Running head: QUALITATIVE STUDY CRITIQUE
Qualitative Study Critique Using Guidelines for Qualitative Designs
Angela M. Baird
Ferris State University
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QUALITATIVE STUDY REVIEW
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Abstract
The article, Insights of Nurses about Assault in Hospital-Based Emergency Departments, was
chosen for this qualitative study review. The article will be reviewed and critiqued using the
guidelines for critiquing qualitative designs as outlined in Foundations of Nursing Research
(Nieswiadomy, 1998, pg. 180). The purpose of the study, specific qualitative approach,
significance for nursing, participants and sample size, data collection and analysis, study
limitations, and any further recommendations for continued future research will be determined.
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Qualitative Study Critique Using Guidelines for Qualitative Designs
In the article, Insights of Nurses about Assault in Hospital-Based Emergency
Departments, a review is done for its purpose, significance for nursing, limitations, and
recommendations for further research. The article is qualitative and uses a descriptive design.
Six components from an ecological, occupational-health framework were used that integrated
personal, organizational, and societal influences (Levin, Hewitt & Misner, 1998). The study
utilized four focus groups of 22 RN’s (registered nurses) employed at 15 different emergency
departments in a large metropolitan area. Half of these nurses were assaulted while working in
the emergency room. A preliminary discussion guide was used for each focus group of which
nurses voiced their own feelings and experiences about assault in the ER (emergency room).
Each focus group session lasted 90 minutes and members within each focus group made similar
comments. Both physical and verbal assault was identified occurring within the emergency
department and has an effect on the nurses’ personal and professional life. Items identified of
importance in the study were: assaults can be prevented, individual’s assaulted need to have a
post assault debriefing, physical assault is treated, and managers need to develop assault
prevention programs (Levin, Hewitt & Misner, 1998).
Qualitative research description
Qualitative research is concerned with an individual’s own knowledge and opinion of an
episode or situation. The researcher usually becomes involved in the study and wants to
understand an individual’s view on a giving episode or situation. The individuals own account
of an event is more important than the researcher’s interpretation. Smaller sample sizes are used
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and the information is collected by interviews and observations. The researcher looks for any
repetition of information or topics and does not rely on existing theories (Nieswiadomy, 1998).
Qualitative research results are also presented in a narrative form and not as statistics.
Qualitative or Quantitative approach
Qualitative methods were used and appropriate for this type of study. Researchers used
smaller sample sizes and conducted focus group interviews to gather new information. The
interviews of the focus groups allowed the researchers to gather individuals exact opinions,
feelings, and perceptions of events or situations. The researchers were also able to look at the
information obtained and see that there were a total of 14 topics that came from the study. This
is a characteristic of qualitative research and something that the researcher is looking for within
the study. Using a quantitative approach with this study would not allow for actual descriptions
from individuals and more importance would have been on past studies, theories, and the
researcher’s interpretation. The final reporting of the study was done in narrative form, telling a
story, and no statistics were used.
Subjective nature of human experience
The study does rely on the subjective description of human experiences as the study was
conducted with RN’s that were working in the Emergency Department and half of these RN’s
had been assaulted in some way in their working career. Also interviewing the RN’s in focus
groups obtains actual descriptions and personal experiences of the situations or events.
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Qualitative approach
The specific qualitative approach is not mentioned within the study. There is a brief
mention of the design at the beginning of the study. The design of the study is descriptive and
an ecological, occupational-health framework that integrated personal, organizational, and
societal influences was used (Levin, Hewitt & Misner, 1998).
Significance to nursing
Violence in healthcare departments is an issue needing continued surveillance,
intervention and research. In the hospital the most violence is directed towards psychiatric
wards, ED’s, waiting rooms, and geriatric units (Gacki-Smith, Juarez & Boyett, 2009). Some of
this vulnerability to workplace violence is due to low staffing levels, lack of recognizing a
dangerous patient, workplaces without a violence prevention program, inadequate security
personnel, patients possessing weapons, and criminals seeing the hospital as a source of drugs
and money (Gacki-Smith, Juarez & Boyett, 2009). Nursing has been recognized as an
occupation at high risk for violent attacks. The average annual rate for violence against nurses
was 21.9 per 1,000 workers, compared with 12.6 per 1,000 workers for all occupations (GackiSmith, Juarez & Boyett, 2009). In 2004 46% of nonfatal assaults and violent acts were targeted
against RN’s. Incidences of verbal abuse is also increasing against RN’s and in some facilities
verbal abuse affects 100% of ER nurses (Gacki-Smith, Juarez & Boyett, 2009).
This study does have significance for nursing and identifies personal factors, workplace
factors, environmental, and situational factors that all contribute to the possibility of assault in
the Emergency Room. Both physical and verbal assaults were identified as experienced or
witnessed and that each had an effect on the nurse’s personal and professional life. The nurses of
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this study helped to indentify factors that contributed to violence against nurses in the ER and
what can be done to improve and decrease violence in the ER. Levin, Hewitt & Misner wrote,
“Learning what assault means to emergency nurses is a critical step in planning a long-term
solution to workplace violence, listening to these nurses’ opinions about factors they believe
contribute to assault provides important information for designing and implementing preventive
pleasures that will be acceptable” (no page #).
How are participants selected?
The participants for this study were accessed from a large metropolitan area through the
state ENA (Emergency Nurses Association). They were assigned to one of the four focus groups
by their responses to screening questions. The participants from the same hospital were divided
up into different focus groups.
Sample size
Sample sizes for a qualitative research study can be as little or large as it needs to be to
gather the information or perceptions that are important to a research study. Qualitative research
is attempting to discover something (DePaulo, 2000). Researchers may be trying to find out
reasons why nurses may or may not be satisfied with their current workplace, what nurse’s feel
makes a good working environment, why nurses leave the profession, or why student nurses
picked the nursing profession. The point with a qualitative sample size is to make sure that is it
large enough to hear most or all of the perceptions that may be important (DePaulo, 2000).
This article did not specifically say how the sample size was chosen. The final sample
was RN’s that worked in various emergency rooms in one large metropolitan area. A total of 22
RN’s from 15 hospitals participated. Ages of participants and years worked in the ER varied
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among all participants of the study; half of the participants had been physically assaulted while at
work (Levin, Hewitt & Misner, 1998).
Data collection and recording
In review of this study data collection was done through 4 focus groups using a
discussion guide based on conceptual framework and literature. Data was recorded from a large
amount of information through notes and verbatim transcripts. There were 14 themes that
became apparent through the data collected. These themes were broken down into person,
workplace and environmental factors, assault injuries, effects, and solutions (Levin, Hewitt &
Misner, 1998). The researcher’s interpretations of major themes were validated through the state
ENA.
Is bias in data collection avoided?
Bias from the researcher was avoided by using a qualitative approach to the study.
Without the use of other theories prevents the researchers from making any interpretations of
their own. This also allows the researchers to obtain new ideas and information regarding the
study.
Data analysis
This particular study used a coding system that was refined through data analysis. This
coding process is described by Nieswiadomy (2008) as content analysis. This involves
producing categories of data and rules for coding data into categories (Nieswiadomy, 2008).
Coded information contributed to the classification of 14 themes in the study and data was then
analyzed by using Ethnograph 4.0 computer software. All of the data analysis methods used is
consistent with the purpose and approach of the study.
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Study findings and limitations
Study findings of the research are clearly documented in categories of personal factors,
workplace factors, environmental and situational factors, assault injuries, effects, and solutions.
In reviewing the study there was little mentioned of limitations within the study, but one caution
was mentioned with using the focus-group methodology and interpretation of study results.
Focus groups are mainly used to identify subjective truth of participants who find the topic
important, but opinions can differ from those who have not participated in the study (Levin,
Hewitt & Misner, 1998).
Suggestions for further research
Further research was recommended to determine if views of emergency nurses and other
high risk health care workers are similar. Through this future research it is projected that a
nursing intervention study can be performed to identify and alter factors that contribute to assault
in the workplace (Levin, Hewitt & Misner, 2008).
Conclusion
The review of the article proved that qualitative research is important and beneficial to
nursing. Nurses that participated in this study offered similar perceptions to the researchers of
assault in the workplace and is a step towards nurses developing new policies and interventions
to prevent assault and violence in the ER or other high-risk health areas.
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References
DePaulo, P., 2000. Sample size for qualitative research. Qualitative Research Solutions.
Retrieved from: http://www.icology.co.uk/qualitativesamplesize.html.
Gacki-Smith, J., Juarez, A. & Boyett, L. 2009. Violence against nurses working in us emergency
departments. The Journal of Nursing Administration, 39, (7/8), 340-349.
Levin, P., Hewitt, J. & Misner, S., 1998. Insights of nurses about assault in hospital-based
emergency departments. Image: Journal of Nursing Scholarship, 30, (3), 249-56.
Nieswiadomy, R. (2008). An overview of qualitative research. Foundations of Nursing Research.
(5th Ed.). New Jersey: Pearson & Prentice Hall.
Nieswiadomy, R. (2008). Qualitative research designs. Foundations of Nursing Research. (5th
Ed.). New Jersey: Pearson & Prentice Hall.