10 Activity 4: Evaluation of Quantitative and Qualitative Research Student Name University

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Activity 4: Evaluation of Quantitative and Qualitative Research

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Activity 4: Evaluation of Quantitative and Qualitative Research

Four academic peer-reviewed articles on the topic of nurses’ burnout experienced in the intensive care unit (ICU) settings and addressed with the help of mindfulness-oriented interventions have been chosen for this activity. Two articles represent the results of quantitative research, and other two articles provide the findings of qualitative research. The application of quantitative and qualitative methodologies is associated with certain strengths and limitations for researchers, and the purpose of this paper is to summarize the selected articles in terms of their research methods, results, and levels of evidence as well as to compare the specifics of different methodological approaches.

Summary of Quantitative Research Articles

Article 1

Title. “Educational Intervention versus Mindfulness-Based Intervention for ICU Nurses with Occupational Burnout: A Parallel, Controlled Trial” by Xie et al. (2020).

Purpose. The researchers’ purpose was to examine the actual outcomes of a developed mindfulness intervention on burnout observed in those nurses working in ICUs (Xie et al., 2020). They were interested in determining how mindfulness-based strategies can be used to decrease nurses’ burnout.

Research Question. What is the effectiveness of a specific mindfulness-based intervention in coping with the symptoms of occupational burnout nurses from ICUs (Xie et al., 2020)?

Sampling Methodology. The researchers applied cluster randomization as a sampling method for the purpose to assign nurses from ICU A and ICU B to different groups (Xie et al., 2020).

Recruiting Process. Xie et al. (2020) invited nurses to participate in the study voluntarily if they meet certain inclusion criteria, such as the presence of considerable burnout, professional certification, and willingness to participate in interventions, among others. Those nurses who had been working only about 12 months or those who previously visited mindfulness sessions or programs were excluded.

Sample Size. 106 nurses participated in the study, where 53 nurses joined the educational burnout intervention program (EB), and 53 nurses were involved in the mindfulness-based intervention (MBIB) (Xie et al., 2020).

Sample Demographics. All subjects (106) were female, and the average determined age was about 28 years. Furthermore, 47 nurses reported to be married, and 59 women asserted to be single (Xie et al., 2020).

Ethical Considerations. The participants were informed about the specifics of the study, they agreed to join the project voluntarily, and the research was successfully approved by the ethics committee (Xie et al., 2020).

Research Design. In their quantitative study, the authors used a parallel, controlled trial. They focused on measuring participants’ results on the baseline, during the post-intervention period, during the one-month follow-up, and then after three months (Xie et al., 2020).

Data Collection Methods. To collect quantitative data, the researchers applied the Maslach Burnout Inventory (MBI), the Acceptance and Action Questionnaire II (AAQ-II), and the Mindfulness Attention Awareness Scale (MAAS) (Xie et al., 2020). The received data were analyzed using Chi-square tests and ANOVA to determine the mindfulness-related intervention’s possible effects on nurses’ burnout.

Study Results. Nurses receiving the MBIB intervention demonstrated a higher level of adherence to mindfulness sessions, and out of 53 persons, 37 nurses finished 30+ practices. In a month and in three months after the mindfulness-based intervention, nurses demonstrated a statistically significant lower level of burnout with a focus on such characteristics as emotional exhaustion, person’s accomplishment, and avoidance (p ＜0.05) (Xie et al., 2020).

Researchers’ Recommendations. Xie et al. (2020) accentuate that the usage of specific mindfulness-related programs for nurses from ICUs should be recommended in order to improve their psychological state and decrease the possibility of developing burnout associated with their work.

Article 2

Title. “Mindfulness as an Antidote to Burnout for Nursing and Support Staff in an Oncological Intensive Care Unit: A Pilot Study” by Urso et al. (2022).

Purpose. The researchers’ purpose was to examine how conducting a specific pilot Mindfulness-Based Intervention (MBI) program in an oncological ICU with the target to help nurses and members of supporting staff can assist them in coping with stress, burnout, depression, and signs of anxiety (Urso et al., 2022).

Research Question. What comparative effects can a customized yoga therapy MBI (LOTUS) have on nurses’ and patient care technicians’ (PCTs) stress, anxiety, depression, and burnout experienced in an oncological ICU (Urso et al., 2022)?

Sampling Methodology. The researchers used a voluntary sampling method, and nurses and PCTs from the ICU were invited to participate in the study via email (Urso et al., 2022).

Recruiting Process. Urso et al. (2022) applied various methods for recruiting participants, including emailing, using sign-in sheets in break rooms, as well as one-on-one MBI-related education. It was voluntary for nurses and PCTs to participate in research, and their consent was taken in the written format.

Sample Size. Forty-five people were involved and divided in two groups. There were 24 professionals in the intervention group and 21 persons in the group of control (Urso et al., 2022).

Sample Demographics. 78% of the subjects were women, where PCTs represented 16%, and nurses were 84%. Furthermore, there were 76% participants who had the habit of practicing yoga before their involvement in the study (Urso et al., 2022).

Ethical Considerations. The MDACC Center Quality Improvement Advisory Board provided its approval for the study. Written informed consent was acquired from every individual involved (Urso et al., 2022).

Research Design. Urso et al. (2022) organized a pre-post interventional study with a focus on measuring the medical staff’s stress, depression, and anxiety levels before and after the intervention (a mindfulness program based on an 8-week individualized yoga therapy). Once a week, one-hour LOTUS classes were held on-site. Since there was a lot of interest in LOTUS in medical workers, intervention group participants were split up into two groups, but the COVID-19 pandemic made the researchers include the second group into a control one (Urso et al., 2022).

Data Collection Methods. Data were collected before and after the intervention. The tools used by the authors included the Depression, Anxiety and Stress Scale (DASS-21) and the Maslach Burnout Inventory-Human Services Survey for Medical Personnel (MBI-HSS (MP)) (Urso et al., 2022). These scales helped assess nurses’ and PCTs’ stress, burnout, depression, and exhaustion pre- and post-intervention. The data were analyzed using standard deviation, mean, frequency counts, Wilcoxon test, and Fisher’s exact test (Urso et al., 2022).

Study Results. It was found that depression, stress, and anxiety were present in the participants with low level prevalence at the baseline. Depersonalization and emotional exhaustion were also reported at a comparably low level. After the conduction of the MBI intervention, both groups’ rates of these problems, also including burnout and anxiety, stayed low and comparable. The participants’ professional efficacy measures improved after LOTUS (0.063 vs −0.25; p = 0.0336) (Urso et al., 2022).

Researchers’ Recommendations. Urso et al. (2022) recommended the future development of similar interventions to include a wider population group. Although the study did not demonstrate significant changes in the participants’ burnout and stress levels after the mindfulness intervention, the researchers found positive changes in professional efficacy and accentuate the helpfulness of such interventions.

Summary of Qualitative Research Articles

Article 1

Title. “Emergency Department Nurses’ Experiences of a Mindfulness Training Intervention: A Phenomenological Exploration” by Lycke et al. (2023).

Purpose. The study’s purpose was to explore the experiences of nurses from the emergency department regarding the impact of mindfulness training on their stress, burnout, and empathy levels (Lycke et al., 2023).

Research Question. Can mindfulness training change compassion, empathy, and stress levels and perceptions in emergency department nurses (Lycke et al., 2023)?

Sampling Methodology. Lycke et al. (2023) used purposive sampling in their qualitative study to choose and attract those nurses who experience stress at work and want to participate in mindfulness sessions.

Recruiting Process. Selected nurses, who worked in the emergency department, were invited to join individual interviews by email. The researchers contacted more than 50 nurses, who received several email reminders (Lycke et al., 2023).

Sample Size. Overall, 51 nurses were contacted, but only 8 individuals agreed to participate in the study (Lycke et al., 2023).

Sample Demographics. One male person and seven female persons from Stockholm became involved in this qualitative study. Their age was 30-63 years, and among them, five subjects worked as nurses and three persons worked as assistant nurses (Lycke et al., 2023).

Ethical Considerations. The participants voluntarily agreed to join the study, they provided verbal informed consent, their privacy and confidentiality were addressed, and the ethical approval was provided for the study (Lycke et al., 2023).

Research Design. Lycke et al. (2023) conducted a qualitative phenomenological study for the purpose to explore nurses’ lived experiences linked to their stress, specific perceptions of work, and mindfulness training.

Data Collection Methods. The researchers collected data with the help of individual 20-50 minutes interviews with 8 participants on the topic of their lived experiences, perceptions of work, mindfulness sessions, and other technical aspects. The interviews based on semi-structured protocols were analyzed with reference to qualitative phenomenological analysis to determine the key themes in subjects’ experiences and visions with a focus on mindfulness exercising (Lycke et al., 2023).

Study Results. The researchers have found three major themes associated with nurses’ experiences. These themes included: “becoming aware,” “changing through mindfulness,” and “gaining the tools for mindfulness through workshops and the mobile app” (Lycke et al., 2023, p. 174). The participants noted that mindfulness training helped them become more aware at work, they improved and changed focusing on the mindfulness aspect in terms of increasing empathy and decreasing stress, anxiety, and burnout levels, and they found the use of mindfulness applications comfortable (Lycke et al., 2023).

Researchers’ Recommendations. Since nurses are rather vulnerable to stress, depression, and burnout, it is helpful for them to utilize mindfulness training and applications regularly in order to decreased the negative impact of their working environment and provide them with compassionate care, raising their empathy, energy, and optimism (Lycke et al., 2023).

Article 2

Title. “The Influence of Mindfulness-Based Stress Reduction on the Work Life of Healthcare Professionals – A Qualitative Study” by Knudsen et al. (2023).

Purpose. The aim is to investigate how taking a Mindfulness-Based Stress Reduction (MBSR) course can affect the relationships of healthcare professionals with team members and patients at work (Knudsen et al., 2023).

Research Question. After completing a well-developed course on mindfulness-based stress reduction, how can healthcare providers experience and apply mindfulness techniques and influence their work (Knudsen et al., 2023)?

Sampling Methodology. Purposeful sampling was selected by the authors to assemble healthcare providers’ ideas regarding stress reduction and mindfulness training (Knudsen et al., 2023).

Recruiting Process. Presentations of the study specifics and purpose were held in gynecology and cardiology departments. Those healthcare providers who were involved in direct patient care, had been working in the department for six months, and interested in the MBSR course were invited via email (Knudsen et al., 2023).

Sample Size. There were fifty-six medical professionals involved in the MBSR course (Knudsen et al., 2023).

Sample Demographics. The majority of the sample were females (43), the age of medical workers was between 25-55 years. The participants’ range of clinical experience was three to 35 years, and among them, 27 participants worked as nurses (Knudsen et al., 2023).

Ethical Considerations. Written and verbal information about the project voluntary participation was given to the subjects. Data were handled in a private and anonymous manner. Written consent was taken from all the participants, and the right to drop out from the study whenever they needed was accentuated. The study was approved by the Danish Data Protection Agency (Knudsen et al., 2023).

Research Design. The researchers employed a qualitative methodology grounded in a “hermeneutic philosophical approach” (Knudsen et al., 2023, p. 2). In order to collect in-depth information and provide fresh perspectives, this study involved interviews with focus group members, some individual interviews, as well as participant observation (Knudsen et al., 2023).

Data Collection Methods. Knudsen et al. (2023) gathered and organized required subjective data with the help of 1) focus group interviews with healthcare providers to determine their experiences, 2) observation of subjects during the MBSR course and making notes, and 3) individual interview sessions. Interviews were semi-structured, and the principles of thematic data analysis were applied.

Study Results. Six specific themes were clearly identified as a result of data analysis. They are: the importance of pausing and concentrating on something, the role of self-compassion when providing care, the importance of being present and calm when interacting with patients, the consequences of stress, the understanding of the freedom of choice, and the importance of applying mindfulness at work (Knudsen et al., 2023). The researchers found that, according to the participants’ experiences and views, the MBSR course positively influenced their further performance and interactions at work.

Researchers’ Recommendations. According to the study, providing mindfulness training to medical professionals can encourage a shift in behavior from disregarding one’s own needs to developing greater compassion for others (Knudsen et al., 2023). Such programs can address stress and burnout problems and influence a compassionate culture in healthcare settings.

Levels of Evidence

Levels of evidence in studies depend on the nature of research, randomization, the application of qualitative or quantitative methods, and the focus on a single study or the analysis of several ones. Following Polit and Beck’s (2021) hierarchy that includes eight levels of evidence, a quantitative study by Xie et al. (2020) belongs to Level II as it is a randomized controlled trial. In its turn, the study by Urso et al. (2022) lacks randomization in its sampling methodology, this non-randomized interventional trial can be described as Level III, according to Polit and Beck (2021). The qualitative studies by Lycke et al. (2023) and Knudsen et al. (2023) can be categorized as Level VII, because, according to Polit and Beck (2021), they are in-depth single qualitative research studies. This classification allows for concluding about the quality of evidence presented in scholarly articles, where quantitative articles provide a higher level of evidence.

Conclusion

In this paper, two quantitative and two qualitative articles have been summarized. These research methodologies should be compared and contrasted as they both have certain strengths and limitations determining their application by researchers. Quantitative research, illustrated in this paper by the study with an interventional design and by the study using a controlled trial, usually offers reliable numerical data through statistical analysis. The strengths of this approach are in objectivity, randomization, clear evidence, and replicability. Quantitative studies allow for involving large samples and determining the efficacy of interventions, which is important for healthcare and medicine research. However, quantitative research studies overlook the complexity of human behavior and experiences and ignore contextual factors that can influence health outcomes in nurses or patients, for example. In this context, qualitative research should be applied.

A qualitative methodology allows researchers to study people’s experiences and perceptions. Thus, a qualitative study adopting thematic analysis and a phenomenological qualitative study have been discussed in this paper. The method’s strength is in the possibility to focus on in-depth subjective perspectives and insights which cannot be measured using quantitative tools. Still, the limitations include the subjective nature of qualitative research, possible bias, the use of small sample sizes, and the absence of generalizability. While comparing these methodologies, it is important to state that their advantages and disadvantages should be assessed with reference to a certain research question and a study purpose because researchers select qualitative or quantitative methods depending on their investigational needs.

References

Knudsen, R. K., Ammentorp, J., Storkholm, M. H., Skovbjerg, S., Tousig, C. G., & Timmermann, C. (2023). The influence of mindfulness-based stress reduction on the work life of healthcare professionals – A qualitative study. Complementary Therapies in Clinical Practice, 53, 1-11. https://doi.org/10.1016/j.ctcp.2023.101805

Lycke, S. T., Airosa, F., & Lundh, L. (2023). Emergency department nurses’ experiences of a mindfulness training intervention: A phenomenological exploration. Journal of Holistic Nursing, 41(2), 170-184. https://doi.org/10.1177/08980101221100091

Polit, D., & Beck, C. (2021). Nursing research: Generating and assessing evidence for nursing practice (11th ed.). Lippincott Williams & Wilkins.

Urso, C., Laserna, A., Feng, L., Agnite, A., Jawe, N., Magoun, C., Layton, L. S., Nates, J. L., & Gutierrez, C. (2022). Mindfulness as an antidote to burnout for nursing and support staff in an oncological intensive care unit: A pilot study. Holistic Nursing Practice, 36(5), E38–E47. https://doi.org/10.1097/hnp.0000000000000544

Xie, C., Zeng, Y., Lv, Y., Li, X., Xiao, J., & Hu, X. (2020). Educational intervention versus mindfulness-based intervention for ICU nurses with occupational burnout: A parallel, controlled trial. Complementary Therapies in Medicine, 52, 102485. https://doi.org/10.1016/j.ctim.2020.102485