Problems arise however concerning the acceptability and credibility of evaluation using such approaches either on the part of the professions themselves, or on the part of the policy makers, or both. The qualitative approach tends to have high face validity with the professions concerned. There is close involvement of researcher and researched, while the information that is obtained tend to be of considerable interest and acceptability to professional practitioners. On the other hand it makes less impact with the policy makers who control and allocate resources because of the ‘soft’ nature of the information collected (Reid 1989).
Contrastingly quantitative data appeals to resource allocators because it tends to measure identified components of professional practice. Reid (1989) argues that this approach however tends to be less attractive to the professions themselves. Reid (1989) further states that this may be caused since the caring professions “place great store by the ethos of qualitative provision, as examplified by such concepts as vocationalism”.
To carry out evaluation research demands the application of research principles to the evaluation process. However this activity is of an entirely different order to other approaches of evaluation that lack scientific rigor and may “amount to no more than a group of professionals sitting around a table and passing opinions unfortunately, all too often decisions are taken before evaluations are reported or without due attention to their findings” (Bond 1993) irrespective of whether the data were ‘soft’ or ‘hard’. Bond (1993) concludes however with the assumption that services are difficult things to do research on since they are multidimensional, complicated, elusive, and always ‘on the move’.
One might postulate that there seem to be a ‘trade off’ between ‘hard’ quantitative data on one hand and ‘soft’ qualitative approaches on the other. The authors believe that health services should be free to combine whatever parts of whatever methods health carers think are promising for their research goals. Also, the same careful skills in analytical reasoning are needed by the qualitative researcher as those required by the quantitative researcher. The debate between qualitative and quantitative research techniques is not new. In fact Glaser and Strauss (1967) indicate that this dialogue has been ongoing for several decades. Referring to quantitative research, Duelli Klein (1989) argues that after years of traditional education it is hard to shed the layers of indoctrination of what is declared ‘good’ and ‘up to standard’ research.
Jick (1983) describes the combination of quantitative and qualitative research as triangulation. He believes he can uncover a unique variance that might not have appeared in a single method of investigation. He (Jick 1983) suggests that this increases confidence on results and allows for creative methods. At the same time, new ways of seeing a problem that may have been overlooked before may be balanced with common methodologies, and a new dimension of the problem may be uncovered. Although there are clearly recognized differences between qualitative and quantitative research methods, the two can overlap at times.
It would seem reasonable that within the structure of health services a move should be made to undertake triangulated research. This would provide the researcher with the numerical, statistical, and scientific data in order to meet the quantitative analytical needs of health services directors and also meet the needs of nursing personnel who wish to explore a more holistic, explanatory research in order that they may provide an improved quality of care.
Strauss and Cortin (1990) argue that qualitative and quantitative research could be effectively used in the same research project. Jayaratne (1989) advocates the use of qualitative data in conjunction with quantitative data to develop, support, and explicate theory. She (Jayaratne 1989) postulates that the appropriate use of ‘both’ methods in health services can help in achieving their goals more effectively than the use of either qualitative or quantitative methods alone. Jayaratne (1989) also argues that this is a political issue.
From a political perspective, all quality social research ought to be used in policy decisions. Obviously the role of the researcher is to contribute knowledge of completed and ongoing studies relevant to the targeted problem, to help policy makers frame their questions in research terms, and to develop research designs which incorporate mechanisms for ongoing evaluation (Tangri and Strasburg 1979). They also stress the need for researchers to be more aware and employ those methods which make their data more useful to policy makers and to change academic structures so that there is support for the use of these methods.
However Morse (1994) expressed concern over mixed methods of research. He felt that it was not impossible to undertake such a research but that this mixing violates the assumptions of data collection, techniques and methods of analysis of all the methods used. He felt that the product was not a good science, rather it was a sloppy mismatch. Morse (1994) found that countless studies combining quantitative and qualitative techniques in a triangulated design, only rarely attempt to integrate the two components of the study. This treatment was felt to be unfortunate because even a simple comparison of the results of the two components could lend confirmation to and thus strengthen the argument.
If indeed scholars want to be ‘agents for change’ rather than simply investigating health issues as a new topic; if indeed they want to work towards a future that “is not merely an extension of the present but significantly a qualitative transformation of the present” (Westkott 1989); then health researchers need to consider which methods are best suited to their quests. One should also bear in mind that data presentation plays an important part in the process of decision making. Cormack and Benton (1993) argue that “Unless results are presented in a clear and visually dynamic format, readers may have difficulty in interpreting findings, or worse still they may not be read.” The way health carers build their future will influence its outcome.
Bond S. (1993) Evaluation Research. In: Cormack D. (Ed) The Research Process in Nursing. Blackwell Scientific, London
Burns N. and Grove S. (1993) The Practice of Nursing Research. W.B. Saunder, Philadelphia
Cormack D. and Benton D. (1993) Data Presentation. In: Cormack D. (Ed) The Research Process in Nursing. Blackwell Scientific, London
Couchman W. and Dawson J. (1990) Nursing and Health Care Research: A Practical Guide. Scutari Press, London. In: Hunt M. (1993) Qualitative Research. In: Cormack D. (Ed) The Research Process in Nursing. Blackwell Scientific, London
Duelli Klein R. (1989) How to do what we want to do: thoughts about feminist methodology. In Theories of Women’s Studies. Bowles G. And Duelli Klein R.(eds) pp 88-103 Routlege, London