and qualitative methods were used.
Results 60 articles were reviewed. Most of the journals were in the discipline of nursing. Patients and non-health care settings were the most common groups of people studied. Diseases and conditions were cancer, mental health, pregnancy and childbirth, and cerebrovascular disease with many other diseases and conditions represented.
Phenomenology and grounded theory were commonly used; substantial ethnography was also present. No substantial differences were noted for content or methods when articles published in all disciplines were compared with articles published in nursing titles or when studies with mixed methods were compared with studies that included only qualitative methods.
Conclusions The clinical literature includes many qualitative studies although they are often published in nursing journals or journals with low SCI Impact Factor journals. Many qualitative studies incorporate both qualitative and quantitative methods.
Background Quantitative studies provide answers or insights for many important questions or issues in health care and clinical research.
Other important questions dealing with why, how, contexts, and experiences of individuals or groups, can be best addressed using qualitative methods.
Other issues benefit from interleaving or integration of both research traditions. Miller and Crabtree [ 1 ], describe their experiences working in family medicine, a clinical domain where balancing qualitative and quantitative research styles benefits both patients and their families and health care professionals.
They embrace holding "quantitative objectivism in one hand and qualitative revelations in another" and encourage others to use findings from both paradigms in understanding and practicing effective health care.
Creswell and colleagues expand on this theme by stating that "When used in combination, both quantitative and qualitative data yield a more complete analysis, and they complement each other" [ 2 ].
Most studies in the major clinical journals have been quantitative studies. Very few qualitative studies and even fewer that combine both qualitative and quantitative approaches are published.
An example of the breadth of qualitative studies and how findings and results can be combined across paradigms is a study by Jolly and Wiles [ 34 ] who used mixed methods to study a nurse-led intervention for adults after myocardial infarction and adults with new-onset angina in 67 general practices in the United Kingdom.
Their study showed statistically insignificant results at 1 month for eating healthy food, participating in exercise programs, and successful smoking cessation. The researchers interviewed a group of patients using qualitative methods and found that people felt survival after a myocardial infarction indicated that the event had not been all that serious.
Health care professionals often communicated simplified data about recurrence and being "back to normal" in 6 weeks. Because of these two issues, patients felt that their cardiac problems had probably been mild and therefore were not sufficiently motivated to implement major lifestyle changes.
Another example of the use of mixed methods was research done by Willms and Wilson and their colleagues [ 5 - 7 ] on smoking cessation. They found the meanings that patients who smoked attributed to their cigarettes peer acceptance, coping during a time of stress and feeling out of control, feeling more like an adult, and smoking as more glamorous, tough, and rebellious had more influence on cessation than did such external conditions as nicotine gum or counseling.
Until the complex issues of why individuals smoke were dealt with, few were motivated to change their attitudes towards smoking and thus stop smoking. Another effective example of integrated qualitative ethnography and quantitative epidemiology methods was a study done by Borkan and colleagues [ 8 ] to determine predictors of recovery after hip fracture in elderly patients.
Traditional predictors such as age, type of break, and comorbidity, were collected by using standard questionnaires. In-depth interviews were used to collect injury narratives focusing on internal explanations of the fracture, sense of disability, and view of the future after hip fracture. None of the epidemiology factors predicted successful outcomes but those who perceived their fracture as more external or mechanical as opposed to an internal or organic problem e.
Persons who perceived their disability in the context of autonomy, independence, and connection with the outside world also showed better ambulation at 3 and 6 months than persons with a more narrow and confined view of the fracture and its resulting disability. Donovan and colleagues [ 9 ] used mixed methods to study prostate cancer screening and treatment choices to determine why study recruitment was lower than expected.
Rousseau and Eccles and their colleagues [ 1011 ] used qualitative methods case interviews to explain the limited use of computerized guidelines for asthma and angina in a primary care study done in the United Kingdom.
Many other examples exist; Creswell and colleagues describe 5 additional mixed methods studies in primary care as well as provide criteria for evaluating mixed methods studies [ 2 ]. We postulate that qualitative studies, either stand-alone reports or studies with mixed methods, are occurring more frequently in health care.
This paper was done to describe the publishing of qualitative studies in 1 year of clinical literature, document and present the range of content and techniques in these studies, and establish a baseline for subsequent studies.
We defined our sample to include all articles published in a set of major general medical, mental health, or nursing journals during Educational Research: Planning, Conducting, and Evaluating Quantitative and Qualitative Research (6th Edition) [John W.
Creswell] on leslutinsduphoenix.com *FREE* shipping on qualifying offers. A practical, step-by-step core research text that balances coverage of qualitative, quantitative and combined methods Educational Research: Planning.
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