Running head: CRITIQUE OF QUANTITATIVE AND QUALITATIVE STUDIES 1

WK7Assgn

Larry Robertson

6052

Dr. Crystal Dodson

October 15, 2017

CRITIQUE OF QUANTITATIVE AND QUALITATIVE STUDIES 2

Table of Contents

Compare and Contrast Information.....................................................................................3

Advantages and Disadvantages of the Research Approach.................................................8

Qualitative Research is not Real Science..........................................................................10

Conclusion.........................................................................................................................12

References..........................................................................................................................14
CRITIQUE OF QUANTITATIVE AND QUALITATIVE STUDIES 3

WK7AssgnRobertsonL

There are two dominant scholarly approaches to answering questions in the human and

social sciences, quantitative and qualitative research. While different in approach, both types of

research aim to provide answers regarding the relationship between the variables in question.

Quantitative research uses the strict scientific investigation to respond to these questions using

formal, objective, and unbiased methods (Smith, 2017). This allows the investigator to collect

numerical data and use statistical analysis to draw a linear cause and effect correlation between

two or more variables of study, which are considered to be accurate, valid, and reliable;

independent of the researcher’s philosophical viewpoint (Smith, 2017). Qualitative research, on

the other hand, uses the subjective interpretations from the participants and researcher to gain

insight into the human experience and give it meaning. It places value on the uniqueness of the

subject’s responses which leads to the development of continuously evolving theories that show

a nonlinear relationship between two or more variables in the natural setting (Smith, 2017;

Grove, Burns & Gray, 2013). The purpose of this paper is to compare and contrast two critiqued

papers, one that used the qualitative research method, the other that used the quantitative

research method, then explaining the advantages and disadvantages of the two methods, finally

responding to the claim that qualitative research in not real science.

Compare and Contrast Information

The first study that was critiqued was a qualitative study. It used a grounded theory

approach, which involves attempting to describe and understand social psychological and

structural processes in social settings (Polit & Beck, 2017). Grounded theory researchers try to

understand actions by focusing on the main problem “missed care” by studying the behaviors of

the individuals (Polit & Beck, 2017). The purpose of the study was to determine nursing care that
CRITIQUE OF QUANTITATIVE AND QUALITATIVE STUDIES 4

is regularly missed on medical-surgical units, and the reasons why it was missed (Kalisch, 2006).

Two questions were asked; what nursing care is regularly missed on medical-surgical units in

acute care hospitals, and what are the reasons nursing staff had for not completing these

particular aspects of care? The reasons these questions need to be answered is that research has

shown a link between staffing levels and mortality/failure to rescue, infection rates, pressure

ulcers, patient falls, length of stay, adverse events, complications after surgery, and patient

satisfaction (Kalisch, 2006). What has not been established in research though is the specific

aspects of missed nursing care potentially leading to the association between staffing levels and

the negative outcomes (Kalisch, 2006). It is not clear, besides staffing levels, what other missed

nursing duties lead to poor patient outcomes (Kalisch, 2006). In both, the purpose and the

questions asked by the researcher, the exploration of the meaning of the particular issue is

sought. The question is exploratory in nature, not predictive. 

Data collection consisted of focus group interviews for the qualitative study. It was semi-

structured in nature and covered topics rather than specific questions. Subjects were interviewed

once, and the session was recorded. Subjects were divided into job classifications for interviews

which was a means of trying to get the subjects to open-up more without fear of repercussions. In

a qualitative design, data is in the form of words, which usually come from interviews,

documents, observations, and audio-visual materials (Polit & Beck, 2017). Narrative information

can come from conservations, detailed notes, or narrative records (Polit & Beck, 2017). The

researcher was the instrument obtaining the data.

Data analysis in qualitative research data collection and data analysis often occur at the

same time seeking themes (Polit & Beck, 2017). For this study the researcher analyzed the

interview transcripts using NVIVO by QRS international which is a qualitative analysis software
CRITIQUE OF QUANTITATIVE AND QUALITATIVE STUDIES 5

(Kalisch, 2006). The data was analyzed a second time using the grounded theory approach

(Kalisch, 2006). Both analyses produced the same theme development. The themes came from

the research itself rather than from the researcher.

Key findings of the qualitative study discovered that ALL participants in the focus group

stated they did not or were not able to provide all of the nursing care that patients needed. Most

expressed regret, guilt, and frustration because they could not complete all of the nursing care for

patients. The researcher concluded that there were nine themes that were extracted from the

focus group of which highlighted the “missed nursing care,” and seven themes to why nursing

care was missed. The key findings were interpretive of the researcher's data analysis. The

findings contained a lot of quotes from the participants that gave credibility to the interpretation

of the data. “Data management in qualitative research is reductionist in nature.” (Polit & Beck,

2017, p. 535) The qualitative researcher takes great amounts of data and breaks it down into

smaller, manageable segments (Polit & Beck, 2017).

The second critiqued study was a quantitative study. This study was a secondary analysis

that was guided by the Missed Nursing Care Model of Kaischer et al. In a secondary analysis, the

use of existing data from a previous study is used to test a new hypothesis or answer questions

that were not initially envisioned (Polit & Beck, 2017). The new questions that were asked by the

researchers were; “what elements of nursing care are frequently missed or always on oncology

units, does missed nursing care vary significantly between oncology units and other

nononcology, medical-surgical units, and is unit staffing significantly associated with missed

nursing care on oncology units?” (Friese, Kalisch, & Lee, 203, p. E53) The questions to this

study involved examining the relationship between independent variables (nursing unit
CRITIQUE OF QUANTITATIVE AND QUALITATIVE STUDIES 6

specialization) and dependent variables (missed work). The questions seek a relationship

between variables.

Data collection for this quantitative study was in the form of a survey. In quantitative

studies, researchers collect data from study participants in numeric form (Polit & Beck, 2017).

Data collection is also obtained from an instrument, which in this study was from the surveys.

Data analysis in quantitative research is accomplished through the use of statistical

analyses (Polit & Beck, 2017). This quantitative study quantified the degree to which the 24

identified items of nursing care as measured by the MISSCARE Survey were reported as missed

rarely, occasionally, frequently, or always (Friese et al., 203). The total score of the survey was

taken and determined to be the average amount of missed care (Friese et al., 203). The total score

was then compared to oncology units and nonooncology units by the Student t-test (Friese et al.,

203). The oncology units sample was then analyzed using the linear regression to estimate the

correlates of increased missed nursing care based on the total missed nursing care score (Friese

et al., 203).

The quantitative key findings found that oncology nurses missed less work than their

counterpart med-surg nurses, but still had missed work (Friese et al., 203). The researcher also

reported that unit staffing and missed nursing care had a significant relationship (Every 1 patient

increase yielded a 2.1% increase in the missed nursing score) (Friese et al., 203). The findings of

this study were shown to be “statistically significant,” by being statistically significant the

researcher claims that the hypothesis of the study was supported. The results of statistical testing

indicate whether an observed relationship or group difference exists (Polit & Beck, 2017). 

Advantages and Disadvantages of the Research Approach

CRITIQUE OF QUANTITATIVE AND QUALITATIVE STUDIES 7

Qualitative and quantitative research are used in studies throughout nursing. Each type of

research is useful in its own way depending on the purpose of the researcher and what is being

sought. In the studies that were looked at; the qualitative study was looking at what relationships

existed between what nursing care that was missed and why, whereas the other study wanted to

know if there was a difference between the two group and missed care. What was the missed

care and what caused it to be missed?

An advantage of qualitative research is if the researcher is unsure of what will be studied,

this type of research gives the researcher the freedom of the design not being so strict and letting

the study unfold on its own which will produce the relationships that exist among the

variables (Jones, 2017).  In the qualitative study, the researcher was unsure of what care if any

was regularly missed and what the reasons were for missing the nursing care. The second

advantage of qualitative research is the data from this type of study produces more detailed and

robust data in the form of written descriptions or written responses by the participants (Jones,

2017), as in the case of the qualitative study that was critiqued. The context and social aspects

were examined and how it affected the participants in the study.

Disadvantages of qualitative research include the researcher's involvement in the study

because they are so involved in the study there could be a subjective view from the researcher.

This interpretation can be biased based on the views of the researcher (Jones, 2017). The

researcher is the qualitative study questioned the participants while recording their responses;

there was no observation of the participants though. A second disadvantage of qualitative

research is it can be very time to consume lasting months or even years (Jones, 2017). This

qualitative study only lasted a few months but no mention of the time it took to interpret the

results were discussed in the study.

CRITIQUE OF QUANTITATIVE AND QUALITATIVE STUDIES 8

Advantages of quantitative studies are that they are standardized, as in the quantitative

study that was critiqued the researcher can apply the findings to other oncology units and med-

surge units. Large amounts of data can also be summarized. Over 400 participants were sampled

in the quantitative study compared to 107 in the qualitative study. Quantitative methods are

reliable and valid because they employ prescribed procedures ("Quantitative methods," n.d.).

Biasness is also eliminated because they involve many studies and few variables which help

prevent researchers from using participants that they know ("Quantitative methods,"

n.d.). Causality is determined within a study framework because the correlation of the

independent and dependent variable is studied ("Quantitative methods," n.d.). The researchers

can control the environment so that extraneous variables are not introduced into the

study ("Quantitative methods," n.d.).

Disadvantages according to the University of Southern California states that the use of

standardized questions in quantitative research may cause structural bias. ("Quantitative

methods," n.d.). Human perception is lost because the research methods are numerical

("Quantitative methods," n.d.). The instruments used to collect the data can be biased because it

can be subjective and misleading ("Quantitative methods," n.d.).

Qualitative Research is not Real Science

The use of qualitative study design in nursing research and whether it subscribes to the

same principles of rigor, objectiveness and study control as quantitative studies, which could

impact the validity and reliability of the findings. Cypress (2017) says replacing the terms

reliability and validity with the word trustworthiness, is a better way to refer to the quality,

authenticity, and truthfulness of qualitative research; addressing the methods for correctly

carrying out studies in which the readers can have confidence in the findings. Qualitative
CRITIQUE OF QUANTITATIVE AND QUALITATIVE STUDIES 9

research, while different in design and objective, can provide trust-worthy results using a

methodical approach for collecting and interpreting subjective, non-numerical data with the same

rigor and adherence to standards as quantitative research. By providing depth and understanding

to the complexity of the relationship between the variables, qualitative research does possess the

controls needed to generate meaningful findings which contribute to the knowledge base of

nurses.

Merriam-Webster’s Collegiate Dictionary defines rigor as having strict precision and the

characteristic of being inflexible (Rigor, n.d.). Grove, Burns, & Gray (2013) state, “The rigor of

qualitative studies is appraised differently from the rigor of quantitative studies because of the

differences in the underlying philosophical perspectives” (p. 58). Quantitative researchers

subscribe to the philosophy of a singular truth and measure rigor by objectively collecting data

under tightly controlled methods for analysis, using large samples representative of the

population, whose results could be replicated by another researcher with similar settings and

samples (Grove et al., 2013). The investigator’s feelings, philosophical or personal views are

independent of the study and not reflected in the study design, sampling, analysis, or

interpretation of the results (Grove et al., 2013).

However, qualitative researchers, while more flexible, cling to rigorous standards of

logical thinking, self-awareness, and receptiveness, and adhere to thorough data collection

methods and study design. According to Grove et al. (2013), “Rigorous qualitative researchers,

however, are characterized by openness and demonstrate methodological congruence, scrupulous

adherence to a philosophical perspective, thoroughness in collecting data, consideration of all the

data in the analysis process, and self-understanding” (p. 58). Grove et al. (2013) goes on to say

study control can be achieved when the researchers are astutely aware of their biases and, by
CRITIQUE OF QUANTITATIVE AND QUALITATIVE STUDIES 10

revealing these viewpoints rather than omitting them and adhering to consistent study design

methods, they can provide study control and “prevent these biases from interfering with the

voices of the participants being heard” (p. 59). The author will develop evolving theories about

the nonlinear relationship of the variables, which are impacted by the demographic and personal

experiences of the investigator and participants, allowing the reader to develop their conclusions

(Grove et al., 2013; Smith, 2017).

Conclusion

In conclusion, qualitative and quantitative research takes different approaches to

providing answers of interest in the studies of human and social science, particularly in the field

of nursing. Qualitative research the goal is not to establish cause and effect but rather to provide

depth and understanding about relationships of variables from the perspective of the individuals

involved while quantitative research is to establish cause and effect. Although qualitative

investigators use subjective data to determine the relationship, the study designs and systematic

processes for collecting and analyzing the data are no less rigorous or controlled than

quantitative research studies and without question, provide useful findings which expand the

knowledge base of nursing and improve the quality of care delivery to patients.
CRITIQUE OF QUANTITATIVE AND QUALITATIVE STUDIES 11

References

Cypress, B. S. (2017, July/August). Rigor or reliability and validity in qualitative research:

Perspectives, strategies, reconceptualization, and recommendations. Dimensions of

Critical Care Nursing, 36(4), 253-263.

http://dx.doi.org/10.1097/DCC.0000000000000253

Friese, C. R., Kalisch, B. J., & Lee, K. H. (203). Patterns and correlates of missed nursing care in

inpatient oncology units. Cancer Nursing , 36(6), E51-E57. Retrieved from

http://ovidsp.tx.ovid.com.ezp.waldenulibrary.org/sp-3.26.1a/ovidweb.cgi?

WebLinkFrameset=1&S=HHEHFPGMCNDDOBCLNCGKJDOBHEDGAA00&returnUrl=ovid

web.cgi%3f%26Titles%3dS.sh.22%257c1%257c10%26FORMAT%3dtitle%26FIELDS

%3dTITLES%26S%3dHHEHFPGMCNDDOBCLNCGKJDOBHEDGAA00&directlink=http

%3a%2f%2fovidsp.tx.ovid.com%2fovftpdfs%2fFPDDNCOBJDCLCN00%2ffs047%2fovft

%2flive%2fgv024%2f00002820%2f00002820-201311000-

00017.pdf&filename=Patterns+and+Correlates+of+Missed+Nursing+Care+in+Inpatient+Oncolo

gy+Units.&navigation_links=NavLinks.S.sh.22.1&PDFIdLinkField=%2ffs047%2fovft%2flive

%2fgv024%2f00002820%2f00002820-201311000-

00017&link_from=S.sh.22%7c1&pdf_key=B&pdf_index=S.sh.22&D=ovft

Jones, C. (2017). Advantages & disadvantages of qualitative & quantitative research. Retrieved

from http://www.ehow.co.uk/info_8091178_advantages-disadvantages-qualitative-

quantitative-research.html

Grove, S. K., Burns, N., & Gray, J. R. (2013). The practice of nursing research: Appraisal,

synthesis, and generation of evidence (7th ed.). St. Louis, MO: Elsevier.
CRITIQUE OF QUANTITATIVE AND QUALITATIVE STUDIES 12

Kalisch, B. (2006). Missed nursing care a qualitative study. Journal of Nursing Care Quality,

21(4), 306-313. Retrieved from

http://eds.b.ebscohost.com.ezp.waldenulibrary.org/eds/pdfviewer/pdfviewer?

vid=1&sid=d86690c9-494e-4608-a787-80576ef20df6%40sessionmgr102

Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for

nursing practice (10th ed.). Philadelphia, PA: Wolters Kluwer.

Quantitative methods. (n.d.). Retrieved from http://libguides.usc.edu/content.php?

pid=83009&sid=615867

Rigor. (n.d.). In Merriam-Webster’s Collegiate Dictionary. Retrieved July 31, 2017, from

https://www.merriam-webster.com/dictionary/rigor

Smith, T. (2017). Qualitative & Quantitative Research. Qualitative & Quantitative Research --

Research Starters Education, 1-9

What are some advantages and disadvantages of quantitative methods? (n.d.). Retrieved from

https://www.reference.com/math/advantages-disadvantages-quantitative-methods-

15899de8bc898ded#
CRITIQUE OF QUANTITATIVE AND QUALITATIVE STUDIES 13

Critique Template for a Qualitative Study

NURS 5052/NURS 6052

Week 6 Assignment: Application: Critiquing Quantitative, Qualitative, or Mixed

Methods Studies (due by Day 7 of Week 7)

Date: 10/15/17

Your name Larry Robertson

Article reference (in APA style): Kalisch, B. (2006). Missed nursing care a
qualitative study. J Nurs Care Qual, 21(4), 306-313

URL: http://eds.b.ebscohost.com.ezp.waldenulibrary.org/eds/pdfviewer/pdfviewer?
vid=1&sid=d86690c9-494e-4608-a787-80576ef20df6%40sessionmgr102

What is a critique? Simply stated, a critique is a critical analysis

undertaken for some purpose. Nurses critique research for three main
reasons: to improve their practice, to broaden their understanding,
and to provide a base for the conduct of a study.

When the purpose is to improve practice, nurses must give

special consideration to questions such as these:

 Are the research findings appropriate to my practice setting and

situation?
 What further research or pilot studies need to be done, if any,
before incorporating findings into practice to assure both safety
and effectiveness?
 How might a proposed change in practice trigger changes in
other aspects of practice?

To help you synthesize your learning throughout this course and prepare you to
utilize research in your practice, you will be critiquing a qualitative, quantitative, or
mixed-methods research study of your choice.

If the article is unavailable in a full-text version through the

Walden University Library, you must e-mail the article as a PDF or
Word attachment to your Instructor.

QUALITATIVE RESEARCH CRITIQUE

CRITIQUE OF QUANTITATIVE AND QUALITATIVE STUDIES 14

1. Research Issue and Purpose

What is the research question or issue of the referenced study? What is its
purpose? (Sometimes ONLY the purpose is stated clearly and the question
must be inferred from the introductory discussion of the purpose.)

The purpose of the study was to determine nursing care that is regularly
missed on medical-surgical units and the reasons why it was missed. The
research questions for this study were: “(1) What nursing care is regularly
missed on medical-surgical units in acute care hospitals? And (2) What are
the reasons Nursing staff give for not completing these particular aspects of
care?”

2. Researcher Pre-understandings

Does the article include a discussion of the researcher’s pre-understandings?

What does the article disclose about the researcher’s professional and
personal perspectives on the research problem?

The author understanding of the problem is there is a link between the level
of nurse staffing and mortality/failure to rescue, infection rates, pressure
ulcers, patient falls, length of stay, adverse events, complications after
surgery, and patient satisfaction but research has not been done on the
specific aspects of missed nursing care potentially caused by less staffing.
She also goes on to say that nurses serve as the surveillance function in
hospitals to prevent errors and ensure quality care and if short staffed it
leads to poor surveillance. What is not clear to her is what other nursing
care omissions lead to poor patient outcomes due to the lack of current
literature on the subject. The problem statement is vague and could have
been worded to present a stronger case as to why the research needed to be
done. The article does not specify in what compacity the author works; She
is a Ph.D., RN, FAAN according to the name on the article. Further research
does reveal this author has done many studies in this field of study.

3. Literature Review

What is the quality of the literature review? Is the literature review current,
relevant? Is there evidence that the author critiqued the literature or merely
reported it without critique? Is there an integrated summary of the current
knowledge base regarding the research problem, or does the literature
review contain opinion or anecdotal articles without any synthesis or
CRITIQUE OF QUANTITATIVE AND QUALITATIVE STUDIES 15

summary of the whole? (Sometimes the literature review is incorporated

into the introductory section without being explicitly identified

Literature review for this article was located in the introduction. It consisted
of 12 articles that were reviewed all of which were current and relevant for
this study. There is no evidence of critiquing the articles that were used. The
author’s review concludes that poor patient outcomes results from decreased
staffing. Topics in the review consist of staffing, nutritional risks, ambulation
and its benefits, and issues after being discharged. Articles were mostly from
nursing journals and primary resources. The authors framework for the
study seems to be supported by the wide array of topics that were reviewed.
The basis for this study was established due to the missing research in this
area, according to the author.

4. Theoretical or Conceptual Framework

Is a theoretical or conceptual framework identified? If so, what is it? Is it a

nursing framework or one drawn from another discipline? (Sometimes there
is no explicitly identified theoretical or conceptual framework; in addition,
many “nursing” research studies draw on a “borrowed” framework, e.g.,
stress, medical pathology, etc.)

The key concepts are identified in the introduction of the study. It is

determined and supported through the authors literature review that staffing
is related to care, but what entails poor patient care or missed care is not
directly identified. The author is clear that examination of this concept is
going to be studied to determine why nurses do not complete or miss care.
The author uses a, “grounded theory approach by which empirical data are
thematically categorized by induction.” “In-depth interviews and observation
are the most common data sources in grounded theory studies.” (Polit & Beck,
2017, p. 474) Grounded theory research comes from sociology (Polit & Beck, 2017).

5. Participants

Who were the participants? Is the setting or study group adequately

described? Is the setting appropriate for the research question? What type
of sampling strategy was used? Was it appropriate? Was the sample size
adequate? Did the researcher stipulate that information redundancy was
achieved?
CRITIQUE OF QUANTITATIVE AND QUALITATIVE STUDIES 16

The participants were 107 registered nurses, 15 licensed practical nurses,

and 51 nursing assistants that worked on a medical-surgical unit. The
participants were divided by job title in the focus groups so that
communication was maximized in case there was reluctance in talking with
other members of the team present. The setting was two hospitals in the
United States, a 210 bed hospital in the southern region and a 458 bed
regional medical center in the northern region. The setting was appropriate
because the researcher wanted to find out the reasons care was being
missed in the hospital, by dividing the medical staff into their job categories
it allowed the participants to open up more without fear of getting
disciplined. No timeframe was mentioned. No mention of how the
participants were picked was mentioned.

6. Protection of Human Research Participants

What steps were taken to protect human research subjects?

The participants were asked to commit to confidentiality. This was done so

the participants would speak frankly about what aspects of their job they
were not performing since they were in front of their peers. In my opinion,
the participants should have been given more privacy so that they were
more open with the interviewer instead of worrying about what they say in
front of their peers.

7. Research Design

What was the design of the study? If the design was modeled from previous
research or pilot studies, please describe.

The researcher uses grounded theory approach which was conducted from
participant interviews. The researcher just interviewed the participants once
and did not observe the participants during the study. In my opinion, the
researcher seemed to have predetermined the design because their seemed
to have been no “unfolding” in the field.

8. Data Collection/Generation Methods

What methods were used for data collection/generation? Was triangulation

used?
CRITIQUE OF QUANTITATIVE AND QUALITATIVE STUDIES 17

The focus group interviews used a semistructured design which is a list of

topics which was covered by the researcher rather than specific questions
(Polit & Beck, 2017). Each focus group lasted 90-120 minutes. The participants were
interviewed only once, but the session was recorded.

9. Credibility

Were the generated data credible? Explain your reasons.

The data was analyzed by two different researchers independent of one-

another. Opinion and influence of the researchers were dismissed by the use
of qualitative analysis software.

10. Data Analysis

What methods were used for data analysis? What evidence was provided
that the researcher’s analysis was accurate and replicable?

All interviews were tape-recorded, fully transcribed, and analyzed initially by

a research associate. The author then analyzed the interview transcripts
independently using NVIVO by QRS International which is a qualitative
analysis software. The researcher also applied the grounded theory
approach. The data was analyzed twice, the second time it was analyzed it
was grouped differently, but the same issues were extracted from the data
which was taken as confirmation of the grounding of the data. For a theme
to have developed, it had to be in both hospitals and in all groups.
Reproduction of the study would be difficult because the topics the
researcher discussed is not clearly stated and how the participants were
picked from the hospitals is not mentioned.

11. Findings

What were the findings?

All of the focus group members stated that they did not, or were not able to,
provide all of the nursing care that patients needed. Most of the Focus group
expressed regret, guilt, and frustration that they were not able to complete
all of the care their patients needed. There were nine themes that were
extracted from the focus group: (1) Ambulation, (2) Turning, (3) Delayed or
missing feedings, (4) Patient education, (5) Discharge planning, (6)
Emotional support, (7) Hygiene, (8) Intake and output documentation, and
CRITIQUE OF QUANTITATIVE AND QUALITATIVE STUDIES 18

(9) Surveillance. Seven themes as to why the nursing care was missed came
out of the focus group: (1) Too few staff, (2) Time required for a nursing
intervention, (3) Poor use of existing staff resources, (4) It’s not my job
syndrome, (5) Ineffective delegation, (6) Habit, and (7) Denial.
The suggested themes of the study was supported with examples of quotes
originating from the focus group. The themes were the “why” the nurse
could not complete the nursing care. The quotations added support to the
themes that came out of the study.

12. Discussion of Findings

Was the discussion of findings related to the framework? Were those the
expected findings? Were they consistent with previous studies? Were
serendipitous (i.e., accidental) findings described?

The discussion section the reasons for missed nursing care is discussed. The
focus group work that was most commonly not done. Those tasks are listed
in this section. The risk for missing the tasks are also spoke about and
supported with research citations. These citations add strength to the
argument by missing nursing care, patient outcomes are worse. The finding
did relate to the framework of the study, and the two original research
questions were answered. No “accidental” findings were described in this
section.

13. Limitations

Did the researcher report limitations of the study? (Limitations are

acknowledgments of internal characteristics of the study that may help
explain insignificant and other unexpected findings, and more importantly,
indicate those groups to whom the findings CANNOT be generalized or
applied. It is a fact that all studies must be limited in some way; not all of
the issues involved in a problem situation can be studied all at once.)

The researcher discusses the need for the development of a tool to measure
missed care quantitatively which would enable researchers to access varying
levels of missed care and determine the conditions under which care is not
completed.

14. Implications
CRITIQUE OF QUANTITATIVE AND QUALITATIVE STUDIES 19

Are the conclusions and implications drawn by the author warranted by the
study findings? (Sometimes researchers will seem to ignore findings that
don’t confirm their expectations as they interpret the meaning of their study
findings.)

The researcher discusses how the finding from this study can be
incorporated into other practice settings. The findings from the study is
discussed and the value of the findings to other nurses and managers on
med-surg floors and how missed care can be reduced. In my opinion, from
working on a medical floor years ago, the themes that came out of the study
hold truth. The implications that are drawn by the author are supported by
the study’s findings.

15. Recommendations

Does the author offer legitimate recommendations for further research? Is

the description of the study sufficiently clear and complete to allow
replication of the study? (Sometimes researchers’ recommendations seem to
come from “left field” rather than following obviously from the discussion of
findings. If a research problem is truly significant, the results need to be
confirmed with additional research; in addition, if a reader wishes to design
a study using a different sample or correcting flaws in the original study, a
complete description is necessary.)

The author offers support as to the reason additional research needs done.
She states that the study only took place in two hospitals so additional
studies should be conducted to determine the validity of these findings. She
also mentions the quantitative tool needing developed that was mentioned
under my limitations of the study. Her reasoning for additional research lays
in the unanswered question; what is the relationship between staffing
patterns and missed nursing care? If this question is answered, then the
author suggests that it would shed light on the relationship between nursing
actions and patient outcomes.

16. Research Utilization in Your Practice

How might this research inform your practice? Are the research findings
appropriate to your practice setting and situation? What further research or
pilot studies need to be done, if any, before incorporating findings into
practice to assure both safety and effectiveness? How might the utilization
of this research trigger changes in other aspects of practice?
CRITIQUE OF QUANTITATIVE AND QUALITATIVE STUDIES 20

The particular themes found in this study would probably be transposed

across most of the nursing units. Working in marketing, the appropriateness
of this study would probably not apply. The reasons for missed nursing care
mentioned in this article though, seems fair, as it is some of the reasons that
I remember missing nursing care when I worked on a nursing unit. The
evidence presented by this study can be applied by administration when
determining nurse-patient ratios for better patient care and patient
outcomes.

Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for
nursing practice (10th ed.). Philadelphia, PA: Wolters Kluwer.
CRITIQUE OF QUANTITATIVE AND QUALITATIVE STUDIES 21

Critique Template for a Quantitative Study

NURS 5052/NURS 6052

Week 6 Assignment: Application: Critiquing Quantitative, Qualitative, or

Mixed Methods Studies (due by Day 7 of Week 7)

Your name: Larry Robertson

Date: 10/15/17
Article reference (in APA style): Friese, C. R., Kalisch, B. J., & Lee, K. H. (2013). Patterns

and correlates of missed nursing care in inpatient oncology units. Cancer Nursing, 36(6),

E51-E57.

URL: http://ovidsp.tx.ovid.com.ezp.waldenulibrary.org/sp-3.26.1a/ovidweb.cgi?
WebLinkFrameset=1&S=HHEHFPGMCNDDOBCLNCGKJDOBHEDGAA00&returnUrl=ovid
web.cgi%3f%26Titles%3dS.sh.22%257c1%257c10%26FORMAT%3dtitle%26FIELDS
%3dTITLES%26S%3dHHEHFPGMCNDDOBCLNCGKJDOBHEDGAA00&directlink=http
%3a%2f%2fovidsp.tx.ovid.com%2fovftpdfs%2fFPDDNCOBJDCLCN00%2ffs047%2fovft
%2flive%2fgv024%2f00002820%2f00002820-201311000-
00017.pdf&filename=Patterns+and+Correlates+of+Missed+Nursing+Care+in+Inpatient+Oncolo
gy+Units.&navigation_links=NavLinks.S.sh.22.1&PDFIdLinkField=%2ffs047%2fovft%2flive
%2fgv024%2f00002820%2f00002820-201311000-
00017&link_from=S.sh.22%7c1&pdf_key=B&pdf_index=S.sh.22&D=ovft

What is a critique? Simply stated, a critique is a critical analysis

undertaken for some purpose. Nurses critique research for three main
reasons: to improve their practice, to broaden their understanding,
and to provide a base for the conduct of a study.

When the purpose is to improve practice, nurses must give

special consideration to questions such as these:

 Are the research findings appropriate to my practice setting and

situation?
 What further research or pilot studies need to be done, if any,
before incorporating findings into practice to assure both safety
and effectiveness?
CRITIQUE OF QUANTITATIVE AND QUALITATIVE STUDIES 22

 How might a proposed change in practice trigger changes in

other aspects of practice?

To help you synthesize your learning throughout this course and prepare you to
utilize research in your practice, you will be critiquing a qualitative, quantitative, or
mixed methods research study of your choice.

If the article is unavailable in a full-text version through the

Walden University Library, you must e-mail the article as a PDF or
Word attachment to your Instructor.

QUANTITATIVE RESEARCH CRITIQUE

1. Research Problem and Purpose

What are the problem and purpose of the referenced study? (Sometimes
ONLY the purpose is stated clearly and the problem must be inferred from
the introductory discussion of the purpose.)

The problem is that the understanding of missed nursing care in inpatient

onclolgy setting is lmited, because of the absence of multisite studies with
sufficient numbers of oncology units and personnel to report on the
phenomena, this study attemps to bridge the knowledge gap by describing
the patterns and correlates of missed nursing care in this high-risk,
understudied setting.
The purpose of the study was to quantify the degree of missed nursing care
in oncology units, compare missed nursing care between oncology and
nononcology medical, surgical units, and identify correlates of missed
nursing care in oncology units.

2. Hypotheses and Research Questions

What are the hypotheses (or research questions/objectives) of the study?

(Sometimes the hypotheses or study questions are listed in the Results
section, rather than preceding the report of the methodology used.
Occasionally, there will be no mention of hypotheses, but anytime there are
inferential statistics used, the reader can recognize what the hypotheses are
from looking at the results of statistical

Three research questions were identified: (1) What elements of nursing care
are frequently missed or always on oncology units?, (2) Does missed nursing
care vary significantly between oncology units and other nononcolgy,
medical-surgical units?, and (3) Is unit staffing significantly associated with
missed nursing care on oncology units?
CRITIQUE OF QUANTITATIVE AND QUALITATIVE STUDIES 23

3. Literature Review

What is the quality of the literature review? Is the literature review current?
Relevant? Is there evidence that the author critiqued the literature or merely
reported it without critique? Is there an integrated summary of the current
knowledge base regarding the research problem, or does the literature
review contain opinion or anecdotal articles without any synthesis or
summary of the whole? (Sometimes the literature review is incorporated
into the introductory section without being explicitly identified.)

Eight of the 14 articles that were sited in the literature review were also
written by two of the authors of this paper. All were current and relevant for
this study. The review was sited in the authors introduction to the paper.
The literature review provided the understanding of the need for the study.
Current knowledge base was incorporated into the introduction which
explained what research has found and what is still lacking. I can assume
the authors
have critiqued the articles because they are attempting to fill the gap with
this study.

4. Theoretical or Conceptual Framework

Is a theoretical or conceptual framework identified? If so, what is it? Is it a

nursing framework or one drawn from another discipline? (Sometimes there
is no explicitly identified theoretical or conceptual framework; in addition,
many “nursing” research studies draw on a “borrowed” framework, e.g.,
stress, medical pathology, etc.)

Analysis was guided by the Missed Nursing Care Model of Kaisch et al.,
Missed nursing care, conceptualized within the Missed Nursing Care Model, is
defined as any aspect of required patient care that is omitted (either in part
or in whole) or delayed. Various attribute categories reported by nurses in
acute care settings contribute to missed nursing care: (1) antecedents that
catalyze the need for a decision about priorities; (2) elements of the nursing
process, and (3) internal perceptions and values of the nursing care is
provided.

Population

What population was sampled? How was the population sampled? Describe
the method and criteria. How many subjects were in the sample?
CRITIQUE OF QUANTITATIVE AND QUALITATIVE STUDIES 24

This secondary analysis examined survey data obtained from nursing

assistants and nurses, both RN’s and LPN’s, who provided direct patient care
in medical-surgical units across nine hospitals in 1 Midwestern state. The
analysis included 62 nursing units, 12 were identified as oncology units with
353 total respondents: the remaining 50 units were identified as med-surge
units with a total of 1966 respondents. Because of institutional differences in
the care delivery models across the settings, nurses and nursing assistants
were invited to participate in the study. Data were collected following
institution-specific human subjects and administrative approval between
November 2008 and April 2009, with an overall response rate of 59.8%.

5. Protection of Human Research Participants

What steps were taken to protect human research subjects?

Institutional review board approval from the authors universities and rom
each participating hospital were obtained.

6. Research Design

What was the design of the study? If the design was modeled from previous
research or pilot studies, please describe.

The research design was a secondary analysis which involves the use of
existing data from a previous or ongoing study to test new hypotheses or
answer questions that were not initially envisioned (Polit & Beck, 2017).

7. Instruments and Strategies for Measurement

What instruments and/or other measurement strategies were used in data

collection? Was information provided regarding the reliability and validity of
the measurement instruments? If so, describe it.

The MISSCARE Survey was passed out in a study packet to participants. The
MISSCARE Survey has been utilized to collect data in hospitals of various
types and location in the US, and the psychometric properties have been
reported. The results of the psychometric testing of the MISSCARE Survey
demonstrated it met standards of validity and reliability.

8. Data Collection
CRITIQUE OF QUANTITATIVE AND QUALITATIVE STUDIES 25

What procedures were used for data collection?

Each unit received a lock box for questionnaire returns, with an average time
frame of survey administration across study units of 2 weeks.

9. Data Analysis

What methods of data analysis were used? Were they appropriate to the
design and hypotheses?

Data Analysis used an analytic data set of responses from the participants
who worked in medical, surgical units. For the secondary analysis, units
were divided into oncology or nononcology patient populations. Nursing unit
specializations was selected as an independent variable. The authors then
quantified the degree to which the 24 identified items of nursing care as
measured by the MISSCARE Survey were reported as missed rarely,
occasionally, frequently, or always. Next, they used the total score of the
MISSCARE Survey, which is the average amount of missed care reported by
a respondent. The total score is based on a 4-point Likert scale. Comparison
between oncology units versus nononcology units by Student t test. Finally,
the oncology units sample was analyzed using the linear regression to
estimate the correlates of increased missed nursing care based on the total
missed nursing care score. Robust cluster methods to adjust the standard
errors for respondent clustering in nursing units.
The Data Analysis was appropriate because it looked at missed care which is
the focus of the study. Also, the data and analysis of the data was analyzed
looking for differences between oncology units and nononcology units.

10. Interpretation of Results

What results were obtained from data analysis? Is sufficient information

given to interpret the results of data analysis?

Differences in missed nursing care between oncology and nononcology units,

data reflected that respondents from oncology units reported less missed
care than do their counterparts from nononcology units. In no instance did
the frequency of missed nursing care for any of the item reported by
oncology personnel exceed the average score by nononcology personnel.
Unit staffing and missed nursing care in oncology units suggested that the
number of patients cared for on the last shift had a significant relationship to
the total missed care score. A 1-patient increase in the assignment of
respondents was associated with a 2.1% increase in the total missed nursing
care score.
CRITIQUE OF QUANTITATIVE AND QUALITATIVE STUDIES 26

Sufficient information is given in table form in the study to interpret the

results of the data analysis along with the analysis that was used in
determining the result.

11. Discussion of Findings

Was the discussion of findings related to the framework? Were those the
expected findings? Were they consistent with previous studies? Were
serendipitous (i.e., accidental) findings described?

The hypothesis that poorer staffing of nursing personnel would be associated

with missed nursing care was suggested to be accurate in this study that
examined the phenomenon of missed nursing care as a contributor to quality
of care for hospitalized patients with cancer.
Several items of nursing care were frequently missed on the oncology units,
but when compared to the nononcology units, overall missed care was lower
in all aspects on the oncology units. Confirmation of the hypothesis and
identification of significant relationships between higher patient work-loads
and reported missed nursing care. The findings support that tenets of the
missed care model that assert a relationship between structure (Unit
staffing) and process of care (missed nursing care).
The discussion findings were related to the framework of the study which
was the missed care model. The expected findings were confirmed. Staffing
was consistent with the previous studies, but no other study had compared
oncology units to nononcology units, but consistency of missed work was
shown.

12. Limitations

Did the researcher report limitations of the study? (Limitations are

acknowledgments of internal characteristics of the study that may help
explain insignificant and other unexpected findings, and more importantly,
indicate those groups to whom the findings CANNOT be generalized or
applied. It is a fact that all studies must be limited in some way; not all of
the issues involved in a problem situation can be studied all at once.)

The authors stated that there were several limitations to this study. The first
was that it was a secondary analysis, and the original study was not
designed a priori to compare differences in missed care across types of
nursing units. Because of that, there was an unbalanced proportion of
respondents and units by the oncology unit. All data was collected from
nurses and nursing assistants in the clinical setting, and it was not validated
with external data sources, such as independent observation, patient report,
or correlation with clinical documentation. There is also the possibility that
CRITIQUE OF QUANTITATIVE AND QUALITATIVE STUDIES 27

nurses perceive missed care differently. The questionnaire in its current form
is not specific to missed care omitted during a specific time frame, just the
general degree to which care is missed.

13. Implications

Are the conclusions and implications drawn by the author warranted by the
study findings? (Sometimes researchers will seem to ignore findings that
don’t confirm their hypotheses as they interpret the meaning of their study
findings.)

The items that were found that were missed by the oncology unit is a prime
target for quality improvement efforts. Institutional leadership should heed
the significant relationship between staffing and missed nursing care as they
set staffing levels for nursing units. Using the MISSCARE Survey on nursing
units would be a useful way to assess for improvements in nursing care
delivery over time.

14. Recommendations

Does the author offer legitimate recommendations for further research? Is

the description of the study sufficiently clear and complete to allow
replication of the study? (Sometimes researchers’ recommendations seem to
come from “left field” rather than following obviously from the discussion of
findings. If a research problem is truly significant, the results need to be
confirmed with additional research; in addition, if a reader wishes to design
a study using a different sample or correcting flaws in the original study, a
complete description is necessary.)

The authors state that the MISSCARE Survey has been administered in adult
nursing units and validated but is has not been validated in pediatric settings
and studies are warranted. Also, future research directions include a
sampling strategy that includes diverse hospitals and nursing units with
sufficient power to detect differences in missed care and outcome across an
array of independent variables which would allow researchers to examine all
concepts in the model simultaneously. The author sited multiple articles, for
example, the problems caused by missing mouth care on a nursing unit and
the complications of it. By being able to determine why nursing care is
missed then patients will have better outcomes.

15. Research Utilization in Your Practice

CRITIQUE OF QUANTITATIVE AND QUALITATIVE STUDIES 28

How might this research inform your practice? Are the research findings
appropriate to your practice setting and situation? What further research or
pilot studies need to be done, if any, before incorporating findings into
practice to assure both safety and effectiveness? How might the utilization
of this research trigger changes in other aspects of practice?

This research was very interesting to me. If I were in a position that I would need to
determine what the best staffing ratio to patient, this article would be very helpful. The
study highlights what nursing care is routinely missed on nursing units and the development
of quality improvement programs from these findings would be a great place to begin so
that one could assure patients were receiving the care that they needed, decreasing their
lengths of stay and ultimately improving the patient’s health outcome. By doing this, it
would be a start at reducing the overall cost of care for patients. In my practice as a
marketing nurse, this study would not apply. Future studies as the authors suggest should
be followed up on.