Research for Evidence Based Practice
Characteristics of Qualitative Descriptive Studies: A Systematic Review
Hyejin Kim, MSN, CRNP, Doctoral Candidate, University of Pennsylvania School of Nursing
Justine S. Sefcik, and MS, RN, Doctoral Candidate, University of Pennsylvania School of Nursing
Christine Bradway PhD, CRNP, FAAN, Associate Professor of Gerontological Nursing, University of Pennsylvania School of Nursing
Abstract
Qualitative description (QD) is a term that is widely used to describe qualitative studies of health
care and nursing-related phenomena. However, limited discussions regarding QD are found in the
existing literature. In this systematic review, we identified characteristics of methods and findings
reported in research articles published in 2014 whose authors identified the work as QD. After
searching and screening, data were extracted from the sample of 55 QD articles and examined to
characterize research objectives, design justification, theoretical/philosophical frameworks,
sampling and sample size, data collection and sources, data analysis, and presentation of findings.
In this review, three primary findings were identified. First, despite inconsistencies, most articles
included characteristics consistent with limited, available QD definitions and descriptions. Next,
flexibility or variability of methods was common and desirable for obtaining rich data and
achieving understanding of a phenomenon. Finally, justification for how a QD approach was
chosen and why it would be an appropriate fit for a particular study was limited in the sample and,
therefore, in need of increased attention. Based on these findings, recommendations include
encouragement to researchers to provide as many details as possible regarding the methods of their
QD study so that readers can determine whether the methods used were reasonable and effective in
producing useful findings.
Keywords
qualitative description; qualitative research; systematic review
Qualitative description (QD) is a label used in qualitative research for studies which are
descriptive in nature, particularly for examining health care and nursing-related phenomena
(Polit & Beck, 2009, 2014). QD is a widely cited research tradition and has been identified
Corresponding Author, Hyejin Kim, School of Nursing, University of Pennsylvania, 418 Curie Blvd. Philadelphia, PA, 19104; [email protected]; Telephone: 215-746-8490; Fax 215-573-7507.
Conflict of Interest Statement The Authors declare that there is no conflict of interest.
HHS Public Access Author manuscript Res Nurs Health. Author manuscript; available in PMC 2018 February 01.
Published in final edited form as: Res Nurs Health. 2017 February ; 40(1): 23–42. doi:10.1002/nur.21768.
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as important and appropriate for research questions focused on discovering the who, what,
and where of events or experiences and gaining insights from informants regarding a poorly
understood phenomenon. It is also the label of choice when a straight description of a
phenomenon is desired or information is sought to develop and refine questionnaires or
interventions (Neergaard et al., 2009; Sullivan-Bolyai et al., 2005).
Despite many strengths and frequent citations of its use, limited discussions regarding QD
are found in qualitative research textbooks and publications. To the best of our knowledge,
only seven articles include specific guidance on how to design, implement, analyze, or report
the results of a QD study (Milne & Oberle, 2005; Neergaard, Olesen, Andersen, &
Sondergaard, 2009; Sandelowski, 2000, 2010; Sullivan-Bolyai, Bova, & Harper, 2005;
Vaismoradi, Turunen, & Bondas, 2013; Willis, Sullivan-Bolyai, Knafl, & Zichi-Cohen,
2016). Furthermore, little is known about characteristics of QD as reported in journal-
published, nursing-related, qualitative studies. Therefore, the purpose of this systematic
review was to describe specific characteristics of methods and findings of studies reported in
journal articles (published in 2014) self-labeled as QD. In this review, we did not have a goal
to judge whether QD was done correctly but rather to report on the features of the methods
and findings.
Features of QD
Several QD design features and techniques have been described in the literature. First,
researchers generally draw from a naturalistic perspective and examine a phenomenon in its
natural state (Sandelowski, 2000). Second, QD has been described as less theoretical
compared to other qualitative approaches (Neergaard et al., 2009), facilitating flexibility in
commitment to a theory or framework when designing and conducting a study
(Sandelowski, 2000, 2010). For example, researchers may or may not decide to begin with a
theory of the targeted phenomenon and do not need to stay committed to a theory or
framework if their investigations take them down another path (Sandelowski, 2010). Third,
data collection strategies typically involve individual and/or focus group interviews with
minimal to semi-structured interview guides (Neergaard et al., 2009; Sandelowski, 2000).
Fourth, researchers commonly employ purposeful sampling techniques such as maximum
variation sampling which has been described as being useful for obtaining broad insights
and rich information (Neergaard et al., 2009; Sandelowski, 2000). Fifth, content analysis
(and in many cases, supplemented by descriptive quantitative data to describe the study
sample) is considered a primary strategy for data analysis (Neergaard et al., 2009;
Sandelowski, 2000). In some instances thematic analysis may also be used to analyze data;
however, experts suggest care should be taken that this type of analysis is not confused with
content analysis (Vaismoradi et al., 2013). These data analysis approaches allow researchers
to stay close to the data and as such, interpretation is of low-inference (Neergaard et al.,
2009), meaning that different researchers will agree more readily on the same findings even
if they do not choose to present the findings in the same way (Sandelowski, 2000). Finally,
representation of study findings in published reports is expected to be straightforward,
including comprehensive descriptive summaries and accurate details of the data collected,
and presented in a way that makes sense to the reader (Neergaard et al., 2009; Sandelowski,
2000).
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It is also important to acknowledge that variations in methods or techniques may be
appropriate across QD studies (Sandelowski, 2010). For example, when consistent with the
study goals, decisions may be made to use techniques from other qualitative traditions, such
as employing a constant comparative analytic approach typically associated with grounded
theory (Sandelowski, 2000).
Methods
Search Strategy and Study Screening
The PubMed electronic database was searched for articles written in English and published
from January 1, 2014 to December 31, 2014, using the terms, “qualitative descriptive study,”
“qualitative descriptive design,” and “qualitative description,” combined with “nursing.”
This specific publication year, “2014,” was chosen because it was the most recent full year
at the time of beginning this systematic review. As we did not intend to identify trends in
QD approaches over time, it seemed reasonable to focus on the nursing QD studies
published in a certain year. The inclusion criterion for this review was data-based, nursing-
related, research articles in which authors used the terms QD, qualitative descriptive study,
or qualitative descriptive design in their titles or abstracts as well as in the main texts of the
publication.
All articles yielded through an initial search in PubMed were exported into EndNote X7
(Thomson Reuters, 2014), a reference management software, and duplicates were removed.
Next, titles and abstracts were reviewed to determine if the publication met inclusion
criteria; all articles meeting inclusion criteria were then read independently in full by two
authors (HK and JS) to determine if the terms – QD or qualitative descriptive study/design –
were clearly stated in the main texts. Any articles in which researchers did not specifically
state these key terms in the main text were then excluded, even if the terms had been used in
the study title or abstract. In one article, for example, although “qualitative descriptive
study” was reported in the published abstract, the researchers reported a “qualitative
exploratory design” in the main text of the article (Sundqvist & Carlsson, 2014); therefore,
this article was excluded from our review. Despite the possibility that there may be other QD
studies published in 2014 that were not labeled as such, to facilitate our screening process
we only included articles where the researchers clearly used our search terms for their
approach. Finally, the two authors compared, discussed, and reconciled their lists of articles
with a third author (CB).
Study Selection
Initially, although the year 2014 was specifically requested, 95 articles were identified (due
to ahead of print/Epub) and exported into the EndNote program. Three duplicate
publications were removed and the 20 articles with final publication dates of 2015 were also
excluded. The remaining 72 articles were then screened by examining titles, abstracts, and
full-texts. Based on our inclusion criteria, 15 (of 72) were then excluded because QD or QD
design/study was not identified in the main text. We then re-examined the remaining 57
articles and excluded two additional articles that did not meet inclusion criteria (e.g., QD
was only reported as an analytic approach in the data analysis section). The remaining 55
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publications met inclusion criteria and comprised the sample for our systematic review (see
Figure 1).
Of the 55 publications, 23 originated from North America (17 in the United States; 6 in
Canada), 12 from Asia, 11 from Europe, 7 from Australia and New Zealand, and 2 from
South America. Eleven studies were part of larger research projects and two of them were
reported as part of larger mixed-methods studies. Four were described as a secondary
analysis.
Quality Appraisal Process
Following the identification of the 55 publications, two authors (HK and JS) independently
examined each article using the Critical Appraisal Skills Programme (CASP) qualitative
checklist (CASP, 2013). The CASP was chosen to determine the general adequacy (or rigor)
of the qualitative studies included in this review as the CASP criteria are generic and intend
to be applied to qualitative studies in general. In addition, the CASP was useful because we
were able to examine the internal consistency between study aims and methods and between
study aims and findings as well as the usefulness of findings (CASP, 2013). The CASP
consists of 10 main questions with several sub-questions to consider when making a
decision about the main question (CASP, 2013). The first two questions have reviewers
examine the clarity of study aims and appropriateness of using qualitative research to
achieve the aims. With the next eight questions, reviewers assess study design, sampling,
data collection, and analysis as well as the clarity of the study’s results statement and the
value of the research. We used the seven questions and 17 sub-questions related to methods
and statement of findings to evaluate the articles. The results of this process are presented in
Table 1.
Once articles were assessed by the two authors independently, all three authors discussed
and reconciled our assessment. No articles were excluded based on CASP results; rather,
results were used to depict the general adequacy (or rigor) of all 55 articles meeting
inclusion criteria for our systematic review. In addition, the CASP was included to enhance
our examination of the relationship between the methods and the usefulness of the findings
documented in each of the QD articles included in this review.
Process for Data Extraction and Analysis
To further assess each of the 55 articles, data were extracted on: (a) research objectives, (b)
design justification, (c) theoretical or philosophical framework, (d) sampling and sample
size, (e) data collection and data sources, (f) data analysis, and (g) presentation of findings
(see Table 2). We discussed extracted data and identified common and unique features in the
articles included in our systematic review. Findings are described in detail below and in
Table 3.
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Findings
Quality Appraisal Results
Justification for use of a QD design was evident in close to half (47.3%) of the 55
publications. While most researchers clearly described recruitment strategies (80%) and data
collection methods (100%), justification for how the study setting was selected was only
identified in 38.2% of the articles and almost 75% of the articles did not include any reason
for the choice of data collection methods (e.g., focus-group interviews). In the vast majority
(90.9%) of the articles, researchers did not explain their involvement and positionality
during the process of recruitment and data collection or during data analysis (63.6%).
Ethical standards were reported in greater than 89% of all articles and most articles included
an in-depth description of data analysis (83.6%) and development of categories or themes
(92.7%). Finally, all researchers clearly stated their findings in relation to research questions/
objectives. Researchers of 83.3% of the articles discussed the credibility of their findings
(see Table 1).
Research Objectives
In statements of study objectives and/or questions, the most frequently used verbs were
“explore” (n = 22) and “describe” (n = 17). Researchers also used “identify” (n = 3),
“understand” (n = 4), or “investigate” (n = 2). Most articles focused on participants’
experiences related to certain phenomena (n = 18), facilitators/challenges/factors/reasons (n = 14), perceptions about specific care/nursing practice/interventions (n = 11), and
knowledge/attitudes/beliefs (n = 3).
Design Justification
A total of 30 articles included references for QD. The most frequently cited references (n =
23) were “Whatever happened to qualitative description?” (Sandelowski, 2000) and “What’s
in a name? Qualitative description revisited” (Sandelowski, 2010). Other references cited
included “Qualitative description – the poor cousin of health research?” (Neergaard et al.,
2009), “Reaching the parts other methods cannot reach: an introduction to qualitative
methods in health and health services research” (Pope & Mays, 1995), and general research
textbooks (Polit & Beck, 2004, 2012).
In 26 articles (and not necessarily the same as those citing specific references to QD),
researchers provided a rationale for selecting QD. Most researchers chose QD because this
approach aims to produce a straight description and comprehensive summary of the
phenomenon of interest using participants’ language and staying close to the data (or using
low inference).
Authors of two articles distinctly stated a QD design, yet also acknowledged grounded-
theory or phenomenological overtones by adopting some techniques from these qualitative
traditions (Michael, O'Callaghan, Baird, Hiscock, & Clayton, 2014; Peacock, Hammond-
Collins, & Forbes, 2014). For example, Michael et al. (2014, p. 1066) reported:
The research used a qualitative descriptive design with grounded theory overtones
(Sandelowski, 2000). We sought to provide a comprehensive summary of
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participants’ views through theoretical sampling; multiple data sources (focus
groups [FGs] and interviews); inductive, cyclic, and constant comparative analysis;
and condensation of data into thematic representations (Corbin & Strauss, 1990,
2008).
Authors of four additional articles included language suggestive of a grounded-theory or
phenomenological tradition, e.g., by employing a constant comparison technique or
translating themes stated in participants’ language into the primary language of the
researchers during data analysis (Asemani et al., 2014; Li, Lee, Chen, Jeng, & Chen, 2014;
Ma, 2014; Soule, 2014). Additionally, Li et al. (2014) specifically reported use of a
grounded-theory approach.
Theoretical or Philosophical Framework
In most (n = 48) articles, researchers did not specify any theoretical or philosophical
framework. Of those articles in which a framework or philosophical stance was included, the
authors of five articles described the framework as guiding the development of an interview
guide (Al-Zadjali, Keller, Larkey, & Evans, 2014; DeBruyn, Ochoa-Marin, & Semenic,
2014; Fantasia, Sutherland, Fontenot, & Ierardi, 2014; Ma, 2014; Wiens, Babenko-Mould, &
Iwasiw, 2014). In two articles, data analysis was described as including key concepts of a
framework being used as pre-determined codes or categories (Al-Zadjali et al., 2014; Wiens
et al., 2014). Oosterveld-Vlug et al. (2014) and Zhang, Shan, and Jiang (2014) discussed a
conceptual model and underlying philosophy in detail in the background or discussion
section, although the model and philosophy were not described as being used in developing
interview questions or analyzing data.
Sampling and Sample Size
In 38 of the 55 articles, researchers reported ‘purposeful sampling’ or some derivation of
purposeful sampling such as convenience (n = 10), maximum variation (n = 8), snowball (n = 3), and theoretical sampling (n = 1). In three instances (Asemani et al., 2014; Chan &
Lopez, 2014; Soule, 2014), multiple sampling strategies were described, for example, a
combination of snowball, convenience, and maximum variation sampling. In articles where
maximum variation sampling was employed, “variation” referred to seeking diversity in
participants’ demographics (n = 7; e.g., age, gender, and education level), while one article
did not include details regarding how their maximum variation sampling strategy was
operationalized (Marcinowicz, Abramowicz, Zarzycka, Abramowicz, & Konstantynowicz,
2014). Authors of 17 articles did not specify their sampling techniques.
Sample sizes ranged from 8 to 1,932 with nine studies in the 8–10 participant range and 24
studies in the 11–20 participant range. The participant range of 21–30 and 31–50 was
reported in eight articles each. Six studies included more than 50 participants. Two of these
articles depicted quite large sample sizes (N=253, Hart & Mareno, 2014; N=1,932, Lyndon
et al., 2014) and the authors of these articles described the use of survey instruments and
analysis of responses to open-ended questions. This was in contrast to studies with smaller
sample sizes where individual interviews and focus groups were more commonly employed.
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Data Collection and Data Sources
In a majority of studies, researchers collected data through individual (n = 39) and/or focus-
group (n = 14) interviews that were semistructured. Most researchers reported that
interviews were audiotaped (n = 51) and interview guides were described as the primary data
collection tool in 29 of the 51 studies. In some cases, researchers also described additional
data sources, for example, taking memos or field notes during participant observation
sessions or as a way to reflect their thoughts about interviews (n = 10). Written responses to
open-ended questions in survey questionnaires were another type of data source in a small
number of studies (n = 4).
Data Analysis
The analysis strategy most commonly used in the QD studies included in this review was
qualitative content analysis (n = 30). Among the studies where this technique was used, most
researchers described an inductive approach; researchers of two studies analyzed data both
inductively and deductively. Thematic analysis was adopted in 14 studies and the constant
comparison technique in 10 studies. In nine studies, researchers employed multiple
techniques to analyze data including qualitative content analysis with constant comparison
(Asemani et al., 2014; DeBruyn et al., 2014; Holland, Christensen, Shone, Kearney, &
Kitzman, 2014; Li et al., 2014) and thematic analysis with constant comparison (Johansson,
Hildingsson, & Fenwick, 2014; Oosterveld-Vlug et al., 2014). In addition, five teams
conducted descriptive statistical analysis using both quantitative and qualitative data and
counting the frequencies of codes/themes (Ewens, Chapman, Tulloch, & Hendricks, 2014;
Miller, 2014; Santos, Sandelowski, & Gualda, 2014; Villar, Celdran, Faba, & Serrat, 2014)
or targeted events through video monitoring (Martorella, Boitor, Michaud, & Gelinas, 2014).
Tseng, Chen, and Wang (2014) cited Thorne, Reimer Kirkham, and O’Flynn-Magee
(2004)’s interpretive description as the inductive analytic approach. In five out of 55 articles,
researchers did not specifically name their analysis strategies, despite including descriptions
about procedural aspects of data analysis. Researchers of 20 studies reported that data
saturation for their themes was achieved.
Presentation of Findings
Researchers described participants’ experiences of health care, interventions, or illnesses in
18 articles and presented straightforward, focused, detailed descriptions of facilitators,
challenges, factors, reasons, and causes in 15 articles. Participants’ perceptions of specific
care, interventions, or programs were described in detail in 11 articles. All researchers
presented their findings with extensive descriptions including themes or categories. In 25 of
55 articles, figures or tables were also presented to illustrate or summarize the findings. In
addition, the authors of three articles summarized, organized, and described their data using
key concepts of conceptual models (Al-Zadjali et al., 2014; Oosterveld-Vlug et al., 2014;
Wiens et al., 2014). Martorella et al. (2014) assessed acceptability and feasibility of hand
massage therapy and arranged their findings in relation to pre-determined indicators of
acceptability and feasibility. In one longitudinal QD study (Kneck, Fagerberg, Eriksson, &
Lundman, 2014), the researchers presented the findings as several key patterns of learning
for persons living with diabetes; in another longitudinal QD study (Stegenga & Macpherson,
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2014), findings were presented as processes and themes regarding patients’ identity work
across the cancer trajectory. In another two studies, the researchers described and compared
themes or categories from two different perspectives, such as patients and nurses (Canzan,
Heilemann, Saiani, Mortari, & Ambrosi, 2014) or parents and children (Marcinowicz et al.,
2014). Additionally, Ma (2014) reported themes using both participants’ language and the
researcher’s language.
Discussion
In this systematic review, we examined and reported specific characteristics of methods and
findings reported in journal articles self-identified as QD and published during one calendar
year. To accomplish this we identified 55 articles that met inclusion criteria, performed a
quality appraisal following CASP guidelines, and extracted and analyzed data focusing on
QD features. In general, three primary findings emerged. First, despite inconsistencies, most
QD publications had the characteristics that were originally observed by Sandelowski (2000)
and summarized by other limited available QD literature. Next, there are no clear boundaries
in methods used in the QD studies included in this review; in a number of studies,
researchers adopted and combined techniques originating from other qualitative traditions to
obtain rich data and increase their understanding of the phenomenon under investigation.
Finally, justification for how QD was chosen and why it would be an appropriate fit for a
particular study is an area in need of increased attention.
In general, the overall characteristics were consistent with design features of QD studies
described in the literature (Neergaard et al., 2009; Sandelowski, 2000, 2010; Vaismoradi et
al., 2013). For example, many authors reported that study objectives were to describe or
explore participants’ experiences and factors related to certain phenomena, events, or
interventions. In most cases, these authors cited Sandelowski (2000) as a reference for this
particular characteristic. It was rare that theoretical or philosophical frameworks were
identified, which also is consistent with descriptions of QD. In most studies, researchers
used purposeful sampling and its derivative sampling techniques, collected data through
interviews, and analyzed data using qualitative content analysis or thematic analysis.
Moreover, all researchers presented focused or comprehensive, descriptive summaries of
data including themes or categories answering their research questions. These characteristics
do not indicate that there are correct ways to do QD studies; rather, they demonstrate how
others designed and produced QD studies.
In several studies, researchers combined techniques that originated from other qualitative
traditions for sampling, data collection, and analysis. This flexibility or variability, a key
feature of recently published QD studies, may indicate that there are no clear boundaries in
designing QD studies. Sandelowski (2010) articulated: “in the actual world of research
practice, methods bleed into each other; they are so much messier than textbook depictions”
(p. 81). Hammersley (2007) also observed:
“We are not so much faced with a set of clearly differentiated qualitative
approaches as with a complex landscape of variable practice in which the
inhabitants use a range of labels (‘ethnography’, ‘discourse analysis’, ‘life history
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work’, narrative study’, ……, and so on) in diverse and open-ended ways in order
to characterize their orientation, and probably do this somewhat differently across
audiences and occasions” (p. 293).
This concept of having no clear boundaries in methods when designing a QD study should
enable researchers to obtain rich data and produce a comprehensive summary of data
through various data collection and analysis approaches to answer their research questions.
For example, using an ethnographical approach (e.g., participant observation) in data
collection for a QD study may facilitate an in-depth description of participants’ nonverbal
expressions and interactions with others and their environment as well as situations or events
in which researchers are interested (Kawulich, 2005). One example found in our review is
that Adams et al. (2014) explored family members’ responses to nursing communication
strategies for patients in intensive care units (ICUs). In this study, researchers conducted
interviews with family members, observed interactions between healthcare providers,
patients, and family members in ICUs, attended ICU rounds and family meetings, and took
field notes about their observations and reflections. Accordingly, the variability in methods
provided Adams and colleagues (2014) with many different aspects of data that were then
used to complement participants’ interviews (i.e., data triangulation). Moreover, by using a
constant comparison technique in addition to qualitative content analysis or thematic
analysis in QD studies, researchers compare each case with others looking for similarities
and differences as well as reasoning why differences exist, to generate more general
understanding of phenomena of interest (Thorne, 2000). In fact, this constant comparison
analysis is compatible with qualitative content analysis and thematic analysis and we found
several examples of using this approach in studies we reviewed (Asemani et al., 2014;
DeBruyn et al., 2014; Holland et al., 2014; Johansson et al., 2014; Li et al., 2014;
Oosterveld-Vlug et al., 2014).
However, this flexibility or variability in methods of QD studies may cause readers’ as well
as researchers’ confusion in designing and often labeling qualitative studies (Neergaard et
al., 2009). Especially, it could be difficult for scholars unfamiliar with qualitative studies to
differentiate QD studies with “hues, tones, and textures” of qualitative traditions
(Sandelowski, 2000, p. 337) from grounded theory, phenomenological, and ethnographical
research. In fact, the major difference is in the presentation of the findings (or outcomes of
qualitative research) (Neergaard et al., 2009; Sandelowski, 2000). The final products of
grounded theory, phenomenological, and ethnographical research are a generation of a
theory, a description of the meaning or essence of people’s lived experience, and an in-
depth, narrative description about certain culture, respectively, through researchers’
intensive/deep interpretations, reflections, and/or transformation of data (Streubert &
Carpenter, 2011). In contrast, QD studies result in “a rich, straight description” of
experiences, perceptions, or events using language from the collected data (Neergaard et al.,
2009) through low-inference (or data-near) interpretations during data analysis
(Sandelowski, 2000, 2010). This feature is consistent with our finding regarding presentation
of findings: in all QD articles included in this systematic review, the researchers presented
focused or comprehensive, descriptive summaries to their research questions.
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Finally, an explanation or justification of why a QD approach was chosen or appropriate for
the study aims was not found in more than half of studies in the sample. While other
qualitative approaches, including grounded theory, phenomenology, ethnography, and
narrative analysis, are used to better understand people’s thoughts, behaviors, and situations
regarding certain phenomena (Sullivan-Bolyai et al., 2005), as noted above, the results will
likely read differently than those for a QD study (Carter & Little, 2007). Therefore, it is
important that researchers accurately label and justify their choices of approach, particularly
for studies focused on participants’ experiences, which could be addressed with other
qualitative traditions. Justifying one’s research epistemology, methodology, and methods
allows readers to evaluate these choices for internal consistency, provides context to assist in
understanding the findings, and contributes to the transparency of choices, all of which
enhance the rigor of the study (Carter & Little, 2007; Wu, Thompson, Aroian, McQuaid, &
Deatrick, 2016).
Use of the CASP tool drew our attention to the credibility and usefulness of the findings of
the QD studies included in this review. Although justification for study design and methods
was lacking in many articles, most authors reported techniques of recruitment, data
collection, and analysis that appeared. Internal consistencies among study objectives,
methods, and findings were achieved in most studies, increasing readers’ confidence that the
findings of these studies are credible and useful in understanding under-explored
phenomenon of interest.
In summary, our findings support the notion that many scholars employ QD and include a
variety of commonly observed characteristics in their study design and subsequent
publications. Based on our review, we found that QD as a scholarly approach allows
flexibility as research questions and study findings emerge. We encourage authors to provide
as many details as possible regarding how QD was chosen for a particular study as well as
details regarding methods to facilitate readers’ understanding and evaluation of the study
design and rigor. We acknowledge the challenge of strict word limitation with submissions
to print journals; potential solutions include collaboration with journal editors and staff to
consider creative use of charts or tables, or using more citations and less text in background
sections so that methods sections are robust.
Limitations
Several limitations of this review deserve mention. First, only articles where researchers
explicitly stated in the main body of the article that a QD design was employed were
included. In contrast, articles labeled as QD in only the title or abstract, or without their
research design named were not examined due to the lack of certainty that the researchers
actually carried out a QD study. As a result, we may have excluded some studies where a
QD design was followed. Second, only one database was searched and therefore we did not
identify or describe potential studies following a QD approach that were published in non-
PubMed databases. Third, our review is limited by reliance on what was included in the
published version of a study. In some cases, this may have been a result of word limits or
specific styles imposed by journals, or inconsistent reporting preferences of authors and may
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have limited our ability to appraise the general adequacy with the CASP tool and examine
specific characteristics of these studies.
Conclusions
A systematic review was conducted by examining QD research articles focused on nursing-
related phenomena and published in one calendar year. Current patterns include some
characteristics of QD studies consistent with the previous observations described in the
literature, a focus on the flexibility or variability of methods in QD studies, and a need for
increased explanations of why QD was an appropriate label for a particular study. Based on
these findings, recommendations include encouragement to authors to provide as many
details as possible regarding the methods of their QD study. In this way, readers can
thoroughly consider and examine if the methods used were effective and reasonable in
producing credible and useful findings.
Acknowledgments
This work was supported in part by the John A. Hartford Foundation’s National Hartford Centers of Gerontological Nursing Excellence Award Program.
Hyejin Kim is a Ruth L. Kirschstein NRSA Predoctoral Fellow (F31NR015702) and 2013–2015 National Hartford Centers of Gerontological Nursing Excellence Patricia G. Archbold Scholar. Justine Sefcik is a Ruth L. Kirschstein Predoctoral Fellow (F31NR015693) through the National Institutes of Health, National Institute of Nursing Research.
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Figure 1. Flow Diagram of Study Selection
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Table 2
Elements for Data Extraction
Elements Data Extraction
Research objectives • Verbs used in objectives or aims
• Focuses of study
Design justification • If the article cited references for qualitative description
• If the article offered rationale to choose qualitative description
• References cited
• Rationale reported
Theoretical or philosophical frameworks
• If the article has theoretical or philosophical frameworks for study
• Theoretical or philosophical frameworks reported
• How the frameworks were used in data collection and analysis
Sampling and sample sizes • Sampling strategies (e.g., purposeful sampling, maximum variation)
• Sample size
Data collection and sources • Data collection techniques (e.g., individual or focus-group interviews, interview guide, surveys, field notes)
Data analysis • Data analysis techniques (e.g., qualitative content analysis, thematic analysis, constant comparison)
• If data saturation was achieved
Presentation of findings • Statement of findings
• Consistency with research objectives
Res Nurs Health. Author manuscript; available in PMC 2018 February 01.
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Ta b
le 3
D at
a E
xt ra
ct io
n an
d A
na ly
si s
R es
ul ts
A ut
ho rs
C ou
nt ry
R es
ea rc
h O
bj ec
ti ve
s D
es ig
n ju
st if
ic at
io n
T he
or et
ic al
/ ph
ilo so
ph ic
al fr
am ew
or ks
Sa m
pl in
g/ sa
m pl
e si
ze D
at a
co lle
ct io
n an
d da
ta s
ou rc
es D
at a
an al
ys is
F in
di ng
s
A da
m s
et a
l. (2
01 4)
• U
SA •
E xp
lo re
• R
es po
ns es
to co
m m
un ic
at io
n st
ra te
gi es
• (-
) R
ef er
en ce
• (-
) R
at io
na le
N ot
r ep
or te
d (N
R )
• Pu
rp os
iv e
sa m
pl in
g/ m
ax im
um va
ri at
io n
• 32
f am
ily m
em be
rs
• In
te rv
ie w
s •
O bs
er va
tio ns
• R
ev ie
w o
f da
ily f
lo w
s he
et •
D em
og ra
ph ic
s
• In
du ct
iv e
an d
de du
ct iv
e qu
al ita
tiv e
co nt
en t
an al
ys is
• (-
) D
at a
sa tu
ra tio
n
Fi ve
th em
es a
bo ut
fa m
ily m
em be
rs ’
pe rc
ep tio
ns o
f nu
rs in
g co
m m
un ic
at io
n ap
pr oa
ch es
A hl
in , E
ri cs
on -L
id m
an , N
or be
rg , a
nd S
tr an
db er
g (2
01 4)
• Sw
ed en
• D
es cr
ib e
• E
xp er
ie nc
es o
f us
in g
gu id
el in
es in
d ai
ly p
ra ct
ic e
• (-
) R
ef er
en ce
• (+
) R
at io
na le
• Pa
rt o
f a
re se
ar ch
pr og
ra m
N R
• U
ns pe
ci fi
ed •
8 ca
re pr
ov id
er s
• Se
m is
tr uc
tu re
d, in
di vi
du al
in te
rv ie
w s
• In
te rv
ie w
g ui
de
• Q
ua lit
at iv
e co
nt en
t an
al ys
is •
(- )
D at
a sa
tu ra
tio n
O ne
th em
e an
d se
ve n
su bt
he m
es ab
ou t c
ar e
pr ov
id er
s’ ex
pe ri
en ce
s of
us in
g gu
id el
in es
in da
ily p
ra ct
ic e
A l-
Z ad
ja li,
K el
le r,
L ar
ke y,
a nd
E va
ns (
20 14
) •
U SA
• E
xa m
in e
• C
ul tu
ra lly
sp ec
if ic
v ie
w s
of pr
oc es
se s
an d
ca us
es o
f m
id lif
e w
ei gh
t g ai
n
• (-
) R
ef er
en ce
• (-
) R
at io
na le
H ea
lth b
el ie
f m
od el
a nd
K le
im an
’s ex
pl an
at or
y m
od el
• U
ns pe
ci fi
ed •
19 a
du lts
• Se
m is
tr uc
tu re
d, in
di vi
du al
in te
rv ie
w
• C
on ve
nt io
na l
co nt
en t a
na ly
si s
• (-
) D
at a
sa tu
ra tio
n
T hr
ee m
ai n
ca te
go ri
es (
fr om
th e
m od
el )
an d
ei gh
t su
bt he
m es
a bo
ut ca
us es
o f
w ei
gh t
ga in
in m
id lif
e
A se
m an
i e t a
l. (2
01 4)
• Ir
an •
E xp
lo re
• Fa
ct or
s in
iti at
in g
re sp
on si
bi lit
y am
on g
m ed
ic al
tr ai
ne es
• (-
) R
ef er
en ce
• (+
) R
at io
na le
N R
• C
on ve
ni en
ce ,
sn ow
ba ll,
a nd
m ax
im um
va ri
at io
n sa
m pl
in g
• 15
tr ai
ne es
an d
ot he
r pr
of es
si on
al s
• Se
m is
tr uc
tu re
d, in
di vi
du al
in te
rv ie
w •
In te
rv ie
w g
ui de
• C
on ve
nt io
na l
co nt
en t a
na ly
si s
• C
on st
an t
co m
pa ri
so n
• (+
) D
at a
sa tu
ra tio
n
Tw o
th em
es a
nd in
di vi
du al
a nd
n on
- in
di vi
du al
-b as
ed fa
ct or
s pe
r th
em e
A te
fi , A
bd ul
la h,
W on
g, a
nd M
az lo
m (
20 14
) •
Ir an
• E
xp lo
re •
Fa ct
or s
re la
te d
to jo
b sa
tis fa
ct io
n an
d di
ss at
is fa
ct io
n
• (-
) R
ef er
en ce
• (-
) R
at io
na le
N R
• C
on ve
ni en
ce sa
m pl
in g
• 85
n ur
se s
• Se
m is
tr uc
tu re
d fo
cu s
gr ou
p in
te rv
ie w
s •
In te
rv ie
w g
ui de
• T
he m
at ic
a na
ly si
s •
(+ )
D at
a sa
tu ra
tio n
T hr
ee m
ai n
th em
es an
d as
so ci
at ed
fa ct
or s
re ga
rd in
g jo
b sa
tis fa
ct io
n an
d di
ss at
is fa
ct io
n
B al
la ng
ru d,
H al
l- L
or d,
P er
se ni
us , a
nd H
ed el
in (
20 14
) •
N or
w ay
• D
es cr
ib e
• Pe
rc ep
tio ns
o n
si m
ul at
io n-
ba se
d te
am tr
ai ni
ng
• (-
) R
ef er
en ce
• (-
) R
at io
na le
N R
• St
ra te
gi c
sa m
pl in
g •
18 r
eg is
te re
d nu
rs es
• Se
m is
tr uc
tu re
d in
di vi
du al
in te
rv ie
w s
• In
du ct
iv e
co nt
en t
an al
ys is
• (-
) D
at a
sa tu
ra tio
n
O ne
m ai
n ca
te go
ry ,
th re
e ca
te go
ri es
, an
d si
x su
b- ca
te go
ri es
re ga
rd in
g nu
rs es
’ pe
rc ep
tio ns
o n
si m
ul at
io n-
ba se
d te
am tr
ai ni
ng
B en
av id
es -V
ae llo
e t a
l. (2
01 4)
• U
SA •
D et
er m
in e
• B
ar ri
er s
an d
su pp
or ts
f or
at te
nd in
g co
lle ge
an d
nu rs
in g
sc ho
ol
• (-
) R
ef er
en ce
• (-
) R
at io
na le
N R
• U
ns pe
ci fi
ed •
45 s
tu de
nt s
• Fo
cu s-
gr ou
p in
te rv
ie w
s •
U si
ng Ph
ot ov
oi ce
a nd
SH O
W eD
• C
on st
an t
co m
pa ri
so n
• (-
) D
at a
sa tu
ra tio
n
Fi ve
th em
es a
bo ut
fa ci
lit at
or s
an d
ba rr
ie rs
B er
nh ar
d, Z
ie lin
sk i,
A ck
er so
n, a
nd E
ng lis
h (2
01 4)
• U
SA •
E xp
lo re
• R
ea so
ns f
or ch
oo si
ng h
om e
bi rt
h an
d bi
rt h
ex pe
ri en
ce s
• (-
) R
ef er
en ce
• (-
) R
at io
na le
N R
• Pu
rp os
ef ul
sa m
pl in
g •
20 w
om en
• Se
m is
tr uc
tu re
d fo
cu s-
gr ou
p in
te rv
ie w
s •
In te
rv ie
w g
ui de
• Fi
el d
no te
s
• Q
ua lit
at iv
e co
nt en
t an
al ys
is •
(+ )
D at
a sa
tu ra
tio n
Fi ve
c om
m on
th em
es an
d co
nc ep
ts a
bo ut
re as
on s
fo r
ch oo
si ng
ho m
e bi
rt h
ba se
d on
th ei
r bi
rt h
ex pe
ri en
ce s
B ra
df or
d an
d M
au de
( 20
14 )
• N
ew Z
ea la
nd •
E xp
lo re
• N
or m
al f
et al
ac tiv
ity r
el at
ed to
hu ng
er a
nd sa
tia tio
n
• (+
) R
ef er
en ce
• (+
) R
at io
na le
• Sa
nd el
ow sk
i ( 20
00 )
• D
en zi
n &
L in
co ln
( 20
11 )
N R
• Pu
rp os
iv e
sa m
pl in
g •
19 p
re gn
an t
w om
en
• Se
m is
tr uc
tu re
d in
di vi
du al
in te
rv ie
w s
• O
pe n-
en de
d qu
es tio
ns
• In
du ct
iv e
qu al
ita tiv
e co
nt en
t an
al ys
is •
D es
cr ip
tiv e
st at
is tic
al a
na ly
si s
• (+
) D
at a
sa tu
ra tio
n
Fo ur
p at
te rn
s re
ga rd
in g
fe ta
l ac
tiv iti
es in
re la
tio n
to m
ea l
an tic
ip at
io n,
m at
er na
l h un
ge r,
m at
er na
l m ea
l co
ns um
m at
io n,
an d
m at
er na
l sa
tie ty
C an
za n,
H ei
le m
an n,
S ai
an i,
M or
ta ri
, a nd
A m
br os
i ( 20
14 )
• It
al y
• E
xp lo
re ,
de sc
ri be
, a nd
co m
pa re
• (+
) R
ef er
en ce
• (-
) R
at io
na le
• Sa
nd el
ow sk
i ( 20
00 )
N R
• Pu
rp os
iv e
sa m
pl in
g •
20 n
ur se
s an
d
• Se
m is
tr uc
tu re
d in
di vi
du al
in te
rv ie
w s
• U
ns pe
ci fi
ed va
ri ou
s an
al yt
ic st
ra te
gi es
in cl
ud in
g
N ur
si ng
c ar
in g
fr om
b ot
h pa
tie nt
s’ an
d nu
rs es
’
Res Nurs Health. Author manuscript; available in PMC 2018 February 01.
A uthor M
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A uthor M
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Kim et al. Page 20
A ut
ho rs
C ou
nt ry
R es
ea rc
h O
bj ec
ti ve
s D
es ig
n ju
st if
ic at
io n
T he
or et
ic al
/ ph
ilo so
ph ic
al fr
am ew
or ks
Sa m
pl in
g/ sa
m pl
e si
ze D
at a
co lle
ct io
n an
d da
ta s
ou rc
es D
at a
an al
ys is
F in
di ng
s
• pe
rc ep
tio ns
o f
nu rs
in g
ca ri
ng 20
p at
ie nt
s •
In te
rv ie
w g
ui de
• Fi
el d
no te
s du
ri ng
in te
rv ie
w s
co ns
ta nt
c om
pa ri
so n
• (-
) D
at a
sa tu
ra tio
n pe
rs pe
ct iv
es –
a su
m m
ar y
of d
at a
in vi
si bl
e ca
ri ng
a nd
in vi
si bl
e ca
ri ng
C ha
n an
d L
op ez
( 20
14 )
• H
on g
K on
g •
A dd
re ss
• H
ow to
r ed
uc e
co ro
na ry
h ea
rt di
se as
e ri
sk s
• (+
) R
ef er
en ce
• (+
) R
at io
na le
• Se
co nd
ar y
an al
ys is
• Sa
nd el
ow sk
i ( 20
00 )
• N
ee rg
aa rd
e t a
l ( 20
09 )
N R
• C
on ve
ni en
ce an
d sn
ow ba
ll sa
m pl
in g
• 10
5 pa
tie nt
s
• Fo
cu s-
gr ou
p in
te rv
ie w
s •
In te
rv ie
w g
ui de
• C
on te
nt a
na ly
si s
• (+
) D
at a
sa tu
ra tio
n Fo
ur c
at eg
or ie
s ab
ou t
pa tie
nt s’
a bi
lit ie
s to
re du
ce c
or on
ar y
he ar
t di
se as
e
C he
n, T
sa i,
L ee
, a nd
L ee
( 20
14 )
• Ta
iw an
• E
xp lo
re •
R ea
so ns
f or
yo un
g– ol
d pe
op le
no t k
ill in
g th
em se
lv es
• (-
) R
ef er
en ce
• (-
) R
at io
na le
N R
• C
on ve
ni en
ce sa
m pl
in g
• 31
o ld
er ad
ul ts
• Se
m is
tr uc
tu re
d in
di vi
du al
in te
rv ie
w s
• In
te rv
ie w
g ui
de •
O bs
er va
tio n
w ith
m em
os /r
ef le
ct iv
e jo
ur na
l
• C
on te
nt a
na ly
si s
• (+
) D
at a
sa tu
ra tio
n Si
x th
em es
r eg
ar di
ng re
as on
s fo
r no
t co
m m
itt in
g to
s ui
ci de
C le
ve la
nd a
nd B
on ug
li (2
01 4)
• U
SA •
E xp
lo re
• N
eo na
ta l
in te
ns iv
e ca
re u
ni t
ex pe
ri en
ce s
• (+
) R
ef er
en ce
• (+
) R
at io
na le
• Sa
nd el
ow sk
i ( 20
00 )
N R
• Pu
rp os
iv e
sa m
pl in
g an
d co
nv en
ie nc
e sa
m pl
e •
15 m
ot he
rs
• Se
m is
tr uc
tu re
d in
di vi
du al
in te
rv ie
w s
• In
te rv
ie w
g ui
de
• Q
ua lit
at iv
e co
nt en
t an
al ys
is •
(+ )
D at
a sa
tu ra
tio n
Fo ur
th em
es a
bo ut
pa rt
ic ip
an ts
’ ex
pe ri
en ce
s of
ne on
at al
in te
ns iv
e ca
re u
ni t
D eB
ru yn
, O ch
oa -M
ar in
, a nd
S em
en ic
( 20
14 )
• C
ol om
bi a
• In
ve st
ig at
e •
B ar
ri er
s/ fa
ci lit
at or
s to
im pl
em en
tin g
ev id
en ce
-b as
ed nu
rs in
g
• (+
) R
ef er
en ce
• (-
) R
at io
na le
• Sa
nd el
ow sk
i ( 20
00 )
O tta
w a
m od
el fo
r re
se ar
ch us
e: kn
ow le
dg e
tr an
sl at
io n
fr am
ew or
k
• C
on ve
ni en
ce sa
m pl
in g
• 13
n ur
si ng
pr of
es si
on al
s
• Se
m is
tr uc
tu re
d in
di vi
du al
in te
rv ie
w s
• In
te rv
ie w
g ui
de
• In
du ct
iv e
qu al
ita tiv
e co
nt en
t an
al ys
is •
C on
st an
t co
m pa
ri so
n •
(- )
D at
a sa
tu ra
tio n
Fo ur
m ai
n ba
rr ie
rs an
d po
te nt
ia l
fa ci
lit at
or s
to ev
id en
ce -b
as ed
nu rs
in g
E w
en s,
C ha
pm an
, T ul
lo ch
, a nd
H en
dr ic
ks (
20 14
) •
A us
tr al
ia •
E xp
lo re
• Pe
rc ep
tio ns
a nd
ut ili
za tio
n of
di ar
ie s
• (+
) R
ef er
en ce
• (-
) R
at io
na le
• Sa
nd el
ow sk
i ( 20
00 )
N R
• U
ns pe
ci fi
ed •
19 p
at ie
nt s
an d
fa m
ili es
• R
es po
ns es
to op
en -e
nd ed
qu es
tio ns
o n
su rv
ey
• U
ns pe
ci fi
ed an
al ys
is s
tr at
eg y
• (-
) D
at a
sa tu
ra tio
n
Fi ve
th em
es re
ga rd
in g
pe rc
ep tio
ns on
u se
o f
di ar
ie s
an d
de sc
ri pt
iv e
st at
is tic
s us
in g
fr eq
ue nc
ie s
of ut
ili za
tio n
Fa nt
as ia
, S ut
he rl
an d,
F on
te no
t, an
d Ie
ra rd
i ( 20
14 )
• U
SA •
E xp
lo re
• K
no w
le dg
e, at
tit ud
es , a
nd be
lie fs
a bo
ut se
xu al
c on
se nt
• (-
) R
ef er
en ce
• (-
) R
at io
na le
• Pa
rt o
f a
la rg
er m
ix ed
-m et
ho d
st ud
y
T he
or y
of pl
an ne
d be
ha vi
or
• Pu
rp os
iv e
sa m
pl in
g •
sn ow
ba ll
sa m
pl in
g •
26 w
om en
• Se
m is
tr uc
tu re
d fo
cu s-
gr ou
p in
te rv
ie w
s •
In te
rv ie
w g
ui de
• C
on te
nt a
na ly
si s
• (+
) D
at a
sa tu
ra tio
n T
hr ee
m ai
n ca
te go
ri es
a nd
su bt
he m
es r
eg ar
di ng
se xu
al c
on se
nt
Fr im
an , W
ah lb
er g,
M at
tia ss
on , a
nd E
bb es
ko g
(2 01
4) •
Sw ed
en •
D es
cr ib
e •
E xp
er ie
nc es
o f
kn ow
le dg
e de
ve lo
pm en
t i n
w ou
nd m
an ag
em en
t
• (+
) R
ef er
en ce
• (+
) R
at io
na le
: w
ea k
• K
ri pp
en do
rf (
20 04
)
N R
• Pu
rp os
iv e
sa m
pl in
g •
16 d
is tr
ic t
nu rs
es
• In
di vi
du al
in te
rv ie
w s
• In
te rv
ie w
g ui
de
• Q
ua lit
at iv
e co
nt en
t an
al ys
is •
(- )
D at
a sa
tu ra
tio n
T hr
ee c
at eg
or ie
s an
d el
ev en
s ub
-c at
eg or
ie s
ab ou
t k no
w le
dg e
de ve
lo pm
en t
ex pe
ri en
ce s
in w
ou nd
m an
ag em
en t
G au
gh an
, L og
an , S
et hn
a, a
nd M
ot t (
20 14
) •
U SA
• D
es cr
ib e
• Pa
re nt
al -p
ai n
jo ur
ne y,
b el
ie fs
ab ou
t p ai
n, a
nd at
tit ud
es /b
eh av
io rs
re la
te d
to ch
ild re
n’ s
re sp
on se
s
• (+
) R
ef er
en ce
• (+
) R
at io
na le
• Sa
nd el
ow sk
i ( 20
00 )
• M
iln e
& O
be rl
e (2
00 5)
• Pa
rt o
f a
la rg
er m
ix ed
m et
ho ds
st ud
y
N R
• Pu
rp os
iv e
sa m
pl in
g •
9 pa
re nt
s
• In
di vi
du al
in te
rv ie
w s
• O
ne o
pe n-
en de
d qu
es tio
n
• Q
ua lit
at iv
e co
nt en
t an
al ys
is •
(+ )
D at
a sa
tu ra
tio n
Tw o
m ai
n th
em es
, ca
te go
ri es
, a nd
su bc
at eg
or ie
s ab
ou t
pa re
nt s’
e xp
er ie
nc es
of o
bs er
vi ng
ch ild
re n’
s pa
in
H ar
t a nd
M ar
en o
(2 01
4) •
U SA
• D
es cr
ib e
• C
ha lle
ng es
a nd
ba rr
ie rs
in pr
ov id
in g
cu ltu
ra lly
co m
pe te
nt c
ar e
• (+
) R
ef er
en ce
• (+
) R
at io
na le
• Sa
nd el
ow sk
i ( 20
00 )
• Se
co nd
ar y
an al
ys is
N R
• St
ra tif
ie d
sa m
pl in
g •
25 3
nu rs
es
• W
ri tte
n re
sp on
se s
to 2
op en
-e nd
ed qu
es tio
ns o
n su
rv ey
• T
he m
at ic
a na
ly si
s •
(- )
D at
a sa
tu ra
tio n
T hr
ee th
em es
re ga
rd in
g ch
al le
ng es
/b ar
ri er
s
H as
m an
, K ja
er ga
ar d,
a nd
E sb
en se
n (2
01 4)
• D
en m
ar k
• D
es cr
ib e
• E
xp er
ie nc
es o
f ch
ild bi
rt h
• (-
) R
ef er
en ce
• (-
) R
at io
na le
• A
s ub
st ud
y
N R
• Pu
rp os
iv e
sa m
pl in
g w
ith m
ax im
um va
ri at
io n
• Pa
rt ne
rs o
f 10
w om
en
• Se
m is
tr uc
tu re
d, in
di vi
du al
in te
rv ie
w s
• In
te rv
ie w
g ui
de
• T
he m
at ic
a na
ly si
s •
(+ )
D at
a sa
tu ra
tio n
T hr
ee th
em es
a nd
fo ur
s ub
th em
es a
bo ut
pa rt
ne rs
’ ex
pe ri
en ce
s of
w om
en ’s
ch ild
bi rt
h
H ig
gi ns
, v an
d er
R ie
t, Sn
ee sb
y, a
nd G
oo d
(2 01
4) •
A us
tr al
ia •
E xp
lo re
• Pe
rc ep
tio ns
ab ou
t m ed
ic al
nu tr
iti on
a nd
hy dr
at io
n at
th e
• (+
) R
ef er
en ce
• (+
) R
at io
na le
• B
or ba
si e
t a l (
20 08
)
N R
• Pu
rp os
ef ul
sa m
pl in
g •
10 n
ur se
s
• Fo
cu s-
gr ou
p in
te rv
ie w
s •
“a na
ly ze
d th
em at
ic al
ly ”
• (-
) D
at a
sa tu
ra tio
n
O ne
m ai
n th
em e
an d
fo ur
s ub
th em
es re
ga rd
in g
nu rs
es ’
pe rc
ep tio
ns o
n E
O L
- re
la te
d m
ed ic
al
Res Nurs Health. Author manuscript; available in PMC 2018 February 01.
A uthor M
anuscript A
uthor M anuscript
A uthor M
anuscript A
uthor M anuscript
Kim et al. Page 21
A ut
ho rs
C ou
nt ry
R es
ea rc
h O
bj ec
ti ve
s D
es ig
n ju
st if
ic at
io n
T he
or et
ic al
/ ph
ilo so
ph ic
al fr
am ew
or ks
Sa m
pl in
g/ sa
m pl
e si
ze D
at a
co lle
ct io
n an
d da
ta s
ou rc
es D
at a
an al
ys is
F in
di ng
s
en d
of li
fe nu
tr iti
on a
nd hy
dr at
io n
H ol
la nd
, C hr
is te
ns en
, S ho
ne , K
ea rn
ey , a
nd K
itz m
an (
20 14
) •
U SA
• D
es cr
ib e
• R
ea so
ns f
or le
av in
g a
ho m
e vi
si tin
g pr
og ra
m ea
rl y
• (-
) R
ef er
en ce
• (-
) R
at io
na le
N R
• C
on ve
ni en
ce sa
m pl
e •
32 m
ot he
rs ,
nu rs
es , a
nd nu
rs e
su pe
rv is
or s
• Se
m is
tr uc
tu re
d, in
di vi
du al
in te
rv ie
w s
• Fo
cu s-
gr ou
p in
te rv
ie w
s •
In te
rv ie
w g
ui de
• In
du ct
iv e
co nt
en t
an al
ys is
• C
on st
an t
co m
pa ri
so n
ap pr
oa ch
• (+
) D
at a
sa tu
ra tio
n
T hr
ee s
et s
of r
ea so
ns fo
r le
av in
g a
ho m
e vi
si tin
g pr
og ra
m
Jo ha
ns so
n, H
ild in
gs so
n, a
nd F
en w
ic k
(2 01
4) •
Sw ed
en •
E xp
lo re
a nd
de sc
ri be
• B
el ie
fs a
nd at
tit ud
es a
ro un
d th
e de
ci si
on f
or a
ca es
ar ea
n se
ct io
n
• (+
) R
ef er
en ce
• (+
) R
at io
na le
• Po
lli t &
B ec
k (2
01 2)
• B
ur ns
& G
ro ve
( 20
05 )
N R
• U
ns pe
ci fi
ed •
21 m
al es
• In
di vi
du al
te le
ph on
e in
te rv
ie w
s
• T
he m
at ic
a na
ly si
s •
C on
st an
t co
m pa
ri so
n ap
pr oa
ch •
(- )
D at
a sa
tu ra
tio n
Tw o
th em
es a
nd su
bt he
m es
in r
el at
io n
to th
e re
se ar
ch ob
je ct
iv e
K ao
a nd
T sa
i ( 20
14 )
• Ta
iw an
• E
xp lo
re •
Il ln
es s
ex pe
ri en
ce s
of ea
rl y
on se
t o f
kn ee
o st
eo ar
th ri
tis
• (+
) R
ef er
en ce
• (+
) R
at io
na le
• Po
pe &
M ay
s (1
99 5)
• Po
lit &
B ec
k (2
00 4)
• Pa
rt o
f a
la rg
e re
se ar
ch s
er ie
s
N R
• Pu
rp os
iv e
sa m
pl in
g •
17 a
du lts
• Se
m is
tr uc
tu re
d, In
di vi
du al
in te
rv ie
w s
• In
te rv
ie w
g ui
de •
M em
o/ fi
el d
no te
s (o
bs er
va tio
ns )
• In
du ct
iv e
co nt
en t
an al
ys is
• (+
) D
at a
sa tu
ra tio
n
T hr
ee m
aj or
th em
es an
d ni
ne s
ub th
em es
re ga
rd in
g ex
pe ri
en ce
s of
e ar
ly on
se t-
kn ee
os te
oa rt
hr iti
s
K er
r, M
cK ay
, K lim
, K el
ly , a
nd M
cC an
n (2
01 4)
• A
us tr
al ia
• E
xp lo
re •
Pe rc
ep tio
ns ab
ou t b
ed si
de ha
nd ov
er (
ne w
m od
el )
by n
ur se
s
• (+
) R
ef er
en ce
• (+
) R
at io
na le
• Sa
nd el
ow sk
( 20
00 )
• N
ee rg
aa rd
e t a
l. (2
00 9)
N R
• Pu
rp os
iv e
sa m
pl in
g •
30 p
at ie
nt s
• Se
m is
tr uc
tu re
d, in
di vi
du al
in te
rv ie
w s
• In
te rv
ie w
g ui
de
• T
he m
at ic
c on
te nt
an al
ys is
• (-
) D
at a
an al
ys is
Tw o
do m
in an
t th
em es
a nd
r el
at ed
su bt
he m
es r
eg ar
di ng
pa tie
nt s’
th ou
gh ts
ab ou
t n ur
se s’
b ed
si de
ha nd
ov er
K ne
ck , F
ag er
be rg
, E ri
ks so
n, a
nd L
un dm
an (
20 14
) •
Sw ed
en •
Id en
tif y
• Pa
tte rn
s in
le ar
ni ng
w he
n liv
in g
w ith
di ab
et es
• (-
) R
ef er
en ce
• (-
) R
at io
na le
N R
• Pu
rp os
iv e
sa m
pl in
g w
ith va
ri at
io ns
in ag
e an
d se
x •
13 pa
rt ic
ip an
ts
• Se
m is
tr uc
tu re
d, in
di vi
du al
in te
rv ie
w s
(3 tim
es o
ve r
3 ye
ar s)
• Sa
ld an
a’ s
(2 00
3) an
al ys
is p
ro ce
ss •
In du
ct iv
e qu
al ita
tiv e
co nt
en t
an al
ys is
• (-
) D
at a
sa tu
ra tio
n
Fi ve
m ai
n pa
tte rn
s of
le ar
ni ng
w he
n liv
in g
w ith
d ia
be te
s fo
r th
re e
ye ar
s fo
llo w
in g
di ag
no si
s
L ar
oc qu
e et
a l.
(2 01
4) •
C an
ad a
• E
va lu
at e
• B
oo k
ch at
in te
rv en
tio n
ba se
d on
a n
ov el
S til
l A
lic e
• (-
) R
ef er
en ce
• (-
) R
at io
na le
• Pa
rt o
f a
la rg
er re
se ar
ch p
ro je
ct
N R
• U
ns pe
ci fi
ed •
11 lo
ng -t
er m
- ca
re s
ta ff
• Q
ue st
io nn
ai re
w ith
tw o
op en
- en
de d
qu es
tio ns
• T
he m
at ic
c on
te nt
an al
ys is
• (-
) D
at a
sa tu
ra tio
n
Fi ve
th em
es (
po si
tiv e
co m
m en
ts )
ab ou
t t he
bo ok
c ha
t w ith
b ri
ef de
sc ri
pt io
n
L i,
L ee
, C he
n, J
en g,
a nd
C he
n (2
01 4)
• Ta
iw an
• E
xp lo
re •
Fa ci
lit at
or s
an d
ba rr
ie rs
to im
pl em
en tin
g sm
ok in
g- ce
ss at
io n
co un
se lin
g se
rv ic
es
• (-
) R
ef er
en ce
• (-
) R
at io
na le
N R
• U
ns pe
ci fi
ed •
16 n
ur se
- co
un se
lo rs
• Se
m is
tr uc
tu re
d in
di vi
du al
in te
rv ie
w s
• In
te rv
ie w
g ui
de
• In
du ct
iv e
co nt
en t
an al
ys is
• C
on st
an t
co m
pa ri
so n
• (-
) D
at a
sa tu
ra tio
n
Tw o
th em
es a
nd ei
gh t s
ub th
em es
ab ou
t f ac
ili ta
to rs
a nd
ba rr
ie rs
d es
cr ib
ed us
in g
2- 4
qu ot
at io
ns pe
r su
bt he
m e
L ux
, H ut
ch es
on , a
nd P
ed en
( 20
14 )
• U
SA •
Id en
tif y
• E
du ca
tio na
l st
ra te
gi es
to m
an ag
e di
sr up
tiv e
be ha
vi or
• (-
) R
ef er
en ce
• (-
) R
at io
na le
• Pa
rt o
f a
la rg
er st
ud y
N R
• U
ns pe
ci fi
ed •
9 nu
rs es
• Se
m is
tr uc
tu re
d, in
di vi
du al
in te
rv ie
w s
• In
te rv
ie w
g ui
de
• C
on te
nt a
na ly
si s
pr oc
ed ur
es •
(- )
D at
a sa
tu ra
tio n
Tw o
m ai
n th
em es
re ga
rd in
g ed
uc at
io n
st ra
te gi
es f
or n
ur se
ed uc
at or
s
Ly nd
on e
t a l.
(2 01
4) •
U SA
• E
xp lo
re •
E xp
er ie
nc es
o f
di ff
ic ul
ty re
so lv
in g
pa tie
nt -
re la
te d
co nc
er ns
• (-
) R
ef er
en ce
• (-
) R
at io
na le
• Se
co nd
ar y
an al
ys is
N R
• U
ns pe
ci fi
ed •
19 32
ph ys
ic ia
n, nu
rs in
g, a
nd m
id w
if er
y pr
of es
si on
al s
• E
-m ai
l s ur
ve y
w ith
m ul
tip le
- ch
oi ce
a nd
f re
e- te
xt r
es po
ns es
• In
du ct
iv e
th em
at ic
an al
ys is
• D
es cr
ip tiv
e st
at is
tic s
• (-
) D
at a
sa tu
ra tio
n
O ne
o ve
ra rc
hi ng
th em
e an
d fo
ur su
bt he
m es
a bo
ut pr
of es
si on
al s’
ex pe
ri en
ce s
of di
ff ic
ul ty
r es
ol vi
ng pa
tie nt
-r el
at ed
co nc
er ns
L . M
a (2
01 4)
• Si
ng ap
or e
• E
xp lic
at e
• E
xp er
ie nc
e of
qu al
ity o
f lif
e fo
r ol
de r
ad ul
ts
• (+
) R
ef er
en ce
• (+
) R
at io
na le
• Pa
rs e
(2 00
1)
Pa rs
e’ s
hu m
an be
co m
in g
pa ra
di gm
• U
ns pe
ci fi
ed •
10 e
ld er
ly re
si de
nt s
• In
di vi
du al
in te
rv ie
w s
• In
te rv
ie w
qu es
tio ns
pr es
en te
d (P
ar se
)
• U
ns pe
ci fi
ed an
al ys
is te
ch ni
qu es
• (-
) D
at a
sa tu
ra tio
n
T hr
ee th
em es
pr es
en te
d us
in g
bo th
pa rt
ic ip
an ts
’ la
ng ua
ge a
nd th
e re
se ar
ch er
’s la
ng ua
ge
F. M
a, L
i, L
ia ng
, B ai
, a nd
S on
g (2
01 4)
• C
hi na
• E
xp lo
re •
Pe rs
pe ct
iv es
o n
le ar
ni ng
a bo
ut ca
ri ng
• (-
) R
ef er
en ce
• (-
) R
at io
na le
N R
• Pu
rp os
ef ul
sa m
pl in
g •
20 n
ur si
ng st
ud en
ts
• Fo
cu s-
gr ou
p in
te rv
ie w
s •
In te
rv ie
w g
ui de
• C
on ve
nt io
na l
co nt
en t a
na ly
si s
• (-
) D
at a
sa tu
ra tio
n
Fo ur
c at
eg or
ie s
an d
as so
ci at
ed su
bc at
eg or
ie s
ab ou
t fa
ci lit
at or
s an
d ch
al le
ng es
to le
ar ni
ng ab
ou t c
ar in
g
Res Nurs Health. Author manuscript; available in PMC 2018 February 01.
A uthor M
anuscript A
uthor M anuscript
A uthor M
anuscript A
uthor M anuscript
Kim et al. Page 22
A ut
ho rs
C ou
nt ry
R es
ea rc
h O
bj ec
ti ve
s D
es ig
n ju
st if
ic at
io n
T he
or et
ic al
/ ph
ilo so
ph ic
al fr
am ew
or ks
Sa m
pl in
g/ sa
m pl
e si
ze D
at a
co lle
ct io
n an
d da
ta s
ou rc
es D
at a
an al
ys is
F in
di ng
s
M ar
ci no
w ic
z, A
br am
ow ic
z, Z
ar zy
ck a,
A br
am ow
ic z,
a nd
K on
st an
ty no
w ic
z (2
01 4)
• Po
la nd
• D
es cr
ib e
an d
as se
ss •
C om
po ne
nt s
of th
e pa
tie nt
–n ur
se re
la tio
ns hi
p an
d pe
di at
ri c-
w ar
d am
en iti
es
• (+
) R
ef er
en ce
• (-
) R
at io
na le
• Sa
nd el
ow sk
i ( 20
00 )
N R
• Pu
rp os
ef ul
, m
ax im
um va
ri at
io n
sa m
pl in
g •
26 p
ar en
ts o
r ca
re gi
ve rs
a nd
22 c
hi ld
re n
• In
di vi
du al
in te
rv ie
w s
• Q
ua lit
at iv
e co
nt en
t an
al ys
is •
(- )
D at
a sa
tu ra
tio n
Fi ve
m ai
n to
pi cs
de sc
ri be
d fr
om th
e pe
rs pe
ct iv
es o
f ch
ild re
n an
d pa
re nt
s
M ar
to re
lla , B
oi to
r, M
ic ha
ud , a
nd G
el in
as (
20 14
) •
C an
ad a
• E
va lu
at e
• A
cc ep
ta bi
lit y
an d
fe as
ib ili
ty o
f ha
nd -m
as sa
ge th
er ap
y
• (-
) R
ef er
en ce
• (-
) R
at io
na le
• Se
co nd
ar y
to a
R C
T
Fo cu
se d
on fe
as ib
ili ty
a nd
ac ce
pt ab
ili ty
• U
ns pe
ci fi
ed •
40 p
at ie
nt s
• Se
m is
tr uc
tu re
d, in
di vi
du al
in te
rv ie
w s
• Fi
el d
no te
s •
V id
eo re
co rd
in g
• T
he m
at ic
a na
ly si
s fo
r ac
ce pt
ab ili
ty •
Q ua
nt ita
tiv e
ra tin
gs o
f vi
de o
ite m
s fo
r fe
as ib
ili ty
• (-
) D
at a
an al
ys is
Su m
m ar
y of
d at
a fo
cu si
ng o
n pr
ed et
er m
in ed
in di
ca to
rs o
f ac
ce pt
ab ili
ty a
nd de
sc ri
pt iv
e st
at is
tic s
to p
re se
nt f
ea si
bi lit
y
M cD
on ou
gh , C
al la
ns , a
nd C
ar ro
ll (2
01 4)
• U
SA •
U nd
er st
an d
• C
ha lle
ng es
oc cu
rr in
g du
ri ng
tr an
si tio
ns o
f ca
re
• (+
) R
ef er
en ce
• (+
) R
at io
na le
• Sa
nd el
ow sk
i ( 20
00 )
• Pa
rt o
f a
la rg
er s
tu dy
N R
• C
on ve
ni en
ce sa
m pl
e •
22 n
ur se
s
• Fo
cu s
gr ou
ps •
In te
rv ie
w g
ui de
• Q
ua lit
at iv
e co
nt en
t an
al ys
is m
et ho
ds •
(+ )
D at
a an
al ys
is
T hr
ee th
em es
a bo
ut ch
al le
ng es
r eg
ar di
ng tr
an si
tio ns
o f
ca re
:
M cG
ilt on
, B os
ca rt
, B ro
w n,
a nd
B ow
er s
(2 01
4) •
C an
ad a
• U
nd er
st an
d •
Fa ct
or s
th at
in fl
ue nc
e nu
rs es
’ re
te nt
io n
in th
ei r
cu rr
en t j
ob
• (-
) R
ef er
en ce
• (-
) R
at io
na le
N R
• Pu
rp os
ef ul
sa m
pl in
g •
41 n
ur se
s
• Fo
cu s-
gr ou
p in
te rv
ie w
s •
In te
rv ie
w g
ui de
• D
ir ec
te d
co nt
en t
an al
ys is
• (+
) D
at a
sa tu
ra tio
n
N ur
se s’
r ea
so ns
to st
ay a
nd le
av e
th ei
r cu
rr en
t j ob
M ic
ha el
, O 'C
al la
gh an
, B ai
rd , H
is co
ck , a
nd C
la yt
on (
20 14
) •
A us
tr al
ia •
E xt
en d
• U
nd er
st an
di ng
of c
ar eg
iv er
s’ vi
ew s
on a
dv an
ce ca
re p
la nn
in g
• (+
) R
ef er
en ce
• (+
) R
at io
na le
• Sa
nd el
ow sk
i ( 20
00 )
• G
ro un
de d
th eo
ry o
ve rt
on e
N R
• T
he or
et ic
al sa
m pl
in g
• 18
c ar
eg iv
er s
• Se
m is
tr uc
tu re
d fo
cu s
gr ou
p an
d in
di vi
du al
in te
rv ie
w s
• In
te rv
ie w
g ui
de •
V ig
ne tte
te ch
ni qu
e
• In
du ct
iv e,
c yc
lic ,
an d
co ns
ta nt
co m
pa ra
tiv e
an al
ys is
• (-
) D
at a
an al
ys is
T hr
ee th
em es
re ga
rd in
g ca
re gi
ve rs
’ pe
rc ep
tio ns
o n
ad va
nc e
ca re
pl an
ni ng
M ill
er (
20 14
) •
U SA
• D
es cr
ib e
• O
ut co
m es
o ld
er ad
ul ts
w ith
ep ile
ps y
ho pe
to ac
hi ev
e in
m an
ag em
en t
• (-
) R
ef er
en ce
• (-
) R
at io
na le
N R
• U
ns pe
ci fi
ed •
20 p
at ie
nt s
• In
di vi
du al
in te
rv ie
w •
C on
ve nt
io na
l co
nt en
t a na
ly si
s •
(- )
D at
a sa
tu ra
tio n
Si x
m ai
n th
em es
a nd
as so
ci at
ed s
ub th
em es
re ga
rd in
g w
ha t o
ld er
ad ul
ts h
op ed
to ac
hi ev
e in
m an
ag em
en t o
f th
ei r
ep ile
ps y
O os
te rv
el d-
V lu
g et
a l.
(2 01
4) •
T he
N et
he rl
an ds
• G
ai n
• E
xp er
ie nc
e of
pe rs
on al
d ig
ni ty
an d
fa ct
or s
in fl
ue nc
in g
it
• (+
) R
ef er
en ce
• (-
) R
at io
na le
• Sa
nd el
ow sk
i ( 20
00 )
M od
el o
f di
gn ity
in ill
ne ss
• M
ax im
um va
ri at
io n
sa m
pl in
g •
30 n
ur si
ng ho
m e
re si
de nt
s
• In
di vi
du al
in te
rv ie
w s
• In
te rv
ie w
g ui
de
• T
he m
at ic
a na
ly si
s •
C on
st an
t co
m pa
ri so
n •
(+ )
D at
a sa
tu ra
tio n
T he
th re
at en
in g
ef fe
ct o
f ill
ne ss
a nd
th re
e do
m ai
ns b
ei ng
th re
at en
ed b
y ill
ne ss
in r
el at
io n
to pa
rt ic
ip an
ts ’
ex pe
ri en
ce s
of pe
rs on
al d
ig ni
ty
O ru
ch e,
D ra
uc ke
r, A
lk ha
tta b,
K no
pf , a
nd M
az ur
cy k
(2 01
4) •
U SA
• Id
en tif
y an
d de
sc ri
be •
N ee
ds in
m en
ta l
he al
th s
er vi
ce s
an d
“i de
al ”
pr og
ra m
• (+
) R
ef er
en ce
• (+
) R
at io
na le
• Sa
nd el
ow sk
i ( 20
00 )
• T
he re
is a
pr im
ar y
st ud
y
N R
• U
ns pe
ci fi
ed •
52 f
am ily
m em
be rs
• Se
m is
tr uc
tu re
d, in
di vi
du al
a nd
fo cu
s- gr
ou p
in te
rv ie
w s
• “S
ta nd
ar d
co nt
en t
an al
yt ic
p ro
ce du
re s”
w ith
c as
e- or
de re
d m
et a-
m at
ri x
• (-
) D
at a
sa tu
ra tio
n
Tw o
m ai
n to
pi cs
– (a
) in
te rv
en tio
n m
od al
iti es
th at
w ou
ld fi
t f am
ily m
em be
rs ’
ne ed
s in
m en
ta l
he al
th s
er vi
ce s
an d
(b )
to pi
cs th
at pr
og ra
m s
sh ou
ld ad
dr es
s
O 'S
he a
(2 01
4) •
U SA
• “W
ha t a
re th
e pe
rc ep
tio ns
o f
st af
f nu
rs es
re ga
rd in
g pa
lli at
iv e
ca re
… ?”
• (-
) R
ef er
en ce
• (-
) R
at io
na le
N R
• Pu
rp os
iv e,
co nv
en ie
nc e
sa m
pl in
g •
18 n
ur se
s
• Se
m is
tr uc
tu re
d an
d fo
cu s-
gr ou
p in
te rv
ie w
s •
In te
rv ie
w g
ui de
• R
itc hi
e an
d Sp
en ce
r’ s
fr am
ew or
k fo
r da
ta an
al ys
is •
(- )
D at
a sa
tu ra
tio n
Fi ve
th em
at ic
ca te
go ri
es a
nd as
so ci
at ed
su bc
at eg
or ie
s ab
ou t
nu rs
es ’
pe rc
ep tio
ns of
p al
lia tiv
e ca
re
Pe ac
oc k,
H am
m on
d- C
ol lin
s, a
nd F
or be
s (2
01 4)
• C
an ad
a •
D es
cr ib
e •
E xp
er ie
nc e
of ca
ri ng
f or
a re
la tiv
e w
ith de
m en
tia
• (+
) R
ef er
en ce
• (+
) R
at io
na le
• Sa
nd el
ow sk
i ( 20
00 ; 2
01 0)
• Se
co nd
ar y
an al
ys is
• Ph
en om
en ol
og ic
al ov
er to
ne
N R
• Pu
rp os
iv e
sa m
pl in
g •
11 b
er ea
ve d
fa m
ily m
em be
rs
• In
di vi
du al
in te
rv ie
w s
• 27
tr an
sc ri
pt s
fr om
th e
pr im
ar y
st ud
y
• U
ns pe
ci fi
ed •
(- )
D at
a sa
tu ra
tio n
Fi ve
m aj
or th
em es
re ga
rd in
g th
e jo
ur ne
y w
ith d
em en
tia f
ro m
th e
tim e
pr io
r to
di ag
no si
s an
d in
to be
re av
em en
t
Pe te
rs on
e t a
l. (2
01 4)
• C
an ad
a •
D es
cr ib
e E
xp er
ie nc
e of
fe ta
l f ib
ro ne
ct in
te st
in g
• (+
) R
ef er
en ce
• (+
) R
at io
na le
• Sa
nd el
ow sk
i ( 20
10 )
• V
ai sm
or ad
i, T
ur un
en , &
B on
da s
(2 01
3)
N R
• U
ns pe
ci fi
ed •
17 w
om en
• Se
m is
tr uc
tu re
d in
di vi
du al
in te
rv ie
w s
• In
te rv
ie w
g ui
de
• C
on ve
nt io
na l
co nt
en t a
na ly
si s
• (+
) D
at a
sa tu
ra tio
n
O ne
o ve
ra rc
hi ng
th em
e, th
re e
th em
es ,
an d
si x
su bt
he m
es ab
ou t w
om en
’s ex
pe ri
en ce
s of
f et
al
Res Nurs Health. Author manuscript; available in PMC 2018 February 01.
A uthor M
anuscript A
uthor M anuscript
A uthor M
anuscript A
uthor M anuscript
Kim et al. Page 23
A ut
ho rs
C ou
nt ry
R es
ea rc
h O
bj ec
ti ve
s D
es ig
n ju
st if
ic at
io n
T he
or et
ic al
/ ph
ilo so
ph ic
al fr
am ew
or ks
Sa m
pl in
g/ sa
m pl
e si
ze D
at a
co lle
ct io
n an
d da
ta s
ou rc
es D
at a
an al
ys is
F in
di ng
s
fi br
on ec
tin te
st in
g
R ap
ha el
, W at
er w
or th
, a nd
G ot
t ( 20
14 )
• N
ew Z
ea la
nd •
E xp
lo re
• R
ol e
of n
ur se
s in
pr ov
id in
g pa
lli at
iv e
an d
en d-
of -l
if e
ca re
• (+
) R
ef er
en ce
• (+
) R
at io
na le
• Po
pe &
M ay
s (2
00 6)
• Pa
rt o
f a
la rg
er s
tu dy
N R
• Pu
rp os
ef ul
sa m
pl in
g •
21 n
ur se
s
• Se
m is
tr uc
tu re
d in
di vi
du al
in te
rv ie
w s
• T
he m
at ic
a na
ly si
s •
(- )
D at
a sa
tu ra
tio n
T hr
ee th
em es
a bo
ut pr
ac tic
e nu
rs es
’ ex
pe ri
en ce
s in
pr ov
id in
g pa
lli at
iv e
an d
en d-
of -l
if e
ca re
Sa nt
os , S
an de
lo w
sk i,
an d
G ua
ld a
(2 01
4) •
B ra
zi l
• U
nd er
st an
d •
E xp
er ie
nc e
w ith
po st
na ta
l de
pr es
si on
• (+
) R
ef er
en ce
• (-
) R
at io
na le
• Sa
nd el
ow sk
i ( 20
00 )
N R
• Pu
rp os
ef ul
, cr
ite ri
on sa
m pl
in g
• 15
w om
en w
ith p
os tn
at al
de pr
es si
on
• M
in im
al ly
st ru
ct ur
ed ,
in di
vi du
al in
te rv
ie w
s
• T
he m
at ic
a na
ly si
s •
(+ )
D at
a sa
tu ra
tio n
Tw o
th em
es –
w om
en ’s
“ ba
d th
ou gh
ts ”
an d
th ei
r fo
ur ty
pe s
of re
sp on
se s
to f
ea r
of ha
rm (
w ith
fr eq
ue nc
ie s)
Sh ar
p et
a l.
(2 01
4) •
A us
tr al
ia •
U nd
er st
an d
• E
xp er
ie nc
e of
pe ri
ph er
al ly
in se
rt ed
c en
tr al
ca th
et er
in se
rt io
n
• (+
) R
ef er
en ce
• (+
) R
at io
na le
• Sa
nd el
ow sk
i ( 20
00 )
N R
• Pu
rp os
ef ul
sa m
pl in
g •
10 p
at ie
nt s
• Se
m is
tr uc
tu re
d, in
di vi
du al
in te
rv ie
w s
• In
te rv
ie w
g ui
de
• T
he m
at ic
a na
ly si
s •
(+ )
D at
a sa
tu ra
tio n
Fo ur
th em
es re
ga rd
in g
pa tie
nt s’
ex pe
ri en
ce s
of pe
ri ph
er al
ly in
se rt
ed ce
nt ra
l c at
he te
r in
se rt
io n
So ul
e (2
01 4)
• U
SA •
D is
co ve
r •
C on
te xt
, v al
ue s,
an d
ba ck
gr ou
nd m
ea ni
ng o
f cu
ltu ra
l co
m pe
te nc
y
• (+
) R
ef er
en ce
• (+
) R
at io
na le
• Sa
nd el
ow sk
i ( 20
00 )
Fo cu
se d
on cu
ltu ra
l co
m pe
te nc
e
• Pu
rp os
iv e,
m ax
im um
va ri
at io
n, a
nd ne
tw or
k •
20 e
xp er
ts
• Se
m is
tr uc
tu re
d, in
di vi
du al
in te
rv ie
w s
• W
ith in
-c as
e an
d ac
ro ss
-c as
e an
al ys
is •
(- )
D at
a sa
tu ra
tio n
T hr
ee th
em es
re ga
rd in
g cu
ltu ra
l co
m pe
te nc
y
St eg
en ga
a nd
M ac
ph er
so n
(2 01
4) •
U SA
• E
xp lo
re a
nd de
sc ri
be •
C an
ce r
ex pe
ri en
ce
• (+
) R
ef er
en ce
• (+
) R
at io
na le
• N
ee ga
ar d
et a
l ( 20
09 )
N R
• U
ns pe
ci fi
ed •
15 p
at ie
nt s
• L
on gi
tu di
na l
in di
vi du
al in
te rv
ie w
s (4
tim e
po in
ts )
• 40
in te
rv ie
w s
• In
du ct
iv e
co nt
en t
an al
ys is
• (-
) D
at a
sa tu
ra tio
n
Pr oc
es se
s an
d th
em es
ab ou
t a do
le sc
en t
id en
tif y
w or
k an
d ca
nc er
id en
tif y
w or
k ac
ro ss
th e
ill ne
ss tr
aj ec
to ry
St ur
es so
n an
d Z
ie ge
rt (
20 14
) •
Sw ed
en •
E xp
lo re
• E
xp er
ie nc
es o
f gi
vi ng
s up
po rt
to pa
tie nt
s du
ri ng
th e
tr an
si tio
n
• (-
) R
ef er
en ce
• (-
) R
at io
na le
Fo cu
se d
on su
pp or
t a nd
tr an
si tio
n
• U
ns pe
ci fi
ed (b
ut li
ke ly
pu rp
os ef
ul sa
m pl
in g)
• 8
nu rs
es
• Se
m is
tr uc
tu re
d In
di vi
du al
in te
rv ie
w s
• In
te rv
ie w
g ui
de
• C
on te
nt a
na ly
si s
• (-
) D
at a
sa tu
ra tio
n O
ne th
em e,
th re
e m
ai n
ca te
go ri
es , a
nd ei
gh t a
ss oc
ia te
d ca
te go
ri es
T se
ng , C
he n,
a nd
W an
g (2
01 4)
• Ta
iw an
• D
es cr
ib e
• Pr
oc es
s of
w om
en ’s
r ec
ov er
y fr
om s
til lb
ir th
• (+
) R
ef er
en ce
• (+
) R
at io
na le
• Sa
nd el
ow sk
i ( 20
00 )
N R
• Pu
rp os
ef ul
sa m
pl in
g •
21 w
om en
• In
di vi
du al
in te
rv ie
w te
ch ni
qu es
• In
du ct
iv e
an al
yt ic
ap pr
oa ch
es (
T ho
rn e,
2 00
4) •
(+ )
D at
a sa
tu ra
tio n
T hr
ee s
ta ge
s (t
he m
es )
re ga
rd in
g th
e re
co ve
ry p
ro ce
ss o
f Ta
iw an
es e
w om
en w
ith s
til lb
ir th
V ai
sm or
ad i,
Jo rd
an , T
ur un
en , a
nd B
on da
s (2
01 4)
• Ir
an •
D es
cr ib
e •
Pe rs
pe ct
iv es
o f
ca us
es o
f m
ed ic
at io
n er
ro rs
• (+
) R
ef er
en ce
• (+
) R
at io
na le
• Sa
nd el
ow sk
i ( 20
10 )
N R
• Pu
rp os
ef ul
sa m
pl in
g •
24 n
ur si
ng st
ud en
ts
• Fo
cu s-
gr ou
p in
te rv
ie w
s •
O bs
er va
tio ns
w ith
n ot
es
• C
on te
nt a
na ly
si s
• (-
) D
at a
sa tu
ra tio
n Tw
o m
ai n
th em
es ab
ou t n
ur si
ng st
ud en
ts ’
pe rc
ep tio
ns on
c au
se s
of m
ed ic
at io
n er
ro rs
V al
iz ad
eh e
t a l.
(2 01
4) •
Ir an
• E
xp lo
re •
Im ag
e of
n ur
si ng
• (-
) R
ef er
en ce
• (-
) R
at io
na le
N R
• Pu
rp os
ef ul
sa m
pl in
g •
18 m
al e
nu rs
es
• Se
m is
tr uc
tu re
d in
di vi
du al
, in
te rv
ie w
s •
Fi el
d no
te s
• C
on te
nt a
na ly
si s
• (-
) D
at a
sa tu
ra tio
n Tw
o m
ai n
vi ew
s (t
he m
es )
on n
ur si
ng pr
es en
te d
w ith
su bt
he m
es p
er v
ie w
V ill
ar , C
el dr
an , F
ab a,
a nd
S er
ra t (
20 14
) •
Sp ai
n •
A sc
er ta
in •
B ar
ri er
s to
se xu
al e
xp re
ss io
n
• (-
) R
ef er
en ce
• (-
) R
at io
na le
N R
• M
ax im
um va
ri at
io n
• 10
0 st
af f
an d
re si
de nt
s
• Se
m is
tr uc
tu re
d, in
di vi
du al
in te
rv ie
w
• C
on te
nt a
na ly
si s
• (-
) D
at a
sa tu
ra tio
n 40
% o
f pa
rt ic
ip an
ts w
ith ou
t i de
nt if
ic at
io n
of b
ar ri
er s
an d
60 %
w ith
s ev
en m
os t c
ite d
ba rr
ie rs
to s
ex ua
l ex
pr es
si on
in th
e lo
ng -t
er m
c ar
e se
tti ng
W ie
ns , B
ab en
ko -M
ou ld
, a nd
I w
as iw
( 20
14 )
• C
an ad
a •
E xp
lo re
• Pe
rc ep
tio ns
o f
em po
w er
m en
t i n
ac ad
em ic
n ur
si ng
en vi
ro nm
en ts
• (+
) R
ef er
en ce
• (+
) R
at io
na le
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Res Nurs Health. Author manuscript; available in PMC 2018 February 01.
A uthor M
anuscript A
uthor M anuscript
A uthor M
anuscript A
uthor M anuscript
Kim et al. Page 24 N
ot e.
N R
= n
ot r
ep or
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Res Nurs Health. Author manuscript; available in PMC 2018 February 01.
- Abstract
- Features of QD
- Methods
- Search Strategy and Study Screening
- Study Selection
- Quality Appraisal Process
- Process for Data Extraction and Analysis
- Findings
- Quality Appraisal Results
- Research Objectives
- Design Justification
- Theoretical or Philosophical Framework
- Sampling and Sample Size
- Data Collection and Data Sources
- Data Analysis
- Presentation of Findings
- Discussion
- Limitations
- Conclusions
- References
- Figure 1
- Table 1
- Table 2
- Table 3