PARADIGMS AND METHODS FOR NURSING RESEARCH
A paradigm is a worldview, a general perspective on the complexities of the world. Paradigms for human inquiry are often characterized in terms of the ways in which they respond to basic philosophical questions, such as, What is the nature of reality? (ontologic) and What is the relationship between the inquirer and those being studied? (epistemologic).
Disciplined inquiry in nursing has been conducted mainly within two broad paradigms, positivism and constructivism. This section describes these two paradigms and outlines the research methods associated with them. In later chapters, we describe the transformative paradigm that involves critical theory research ( Chapter 21 ), and a pragmatism paradigm that involves mixed methods research ( Chapter 26 ).
The Positivist Paradigm
The paradigm that dominated nursing research for decades is known as positivism (also called logical positivism ). Positivism is rooted in 19th century thought, guided by such philosophers as Mill, Newton, and Locke. Positivism reflects a broader cultural phenomenon that, in the humanities, is referred to as modernism, which emphasizes the rational and the scientific.
As shown in Table 1.2 , a fundamental assumption of positivists is that there is a reality out there that can be studied and known (an assumption is a basic principle that is believed to be true without proof or verification). Adherents of positivism assume that nature is basically ordered and regular and that reality exists independent of human observation. In other words, the world is assumed not to be merely a creation of the human mind. The related assumption of determinism refers to the positivists’ belief that phenomena are not haphazard but rather have antecedent causes. If a person has a cerebrovascular accident, the researcher in a positivist tradition assumes that there must be one or more reasons that can be potentially identified. Within the positivist paradigm, much research activity is directed at understanding the underlying causes of phenomena.
TABLE 1.2: Major Assumptions of the Positivist and Constructivist Paradigms
TYPE OF QUESTION
POSITIVIST PARADIGM ASSUMPTION
CONSTRUCTIVIST PARADIGM ASSUMPTION
Ontologic: What is the nature of reality?
Reality exists; there is a real world driven by real natural causes and subsequent effects
Reality is multiple and subjective, mentally constructed by individuals; simultaneous shaping, not cause and effect
Epistemologic: How is the inquirer related to those being researched?
The inquirer is independent from those being researched; findings are not influenced by the researcher
The inquirer interacts with those being researched; findings are the creation of the interactive process
Axiologic: What is the role of values in the inquiry?
Values and biases are to be held in check; objectivity is sought
Subjectivity and values are inevitable and desirable
Methodologic: How is evidence best obtained?
Deductive processes → hypothesis testing
Inductive processes → hypothesis generation
Emphasis on discrete, specific concepts
Emphasis on entirety of some phenomenon, holistic
Focus on the objective and quantifiable
Focus on the subjective and nonquantifiable
Corroboration of researchers’ predictions
Emerging insight grounded in participants’ experiences
Outsider knowledge—researcher is external, separate
Insider knowledge—researcher is internal, part of process
Fixed, prespecified design
Flexible, emergent design
Controls over context
Context-bound, contextualized
Large, representative samples
Small, information-rich samples
Measured (quantitative) information
Narrative (unstructured) information
Statistical analysis
Qualitative analysis
Seeks generalizations
Seeks in-depth understanding
Positivists value objectivity and attempt to hold personal beliefs and biases in check to avoid contaminating the phenomena under study. The positivists’ scientific approach involves using orderly, disciplined procedures with tight controls of the research situation to test hunches about the phenomena being studied.
Strict positivist thinking has been challenged, and few researchers adhere to the tenets of pure positivism. In the postpositivist paradigm , there is still a belief in reality and a desire to understand it, but postpositivists recognize the impossibility of total objectivity. They do, however, see objectivity as a goal and strive to be as neutral as possible. Postpositivists also appreciate the impediments to knowing reality with certainty and therefore seek probabilistic evidence—that is, learning what the true state of a phenomenon probably is, with a high degree of likelihood. This modified positivist position remains a dominant force in nursing research. For the sake of simplicity, we refer to it as positivism.
The Constructivist Paradigm
The constructivist paradigm (often called the naturalistic paradigm ) began as a countermovement to positivism with writers such as Weber and Kant. Just as positivism reflects the cultural phenomenon of modernism that burgeoned after the industrial revolution, naturalism is an outgrowth of the cultural transformation called postmodernism. Postmodern thinking emphasizes the value of deconstruction—taking apart old ideas and structures—and reconstruction—putting ideas and structures together in new ways. The constructivist paradigm represents a major alternative system for conducting disciplined research in nursing. Table 1.2 compares the major assumptions of the positivist and constructivist paradigms.
For the naturalistic inquirer, reality is not a fixed entity but rather is a construction of the individuals participating in the research; reality exists within a context, and many constructions are possible. Naturalists thus take the position of relativism: If there are multiple interpretations of reality that exist in people’s minds, then there is no process by which the ultimate truth or falsity of the constructions can be determined.