Both qualitative and quantitative research can serve as contributors to evidence-based practice (EBP) in nursing. Qualitative projects promote nursing EBP by producing evidence that eventually gives rise to empirically supported EBP interventions inspired by qualitative findings and theoretical assumptions about care processes, whereas quantitative ones add specificity and evidential value to such propositions. This discussion is aimed at exemplifying these approaches’ influences on EBP in mental health nursing and explaining quantitative methods’ advantage.
Quantitative and Qualitative Research Projects in Nursing EBP
In general, qualitative research makes use of inductive approaches to knowledge generation. Thus, it manages to generate novel insights into hardly quantifiable phenomena, such as holistic descriptions of nurse-patient interactions in particular settings or the experiences of interdisciplinary collaboration within the frame of care provision tasks (Yale University, 2015). Hypothesis generation and opportunities for iterative interpretation of the collected data present the points of critical importance when it comes to qualitative studies’ applicability to EBP in patient care, including processes in adult and geriatric mental health settings.
Current descriptive studies peculiar to inpatient mental health environments shed light on the promise of qualitative projects for promoting the proactive implementation of EBP in nursing through the exploration of student- and practitioner-level barriers to EBP. As an example, Charania et al. (2019) apply the interview and content analysis methods to provide an insight into the quality of the Psychiatric-Mental Health Clinical Course in terms of promoting EBP use in the post-graduation period and assess its impacts on practitioner-perceived roles of evidence in clinical practice. Being complicated in nature, the results entail a variety of practically relevant conclusions, including the potential effects of EBP-based reflection activities on the acquisition of self-awareness skills and knowledge about the representations of mental illness stigma in psychiatric nurses (Charania et al., 2019). In a similar manner, projects that use interview techniques offer an initial insight into nurse-perceived subjective contributors to medication errors in psychiatric settings, for instance, understaffing, miscommunication, and insufficient hospital noise control practices (Keers et al., 2018). Therefore, qualitative projects generate initial evidence regarding barriers to EBP, which can promote further research endeavors.
Quantitative studies’ applicability to EBP in nursing practice is far more evident and exemplifiable and may find reflection in duty distribution decisions in psychiatric settings that would optimize the workload on mental health professionals without taking from patient safety. For instance, using the cluster randomized controlled trial methodology, which is a distinct type of RCTs, Van der Zalm et al. (2020) demonstrate that advanced nurse practitioners can conduct clozapine monitoring activities as effectively as qualified psychiatrists. The findings are potentially helpful for the reconsideration of these professionals’ roles in the treatment of chronic psychosis, and their quantitative nature and the use of randomization and blinding procedures strengthen their credibility and practice-oriented promise by ensuring transferability and replicability (Van der Zalm et al., 2020). Thus, quantitative research, including RCTs that measure the effects of changes to psychiatric nurses’ scope of responsibilities, supports EBP in mental health settings by offering novel empirically-tested approaches to the distribution of labor-intensive treatment monitoring activities.
Why Quantitative Research is More Appropriate for Addressing EBP Problems
Quantitative research is the most successful approach to resolving EBP-related clinical problems due to its essential characteristics, such as the production of breadth-oriented data and reliance on random sampling. Quantitative methods emphasize experiment-based reasoning, and their goal of increasing the breadth of existing knowledge leads to significant advantages in terms of results’ transferability (Yale University, 2015). In contrast, with their depth-oriented approach and interpretative analytics, qualitative methods make data analysis more time-consuming, which cannot go unnoticed for possible sample sizes (Yale University, 2015). Aside from everyday practice, this tendency finds manifestation in mental health nursing studies reviewed in the previous section. Thus, the abovementioned qualitative studies interview between twenty and sixty-four participants, whereas the RCT’s sample exceeds one hundred and seventy patients (Charania et al., 2019; Keers et al., 2018; Van der Zalm et al., 2020). Randomization adds to samples’ representativeness, thus maximizing the chances of getting similar positive results when implementing the quantitatively approved interventions (Van der Zalm et al., 2020; Yale University, 2015). The integration of EBP into practice requires the selection of large-scale studies with representative samples, which is why quantitative studies remain the basis of EBP.
The position of studies that are based on quantitative data in the globally accepted hierarchy of evidence is another characteristic of quantitative research that makes it more applicable to EBP problem resolution. In terms of the influences on clinical decision-making, the hierarchy is dominated by systematic reviews of randomized controlled trials, studies with randomization, true experimental research, and meta-analytical research reports, whereas descriptive approaches occupy the lowest levels, which points to their limited ability to produce generalizable and transferable findings (Baixinho et al., 2020). Notably, even the advocates of qualitative research for the generation of EBP interventions acknowledge its inability to substitute the quantitative deductive method (Baixinho et al., 2020). It results in the proposals to further develop descriptive methods to improve their potential in supplementing quantitative findings but without challenging the latter’s hegemony (Baixinho et al., 2020). Therefore, quantitative methods’ widely-recognized evidential value adds to their appropriateness for addressing EBP problems.
Conclusion
To sum up, the two groups of research methodologies influence nursing EBP in dissimilar ways. Qualitative approaches mainly generate theoretical assumptions for further exploration, whereas quantitative evidence is capable of producing non-abstract practice improvement recommendations. Due to a set of characteristics, including the position in the breadth-depth conflict, randomization, sample sizes, and representativeness, quantitative methods remain more appropriate for addressing practice problems pertaining to EBP.
References
Baixinho, C. L., Presado, M. H., & Oliveira, E. S. F. D. (2020). The place of qualitative research in evidence-based practice. Revista Brasileira de Enfermagem, 73(5), 1-2.
Charania, N. A. M. A., Ross-Durrow, P., Sullivan, B., & Dansel, L. (2019). Undergraduate nursing students’ perceptions of integrating evidence into practice in a psychiatric-mental health nursing clinical course. Journal of Nursing Education and Practice, 9(9), 1-5.
Keers, R. N., Plácido, M., Bennett, K., Clayton, K., Brown, P., & Ashcroft, D. M. (2018). What causes medication administration errors in a mental health hospital? A qualitative study with nursing staff. PloS One, 13(10), 1-18.
Van der Zalm, Y. C., Schulte, P. F., Bogers, J. P. A. M., Termorshuizen, F., Marcelis, M., Van Piere, M. A. G. B., Sommer, I. E., & Selten, J. P. (2020). Delegating clozapine monitoring to advanced nurse practitioners: An exploratory, randomized study to assess the effect on prescription and its safety. Administration and Policy in Mental Health and Mental Health Services Research, 47, 632-640.
Yale University. (2015). Fundamentals of qualitative research methods: What is qualitative research (module 1) [Video]. YouTube.