Case Study as a Method of Nursing Research

Afza.Malik GDA

Case Study as a Research Method 

Case Study as a Method of Nursing Research

Case study as a method of research,History Of Case Study In Nursing Profession, What Is Case Study Actually, Purpose of Case Study , Case Study Design Case Study Data Analysis, Possible Designs In Case Study, Report Writing In Case Study , Reliability And Validity Of Case Study, Researcher Nature And Case Study, Importance Of Case Study For Nursing Profession.

Case Study as a Method of Research...?

    There are many references to case study in the literature, but there is little agreement about what a case study actually is. Case study is described by some as a research method (Yin, R., 1989), a data collection method, and a reporting method (Lincoln & Guba, 1985). 

    Others argued that "case study is not a methodologic choice, but a choice of object to be studied... case study is defined by interest in individual cases, not by methods of inquiry" (Stake, 1994, p. 236).

History Of Case Study In Nursing Profession

    Thirty years ago case study was a popular design for nursing research. Today it is used less frequently in nursing because of the development of more sophisticated methods of research. Disciplines such as nursing, medicine, psychology, sociology, anthropology, ethics, and history frequently use case study as a teaching method. 

    Used as a research method, case study can be quantitative; but because of the narrative nature of the case study, it is often used as a qualitative method. Case studies can be as simple as a single, brief case or very complex, examining a large number of variables. It is also used for hypothesis testing and theory generation.

What Is Case Study Actually 

    Generally, case study is defined as an intensive systematic study of an entity or entities with definable boundaries, conducted within the context of the situation and examining in-depth data about the background, environmental characteristics, culture, and interactions (Bromley, 1986 ). 

    Used as a research method, case study can be exploratory, descriptive, interpretive, experimental, or explanatory. The level of analysis also varies from factual or interpretive to evaluative, with the unit of analysis of a single person, family, community, or institution.

Case Study Context Or Subject

    Case studies must be conducted within the context of the individual or group of individuals because beliefs and values are an integral element in defining and influencing the behavior and experience of people. To determine mine if the conclusions of a case study can be applied to other situations, the case-in-context must be delineated. 

    Another characteristic of case studies is that they are present-oriented. Even though historical data about the entity being studied is included in the research, the study focus is on the present.

Purpose of Case Study 

    One purpose of case study is to expand the understanding of phenomena about which little is known. The data then can be used to formulate hypotheses and plan larger studies. Other purposes of case study include theory testing, description, and explanation. 

    For example, the intensive analysis involved in case study is appropriate to answer questions of explanation, such as why subjects think or behave in certain ways. The case study approach also can be used when a problem has been identified and a solution needs to be found.

Case Study Design

    The research process for case study design is similar to techniques used in other designs. First, the purpose and the research questions are developed. Questions of what, how, and why are appropriate for case study designs. 

  A theoretical framework may be used to guide the case study. This helps identify assumptions that the researcher may have about the phenomenon at the beginning of the study.

Case Study Data Analysis

    At the outset of the study the unit of analysis must be clearly delineated. The unit of analysis can be an individual, family, organization, or event. Clearly identifying the unit of analysis has implications for data collection and the study protocol. 

    The protocol should list how subjects will be recruited, what constitutes data (documents, letters, interviews, field observation, etc.), what resources will be needed, and a tentative time line for data collection. 

    The protocol may need to be modified as the study progresses and problems arise. The protocol also identifies a plan for data analysis and reporting the data.

Possible Designs In Case Study 

    There are two basic designs in case study research. The first is the single-case design, which is used when a case represents a typical, extreme, critical, unique, or revelatory case. Multiple-case designs draw inferences and interpretations from a group of cases. 

    When the purpose of the study is theory generation, multiple-case design is appropriate. Multiple-case designs also are useful to add depth to explanatory and descriptive studies. Data for case study can be quantitative or qualitative and often include both in the same study. 

    To improve the rigor of the study, three principles of data collection are employed: 

(a) multiple sources of data are used

(b) a case study base is developed using field notes, audio or video tapes, logs, documents, and narratives

(c) an audit trail is evident whereby the reader can follow the researcher's process from question to conclusion (Lincoln & Guba, 1985).

    Data analysis in case study is not well developed. Methods for analyzing qualitative data include content analysis, analytic induction, constant comparison, and phenomenal analysis.

    "Unlike statistical analysis, there are few fixed formulas (for data analysis]... much depends on an investigator's own style or rigorous thinking... and careful consideration of alternative interpretations" (Yin, R., 1989, p. 105).

    Methods for analyzing quantitative data are similar to those in any quantitative study and would depend on the research questions.

Report Writing In Case Study 

    Case study reports are presented in a variety of ways, from formally written narratives to creative montages of photographs, videotape, and arts and craft work. Most case study reports in nursing, however, are formally written narratives. 

    The written product of case study is often artistic in its composition. There are no rules or standardized ways to write a report, but most case studies include an explanation of the problem or issue and a detailed description of the context and processes surrounding the phenomenon under investigation. 

    A discussion of the results is also included in the report, which can contain inferences about how these results fit with the existing literature and practice implications.

Reliability And Validity Of Case Study 

    The standard measures of reliability and validity apply to case studies that are quantitative. When a qualitative study meets the criteria for credibility, transferability, dependability, and confirmability, it is considered to be trustworthy. 

    Credibility of the interpretations is supported by techniques such as triangulation of data collection methods, negative case analysis, and checking the interpretation with the participants themselves. Transferability (or fittingness) is an indication of whether the findings or conclusions of the study fit in other contexts and fit with the existing literature. 

    When another person is able to follow the researcher's audit trail or the process and procedures of the inquiry, then the study is considered to be dependable. Confirmability is achieved when the results, conclusions, and recommendations are supported in the data and the audit trail is evident.

Researcher Nature And Case Study 

    Conducting case studies requires a researcher who is flexible and comfortable with ambiguity. It is essential that the investigator be open to the idea that there is more than one "truth." 

    It is necessary for the researcher to be aware of his or her own assumptions, preconceived ideas and values, and of how these impact data collection and analysis.

Importance Of Case Study For Nursing Profession

    Case studies are essential to nursing because they are an excellent way to study phenomena within the context in which they occur. Because nurses believe in the uniqueness of human beings, case study is a method to capture this uniqueness and afford a way to gain knowledge about human interaction and behavior as it is situated within time and culture.

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