Review of Mixed-Methods Research in Nursing

Abstract

Background Inadequate justification for using mixed-methods and inadequate data integration compromises the rigor of mixed-methods studies, and data integration remains a challenge for nurse researchers. Objectives The aim of the study was to determine the 5-year prevalence of mixed-methods research in nursing journals and to determine the extent of integration of qualitative and quantitative findings. Methods Ten journals were hand-searched, and additional search was conducted within three databases. Prevalence was calculated by counting the number of published mixed-methods studies divided by the number of published studies over 5 years. Three reviewers independently performed methodological assessment using a checklist based on guidelines by expert methodologists. Results Prevalence of mixed-methods studies was 1.89%. Concerning methodological assessment, of 175 studies, 29% did not provide an explicit label of the study design and four studies incorrectly labeled the design. In total, 31% of the studies did not justify using mixed methods, 95% did not identify the research paradigm, and 78% did not state the weight given to individual phases. The extent of data integration was 73%, but 83% of studies integrated data using narrative summaries with integration occurring at the interpretation (69.8%). Few studies used joint displays (10.9%), transformation (3.1%), and triangulation (1.6%) for data integration. Discussion Mixed-methods research is still in its infancy in nursing, and researchers encounter challenges during its conduct, analysis, and reporting. There is a need to determine researchers’ attitudes and challenges toward using mixed methods and educate them about advanced mixed methods. Emphasis should be placed on use of advanced data integration methods so that the rigor and quality of mixed research can be enhanced in nursing research.

A Methodological Review of Mixed Methods Research in Palliative and End-of-Life Care (2014–2019)

“…Our findings show that fewer than 5% of the empirical articles published during the six-year period under study used a mixed methods design. While this low frequency of articles is consistent with the results of previous reviews on mixed methods research in the health sciences [10,11,33], it belies the unanimous agreement on the usefulness of this methodological approach in answering the kind of complex questions that are being asked in palliative care and end-of-life research [1].…”

The Philosophical Turn to Mixed Methods for Nursing Science

“…The turn to mixed methods not only expands our repertoire of research methods and theory development opportunities but encourages confidence that our discipline can generate knowledge from and about the open, dynamic, and complex nature of human-environment-health phenomena. Results from two reviews of mixed methods in nursing research indicated increasing use of integration in mixed methods: In an earlier study, researchers in 12% of the articles reported integrating at both levels of data analysis and interpretation (Beck & Harrison, 2016); a second study showed that approximately 70% of the research reports included some form of integration (Younas et al, 2019). The practice of integration will likely increase as more nurses learn about mixed methods along with the vital links between research and theory.…”

“…In a study of mixed-method publications by nurses across research journals from 1998 to 2014, Beck and Harrison (2016) found that nearly all the 294 studies identified were published after 2010. Investigators’ review of 10 peer-reviewed nursing research journals from 2014 to 2018 identified 134 mixed-methods reports (about 2% of the total research articles) that included at least one nurse author (Younas, Pederson, & Laoagan Tayaben, 2019). Irvine et al (2020) reviewed five top research journals from 2015 to 2018 and found 34 mixed-methods articles published by nurses.…”

Data Integration in Mixed-Method Research Studies: Challenge and Opportunity for Nursing

“…2 On the other hand, it was recently noted in a literature review conducted by researchers from Canada, Denmark, and the Philippines that, besides the use of mixed-method research still being low (1.89%) among studies (N=7,089) in the nursing field, there are also methodological gaps (or fragilities) in the research studies, especially with regard to the explanation of the study's design; to the due rationale for the mixed method option; to the nondeclaration of the assigned weight among the phases and/or approaches of the study; and also, by the absence of more robust instruments of data integration, as the majority of the studies integrated quantitative and qualitative information at the interpretation level only in the findings' discussion. 4 An emerging possibility of data integration in mixed-method research studies, including in nursing, is the so-called Pillar Integration Process (PIP) -which by itself is a type of joint display -and corresponds to a four-stage process: a) listing the most relevant qualitative and quantitative data at the extremes of a table/frame/matrix; b) combination/correspondence of data, on the opposite side of the table/frame/matrix, so that the qualitative data reflect patterns, parallels or similarities with the quantitative data or not, as the investigators may not notice correspondence and leave this space blank or describe "not found", for example; c) checking/verification, which is an evaluation activity to see if the correspondence in the data set is refined, and an opportune time for the researchers to reflect on their lists of information, and to take up aspects or move forward in some direction; and, d) construction of pillars to write the inferences generated from the mixed analysis in the center of the table/frame/matrix. 5 By taking over the mixed-method research studies, it is perceived that Nursing needs to devote to creative and, at the same time, methodologically rigorous ways to integrate quantitative and qualitative data.…”