Characteristics of Qualitative Descriptive Studies: A Systematic Review

Characteristics of Qualitative Descriptive
Studies: A Systematic Review

Hyejin Kim, Justine S. Sefcik, Christine Bradway
Correspondence to: Hyejin Kim Abstract: Qualitative description (QD) is a term that is widely used to describe
E-mail: hyejin@nursing.upenn.edu qualitative studies of health care and nursing-related phenomena. However, limited
discussions regarding QD are found in the existing literature. In this systematic
Hyejin Kim review, we identified characteristics of methods and findings reported in research
Doctoral Candidate articles published in 2014 whose authors identified the work as QD. After search-
School of Nursing ing and screening, data were extracted from the sample of 55 QD articles and
University of Pennsylvania
examined to characterize research objectives, design justification, theoretical/philo-
418 Curie Blvd.
sophical frameworks, sampling and sample size, data collection and sources, data
Philadelphia, PA 19104
analysis, and presentation of findings. In this review, three primary findings were
identified. First, although there were some inconsistencies, most articles included
Justine S. Sefcik
characteristics consistent with the limited available QD definitions and descriptions.
Doctoral Candidate
Next, flexibility or variability of methods was common and effective for obtaining
School of Nursing
University of Pennsylvania
rich data and achieving understanding of a phenomenon. Finally, justification for
Philadelphia, PA how a QD approach was chosen and why it would be an appropriate fit for a partic-
ular study was limited in the sample and, therefore, in need of increased attention.
Christine Bradway Based on these findings, recommendations include encouragement to researchers
Associate Professor of Gerontological Nursing to provide as many details as possible regarding the methods of their QD studies
School of Nursing so that readers can determine whether the methods used were reasonable and
University of Pennsylvania effective in producing useful findings. ß 2016 Wiley Periodicals, Inc.
Philadelphia, PA
Keywords: qualitative description; qualitative research; systematic review
Research in Nursing & Health, 2017, 40, 23–42
Accepted 6 September 2016
DOI: 10.1002/nur.21768
Published online 30 September 2016 in Wiley Online Library (wileyonlinelibrary.com).
Qualitative description (QD) is a label used in qualitative of a QD study (Milne & Oberle, 2005; Neergaard et al.,
research for studies that are descriptive in nature. This 2009; Sandelowski, 2000, 2010; Sullivan-Bolyai et al.,
genre is particularly common in qualitative studies of health 2005; Vaismoradi, Turunen, & Bondas, 2013; Willis, Sullivan-
care and nursing-related phenomena (Polit & Beck, 2009, Bolyai, Knafl, & Zichi-Cohen, 2016). Furthermore, little is
2014). QD has been identified as important and appropriate known about characteristics of QD as reported in journal-
for research questions focused on discovering the who, published, nursing-related studies. Therefore, the purpose of
what, and where of events or experiences and on gaining this systematic review was to describe specific characteris-
insights from informants regarding a poorly understood tics of methods and findings of studies reported in journal
phenomenon. Qualitative description is a suitable goal articles published in 2014 that were labeled by their authors
when a straight description of a phenomenon is desired or as QD. In this review, we did not have a goal to judge
information is sought to develop and refine questionnaires whether QD was done correctly but rather to report on the
or interventions (Neergaard, Olesen, Andersen, & Sonder- features of the methods and findings.
gaard, 2009; Sullivan-Bolyai, Bova, & Harper, 2005).
Despite these strengths and frequent claims of its
Features of QD
use, limited discussions regarding QD are found in qualita-
tive research textbooks and publications. To the best of our Six QD design features and techniques were identified
knowledge, only seven articles include specific guidance from descriptions of the approach in the literature. First,
on how to design, implement, analyze, or report the results researchers generally draw from a naturalistic perspective

C 2016 Wiley Periodicals, Inc.
24 RESEARCH IN NURSING & HEALTH
and examine a phenomenon in its natural state (Sande- articles in which authors used the terms QD, qualitative
lowski, 2000). Second, QD has been described as less descriptive study, or qualitative descriptive design in their
theory-driven than some other qualitative approaches titles or abstracts as well as in the main texts of the
(Neergaard et al., 2009), facilitating flexibility in commit- publications.
ment to a theory or framework when designing and con- All articles yielded by an initial search in PubMed
ducting a study (Sandelowski, 2000, 2010). For example, were exported into reference management software
researchers may or may not decide to begin with a theory EndNote X7. Duplicates were removed. Next, titles and
of the targeted phenomenon and need not stay commit- abstracts were reviewed to determine if the publication met
ted to a theory or framework if their investigations take inclusion criteria; all articles meeting inclusion criteria were
them down another path (Sandelowski, 2010). Third, then read independently in full by two authors (HK and JS)
data collection strategies typically involve individual to determine if the terms—QD or qualitative descriptive
and/or focus group interviews with minimally structured study/design—were clearly stated in the main texts. Any
or semi-structured interview guides (Neergaard et al.; articles in which authors did not specifically state these
Sandelowski, 2000). Fourth, researchers commonly employ key terms in the main text were excluded, even if the
purposeful sampling techniques, such as maximum variation terms had been used in the study title or abstract. In one
sampling, which has been described as being useful for article, for example, although “qualitative descriptive study”
obtaining broad insights and rich information (Neergaard was reported in the published abstract, the researchers
et al.; Sandelowski, 2000). reported a “qualitative exploratory design” in the main text
Fifth, qualitative content analysis (often supplemented of the article (Sundqvist & Carlsson, 2014); therefore,
by descriptive statistics to describe the study sample) is a this article was excluded from our review. Despite the
common strategy for data analysis (Neergaard et al., 2009; possibility of other QD studies published in 2014 that were
Sandelowski, 2000). In some instances, thematic analysis is not labeled as such, we only included articles in which the
used, which should not be confused with content analysis authors specifically used these terms to describe their
(Vaismoradi et al., 2013). These data analysis approaches approach. Finally, the two authors compared, discussed,
allow researchers to stay close to the data, with minimal and reconciled their lists of eligible articles with a third
transformation during analysis. Such interpretation is low- author (CB).
inference (Neergaard et al.), which should enable readers Initially, 95 articles were identified and exported into
familiar with the topic to recognize their own experience of the EndNote program. Three duplicate publications were
the phenomenon in the findings (Sandelowski, 2000). removed, and the 20 articles with final publication dates of
Finally, representation of study findings in published reports 2015 (retrieved due to advance publication in 2014) were
is expected to be straightforward, including comprehensive also excluded. The remaining 72 articles were then
descriptive summaries and accurate details presented in screened by examining titles, abstracts, and full texts.
a way that makes sense to the reader (Neergaard et al.; Based on our inclusion criteria, 15 (of 72) were then
Sandelowski, 2000). It is important to acknowledge that excluded because QD or QD design/study was not identi-
variation in methods or techniques may be appropriate fied in the main text. We then re-examined the remaining
across QD studies (Sandelowski, 2010). For example, when 57 articles and excluded two additional articles that did not
consistent with the study goals, decisions may be made to meet inclusion criteria (e.g., QD was only reported as an
use techniques from other qualitative traditions, such as analytic approach in the data analysis section). The
employing a constant comparative analytic approach typi- remaining 55 publications met inclusion criteria and com-
cally associated with grounded theory (Sandelowski, 2000). prised the sample for our systematic review (see Fig. 1).
Methods Article Characteristics

Of the 55 publications, 23 originated from North America
Search Strategy and Study Screening
(17 in the United States; 6 in Canada), 12 from Asia, 11
The PubMed electronic database was searched for articles from Europe, 7 from Australia and New Zealand, and 2 from
written in English and published from January 1, 2014 to South America. Eleven studies were part of larger research
December 31, 2014, using the terms, “qualitative descriptive projects, and two of them were reported as part of larger
study,” “qualitative descriptive design,” and “qualitative mixed-methods studies. Four were described as secondary
description,” combined with “nursing.” This publication year analyses.
was chosen because it was the most recent full year at the
time of beginning the systematic review. As we did not
Quality Appraisal Process
intend to identify trends in QD approaches over time, it
seemed reasonable to focus on the nursing QD studies Following the identification of the 55 publications, two
published in a single recent year. The inclusion criteria for authors (HK and JS) independently examined each article
this review were data-based, nursing-related, research using the Critical Appraisal Skills Programme (CASP)
Research in Nursing & Health

QUALITATIVE DESCRIPTION: SYSTEMATIC REVIEW/ KIM ET AL. 25
Articles identified through PubMed search

(n = 95)
Articles excluded (n = 20)

Papers after duplicates removed
Reasons:
(n = 92)
• Appeared as advance online
publication in 2014 but final
publication year was 2015
Titles and abstracts reviewed Articles excluded (n = 0)

(n = 72)
Full-text papers excluded (n = 17)

Full-text articles assessed for Reasons:
eligibility • “Qualitative description” not
(n = 72) found in main text (n=15) or
only reported in description of
analysis (n=2)
Articles included in review

(n = 55)
FIGURE 1. Flow diagram of study selection.
qualitative study review checklist (CASP, 2013). The CASP Process for Data Extraction and Analysis
was chosen to determine the general adequacy (or rigor) of
To further assess each of the 55 articles, data were
the qualitative studies included in this review. The CASP
extracted on: (a) research objectives; (b) design justifica-
criteria are generic and intend to be applied to qualitative
tion; (c) theoretical or philosophical framework; (d) sam-
studies in general. This review enabled us to examine the
pling and sample size; (e) data collection and data
internal consistency between study aims and methods and
sources; (f) data analysis; and (g) presentation of findings
between study aims and findings, as well as the usefulness
(see Table 2). We discussed the extracted data and identi-
of findings. The CASP consists of 10 main questions, some
fied common and unique features in the articles included in
with sub-questions. The first two questions are focused on
the review. Findings are described in detail below and in
the clarity of study aims and appropriateness of using qual-
Table 3.
itative research to achieve the aims. With the next eight
questions, reviewers assess study design, sampling, data
collection, and analysis, as well as the clarity of results and
the value of the research. We used the 7 questions and 17 Results
sub-questions related to methods and statement of findings
Quality Appraisal-Based CASP Criteria
to evaluate the articles. The results of this process are pre-
sented in Table 1. Justification for use of a QD design was evident in close to
Once articles were assessed by the two authors half (47.3%) of the 55 publications. While most researchers
independently, all three authors discussed and reconciled clearly described recruitment strategies (80%) and data
our assessments. No articles were excluded based on collection methods (100%), justification for how the study
CASP results; results were used to depict the general setting was selected was identified in only 38% of the
adequacy (or rigor) of studies depicted in the sample and articles, and almost 75% of the articles did not include any
to enhance our examination of the relationship between reason for the choice of data collection methods (e.g.,
methods and usefulness of the findings. focus group interviews). In the vast majority (91%) of the

Table 1. CASP Questions and Results of Quality Appraisal of Studies in Systematic Review (N ¼ 55)
Could Not
Yes No Determine
n % n % n %
Was the research design appropriate to address the aims of the research?
Did the researcher justify the research design? 26 47.3 28 50.9 1 1.8
Was the recruitment strategy appropriate to the aims of the research?
Did the researcher explain how the participants were selected? 44 80.0 6 10.9 5 9.1
Was the data collected in a way that addressed the research issue?
Was the setting for data collection justified? 31 56.4 21 38.2 3 5.4
Was it clear how data were collected e.g., focus group, semi-structured interview, etc.? 55 100.0 0 0.0 0 0.0
Did the researcher justify the methods chosen? 13 23.6 41 74.5 1 1.8
Did the researcher make the methods explicit, e.g., for the interview method, was 51 92.7 4 7.3 0 0.0
there an indication of how interviews were conducted, or did they use a topic guide?
Was the form of data clear, e.g., tape recordings, video materials, notes, etc.? 54 98.2 0 0.0 1 1.8
Did the researcher discuss saturation of data? 20 36.4 35 63.6 0 0.0
Has the relationship between researcher and participants been adequately considered?
Did the researcher critically examine their own role, potential bias, and influence during 4 7.3 50 90.9 1 1.8
data collection, including sample recruitment and choice of location
Have ethical issues been taken into consideration?
Was there sufficient detail about how the research was explained to participants for the 49 89.1 4 7.3 2 3.6
reader to assess whether ethical standards were maintained?
Was approval sought from an ethics committee? 51 92.7 4 7.3 0 0.0
Was the data analysis sufficiently rigorous?
Was there an in-depth description of the analysis process? 46 83.6 9 16.4 0 0.0
Was thematic or content analysis used. If so, was it clear how the categories/themes 51 92.7 3 5.5 1 1.8
derived from the data?
Did the researcher critically examine their own role, potential bias, and influence 20 36.4 30 54.5 5 9.1
during analysis and selection of data for presentation?
Was there a clear statement of findings?
Were the findings explicit? 55 100.0 0 0.0 0 0.0
Did the researcher discuss the credibility of their findings (e.g., triangulation) 46 83.6 8 14.5 1 1.8
Were the findings discussed in relation to the original research question? 55 100.0 0 0.0 0 0.0
Note. CASP, Critical Appraisal Skills Programme. CASP questions are adapted from Critical Appraisal Skills Programme (2013), “10 questions
to help you make sense of qualitative research,” retrieved from http://media.wix.com/ugd/dded87_29c5b002d99342f788c6ac670e49f274.pdf.
Its license can be found at http://creativecommons.org/licenses/by-nc-sa/3.0/
articles, researchers did not explain their personal factors, or reasons for behavior (n ¼ 14), perceptions of
approach or positionality during the process of recruitment specific care or nursing practice or interventions (n ¼ 11),
and data collection, and a majority did not describe posi- or knowledge, attitudes, or beliefs (n ¼ 3).
tionality during data analysis (64%). Ethical standards were
reported in more than 89% of all articles. Most articles
Design Justification
included an in-depth description of data analysis (84%)
and development of categories or themes (93%). Finally, A total of 30 articles included references to support use of
all researchers clearly stated their findings in relation QD. The most frequently cited references (n ¼ 23) were
to research questions/objectives. Authors of 83% of the “Whatever happened to qualitative description?” (Sande-
articles discussed the credibility of their findings (see lowski, 2000) and “What's in a name? Qualitative descrip-
Table 1). tion revisited” (Sandelowski, 2010). Other references
included “Qualitative description—The poor cousin of
health research?” (Neergaard et al., 2009), “Reaching the
Research Objectives
parts other methods cannot reach: An introduction to quali-
In statements of study objectives and/or questions, the tative methods in health and health services research”
most frequently used verbs were “explore” (n ¼ 22) and (Pope & Mays, 1995), and general research textbooks
“describe” (n ¼ 17). Researchers also used “identify” (Polit & Beck, 2004, 2012).
(n ¼ 3), “understand” (n ¼ 4), or “investigate” (n ¼ 2). Most In 26 articles (not necessarily the same as those
studies were focused on participants’ experiences related above), researchers provided rationales for selecting QD.
to certain phenomena (n ¼ 18), facilitators, challenges, Most researchers chose QD because this design aims to

Table 2. Content Extracted From Study Reports for Analysis
Element Data Extracted
Research objectives Verbs used in objectives or aims

Foci of study
Design justification Whether the article cited references for qualitative description
Whether the article offered rationale to choose qualitative description
References cited
Rationale reported
Theoretical or philosophical Whether the article has theoretical or philosophical frameworks for study
frameworks Theoretical or philosophical frameworks reported
How the frameworks were used in data collection and analysis
Sampling and sample sizes Sampling strategies (e.g., purposeful sampling, maximum variation)
Sample size
Data collection and sources Data collection techniques (e.g., individual or focus-group interviews, interview guide, surveys,
field notes)
Data analysis Data analysis techniques (e.g., qualitative content analysis, thematic analysis, constant comparison)
Whether data saturation was described as achieved
Presentation of findings Statement of findings
Consistency with research objectives
produce a straight description and comprehensive sum- which a framework or philosophical stance was identified,
mary of the phenomenon of interest, using participants’ the authors of five articles described the framework as
language and staying close to the data (or using low guiding the development of an interview guide (Al-Zadjali,
inference). Keller, Larkey, & Evans, 2014; DeBruyn, Ochoa-Marin, &
Authors of two articles wrote that they had used a QD Semenic, 2014; Fantasia, Sutherland, Fontenot, & Ierardi,
design yet also acknowledged grounded-theory or phenome- 2014; Ma, 2014; Wiens, Babenko-Mould, & Iwasiw,
nological overtones by adopting some techniques from these 2014). In two articles, data analysis was described as
qualitative traditions (Michael, O’Callaghan, Baird, Hiscock, & using key concepts of a framework as pre-determined
Clayton, 2014; Peacock, Hammond-Collins, & Forbes, 2014). codes or categories (Al-Zadjali et al.; Wiens et al.).
For example, Michael et al. (2014, p. 1066) reported: Oosterveld-Vlug et al. (2014) and Zhang, Shan, and
Jiang (2014) discussed a conceptual model and underly-
The research used a qualitative descriptive ing philosophy in detail in the background or discussion
design with grounded theory overtones sections, although how the model and philosophy were
(Sandelowski, 2000). We sought to provide a used was not indicated.
comprehensive summary of participants’
views through theoretical sampling; multiple
Sampling and Sample Size
data sources (focus groups [FGs] and
interviews); inductive, cyclic, and constant In 38 of the 55 articles, researchers reported a sampling
comparative analysis; and condensation of strategy, including purposeful sampling or some deriva-
data into thematic representations (Corbin & tion of purposeful sampling such as maximum variation
Strauss, 1990, 2008). (n ¼ 8), snowball (n ¼ 3), and theoretical sampling (n ¼ 1).
Ten author teams used convenience sampling. In
Authors of four additional articles included language three instances (Asemani et al., 2014; Chan & Lopez,
to describe data analysis that was suggestive of a 2014; Soule, 2014), multiple sampling strategies were
grounded-theory or phenomenological tradition, for exam- described, for example, a combination of snowball, con-
ple, by employing a constant comparison technique or venience, and maximum variation sampling. In articles
translating themes stated in participants’ language into the where maximum variation sampling was cited, variation
primary language of the researchers (Asemani et al., 2014; referred to diversity in participants’ demographics (n ¼ 7;
Li, Lee, Chen, Jeng, & Chen, 2014; Ma, 2014; Soule, e.g., age, gender, and education level), while one
2014). Additionally, Li et al. (2014) specifically reported use article did not include details regarding how maximum
of a grounded-theory approach. variation sampling was operationalized (Marcinowicz,
Abramowicz, Zarzycka, Abramowicz, & Konstantynowicz,
2014). Authors of 17 articles did not specify their sam-
Theoretical or Philosophical Framework
pling techniques.
In most (n ¼ 48) articles, researchers did not specify any Sample sizes ranged from 8 to 1,932, with nine
theoretical or philosophical framework. In those articles in studies in the 8–10 participant range and 24 studies in

28
Table 3. Data Extraction and Analysis Results
Theoretical/
Design Philosophical Data Collection and
Authors, Country Research Objectives Justification Frameworks Sampling/Sample Size Data Sources Data Analysis Findings
Adams et al. (2014), • Explore • () Reference Not reported (NR) • Purposive sampling/ • Interviews • Inductive and Five themes about family
USA • Responses to • () Rationale maximum variation • Observations deductive qualitative members’ perceptions of
communication • 32 family members • Review of daily flow content analysis nursing communication
strategies sheet • () Data saturation approaches
• Demographics

Ahlin, Ericson-Lidman, • Describe • () Reference NR • Unspecified • Semistructured, • Qualitative content One theme and seven
Norberg, and • Experiences of using • (þ) Rationale • 8 care providers individual interviews analysis subthemes about care
Strandberg (2014), guidelines in daily • Part of a research • Interview guide • () Data saturation providers’ experiences of
Sweden practice program using guidelines in daily
practice
Al-Zadjali, Keller, • Examine • () Reference Health belief model and • Unspecified • Semistructured, • Conventional content Three main categories (from
Larkey, and Evans • Culturally specific views • () Rationale Kleiman’s explanatory • 19 adults individual interview analysis the model) and eight
(2014), USA of processes and model • () Data saturation subthemes about causes of
causes of midlife weight weight gain in midlife
gain
Asemani et al. (2014), • Explore • () Reference NR • Convenience, snowball, • Semistructured, • Conventional content Two themes and individual
Iran • Factors initiating • (þ) Rationale and maximum variation individual interview analysis and non-individual-based
responsibility among sampling • Interview guide • Constant comparison factors per theme
medical trainees • 15 trainees and other • (þ) Data saturation
professionals
RESEARCH IN NURSING & HEALTH
Atefi, Abdullah, Wong, • Explore • () Reference NR • Convenience sampling • Semistructured focus • Thematic analysis Three main themes and
and Mazlom (2014), • Factors related to job • () Rationale • 85 nurses group interviews • (þ) Data saturation associated factors
Iran satisfaction and • Interview guide regarding job satisfaction
dissatisfaction and dissatisfaction
Ballangrud, Hall-Lord, • Describe • () Reference NR • Strategic sampling • Semistructured • Inductive content One main category, three
Persenius, and • Perceptions on • () Rationale • 18 registered nurses individual interviews analysis categories, and six sub-
Hedelin (2014), simulation-based team • () Data saturation categories regarding
Norway training nurses’ perceptions on
simulation-based team
training
Benavides-Vaello et al. • Determine • () Reference NR • Unspecified • Focus-group • Constant comparison Five themes about facilitators
(2014), USA • Barriers and supports • () Rationale • 45 students interviews • () Data saturation and barriers
for attending college • Using Photovoice and
and nursing school SHOWeD
Note. NR, not reported; (), element not found; (þ) element present..
Table 3. (Continued )
Theoretical/
Bernhard, Zielinski, • Explore • () Reference NR • Purposeful sampling • Semistructured focus- • Qualitative content Five common themes and
Ackerson, and • Reasons for choosing • () Rationale • 20 women group interviews analysis concepts about reasons for
English (2014), USA home birth and birth • Interview guide • (þ) Data saturation choosing home birth based
experiences • Field notes on their birth experiences

Bradford and Maude • Explore • (þ) Reference NR • Purposive sampling • Semistructured • Inductive qualitative Four patterns regarding fetal
(2014), New Zealand • Normal fetal activity • (þ) Rationale • 19 pregnant women individual interviews content analysis activities in relation to meal
related to hunger and • Sandelowski • Open-ended questions • Descriptive statistical anticipation, maternal
satiation (2000) analysis hunger, maternal meal
• Denzin and Lincoln • (þ) Data saturation consummation, and
(2000) maternal satiety
Canzan, Heilemann, • Explore, describe, and • (þ) Reference NR • Purposive sampling • Semistructured • Unspecified various Nursing caring from both
Saiani, Mortari, and compare • () Rationale • 20 nurses and 20 patients individual interviews analytic strategies patients’ and nurses’
Ambrosi (2014), Italy • Perceptions of nursing • Sandelowski • Interview guide including constant perspectives—a summary
caring (2000) • Field notes during comparison of data in visible caring and
interviews • () Data saturation invisible caring
Chan and Lopez • Address • (þ) Reference NR • Convenience and • Focus-group • Content analysis Four categories about
(2014), Hong Kong • How to reduce coronary • (þ) Rationale snowball sampling interviews • (þ) Data saturation patients’ abilities to reduce
heart disease risks • Secondary • 105 patients • Interview guide coronary heart disease
analysis
• Sandelowski
(2000)
• Neergaard et al.
(2009)
Chen, Tsai, Lee, and • Explore • () Reference NR • Convenience sampling • Semistructured • Content analysis Six themes regarding reasons
Lee (2014), Taiwan • Reasons for young–old • () Rationale • 31 older adults individual interviews • (þ) Data saturation for not committing to
people not killing • Interview guide suicide
QUALITATIVE DESCRIPTION: SYSTEMATIC REVIEW/ KIM ET AL.
themselves • Observation with

memos/reflective
journal
Cleveland and Bonugli • Explore • (þ) Reference NR • Purposive sampling and • Semistructured • Qualitative content Four themes about
(2014), USA • Neonatal intensive care • (þ) Rationale convenience sample individual interviews analysis participants’ experiences
unit experiences • Sandelowski • 15 mothers • Interview guide • (þ) Data saturation of neonatal intensive care
(2000) unit
29
30
Theoretical/
DeBruyn, Ochoa-Marin, • Investigate • (þ) Reference Ottawa model for • Convenience sampling • Semistructured • Inductive qualitative Four main barriers and
and Semenic (2014), • Barriers/facilitators to • () Rationale research use: • 13 nursing professionals individual interviews content analysis potential facilitators to
Colombia implementing • Sandelowski knowledge translation • Interview guide • Constant comparison evidence-based nursing
evidence-based (2000) framework • () Data saturation
nursing

Ewens, Chapman, • Explore • (þ) Reference NR • Unspecified • Responses to open- • Unspecified analysis Five themes regarding
Tulloch, and • Perceptions and • () Rationale • 19 patients and families ended questions on strategy perceptions on use of
Hendricks (2014), utilization of diaries • Sandelowski survey • () Data saturation diaries and descriptive
Australia (2000) statistics using frequencies
of utilization
Fantasia, Sutherland, • Explore • () Reference Theory of planned • Purposive sampling • Semistructured focus- • Content analysis Three main categories and
Fontenot, and Ierardi • Knowledge, attitudes, • () Rationale behavior • Snowball sampling group interviews • (þ) Data saturation subthemes regarding
(2014), USA and beliefs about • Part of a larger • 26 women • Interview guide sexual consent
sexual consent mixed-method
study
Friman, Wahlberg, • Describe • (þ) Reference NR • Purposive sampling • Individual interviews • Qualitative content Three categories and eleven
Mattiasson, and • Experiences of • (þ) Rationale: • 16 district nurses • Interview guide analysis sub-categories about
Ebbeskog (2014), knowledge weak • () Data saturation knowledge development
Sweden development in wound • Krippendorf (2004) experiences in wound
management management
Gaughan, Logan, • Describe • (þ) Reference NR • Purposive sampling • Individual interviews • Qualitative content Two main themes, categories,
Sethna, and Mott • Parental-pain journey, • (þ) Rationale • 9 parents • One open-ended analysis and subcategories about
(2014), USA beliefs about pain, and • Sandelowski question • (þ) Data saturation parents’ experiences of
attitudes/behaviors (2000) observing children’s pain
related to children’s • Milne & Oberle
responses (2005)
• Part of a larger
mixed methods
study
Hart and Mareno • Describe • (þ) Reference NR • Stratified sampling • Written responses to • Thematic analysis Three themes regarding
(2014), USA • Challenges and barriers • (þ) Rationale • 253 nurses two open-ended • () Data saturation challenges/barriers
in providing culturally • Sandelowski questions on survey
competent care (2000)
• Secondary
analysis
Theoretical/
Hasman, Kjaergaard, • Describe • () Reference NR • Purposive sampling with • Semistructured, • Thematic analysis Three themes and four
and Esbensen • Experiences of • () Rationale maximum variation individual interviews • (þ) Data saturation subthemes about partners’
(2014), Denmark childbirth • A substudy • Partners of 10 women • Interview guide experiences of women’s
childbirth

Higgins, van der Riet, • Explore • (þ) Reference NR • Purposeful sampling • Focus-group • “Analyzed One main theme and four
Sneesby, and Good • Perceptions about • (þ) Rationale • 10 nurses interviews thematically” subthemes regarding
(2014), Australia medical nutrition and • Borbasi, Jackson, • () Data saturation nurses’ perceptions on
hydration at the end of and Langford EOL-related medical
life (2008) nutrition and hydration
Holland, Christensen, • Describe • () Reference NR • Convenience sample • Semistructured, • Inductive content Three sets of reasons for
Shone, Kearney, and • Reasons for leaving a • () Rationale • 32 mothers, nurses, and individual interviews analysis leaving a home visiting
Kitzman (2014), USA home visiting program nurse supervisors • Focus-group • Constant comparison program
early interviews approach
• Interview guide • (þ) Data saturation
Johansson, • Explore and describe • (þ) Reference NR • Unspecified • Individual telephone • Thematic analysis Two themes and subthemes
Hildingsson, and • Beliefs and attitudes • (þ) Rationale • 21 males interviews • Constant comparison in relation to the research
Fenwick (2014), around the decision for • Pollit and Beck approach objective
Sweden a caesarean section (2012) • () Data saturation
• Burns and Grove
(2005)
Kao and Tsai (2014), • Explore • (þ) Reference NR • Purposive sampling • Semistructured, • Inductive content Three major themes and nine
Taiwan • Illness experiences of • (þ) Rationale • 17 adults Individual interviews analysis subthemes regarding
early onset of knee • Pope and Mays • Interview guide • (þ) Data saturation experiences of early onset-
osteoarthritis (1995) • Memo/field notes knee osteoarthritis
• Polit and Beck (observations)
(2004)
• Part of a large
research series
Kerr, McKay, Klim, • Explore • (þ) Reference NR • Purposive sampling • Semistructured, • Thematic content Two dominant themes and
Kelly, and McCann • Perceptions about • (þ) Rationale • 30 patients individual interviews analysis related subthemes
(2014), Australia bedside handover (new • Sandelowski • Interview guide • () Data analysis regarding patients’
model) by nurses (2000) thoughts about nurses’
• Neergaard et al. bedside handover
(2009)
31
32
Theoretical/
Kneck, Fagerberg, • Identify • () Reference NR • Purposive sampling with Semistructured, • Saldana’s (2003) Five main patterns of learning
Eriksson, and • Patterns in learning • () Rationale variations in age and sex individual interviews analysis process when living with diabetes
Lundman (2014), when living with • 13 participants (3 times over 3 years) • Inductive qualitative for 3 years following
Sweden diabetes content analysis diagnosis
• () Data saturation

Larocque et al. (2014), • Evaluate • () Reference NR • Unspecified • Questionnaire with two • Thematic content Five themes (positive
Canada • Book chat intervention • () Rationale • 11 long-term-care staff open-ended questions analysis comments) about the book
based on a novel Still • Part of a larger • () Data saturation chat with brief description
Alice research project
Li, Lee, Chen, Jeng, • Explore • () Reference NR • Unspecified • Semistructured • Inductive content Two themes and eight
and Chen (2014), • Facilitators and barriers • () Rationale • 16 nurse-counselors individual interviews analysis subthemes about
Taiwan to implementing • Interview guide • Constant comparison facilitators and barriers
smoking-cessation • () Data saturation described using 2–4
counseling services quotations per subtheme
Lux, Hutcheson, and • Identify • () Reference NR • Unspecified • Semistructured, • Content analysis Two main themes regarding
Peden (2014), USA • Educational strategies • () Rationale individual interviews procedures education strategies for
to manage disruptive • Part of a larger • Interview guide • () Data saturation nurse educators
behavior study
Lyndon et al. (2014), • Explore • () Reference NR • Unspecified • E-mail survey with • Inductive thematic One overarching theme and
USA • Experiences of difficulty • () Rationale • 1,932 physician, nursing, multiple-choice and analysis four subthemes about
resolving patient- • Secondary and midwifery free-text responses • Descriptive statistics professionals’ experiences
related concerns analysis professionals • () Data saturation of difficulty resolving
patient-related concerns
Ma (2014), Singapore • Explicate • (þ) Reference Parse’s human • Unspecified • Individual interviews • Unspecified analysis Three themes presented
• Experience of quality of • (þ) Rationale becoming paradigm • 10 elderly residents • Interview questions techniques using both participants’
life for older adults • Parse (2001) presented (Parse) • () Data saturation language and the
researcher’s language
Ma, Li, Liang, Bai, and • Explore • () Reference NR • Purposeful sampling • Focus-group • Conventional content Four categories and
Song (2014), China • Perspectives on • () Rationale • 20 nursing students interviews analysis associated subcategories
learning about caring • () Data saturation about facilitators and
challenges to learning
about caring
Theoretical/
Marcinowicz, • Describe and assess • (þ) Reference NR • Purposeful, maximum • Individual interviews • Qualitative content Five main topics described
Abramowicz, • Components of the • () Rationale variation sampling analysis from the perspectives of
Zarzycka, patient–nurse • Sandelowski • 26 parents or caregivers • () Data saturation children and parents
Abramowicz, and relationship and (2000) and 22 children
Konstantynowicz pediatric-ward

(2014), Poland amenities
Martorella, Boitor, • Evaluate • () Reference Focused on feasibility • Unspecified • Semistructured, • Thematic analysis for Summary of data focusing on
Michaud, and • Acceptability and • () Rationale and acceptability • 40 patients individual interviews acceptability predetermined indicators
Gelinas (2014), feasibility of hand- • Secondary to a • Field notes • Quantitative ratings of of acceptability and
Canada massage therapy RCT • Video recording video items for descriptive statistics to
feasibility present feasibility
• () Data analysis
McDonough, Callans, • Understand • (þ) Reference NR • Convenience sample • Focus groups • Qualitative content Three themes about
and Carroll (2014), • Challenges occurring • (þ) Rationale • 22 nurses • Interview guide analysis methods challenges regarding
USA during transitions of • Sandelowski • (þ) Data analysis transitions of care
care (2000)
study
McGilton, Boscart, • Understand • () Reference NR • Purposeful sampling • Focus-group • Directed content Nurses’ reasons to stay and
Brown, and Bowers • Factors that influence • () Rationale • 41 nurses interviews analysis leave their current job
(2014), Canada nurses’ retention in their • Interview guide • (þ) Data saturation
current job
Michael, O’Callaghan, • Extend • (þ) Reference NR • Theoretical sampling • Semistructured focus • Inductive, cyclic, and Three themes regarding
Baird, Hiscock, and • Understanding of • (þ) Rationale • 18 caregivers group and individual constant comparative caregivers’ perceptions on
Clayton (2014), caregivers’ views on • Sandelowski interviews analysis advance care planning
Australia advance care planning (2000) • Interview guide • () Data analysis
• Grounded theory • Vignette technique
overtone
Miller (2014), USA • Describe • () Reference NR • Unspecified • Individual interview • Conventional content Six main themes and
• Outcomes older adults • () Rationale • 20 patients analysis associated subthemes
with epilepsy hope to • () Data saturation regarding what older adults
achieve in management hoped to achieve in
management of their
epilepsy
33
34
Theoretical/
Oosterveld-Vlug et al. • Gain • (þ) Reference Model of dignity in illness • Maximum variation • Individual interviews • Thematic analysis The threatening effect of
(2014), The • Experience of personal • () Rationale sampling • Interview guide • Constant comparison illness and three domains
Netherlands dignity and factors • Sandelowski • 30 nursing home residents • (þ) Data saturation being threatened by illness
influencing it (2000) in relation to participants’
experiences of personal

dignity
Oruche, Draucker, • Identify and describe • (þ) Reference NR • Unspecified • Semistructured, • “Standard content Two main topics—(a)
Alkhattab, Knopf, • Needs in mental health • (þ) Rationale • 52 family members individual and focus- analytic procedures” intervention modalities that
and Mazurcyk services and “ideal” • Sandelowski group interviews with case-ordered would fit family members’
(2014), USA program (2000) meta-matrix needs in mental health
• There is a primary • () Data saturation services and (b) topics
study that programs should
address
O’Shea (2014), USA • “What are the • () Reference NR • Purposive, convenience • Semistructured and • Ritchie and Spencer’s Five thematic categories and
perceptions of staff • () Rationale sampling focus-group interviews framework for data associated subcategories
nurses regarding • 18 nurses • Interview guide analysis about nurses’ perceptions
palliative care. . .?” • () Data saturation of palliative care
Peacock, Hammond- • Describe • (þ) Reference NR • Purposive sampling • Individual interviews • Unspecified Five major themes regarding
Collins, and Forbes • Experience of caring • (þ) Rationale • 11 bereaved family • 27 transcripts from the • () Data saturation the journey with dementia
(2014), Canada for a relative with • Sandelowski members primary study from the time prior to
dementia (2000, 2010) diagnosis and into

• Secondary bereavement
analysis
• Phenomenological
overtone
Peterson et al. (2014), • Describe experience • (þ) Reference NR • Unspecified • Semistructured • Conventional content One overarching theme, three
Canada of fetal fibronectin • (þ) Rationale • 17 women individual interviews analysis themes, and six subthemes
testing • Sandelowski • Interview guide • (þ) Data saturation about women’s
(2010) experiences of fetal
• Vaismoradi et al. fibronectin testing
(2013)
Theoretical/
Raphael, Waterworth, • Explore • (þ) Reference NR • Purposeful sampling • Semistructured • Thematic analysis Three themes about practice
and Gott (2014), New • Role of nurses in • (þ) Rationale • 21 nurses individual interviews • () Data saturation nurses’ experiences in
Zealand providing palliative and • Pope and Mays providing palliative and
end-of-life care (2006) end-of-life care

study
Santos, Sandelowski, • Understand • (þ) Reference NR • Purposeful, criterion • Minimally structured, • Thematic analysis Two themes—women’s “bad
and Gualda (2014), • Experience with • () Rationale sampling individual interviews • (þ) Data saturation thoughts” and their four
Brazil postnatal depression • Sandelowski • 15 women with postnatal types of responses to fear
(2000) depression of harm (with frequencies)
Sharp et al. (2014), • Understand • (þ) Reference NR • Purposeful sampling • Semistructured, • Thematic analysis Four themes regarding
Australia • Experience of • (þ) Rationale • 10 patients individual interviews • (þ) Data saturation patients’ experiences of
peripherally inserted • Sandelowski • Interview guide peripherally inserted
central catheter (2000) central catheter insertion
insertion
Soule (2014), USA • Discover • (þ) Reference Focused on cultural • Purposive, maximum • Semistructured, • Within-case and Three themes regarding
• Context, values, and • (þ) Rationale competence variation, and network individual interviews across-case analysis cultural competency
background meaning of • Sandelowski • 20 experts • () Data saturation
cultural competency (2000)
Stegenga and • Explore and describe • (þ) Reference NR • Unspecified • Longitudinal individual • Inductive content Processes and themes about
Macpherson (2014), • Cancer experience • (þ) Rationale • 15 patients interviews (4 time analysis adolescent identify work
USA • Neergaard et al. points) • () Data saturation and cancer identify work
(2009) • 40 interviews across the illness trajectory
Sturesson and Ziegert • Explore • () Reference Focused on support and • Unspecified (but likely • Semistructured • Content analysis One theme, three main
(2014), Sweden • Experiences of giving • () Rationale transition purposeful sampling) Individual interviews • () Data saturation categories, and eight
support to patients • 8 nurses • Interview guide associated categories
during the transition
Tseng, Chen, and • Describe • (þ) Reference NR • Purposeful sampling • Individual interview • Inductive analytic Three stages (themes)
Wang (2014), Taiwan • Process of women’s • (þ) Rationale • 21 women techniques approaches (Thorne regarding the recovery
recovery from stillbirth • Sandelowski et al., 2004) process of Taiwanese
(2000) • (þ) Data saturation women with stillbirth
35
36
Theoretical/
Vaismoradi, Jordan, • Describe • (þ) Reference NR • Purposeful sampling • Focus-group • Content analysis Two main themes about
Turunen, and Bondas • Perspectives of causes • (þ) Rationale • 24 nursing students interviews • () Data saturation nursing students’
(2014), Iran of medication errors • Sandelowski • Observations with perceptions on causes of
(2010) notes medication errors

Valizadeh et al. (2014), • Explore • () Reference NR • Purposeful sampling • Semistructured • Content analysis Two main views (themes) on
Iran • Image of nursing • () Rationale • 18 male nurses individual, interviews • () Data saturation nursing presented with
• Field notes subthemes per view
Villar, Celdran, Faba, • Ascertain • () Reference NR • Maximum variation • Semistructured, • Content analysis 40% of participants without
and Serrat (2014), • Barriers to sexual • () Rationale • 100 staff and residents individual interview • () Data saturation identification of barriers
Spain expression and 60% with seven most
cited barriers to sexual
expression in the long-term
care setting
Wiens, Babenko- • Explore • (þ) Reference Theories of structural • Unspecified • Semistructured, • Unspecified (but used Structural empowerment and
Mould, and Iwasiw • Perceptions of • (þ) Rationale power in organizations • 8 clinical instructors individual pre-determined psychological
(2014), Canada empowerment in • Sandelowski and psychological • Interview guide concepts) empowerment described
academic nursing (2000, 2010) empowerment • (þ) Data saturation using predetermined
environments concepts
Zhang, Shan, and Jiang • Investigate • (þ) Reference Positive health • Purposive, convenience • Individual interviews • Thematic analysis Four themes regarding the
(2014), China • Meaning of life and • (þ) Rationale philosophy sampling • Observations of daily • () Data saturation meaning of life and health
health experience with • Sandelowski • 11 patients behavior with field when living with chronic
chronic illness (2000, 2010) notes illnesses
the 11–20 participant range. Eight had sample sizes of Presentation of Findings
21–30 and eight others of 31–50. Six studies included
Researchers described participants’ experiences of health
more than 50 participants. Two of these articles
care, interventions, or illnesses in 18 articles and presented
depicted quite large sample sizes (N ¼ 253, Hart &
straightforward, focused, detailed descriptions of facilita-
Mareno, 2014; N ¼ 1,932, Lyndon et al., 2014). The
tors, challenges, factors, reasons, and causes in 15
studies were surveys, with qualitative analysis of
articles. Participants’ perceptions of specific care, interven-
responses to open-ended survey questions. This was in
tions, or programs were described in detail in 11 articles.
contrast to studies with smaller sample sizes, in which
All researchers presented their findings with extensive
individual interviews and focus groups were more com-
descriptions, including themes or categories. In 25 of 55
monly employed.
articles, figures or tables were presented to illustrate or
summarize the findings. In addition, the authors of three
Data Collection and Data Sources articles summarized, organized, and described their data
using key concepts of conceptual models (Al-Zadjali et al.,
In a majority of studies, researchers collected data through
2014; Oosterveld-Vlug et al., 2014; Wiens et al., 2014).
individual (n ¼ 39) and/or focus-group (n ¼ 14) interviews
Martorella et al. (2014) assessed acceptability and feasibil-
that were semi-structured. Most researchers reported that
ity of hand massage therapy and arranged their findings in
interviews were audiotaped (n ¼ 51). Interview guides were
relation to pre-determined indicators of acceptability and
described in 29 of these 51 studies. In some cases,
feasibility. In one longitudinal QD study (Kneck, Fagerberg,
researchers also described additional data sources, for
Eriksson, & Lundman, 2014), the researchers presented
example, taking memos or field notes during participant
the findings as key patterns of learning for persons living
observation sessions or as a way to reflect their thoughts
with diabetes; in another longitudinal QD study (Stegenga
about interviews (n ¼ 10). Written responses to open-ended
& Macpherson, 2014), findings were presented as pro-
questions in survey questionnaires were a data source in a
cesses and themes regarding patients’ identity work across
small number of studies (n ¼ 4).
the cancer trajectory. In another two studies, the research-
ers described and compared themes or categories from
Data Analysis two different perspectives, such as those of patients and
nurses (Canzan, Heilemann, Saiani, Mortari, & Ambrosi,
The analysis strategy most commonly used in the QD
2014) or of parents and children (Marcinowicz et al., 2014).
studies included in this review was qualitative content
Additionally, Ma (2014) reported themes using both partic-
analysis (n ¼ 30). Among the studies in which this tech-
ipants’ language and the researcher's language.
nique was used, most researchers described an inductive
approach; researchers of two studies analyzed data both
inductively and deductively. Thematic analysis was
Discussion
adopted in 14 studies and the constant comparison tech-
nique in 10 studies. In nine studies, researchers In this systematic review, we examined and reported spe-
employed multiple techniques to analyze data, including cific characteristics of methods and findings presented in
qualitative content analysis with constant comparison journal articles self-identified as QD that were published
(Asemani et al., 2014; DeBruyn et al., 2014; Holland, during one calendar year. Three primary findings were
Christensen, Shone, Kearney, & Kitzman, 2014; Li et al., observed. First, despite inconsistencies, most QD study
2014) and thematic analysis with constant comparison reports had the characteristics that were originally
(Johansson, Hildingsson, & Fenwick, 2014; Oosterveld- observed by Sandelowski (2000) and depicted in the lim-
Vlug et al., 2014). In addition, five teams conducted ited available QD methods literature. Next, there were not
descriptive statistical analysis using both quantitative and strict boundaries in the methods used; in a number of stud-
qualitative data, including frequency counts of codes or ies, researchers adopted and combined techniques origi-
themes (Ewens, Chapman, Tulloch, & Hendricks, 2014; nating from other qualitative traditions to obtain rich data
Miller, 2014; Santos, Sandelowski, & Gualda, 2014; Villar, and increase their understanding of the phenomenon under
Celdran, Faba, & Serrat, 2014) or of targeted events investigation. Finally, justification for how QD was chosen
captured in video monitoring (Martorella, Boitor, Michaud, and why it would be an appropriate fit for the study in ques-
& Gelinas, 2014). Tseng, Chen, and Wang (2014) tion was found in fewer than half of the reports and is in
cited Thorne, Reimer Kirkham, and O’Flynn-Magee need of increased attention.
(2004)'s interpretive description as the inductive analytic In general, the overall characteristics were consistent
approach. In five out of 55 articles, researchers did not with design features of QD studies described in the litera-
specifically name the analysis strategies, although they ture (Neergaard et al., 2009; Sandelowski, 2000, 2010;
included descriptions of procedural aspects of data analy- Vaismoradi et al., 2013). For example, many authors
sis. Authors of 20 articles reported that data saturation reported that study objectives were to describe or explore
was achieved. participants’ experiences and factors related to certain

phenomena, events, or interventions. In most cases, these when using a constant comparison technique in addition to
authors cited Sandelowski (2000) as a reference for this qualitative content analysis or thematic analysis in QD
characteristic. It was rare that theoretical or philosophical studies, researchers compare each case with others, look-
frameworks were identified, which also is consistent with ing for similarities and differences and exploring why
descriptions of QD. In most studies, researchers used pur- differences exist to generate a more general understanding
poseful sampling and its derivative sampling techniques, of phenomena of interest (Thorne, 2000). In fact, this
collected data through interviews, and analyzed data using type of constant comparison is compatible with qualitative
qualitative content analysis or thematic analysis. Moreover, content analysis and thematic analysis, and we found sev-
all researchers presented focused or comprehensive, eral examples of this approach in our sample (Asemani
descriptive summaries of findings, including themes or cat- et al., 2014; DeBruyn et al., 2014; Holland et al., 2014;
egories, to answer their research questions. Although our Johansson et al., 2014; Li et al., 2014; Oosterveld-Vlug
intention was not to judge whether these studies did or did et al., 2014).
not meet criteria for correctness, findings demonstrate that However, this flexibility or variability in methods of
authors in a recent year designed and actualized QD stud- QD studies may cause confusion for readers and would-be
ies in ways highly consistent with previous depictions. researchers (Neergaard et al., 2009). It could be difficult for
In several studies, researchers also used techniques scholars unfamiliar with qualitative studies to differentiate
that originated in other qualitative traditions. This variability QD studies that have “hues, tones, and textures” of other
may indicate that there are no clear boundaries between qualitative traditions (Sandelowski, 2000, p. 337) from
QD and other qualitative strategies. Sandelowski (2010) grounded theory, phenomenological, and ethnographical
articulated, “in the actual world of research practice, meth- research. In fact, the major difference would be seen in
ods bleed into each other; they are so much messier the presentation of the findings or outcomes (Neergaard
than textbook depictions” (p. 81). Hammersley (2007) also et al.; Sandelowski, 2000). The final products of grounded
observed: theory, phenomenological, and ethnographical research
are a theory, a description of the meaning or essence
We are not so much faced with a set of of people's lived experience, and an in-depth, narrative
clearly differentiated qualitative approaches description about certain culture, respectively, achieved
as with a complex landscape of variable through researchers’ intensive/deep interpretations, reflec-
practice in which the inhabitants use a range tions, and/or transformation of data (Streubert & Carpenter,
of labels (“ethnography,” “discourse analy- 2011). In contrast, QD studies result in “a rich, straight
sis,” “life history work,” “narrative study,” . . . description” of experiences, perceptions, or events using
and so on) in diverse and open-ended ways language from the collected data (Neergaard et al.) through
in order to characterize their orientation, and low-inference (or data-near) interpretation during data anal-
probably do this somewhat differently across ysis (Sandelowski, 2000, 2010), which was seen in all QD
audiences and occasions (p. 293). articles included in this systematic review.
Finally, an explanation or justification of why a QD
Lack of strict boundaries in methods when designing approach was chosen or appropriate for the study aims
a QD study should enable researchers to obtain rich data was not found in more than half studies in this sample.
and produce a comprehensive summary to answer their While other qualitative approaches, including grounded
research questions through various data collection and theory, phenomenology, ethnography, and narrative analy-
analysis approaches. For example, using an ethnographic sis, are used to better understand people's thoughts,
approach (e.g., participant observation) in data collection behaviors, and situations regarding certain phenomena
for a QD study may facilitate an in-depth description of par- (Sullivan-Bolyai et al., 2005), as noted above, the results
ticipants’ nonverbal expressions and interactions with will likely read differently than those for a QD study (Carter
others and their environment, as well as situations or & Littler, 2007). Therefore, it is important that researchers
events in which researchers are interested (Kawulich, accurately label and justify their choices of approach, par-
2005). One example in our sample was Adams et al.'s ticularly for studies focused on participants’ experiences,
(2014) exploration of family members’ responses to nursing which could be addressed with other qualitative traditions.
communication strategies in intensive care units (ICUs). In Justifying one's research epistemology, methodology, and
this study, researchers conducted interviews with family methods allows readers to evaluate these choices for inter-
members, observed interactions between healthcare pro- nal consistency, provides context to assist in understanding
viders, patients, and family members in ICUs, attended ICU the findings, and contributes to the transparency of
rounds and family meetings, and took field notes about choices, all of which enhance the rigor of the study (Carter
their observations and reflections. The combination of & Littler; Wu, Thompson, Aroian, McQuaid, & Deatrick,
methods provided Adams and colleagues (2014) with dif- 2016).
ferent sources and forms of data that complemented data Use of the CASP tool drew our attention to the credi-
gathered in interviews (i.e., data triangulation). Likewise, bility and usefulness of the findings of the QD studies

included in this review. Although justification for study judgment on whether the methods used were effective and
design and methods was lacking in many articles, appropriate in producing credible and useful findings.
most authors reported techniques of recruitment, data
collection, and analysis that appeared appropriate. Internal
consistencies among study objectives, methods, and find- References
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Acknowledgments
This work was supported in part by the John A. Hartford Foundation's National Hartford Centers of Gerontological Nursing Excellence Award
Program. Hyejin Kim is a Ruth L. Kirschstein NRSA Predoctoral Fellow (F31NR015702) and 2013–2015 National Hartford Centers of Gerontologi-
cal Nursing Excellence Patricia G. Archbold Scholar. Justine Sefcik is a Ruth L. Kirschstein Predoctoral Fellow (F31NR015693) through the
National Institutes of Health, National Institute of Nursing Research.

Characteristics of Qualitative Descriptive Studies: A Systematic Review

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Characteristics of Qualitative Descriptive

Studies: A Systematic Review

Methods Article Characteristics

Research in Nursing & Health

Articles identified through PubMed search

Articles excluded (n = 20)

Titles and abstracts reviewed Articles excluded (n = 0)

Full-text papers excluded (n = 17)

Articles included in review

FIGURE 1. Flow diagram of study selection.

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Table 2. Content Extracted From Study Reports for Analysis

Element Data Extracted

Research objectives Verbs used in objectives or aims

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Table 3. Data Extraction and Analysis Results

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themselves • Observation with

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dementia (2000, 2010) diagnosis and into

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Burns, N., & Grove, S. K. (2005). The practice of nursing research:

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Research in Nursing & Health

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