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An overview of research designs relevant to nursing: Part 3: Mixed and

multiplemethods

Article  in  Revista Latino-Americana de Enfermagem · September 2007

DOI: 10.1590/S0104-11692007000500025 · Source: PubMed

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Martha Driessnack Valmi D Sousa

Oregon Health and Science University University of Kansas
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Rev Latino-am Enfermagem 2007 setembro-outubro; 15(5):1046-9
www.eerp.usp.br/rlae 1046

AN OVERVIEW OF RESEARCH DESIGNS RELEVANT TO NURSING: PART 3: MIXED AND

MULTIPLE METHODS

1
Martha Driessnack
Valmi D. Sousa2
3
Isabel Amélia Costa Mendes

Driessnack M, Sousa VD, Mendes IAC. An overview of research designs relevant to nursing: Part 3: Mixed and
multiple methods. Rev Latino-am Enfermagem 2007 setembro-outubro; 15(5):1046-9.

This third article of the series “An Overview of Research Designs Relevant to Nursing” presents the use
of mixed or multiple methods in nursing research. The use of mixed or multiple methods is a growing trend that
offers another option for researchers in addressing the complex health problems faced in nursing today.
Understanding of all methods and all combinations of methods facilitate the conduction and dissemination of
research to serve nursing practice.

DESCRIPTORS: nursing research; qualitative analysis; methodology; nursing

REVISIÓN DE LOS DISEÑOS DE INVESTIGACIÓN RELEVANTES PARA LA ENFERMERÍA:

PARTE 3: MÉTODOS MIXTOS Y MÚLTIPLES

Este tercero artículo de la serie “Revisión de los Diseños de Investigación Relevantes para la Enfermería”
presenta el uso de los métodos mixtos o múltiples en la investigación en enfermería. El uso de métodos mixtos
o múltiples es una tendencia creciente que ofrece una alternativa a los investigadores en la aproximación de
problemas complejos de la salud enfrentados actualmente en la enfermería. Entender todos los métodos y
todas las combinaciones de métodos facilita la conducción y diseminación de la investigación para servir a la
práctica de la enfermería.

DESCRIPTORES: investigación en enfermería; análisis cualitativo; metodología; enfermería

REVISÃO DOS DESENHOS DE PESQUISA RELEVANTES PARA ENFERMAGEM: PARTE 3:

MÉTODOS MISTOS E MÚLTIPLOS

Este terceiro artigo da série “Revisão dos Desenhos de Pesquisa Relevantes para Enfermagem” apresenta
o uso dos métodos mistos ou múltiplos na pesquisa em enfermagem. O uso de métodos mistos ou múltiplos é
uma tendência crescente que oferece uma alternativa aos pesquisadores na abordagem de problemas complexos
da saúde enfrentados atualmente em enfermagem. Entender todos os métodos e todas as combinações de
métodos facilita a condução e disseminação da pesquisa para servir a prática da enfermagem.

DESCRITORES: pesquisa em enfermagem; análise qualitativa; metodologia; enfermagem

1
Assistant Professor, The University of Iowa, College of Nursing, United States of America, e-mail: martha-driessnack@uiowa.edu; 2 Associate Professor,
3
The University of Kansas Medical Center, School of Nursing, United States of America, e-mail: vsousa@kumc.edu; RN, Full Professor, University of São
Paulo at Ribeirão Preto College of Nursing, WHO Collaborating Centre for Nursing Research Development, Brazil, CNPq Researcher 1A, e-mail:
iamendes@eerp.usp.br

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SciELO Brasil www.scielo.br/rlae
Rev Latino-am Enfermagem 2007 setembro-outubro; 15(5):1046-9
www.eerp.usp.br/rlae
An overview of research designs...
Driessnack M, Sousa VD, Mendes IAC. 1047

INTRODUCTION MULTIPLE METHODS

In the first two articles of this three part Multiple methods, or multi-method design, is
series, both quantitative and qualitative research when two or more research projects are conducted,
designs relevant to nursing have been introduced and each complete in itself, to address research questions
(1-2) (4)
discussed . The focus of this third article is to and/or hypotheses, a topic, or a program . As with
introduce the concept of using two or more mixed methods, the studies may be a combination of
quantitative and/or qualitative methods within the quantitative methods, qualitative methods, or both.
same study design - which is referred to as either The projects can be implemented concurrently or
mixed or multiple methods, depending on the number sequentially. However, unlike mixed methods, each
of projects needed to address the research question. study project is independently planned and conducted
(4)
The use of mixed or multiple method to answer a particular sub-question . For example,
(3)
research designs is a growing trend in nursing . the purpose statement for a multiple methods, or
Combining methods offers another option to multi-method study might read - “The purpose of this
address the complex health problems frequently sequential [QUALØquan] multimethod study is to
faced by the nursing discipline. The discussion of explore children’s ideas about fear with the intent of
using more than one method will begin with an using this information to develop and test an
overview of the specific design principles of mixed instrument. The first phase will be the qualitative
or multiple methods followed by a discussion of their exploration of fear using semi-structured interviews.
main differences. Themes from this qualitative data will be then be
developed into an instrument to survey children about
their fears and pilot tested”.
MIXED METHODS

Mixed methods refer to the use of two or MIXED AND MULTIPLE METHODS DESIGN
more quantitative and/or qualitative strategies within PRINCIPLES
a single research project(4-6). Said another way, mixed
methods is exemplified when a single study uses There are two main principles that guide
multiple or mixed strategies to answer the research researchers in using more than one method. The first
questions and/or test hypotheses. Strategies are design principle is to recognize and respect the
implemented concurrently or sequentially. For project’s primary theoretical drive or paradigm and
example, the purpose statement for a mixed methods adhere to its methodological assumptions. The primary
study might read - “The purpose of this concurrent theoretical drive, which may be either quantitative
[QUAN+qual] mixed methods study is to better (deductive) or qualitative (inductive), forms the
understand children’s fears by converging both analytical core of the project. It is determined by the
quantitative and qualitative data. The Fear Survey research question(s) or hypothesi(e)s and should drive
Schedule for Children will be used to measure the approach to the data and the sample. For example,
children’s overall fearfulness. At the same time, if the primary theoretical drive is qualitative [QUAL],
children’s fears will be explored using qualitative the sample is typically small and purposely selected.
interviews with a purposively selected sub- If the secondary component is quantitative [quan],
population”. external normative values must be available for the
The important distinction is the variation in interpretation of quantitative data because of sampling
data collection strategies occur within a single study. violations (4) . If the primary theoretical drive is
The secondary or minor strategy is described as being quantitative [QUAN], and the secondary component
imported into the study, as it normally would not fit in is qualitative [qual], then the sample must be
the overall design assumptions. The imported strategy purposefully selected from the main study(4) . The
cannot stand alone but instead is imported to support primary theoretical drive is typically designated by
the primary data collection strategy. This is different the use of upper case letters, QUAN or QUAL.
from a multiple methods design, which is discussed The second principle is to recognize the role of
below. the secondary or supplemental component. The role of
An overview of research designs...
Driessnack M, Sousa VD, Mendes IAC.
Rev Latino-am Enfermagem 2007 setembro-outubro; 15(5):1046-9
www.eerp.usp.br/rlae 1048

the secondary component is to elicit a perspective or methodological triangulation and triangulation are often
dimension that cannot be accessed by the first approach, used by different researchers as being synonymous with
enhance description, or enable further exploration or the broader designation of mixed or multiple methods.
(4)
tentative testing of an emerging conjecture . The data The use of these terms can be confusing.
generated from the supplemental data inform the primary
data and analysis. The secondary component is typically Complementary
designated using lower case letters, quan or qual.
There are four possible combinations for a Complementarity reaches beyond triangulation
qualitative theoretical drive and four with a quantitative by focusing not only on overlapping or converging data,
theoretical drive: [QUAL+qual], [QUALØqual], but also on the different facets of phenomenon,
[QUAL+quan], [QUALØquan] and [QUAN+quan], providing a greater range of insights and perspectives.
[QUANØquan], [QUAN+qual], [QUANØqual].
The plus sign (+) indicates that the secondary Development
or supplemental method is implemented
simultaneously or concurrently, within the same data Development combines, or uses, the findings
collection period, while the arrow (Ø) indicates that from one method of studying a phenomenon to
the secondary method was implemented sequentially, develop another method. For example, focus groups
(7)
or after the primary data is obtained . are sometimes used to gain feedback on a
questionnaire beyond it is piloted.

PURPOSES FOR USING MIXED AND Initiation

MULTIPLE METHODS
Initiation involves the intentional analysis of
There are five main purposes for using more new perspectives on a phenomenon of interest.
than one method when studying a phenomenon of
interest. These include: 1) triangulation, 2) Expansion
complementarity, 3) development, 4) initiation, and
5) expansion(7-10). Research design options become Expansion is the overall widening of the
wider as design purposes move from triangulation to scope, breadth, or range of a study.
expansion. To date, nurse researchers have primarily
focused their efforts on triangulation(11-12). However, it
Triangulation is also important to note, that as mixed and multiple
methods continue to develop and evolve, so does their
Triangulation is the most well known of these associated terminology. Researcher should clearly
five purposes. It refers to the convergence or define their purpose and approach to using mixed or
corroboration of data gathering and interpretation about multiple methods when describing their studies.
the same phenomenon. The exact approach or form of
data gathering and/or interpretation can vary. For
example, researchers sometimes state they are using SUMMARY
data triangulation, investigator triangulation, theoretical
triangulation, or methodological triangulation. Data Mixed or multiple methods promise new
triangulation refers to the convergence or corroboration insights and perspective in the understanding of
of data about the same phenomenon. Investigator phenomena in nursing research. Using more than one
triangulation refers to the collaboration of two or more method offers the potential for deeper understandings
investigators to gather and interpret the data. Theoretical of the complex health problems frequently faced by
triangulation refers to the use of more than one the nursing discipline. Today, nurses need to expand
theoretical framework to guide the conceptualization of their understanding of all methods and all
the study and the interpretation of the data. And, combinations of methods, so they are prepared to
methodological triangulation refers to the use of more answer the research questions that arise from the
than one method to gather the data. The terms complex health care situations they are faced with.
 Rev Latino-am Enfermagem 2007 setembro-outubro; 15(5):1046-9
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An overview of research designs...
Driessnack M, Sousa VD, Mendes IAC. 1049

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Recebido em: 26.7.2006

Aprovado em: 25.6.2007

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