World Rural Health Conference
Home Print this page Email this page Small font size Default font size Increase font size
Users Online: 1765
Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 


 
 Table of Contents 
RESEARCH AND AUDIT
Year : 2015  |  Volume : 4  |  Issue : 3  |  Page : 324-327  

Validity, reliability, and generalizability in qualitative research


Department of Family Medicine and Centre of Studies in Primary Care, Queen's University, Kingston, Ontario, Canada

Date of Web Publication23-Jul-2015

Correspondence Address:
Lawrence Leung
Centre of Studies in Primary Care, Queen's University, 220 Bagot Street, Kingston, ON K7L 5E9
Canada
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2249-4863.161306

Rights and Permissions
  Abstract 

In general practice, qualitative research contributes as significantly as quantitative research, in particular regarding psycho-social aspects of patient-care, health services provision, policy setting, and health administrations. In contrast to quantitative research, qualitative research as a whole has been constantly critiqued, if not disparaged, by the lack of consensus for assessing its quality and robustness. This article illustrates with five published studies how qualitative research can impact and reshape the discipline of primary care, spiraling out from clinic-based health screening to community-based disease monitoring, evaluation of out-of-hours triage services to provincial psychiatric care pathways model and finally, national legislation of core measures for children's healthcare insurance. Fundamental concepts of validity, reliability, and generalizability as applicable to qualitative research are then addressed with an update on the current views and controversies.

Keywords: Controversies, generalizability, primary care research, qualitative research, reliability, validity


How to cite this article:
Leung L. Validity, reliability, and generalizability in qualitative research. J Family Med Prim Care 2015;4:324-7

How to cite this URL:
Leung L. Validity, reliability, and generalizability in qualitative research. J Family Med Prim Care [serial online] 2015 [cited 2019 Mar 25];4:324-7. Available from: http://www.jfmpc.com/text.asp?2015/4/3/324/161306


  Nature of Qualitative Research versus Quantitative Research Top


The essence of qualitative research is to make sense of and recognize patterns among words in order to build up a meaningful picture without compromising its richness and dimensionality. Like quantitative research, the qualitative research aims to seek answers for questions of "how, where, when who and why" with a perspective to build a theory or refute an existing theory. Unlike quantitative research which deals primarily with numerical data and their statistical interpretations under a reductionist, logical and strictly objective paradigm, qualitative research handles nonnumerical information and their phenomenological interpretation, which inextricably tie in with human senses and subjectivity. While human emotions and perspectives from both subjects and researchers are considered undesirable biases confounding results in quantitative research, the same elements are considered essential and inevitable, if not treasurable, in qualitative research as they invariable add extra dimensions and colors to enrich the corpus of findings. However, the issue of subjectivity and contextual ramifications has fueled incessant controversies regarding yardsticks for quality and trustworthiness of qualitative research results for healthcare.


  Impact of Qualitative Research upon Primary Care Top


In many ways, qualitative research contributes significantly, if not more so than quantitative research, to the field of primary care at various levels. Five qualitative studies are chosen to illustrate how various methodologies of qualitative research helped in advancing primary healthcare, from novel monitoring of chronic obstructive pulmonary disease (COPD) via mobile-health technology, [1] informed decision for colorectal cancer screening, [2] triaging out-of-hours GP services, [3] evaluating care pathways for community psychiatry [4] and finally prioritization of healthcare initiatives for legislation purposes at national levels. [5] With the recent advances of information technology and mobile connecting device, self-monitoring and management of chronic diseases via tele-health technology may seem beneficial to both the patient and healthcare provider. Recruiting COPD patients who were given tele-health devices that monitored lung functions, Williams et al. [1] conducted phone interviews and analyzed their transcripts via a grounded theory approach, identified themes which enabled them to conclude that such mobile-health setup and application helped to engage patients with better adherence to treatment and overall improvement in mood. Such positive findings were in contrast to previous studies, which opined that elderly patients were often challenged by operating computer tablets, [6] or, conversing with the tele-health software. [7] To explore the content of recommendations for colorectal cancer screening given out by family physicians, Wackerbarth, et al. [2] conducted semi-structure interviews with subsequent content analysis and found that most physicians delivered information to enrich patient knowledge with little regard to patients' true understanding, ideas, and preferences in the matter. These findings suggested room for improvement for family physicians to better engage their patients in recommending preventative care. Faced with various models of out-of-hours triage services for GP consultations, Egbunike et al. [3] conducted thematic analysis on semi-structured telephone interviews with patients and doctors in various urban, rural and mixed settings. They found that the efficiency of triage services remained a prime concern from both users and providers, among issues of access to doctors and unfulfilled/mismatched expectations from users, which could arouse dissatisfaction and legal implications. In UK, a care pathways model for community psychiatry had been introduced but its benefits were unclear. Khandaker et al. [4] hence conducted a qualitative study using semi-structure interviews with medical staff and other stakeholders; adopting a grounded-theory approach, major themes emerged which included improved equality of access, more focused logistics, increased work throughput and better accountability for community psychiatry provided under the care pathway model. Finally, at the US national level, Mangione-Smith et al. [5] employed a modified Delphi method to gather consensus from a panel of nominators which were recognized experts and stakeholders in their disciplines, and identified a core set of quality measures for children's healthcare under the Medicaid and Children's Health Insurance Program. These core measures were made transparent for public opinion and later passed on for full legislation, hence illustrating the impact of qualitative research upon social welfare and policy improvement.


  Overall Criteria for Quality in Qualitative Research Top


Given the diverse genera and forms of qualitative research, there is no consensus for assessing any piece of qualitative research work. Various approaches have been suggested, the two leading schools of thoughts being the school of Dixon-Woods et al. [8] which emphasizes on methodology, and that of Lincoln et al. [9] which stresses the rigor of interpretation of results. By identifying commonalities of qualitative research, Dixon-Woods produced a checklist of questions for assessing clarity and appropriateness of the research question; the description and appropriateness for sampling, data collection and data analysis; levels of support and evidence for claims; coherence between data, interpretation and conclusions, and finally level of contribution of the paper. These criteria foster the 10 questions for the Critical Appraisal Skills Program checklist for qualitative studies. [10] However, these methodology-weighted criteria may not do justice to qualitative studies that differ in epistemological and philosophical paradigms, [11],[12] one classic example will be positivistic versus interpretivistic. [13] Equally, without a robust methodological layout, rigorous interpretation of results advocated by Lincoln et al. [9] will not be good either. Meyrick [14] argued from a different angle and proposed fulfillment of the dual core criteria of "transparency" and "systematicity" for good quality qualitative research. In brief, every step of the research logistics (from theory formation, design of study, sampling, data acquisition and analysis to results and conclusions) has to be validated if it is transparent or systematic enough. In this manner, both the research process and results can be assured of high rigor and robustness. [14] Finally, Kitto et al. [15] epitomized six criteria for assessing overall quality of qualitative research: (i) Clarification and justification, (ii) procedural rigor, (iii) sample representativeness, (iv) interpretative rigor, (v) reflexive and evaluative rigor and (vi) transferability/generalizability, which also double as evaluative landmarks for manuscript review to the Medical Journal of Australia. Same for quantitative research, quality for qualitative research can be assessed in terms of validity, reliability, and generalizability.


  Validity Top


Validity in qualitative research means "appropriateness" of the tools, processes, and data. Whether the research question is valid for the desired outcome, the choice of methodology is appropriate for answering the research question, the design is valid for the methodology, the sampling and data analysis is appropriate, and finally the results and conclusions are valid for the sample and context. In assessing validity of qualitative research, the challenge can start from the ontology and epistemology of the issue being studied, e.g. the concept of "individual" is seen differently between humanistic and positive psychologists due to differing philosophical perspectives: [16] Where humanistic psychologists believe "individual" is a product of existential awareness and social interaction, positive psychologists think the "individual" exists side-by-side with formation of any human being. Set off in different pathways, qualitative research regarding the individual's wellbeing will be concluded with varying validity. Choice of methodology must enable detection of findings/phenomena in the appropriate context for it to be valid, with due regard to culturally and contextually variable. For sampling, procedures and methods must be appropriate for the research paradigm and be distinctive between systematic, [17] purposeful [18] or theoretical (adaptive) sampling [19],[20] where the systematic sampling has no a priori theory, purposeful sampling often has a certain aim or framework and theoretical sampling is molded by the ongoing process of data collection and theory in evolution. For data extraction and analysis, several methods were adopted to enhance validity, including 1 st tier triangulation (of researchers) and 2 nd tier triangulation (of resources and theories), [17],[21] well-documented audit trail of materials and processes, [22],[23],[24] multidimensional analysis as concept- or case-orientated [25],[26] and respondent verification. [21],[27]


  Reliability Top


In quantitative research, reliability refers to exact replicability of the processes and the results. In qualitative research with diverse paradigms, such definition of reliability is challenging and epistemologically counter-intuitive. Hence, the essence of reliability for qualitative research lies with consistency. [24],[28] A margin of variability for results is tolerated in qualitative research provided the methodology and epistemological logistics consistently yield data that are ontologically similar but may differ in richness and ambience within similar dimensions. Silverman [29] proposed five approaches in enhancing the reliability of process and results: Refutational analysis, constant data comparison, comprehensive data use, inclusive of the deviant case and use of tables. As data were extracted from the original sources, researchers must verify their accuracy in terms of form and context with constant comparison, [27] either alone or with peers (a form of triangulation). [30] The scope and analysis of data included should be as comprehensive and inclusive with reference to quantitative aspects if possible. [30] Adopting the Popperian dictum of falsifiability as essence of truth and science, attempted to refute the qualitative data and analytes should be performed to assess reliability. [31]


  Generalizability Top


Most qualitative research studies, if not all, are meant to study a specific issue or phenomenon in a certain population or ethnic group, of a focused locality in a particular context, hence generalizability of qualitative research findings is usually not an expected attribute. However, with rising trend of knowledge synthesis from qualitative research via meta-synthesis, meta-narrative or meta-ethnography, evaluation of generalizability becomes pertinent. A pragmatic approach to assessing generalizability for qualitative studies is to adopt same criteria for validity: That is, use of systematic sampling, triangulation and constant comparison, proper audit and documentation, and multi-dimensional theory. [17] However, some researchers espouse the approach of analytical generalization [32] where one judges the extent to which the findings in one study can be generalized to another under similar theoretical, and the proximal similarity model, where generalizability of one study to another is judged by similarities between the time, place, people and other social contexts. [33] Thus said, Zimmer [34] questioned the suitability of meta-synthesis in view of the basic tenets of grounded theory, [35] phenomenology [36] and ethnography. [37] He concluded that any valid meta-synthesis must retain the other two goals of theory development and higher-level abstraction while in search of generalizability, and must be executed as a third level interpretation using Gadamer's concepts of the hermeneutic circle, [38],[39] dialogic process [38] and fusion of horizons. [39] Finally, Toye et al. [40] reported the practicality of using "conceptual clarity" and "interpretative rigor" as intuitive criteria for assessing quality in meta-ethnography, which somehow echoed Rolfe's controversial aesthetic theory of research reports. [41]


  Food for Thought Top


Despite various measures to enhance or ensure quality of qualitative studies, some researchers opined from a purist ontological and epistemological angle that qualitative research is not a unified, but ipso facto diverse field, [8] hence any attempt to synthesize or appraise different studies under one system is impossible and conceptually wrong. Barbour argued from a philosophical angle that these special measures or "technical fixes" (like purposive sampling, multiple-coding, triangulation, and respondent validation) can never confer the rigor as conceived. [11] In extremis, Rolfe et al. opined from the field of nursing research, that any set of formal criteria used to judge the quality of qualitative research are futile and without validity, and suggested that any qualitative report should be judged by the form it is written (aesthetic) and not by the contents (epistemic). [41] Rolfe's novel view is rebutted by Porter, [42] who argued via logical premises that two of Rolfe's fundamental statements were flawed: (i) "The content of research report is determined by their forms" may not be a fact, and (ii) that research appraisal being "subject to individual judgment based on insight and experience" will mean those without sufficient experience of performing research will be unable to judge adequately - hence an elitist's principle. From a realism standpoint, Porter then proposes multiple and open approaches for validity in qualitative research that incorporate parallel perspectives [43],[44] and diversification of meanings. [44] Any work of qualitative research, when read by the readers, is always a two-way interactive process, such that validity and quality has to be judged by the receiving end too and not by the researcher end alone.

In summary, the three gold criteria of validity, reliability and generalizability apply in principle to assess quality for both quantitative and qualitative research, what differs will be the nature and type of processes that ontologically and epistemologically distinguish between the two.

 
  References Top

1.
Williams V, Price J, Hardinge M, Tarassenko L, Farmer A. Using a mobile health application to support self-management in COPD: A qualitative study. Br J Gen Pract 2014;64:e392-400.  Back to cited text no. 1
    
2.
Wackerbarth SB, Tarasenko YN, Joyce JM, Haist SA. Physician colorectal cancer screening recommendations: An examination based on informed decision making. Patient Educ Couns 2007;66:43-50.  Back to cited text no. 2
    
3.
Egbunike JN, Shaw C, Porter A, Button LA, Kinnersley P, Hood K, et al. Streamline triage and manage user expectations: Lessons from a qualitative study of GP out-of-hours services. Br J Gen Pract 2010;60:e83-97.  Back to cited text no. 3
    
4.
Khandaker GM, Gandamaneni PK, Dibben CR, Cherukuru S, Cairns P, Ray MK. Evaluating care pathways for community psychiatry in England: A qualitative study. J Eval Clin Pract 2013;19:298-303.  Back to cited text no. 4
    
5.
Mangione-Smith R, Schiff J, Dougherty D. Identifying children′s health care quality measures for Medicaid and CHIP: An evidence-informed, publicly transparent expert process. Acad Pediatr 2011;11:S11-21.  Back to cited text no. 5
    
6.
Hess R, Santucci A, McTigue K, Fischer G, Kapoor W. Patient difficulty using tablet computers to screen in primary care. J Gen Intern Med 2008;23:476-80.  Back to cited text no. 6
    
7.
Sanders C, Rogers A, Bowen R, Bower P, Hirani S, Cartwright M, et al. Exploring barriers to participation and adoption of telehealth and telecare within the Whole System Demonstrator trial: A qualitative study. BMC Health Serv Res 2012;12:220.  Back to cited text no. 7
    
8.
Dixon-Woods M, Shaw RL, Agarwal S, Smith JA. The problem of appraising qualitative research. Qual Saf Health Care 2004;13:223-5.  Back to cited text no. 8
    
9.
Lincoln YS, Lynham SA, Guba EG. Paradigmatic controversies, contradictions, and emerging confluences, revisited. The Sage Handbook of Qualitative Research. Vol. 4. Sage Publications; 2011. p. 97-128.  Back to cited text no. 9
    
10.
CASP. CASP Qualitative Checklist: Critical Appraisal Skills Program; 2013. Available from: http://www.media.wix.com/ugd/dded87_29c5b002d99342f788c6ac670e49f274.pdf. [Last cited on 2015 Mar 01].  Back to cited text no. 10
    
11.
Barbour RS. Checklists for improving rigour in qualitative research: A case of the tail wagging the dog? BMJ 2001;322:1115-7.  Back to cited text no. 11
    
12.
Popay J, Rogers A, Williams G. Rationale and standards for the systematic review of qualitative literature in health services research. Qual Health Res 1998;8:341-51.  Back to cited text no. 12
    
13.
Sale JE. How to assess rigour…or not in qualitative papers. J Eval Clin Pract 2008;14:912-3.  Back to cited text no. 13
    
14.
Meyrick J. What is good qualitative research? A first step towards a comprehensive approach to judging rigour/quality. J Health Psychol 2006;11:799-808.  Back to cited text no. 14
    
15.
Kitto SC, Chesters J, Grbich C. Quality in qualitative research. Med J Aust 2008;188:243-6.  Back to cited text no. 15
    
16.
Waterman AS. The humanistic psychology-positive psychology divide: Contrasts in philosophical foundations. Am Psychol 2013;68:124-33.  Back to cited text no. 16
    
17.
Finfgeld-Connett D. Generalizability and transferability of meta-synthesis research findings. J Adv Nurs 2010;66:246-54.  Back to cited text no. 17
    
18.
Palinkas LA, Horwitz SM, Green CA, Wisdom JP, Duan N, Hoagwood K. Purposeful Sampling for Qualitative Data Collection and Analysis in Mixed Method Implementation Research. Adm Policy Ment Health 2013. p. 1-12.  Back to cited text no. 18
    
19.
Coyne IT. Sampling in qualitative research. Purposeful and theoretical sampling; merging or clear boundaries? J Adv Nurs 1997;26:623-30.  Back to cited text no. 19
    
20.
Becker PH. Common pitfalls in published grounded theory research. Qual Health Res 1993;3:254-60.  Back to cited text no. 20
    
21.
Lincoln YS, Guba EG. Naturalistic Inquiry . Newbury Park, London: Sage Publications; 1985. p. 416.  Back to cited text no. 21
    
22.
Rodgers BL, Cowles KV. The qualitative research audit trail: A complex collection of documentation. Res Nurs Health 1993;16:219-26.  Back to cited text no. 22
    
23.
Kahn DL. Reducing bias. In: Cohen MZ, Kahn DL, Steeves RH, editors. Hermeneutic Phenomenological Research: A Practical Guide for Nurse Researchers. Newbury Park, London: Sage Publications; 2000. p. 85-99.  Back to cited text no. 23
    
24.
Carcary M. The research audit trail - Enhancing trustworthiness in qualitative inquiry. Electron J Bus Res Methods 2009;7:11-24. Available from: http://www.ejbrm.com. [Last accessed on 2015 Mar 03].  Back to cited text no. 24
    
25.
Jansen H. The logic of qualitative survey research and its position in the field of social research methods. Forum Qual Soc Res 2010;11:2.  Back to cited text no. 25
    
26.
Miles MB, Huberman AM. Qualitative Data Analysis: An Expanded Sourcebook. Newbury Park; London: Sage; 1994.  Back to cited text no. 26
    
27.
George M, Apter AJ. Gaining insight into patients′ beliefs using qualitative research methodologies. Curr Opin Allergy Clin Immunol 2004;4:185-9.  Back to cited text no. 27
    
28.
Grossoehme DH. Overview of qualitative research. J Health Care Chaplain 2014;20:109-22.  Back to cited text no. 28
    
29.
Silverman D. Doing Qualitative Research. 3 rd ed . Newbury Park, London: SAGE Publications Ltd.; 2009. p. 472.  Back to cited text no. 29
    
30.
Patton MQ. Enhancing the quality and credibility of qualitative analysis. Health Serv Res 1999;34:1189-208.  Back to cited text no. 30
    
31.
Allmark P. Popper and nursing theory. Nurs Philos 2003;4:4-16.  Back to cited text no. 31
    
32.
Kvale S, Brinkmann S. Interviews: Learning the Craft of Qualitative Research Interviewing. Newbury Park, London: Sage; 2009.  Back to cited text no. 32
    
33.
Trochim WM. Research Methods: The Concise Knowledge Base . Cincinnati, Ohio: Atomic Dog Publishing; 2005.  Back to cited text no. 33
    
34.
Zimmer L. Qualitative meta-synthesis: A question of dialoguing with texts. J Adv Nurs 2006;53:311-8.  Back to cited text no. 34
    
35.
Glaser BG, Strauss AL, Strutzel E. The discovery of grounded theory; strategies for qualitative research. Nurs Res 1968;17:364.  Back to cited text no. 35
    
36.
Van Manen M. Researching Lived Experience: Human Science for An Action Sensitive Pedagogy. New York. SUNY Press: Suny Press; 1990.  Back to cited text no. 36
    
37.
Noblit GW, Hare RD. Meta-Ethnography: Synthesizing Qualitative Studies . Newbury Park, London: Sage; 1988.  Back to cited text no. 37
    
38.
Gadamer HG. Truth and Method (Weinsheimer J, Marshall DG. Trans). New York: Continuum; 1989.  Back to cited text no. 38
    
39.
Thompson J. Hermeneutic inquiry. Advancing Nursing Science Through Research. Vol. 2. Sage Publications: Newbury Park, London; 1990. p. 223-86.  Back to cited text no. 39
    
40.
Toye F, Seers K, Allcock N, Briggs M, Carr E, Andrews J, et al. Trying to pin down jelly - Exploring intuitive processes in quality assessment for meta-ethnography. BMC Med Res Methodol 2013;13:46.  Back to cited text no. 40
    
41.
Rolfe G. Validity, trustworthiness and rigour: Quality and the idea of qualitative research. J Adv Nurs 2006;53:304-10.  Back to cited text no. 41
    
42.
Porter S. Validity, trustworthiness and rigour: Reasserting realism in qualitative research. J Adv Nurs 2007;60:79-86.  Back to cited text no. 42
[PUBMED]    
43.
Guba EG, Lincoln YS. Fourth Generationm Evaluation . Newbury Park, London: Sage Publications; 1989. p. 296.  Back to cited text no. 43
    
44.
Sparkes AC. Myth 94: Qualitative health researchers will agree about validity. Qual Health Res 2001;11:538-52.  Back to cited text no. 44
    



This article has been cited by
1 Overcoming Performance Slumps: Psychological Resilience in Expert Cricket Batsmen
Christopher J. Brown,Joanne Butt,Mustafa Sarkar
Journal of Applied Sport Psychology. 2019; : 1
[Pubmed] | [DOI]
2 Comparison of rapid vs in-depth qualitative analytic methods from a process evaluation of academic detailing in the Veterans Health Administration
Randall C. Gale,Justina Wu,Taryn Erhardt,Mark Bounthavong,Caitlin M. Reardon,Laura J. Damschroder,Amanda M. Midboe
Implementation Science. 2019; 14(1)
[Pubmed] | [DOI]
3 A Qualitative Study to Understand the Potential Efficacy of an Information-Based Sugar Reduction Intervention among Low Socioeconomic Individuals in the UK
Hannah Forde,Emma Solomon-Moore
International Journal of Environmental Research and Public Health. 2019; 16(3): 413
[Pubmed] | [DOI]
4 Representations of maladaptive daydreaming and the self: A qualitative analysis of drawings
Eli Somer,Liora Somer,Naomi Halpern
The Arts in Psychotherapy. 2019;
[Pubmed] | [DOI]
5 Community-based mealtime management for adolescents with anorexia nervosa: A qualitative study of clinicians’ perspectives and experiences
Jaclyn Watt,Geoffrey L. Dickens
Journal of Child and Adolescent Psychiatric Nursing. 2018;
[Pubmed] | [DOI]
6 Reflexividad y reciprocidad: una mirada a la ética en la investigación a través de las relaciones inter-clase social en la Universidad de los Andes
José Leonardo Guevara Fino
Voces y Silencios. Revista Latinoamericana de Educación. 2018; 9(2): 178
[Pubmed] | [DOI]
7 Study design and the estimation of the size of key populations at risk of HIV: lessons from Viet Nam
Ali Safarnejad,Wim Groot,Milena Pavlova
BMC International Health and Human Rights. 2018; 18(1)
[Pubmed] | [DOI]
8 Master degree under crisis: the salient motives of Business students to enroll in a postgraduate programme
Bayan Khalifa,Osama Dukhan,Sulaiman Mouselli,Brian Roberts
International Journal of Educational Management. 2018; : 00
[Pubmed] | [DOI]
9 Dysphonia, Perceived Control, and Psychosocial Distress: A Qualitative Study
Stephanie Misono,Caroline Haut,Liza Meredith,Patricia A. Frazier,Ali Stockness,Deirdre D. Michael,Lisa Butcher,Eileen M. Harwood
Journal of Voice. 2018;
[Pubmed] | [DOI]
10 Process evaluation of the midwifery initiated oral health-dental service program: Perceptions of dental professionals
Shilpi Ajwani,Mariana S. Sousa,Ariana C. Villarosa,Sameer Bhole,Maree Johnson,Hannah G. Dahlen,Julia Hoolsema,Anthony Blinkhorn,Ravi Srinivas,Albert Yaacoub,Andrew Milat,John Skinner,Ajesh George
Health Promotion Journal of Australia. 2018;
[Pubmed] | [DOI]
11 Trends in Contemporary Holistic Nursing Research: 2010-2015
Colleen Delaney,Ruth G. McCaffrey,Cynthia Barrere,Amy Kenefick Moore,Dorothy J. Dunn,Robin J. Miller,Sheila L. Molony,Debra Thomas,Teresa C. Twomey,Xiaoyuan (Susan) Zhu
Journal of Holistic Nursing. 2018; 36(4): 385
[Pubmed] | [DOI]
12 Validating factors influencing monitoring and evaluation in the Ghanaian construction industry: a Delphi study approach
Callistus Tengan,Clinton Aigbavboa
International Journal of Construction Management. 2018; : 1
[Pubmed] | [DOI]
13 Hazards from physical attributes of the home environment among patients on outpatient parenteral antimicrobial therapy
Sara C. Keller,Sara E. Cosgrove,Michael Kohut,Amanda Krosche,Huai-En Chang,Deborah Williams,Ayse P. Gurses
American Journal of Infection Control. 2018;
[Pubmed] | [DOI]
14 Simulation-Based Learning Strategies to Teach Undergraduate Students Basic Surgical Skills: A Systematic Review
Iakovos Theodoulou,Marios Nicolaides,Thanos Athanasiou,Apostolos Papalois,Michail Sideris
Journal of Surgical Education. 2018;
[Pubmed] | [DOI]
15 Implementing A Competency-Based Midwifery Programme In Lesotho: A Gap Analysis
Champion N. Nyoni,Yvonne Botma
Nurse Education in Practice. 2018;
[Pubmed] | [DOI]
16 Defining the minimally clinically important difference of the SF-36 physical function subscale for paediatric CFS/ME: triangulation using three different methods
Amberly Brigden,Roxanne M Parslow,Daisy Gaunt,Simon M Collin,Andy Jones,Esther Crawley
Health and Quality of Life Outcomes. 2018; 16(1)
[Pubmed] | [DOI]
17 Attitudes toward tobacco among low-income Hispanic adolescents: Implications for prevention
Denise Vasquez,Mika Cohen Jones,Louis D. Brown
Journal of Ethnicity in Substance Abuse. 2018; : 1
[Pubmed] | [DOI]
18 Surgeons and preventative health: protocol for a mixed methods study of current practice, beliefs and attitudes influencing health promotion activities amongst public hospital surgeons
Stephen Barrett,Stephen Begg,Michael Kingsley
BMC Health Services Research. 2018; 18(1)
[Pubmed] | [DOI]
19 “I Treat Him as a Normal Patient”: Unveiling the Normalization Coping Strategy Among Formal Caregivers of Persons With Dementia and Its Implications for Person-Centered Care
Miriam Ethel Bentwich,Nomy Dickman,Amitai Oberman,Ya’arit Bokek-Cohen
Journal of Transcultural Nursing. 2018; 29(5): 420
[Pubmed] | [DOI]
20 Changing practice using recovery-focused care in acute mental health settings to reduce aggression: A qualitative study
Eric Lim,Dianne Wynaden,Karen Heslop
International Journal of Mental Health Nursing. 2018;
[Pubmed] | [DOI]
21 Towards a public health approach for palliative care: an action-research study focused on engaging a local community and educating teenagers
Sandra Martins Pereira,Joana Araújo,Pablo Hernández-Marrero
BMC Palliative Care. 2018; 17(1)
[Pubmed] | [DOI]
22 Mental health service users’ experiences of psychiatric re-hospitalisation - an explorative focus group study in six European countries
M. Ĺdnanes,L. Melby,J. Cresswell-Smith,H. Westerlund,L. Rabbi,M. Z. Dernovšek,L. Šprah,R. Sfetcu,C. Straßmayr,V. Donisi
BMC Health Services Research. 2018; 18(1)
[Pubmed] | [DOI]
23 Older Patient Preferences for Internal Fixation after a Distal Radius Fracture
Jacob S. Nasser,Helen E. Huetteman,Melissa J. Shauver,Kevin C. Chung
Plastic and Reconstructive Surgery. 2018; 142(1): 34e
[Pubmed] | [DOI]
24 Service guarantees as a base for positioning in B2B
Rod McColl,Yann Truong,Antonella La Rocca
Industrial Marketing Management. 2018;
[Pubmed] | [DOI]
25 A qualitative study of primary healthcare professionals’ views of falls prevention
Suhail Amin Tarafdar,Nichola Pugh,Alison Doyle,Debbie Bowen,Kathy Lee,Julie Law,Hashum Mahmood
Primary Health Care. 2018;
[Pubmed] | [DOI]
26 A Guide to Multisite Qualitative Analysis
Emily K. Jenkins,Allie Slemon,Rebecca J. Haines-Saah,John Oliffe
Qualitative Health Research. 2018; 28(12): 1969
[Pubmed] | [DOI]
27 Relevance of the intervention module “Coping with stress and unhelpful emotions” for parents living in multi-ethnic deprived neighborhoods
K. van Mourik,M.R. Crone,R. Reis
Children and Youth Services Review. 2018; 88: 426
[Pubmed] | [DOI]
28 Nursing student perspectives on a quality learning environment in general practice
Caroline Donley,Kay Norman
Primary Health Care. 2018; 28(4): 36
[Pubmed] | [DOI]
29 An Application of Hofstede’s Cultural Dimension among Female Educational Leaders
Charmaine Bissessar
Education Sciences. 2018; 8(2): 77
[Pubmed] | [DOI]
30 Collaborative risk management: a systematic literature review
Derek Friday,Suzanne Ryan,Ramaswami Sridharan,David Collins
International Journal of Physical Distribution & Logistics Management. 2018;
[Pubmed] | [DOI]
31 When and why does the name of the brand still matter? Developing the temporal dimension of brand name equity theory
Griff Round,Stuart Roper,Nick Lee,Christina Goulding
European Journal of Marketing. 2017; : 00
[Pubmed] | [DOI]
32 Narrative inquiry as a research methodology exploring person centred care in nursing
Gunilla Haydon,Graeme Browne,Pamela van der Riet
Collegian. 2017;
[Pubmed] | [DOI]
33 Dutch youth of parents with a mental illness reflect upon their feelings of guilt and shame
Annick Bosch,Joanne Riebschleger,Linda van Loon
International Journal of Mental Health Promotion. 2017; : 1
[Pubmed] | [DOI]
34 Developing a Taxonomy of Dark Triad Triggers at Work – A Grounded Theory Study Protocol
Annika Nübold,Josef Bader,Nera Bozin,Romil Depala,Helena Eidast,Elisabeth A. Johannessen,Gerhard Prinz
Frontiers in Psychology. 2017; 8
[Pubmed] | [DOI]
35 Perceptions and Use of a Web-Based Referral System in Child Welfare: Differences by Caseworker Tenure
Susanna R. Curry,Jenna van Draanen,Bridget Freisthler
Journal of Technology in Human Services. 2017; 35(2): 152
[Pubmed] | [DOI]
36 Gamification as a platform for brand co-creation experiences
Helena Nobre,André Ferreira
Journal of Brand Management. 2017;
[Pubmed] | [DOI]
37 Turkish foreign direct investment and peace in Somalia: a new political stabilization policy
Mohamed Ibrahim Nor,TAJUL ARIFFIN MASRON,James Connelly
International Journal of Social Economics. 2017; : 00
[Pubmed] | [DOI]
38 Machinery-related perceived risks and safety attitudes in senior Swedish farmers
Federica Caffaro,Peter Lundqvist,Margherita Micheletti Cremasco,Kerstin Nilsson,Stefan Pinzke,Eugenio Cavallo
Journal of Agromedicine. 2017;
[Pubmed] | [DOI]
39 The effects on the student-teacher relationship in a one-to-one technology classroom
Kevin Higgins,Shawna BuShell
Education and Information Technologies. 2017;
[Pubmed] | [DOI]
40 Scaling a waterfall: a meta-ethnography of adolescent progression through the stages of HIV care in sub-Saharan Africa
Shannon Williams,Jenny Renju,Ludovica Ghilardi,Alison Wringe
Journal of the International AIDS Society. 2017; 20(1): 21922
[Pubmed] | [DOI]
41 Perspectives on rehabilitation of children with cerebral palsy: exploring a cross-cultural view of parents from India and Canada using the international classification of functioning, disability and health
Pranay Jindal,Joy C. MacDermid,Peter Rosenbaum,Briano DiRezze,Amitesh Narayan
Disability and Rehabilitation. 2017; : 1
[Pubmed] | [DOI]
42 Value creation models in the 3PL industry: what 3PL providers do to cope with shipper requirements
Gino Marchet,Marco Melacini,Sara Perotti,Chiara Sassi,Elena Tappia
International Journal of Physical Distribution & Logistics Management. 2017; 47(6): 472
[Pubmed] | [DOI]
43 The views of carers about support for their family member with an intellectual disability: With a focus on positive behavioural approaches
Karen McKenzie,Claire Mayer,Kathryn J. Whelan,Anne McNall,Steve Noone,Jill Chaplin
Health & Social Care in the Community. 2017;
[Pubmed] | [DOI]
44 Factors Motivating HPV Vaccine Uptake Among Vaccinated and Nonvaccinated Hispanic Young Adult Women
Dionne P. Stephens,Hod Tamir,Tami L. Thomas
Hispanic Health Care International. 2016; 14(4): 184
[Pubmed] | [DOI]
45 Concerns about body change behaviors, and construction of flexible masculinity among Iranian students
Saideh Garousi,Rouhollah Khajeh Dolatabad,Behshid Garrusi
Quality & Quantity. 2016;
[Pubmed] | [DOI]
46 Hispanic College Menćs Perceptions of Appropriate Strategies for Initiating Sexual Intercourse with Women
Dionne P. Stephens,Asia A. Eaton,Brittany Boyd
Sex Roles. 2016;
[Pubmed] | [DOI]
47 Palliative Care Consultations in the Neuro-ICU: A Qualitative Study
Len N. Tran,Anthony L. Back,Claire J. Creutzfeldt
Neurocritical Care. 2016;
[Pubmed] | [DOI]
48 Undergraduate, Female, Nutrition Students’ Perceptions of Curricular Influence on Attitudes toward Individuals with Obesity
John J. M. Dwyer,Andrea Starr,Christine Mills,Jess Haines
Canadian Journal of Dietetic Practice and Research. 2016; : 1
[Pubmed] | [DOI]
49 Evidence-based practice in local public health service in Ghana
E. Owusu-Addo,R. Cross,P. Sarfo-Mensah
Critical Public Health. 2016; : 1
[Pubmed] | [DOI]



 

Top
   
 
  Search
 
Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

 
  In this article
   Abstract
   Nature of Qualit...
   Impact of Qualit...
   Overall Criteria...
  Validity
  Reliability
  Generalizability
  Food for Thought
   References

 Article Access Statistics
    Viewed11724    
    Printed84    
    Emailed0    
    PDF Downloaded2984    
    Comments [Add]    
    Cited by others 49    

Recommend this journal