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Mixed methods studies.

Owens, Jackson, and Berndt (2009) presented an interesting study about an aerobic exercise program for Hispanic women during treatment for breast cancer. The authors used a mixed methods research design, which can add more richness to a study than only one type of data collection. In this study, researchers collected interview data to understand the process of adopting exercise into the women's lifestyle, while quantitative measures were used to collect data on side effects of the breast cancer treatments and physiological outcomes of the exercise program. Mixed methods studies are being conducted more frequently and have important considerations for readers.

What Are Mixed Methods Studies?

In mixed methods research designs, researchers use both quantitative and qualitative methods and data in the same study or series of studies (Creswell & Piano-Clark, 2007). The goal of mixed methods research is to draw on the strengths and minimize the weaknesses of both types of research. This design is based on the pragmatic philosophy that a researcher should use the approach or mixture of approaches best suited to answer the research question (Johnson & Onwueghuzie, 2004).

The research question ideal to a mixed methods approach should reflect interconnected qualitative and quantitative components (Tashakkori & Creswell, 2007). Qualitative and quantitative data can be collected at the same time or in sequence. Depending on the purpose, many different designs are possible in a mixed method study. In addition, different types of mixed methods designs are available depending on the weight given to the qualitative and quantitative portions. Authors should be clear which approach has dominance.

Some studies are mainly qualitative in nature and are supplemented by quantitative data, usually to describe the participants further. For example, Kramer and colleagues (2008) primarily used qualitative data with interviews, participant observations, and document analysis to describe the structures and practices that enable nurses to control their practice. In addition, they administered a quantitative scale that measured perceived empowerment of staff nurses in the eight study hospitals to compare facilities with different shared governance structures.

Another type of study is mainly quantitative, supplemented by a qualitative study to explore a particular experience in more depth. Yoder, O'Rourke, Etnyer, Spears, and Brown (1997) conducted a qualitative study of participants already enrolled in a chemotherapy trial (large quantitative study) to describe their expectations and experience as subjects in a phase 1 clinical trial.

The third general type of mixed methods study gives equal weight to both types of research. It is more difficult to find an example of a nursing study where researchers used this design, especially with results reported in one article. One type of research data tends to dominate in each report. Sorenson and Yankech (2008) reported equal emphasis was given to the quantitative measurement of new graduates' critical thinking and to the focus group data of preceptors who participated in an education program.

Strengths and Weaknesses

Mixed methods research has many advantages, such as providing narrative to add meaning to numbers but also using numbers to add precision to narrative data. Researchers can generate theory (qualitative research) and then test it quantitatively. Mixed methods allow researchers to answer a broader, more complete range of research questions because they are not limited to one approach (Johnson & Onwueghuzie, 2004). As mentioned earlier, a researcher can use one method to overcome the weaknesses of another method and therefore have stronger evidence for a conclusion. Using both qualitative and quantitative data in a study can produce more complete knowledge needed to inform clinical practice (Creswell &Plano Clark, 2007).

On the other hand, mixed methods research has disadvantages. One researcher may find it difficult to conduct both quantitative and qualitative research, especially if both types of data are collected at the same time. Therefore, a team approach usually is necessary. The team has to understand multiple methods and the best sequence to conduct the research, and also be able to combine the findings into a meaningful product (Yin, 2006). In addition, mixed methods research usually is more expensive and time consuming to conduct. One of the key criticisms of mixed methods reports is that researchers often are not clear on how the findings from qualitative and quantitative data were integrated or linked to provide a fuller understanding of the phenomenon (Creswell & Tashakkori, 2007; Yin, 2006.)

Reporting Mixed Methods Studies

As more researchers conduct mixed methods studies, the issue of how to publish all the findings is receiving more attention. Authors may be able to include all the findings in one concisely written article.

Another way authors address the various parts of the research is to publish two articles, one with quantitative and one with qualitative findings. In this case, how the researchers integrated both types of findings within the study often is missing unless an article is written on that issue. Articles are sometimes published in different journals or they could be published in subsequent issues of the same journal. The problem for readers is that they may not know about the entire study by reading one of the articles unless authors explain the mixed methods approach and reference other articles with additional findings.

Because mixed methods studies are seen more frequently in the nursing literature, an understanding of this type of research is important. First, nurses need a solid understanding of both quantitative and qualitative research as single approaches. In addition, they need some knowledge about appropriate sampling and data collection strategies for mixed methods research, as well as methods of integrating the findings of the two approaches. The references listed in this article are a place to start for further information. *


Creswell, J.W., & Piano-Clark, V. (2007). Designing and conducting mixed methods research. Thousand Oaks, CA: Sage.

Creswell, J.W., & Tashakkori, A. (2007). Developing publishable mixed methods manuscripts. Journal of Mixed Methods Research, 1(2), 107-111.

Johnson, R.B., & Onwueghuzie, A.J. (2004). Mixed methods research: A research paradigm whose time has come. Educational Researcher, 33(7), 14-26.

Kramer, M., Schmalenberg, C., Maguire, P., Brewer, B.B., Burke, R., Chmielewski, L., et al. (2008). Structures and practices enabling staff nurses to control their practice. Western Journal of Nursing Research, 30(5), 539-559.

Owens, B., Jackson, M., & Berndt, A. (2009). Pilot study of a structured aerobic exercise program for Hispanic women during treatment for early-stage breast cancer. MEDSURG Nursing, 18(1), 23-30.

Sorensen, H.A.J., & Yankech, L.R. (2008). Precepting in the fast lane: Improving critical thinking in new graduate nurses. The Journal of Continuing Education in Nursing, 39(5), 208-216.

Tashakkori, A., & Creswell, J.W. (2007). Exploring the nature of research questions in mixed methods research. Journal of Mixed Methods Research, 1(3), 207-211.

Yin, R.K. (2006). Mixed methods research: Are the methods genuinely integrated or merely parallel? Research in the Schools, 13(1), 41-47.

Yoder, L.H., O'Rourke, T. J., Etnyre, A., Spears, D.T., & Brown, T.D. (1997). Expectations and experiences of patients with cancer participating in phase I clinical trials. Oncology Nursing Forum, 24(5), 891-896.

Lynne M. Connelly, PhD, RN, is an Assistant Professor, University of Kansas, School of Nursing, and Clinical Nurse Researcher, University of Kansas Hospital, Kansas City, KS. She is Research Editor for MEDSURG Nursing.
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Title Annotation:Research Roundtable; side effects of the breast cancer treatments and physiological outcomes of the exercise
Author:Connelly, Lynne M.
Publication:MedSurg Nursing
Geographic Code:1USA
Date:Jan 1, 2009
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