QBRDM #6

November-December 2016 • Vol. 25/No. 6 435

Lynne M. Connelly, PhD, RN, is Associate Professor and Director of Nursing, Robert J. Dehaemers Endowed Chair, Benedictine College Atchison, KS. She is Research Editor for MEDSURG Nursing.

Trustworthiness in Qualitative Research

I n their qualitative study on nurses’ confusion and uncertainty with cardiac monitoring, Nickasch, Marnocha, Grebe, Scheelk, and Kuehl (2016)

addressed trustworthiness in a number of ways. Trustworthiness or truth value of qualitative research and transparency of the conduct of the study are crucial to the usefulness and integrity of the findings (Cope, 2014). In this column, I will discuss the components of trustworthiness in qualitative research.

What Is Trustworthiness? Trustworthiness or rigor of a study refers to the degree

of confidence in data, interpretation, and methods used to ensure the quality of a study (Pilot & Beck, 2014). In each study, researchers should establish the protocols and procedures necessary for a study to be considered worthy of consideration by readers (Amankwaa, 2016). Although most experts agree trustworthiness is neces- sary, debates have been waged in the literature as to what constitutes trustworthiness (Leung, 2015).

Criteria outlined by Lincoln and Guba (1985) are accepted by many qualitative researchers and will be the focus of this column. These criteria include credibility, dependability, confirmability, and transferability; they later added authenticity (Guba & Lincoln, 1994). Each of these criteria and the typically used procedures will be out- lined. Not all procedures are used in each study.

Credibility Credibility of the study, or the confidence in the

truth of the study and therefore the findings, is the most important criterion (Polit & Beck, 2014). This concept is analogous to internal validity in quantitative research. The question a reader might ask is, “Was the study con- ducted using standard procedures typically used in the indicated qualitative approach, or was an adequate jus- tification provided for variations?” Thus a grounded theory study should be conducted similar to other grounded theory studies. Techniques used to establish credibility include prolonged engagement with partici- pants, persistent observation if appropriate to the study, peer-debriefing, member-checking, and reflective jour-

naling. Evidence also should be presented of iterative questioning of the data, returning to examine it several times. Negative case analysis or alternate explanations should be explored as well.

Dependability Dependability refers to the stability of the data over

time and over the conditions of the study (Polit & Beck, 2014). It is similar to reliability in quantitative research, but with the understanding stability of conditions depends on the nature of the study. A study of a phe- nomenon experienced by a patient may be very similar from time to time. In a study of a program instituted at a hospital, however, conditions will change. Procedures for dependability include maintenance of an audit trail of process logs and peer-debriefings with a colleague. Process logs are researcher notes of all activities that happen during the study and decisions about aspects of the study, such as whom to interview and what to observe.

Confirmability Confirmability is the neutrality or the degree find-

ings are consistent and could be repeated. This is analo- gous to objectivity in quantitative research (Polit & Beck, 2014). Methods include maintenance of an audit trail of analysis and methodological memos of log. Qualitative researchers keep detailed notes of all their decisions and their analysis as it progresses. In some studies, these notes are reviewed by a colleague; in other studies, they may be discussed in peer-debriefing ses- sions with a respected qualitative researcher. These dis- cussions prevent biases from only one person’s perspec- tive on the research. In addition, depending on the study, the researcher may conduct member-checking with study participants or similar individuals. For exam- ple, Nickasch and colleagues (2016) presented their findings at a national research conference and received feedback indicating the presented issues were similar for other nurses.

Transferability The nature of transferability, the extent to which

findings are useful to persons in other settings, is differ- ent from other aspects of research in that readers actual- ly determine how applicable the findings are to their sit- uations (Polit & Beck, 2014). Although this is considered analogous to generalization in quantitative research, it

Understanding Research Lynne M. Connelly

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is different from statistical generalization. Qualitative researchers focus on the informants and their story without saying this is everyone’s story. Researchers sup- port the study’s transferability with a rich, detailed description of the context, location, and people studied, and by being transparent about analysis and trustwor- thiness. Researchers need to provide a vivid picture that will inform and resonant with readers (Amankwaa, 2016).

Authenticity Authenticity is the extent to which researchers fairly

and completely show a range of different realities and realistically convey participants’ lives (Polit & Beck, 2014). Selection of appropriate people for the study sample and provision of a rich, detailed description are ways the researchers address this criterion (Schou, Høstrup, Lyngsø, Larsen, & Poulsen, 2011). No analogy to authenticity exists in quantitative research; this area represents the advantage of qualitative research to por- tray fully the deep meaning of a phenomenon to increases readers’ understanding.

Other Issues The above criteria are mainstays of qualitative trust-

worthiness, but additional considerations exist as well. The ethical implications of a study also affect its integri- ty and useful. Recruiting procedures are important in obtaining a group of people who can articulate their experiences. Conduct of data analysis is another impor- tant issue that can affect trustworthiness. These items may be described in different sections of the research report, but they are important to review when reading

Understanding Research

and critiquing an article. In addition, the procedures used for trustworthiness must fit the research design. Trustworthiness procedures and protocols used in a phe- nomenological study may be similar but not identical to grounded theory, ethnography, or qualitative descrip- tive studies (Cope, 2014).

In this brief overview of trustworthiness, all proce- dures could not be discussed in detail. Readers are referred to the references or a qualitative research text if further information is needed. Trustworthiness or rigor is crucial to the confidence readers have in the findings of any study, so this is an area readers should examine when reading a research report.

REFERENCES Amankwaa, L. (2016). Creating protocols for trustworthiness in qualita-

tive research, Journal of Cultural Diversity, 23(3), 121-127. Cope, D.G. (2014). Methods and meanings: Credibility and trustworthi-

ness of qualitative research. Oncology Nursing Forum, 41(1), 89- 91.

Guba, E.G., & Lincoln, Y. (1994). Competing paradigms in qualitative research. In N. Denzin & Y. Lincoln (Eds.), Handbook of qualitative research (pp. 105-117). Thousand Oaks, CA: Sage.

Leung, L. (2015). Validity, reliability and generalizability in qualitative research. Journal of Medicine and Primary Care, 4(3), 324-327.

Lincoln, Y.S., & Guba, E.G. (1985). Naturalistic inquiry. Newbury Park, CA: Sage.

Nickasch, B.L., Marnocha, S., Grebe, L., Scheelk, H., & Kuehl, C. (2016). ‘What do I do next?’ Nurses’ confusion and uncertainty with ECG monitoring. MEDSURG Nursing, 25(6), 418-422.

Polit, D.F., & Beck, C.T. (2014). Essentials of nursing research: Appraising evidence for nursing practice (8th ed.). Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins.

Schou, L., Høstrup, H., Lyngsø, E.E., Larsen, S., & Poulsen, I. (2011). Validation of a new assessment tool for qualitative articles. Journal of Nursing Scholarship, 68(9), 2086-2094.

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