November-December 2016 • Vol. 25/No. 6 435

Lynne M. Connelly, PhD, RN, is Associate Professor and Director ofNursing, Robert J. Dehaemers Endowed Chair, Benedictine CollegeAtchison, KS. She is Research Editor for MEDSURG Nursing.

Trustworthiness in QualitativeResearch

I n their qualitative study on nurses’ confusion anduncertainty with cardiac monitoring, Nickasch,Marnocha, Grebe, Scheelk, and Kuehl (2016)

addressed trustworthiness in a number of ways.Trustworthiness or truth value of qualitative researchand transparency of the conduct of the study are crucialto the usefulness and integrity of the findings (Cope,2014). In this column, I will discuss the components oftrustworthiness in qualitative research.

What Is Trustworthiness?Trustworthiness or rigor of a study refers to the degree

of confidence in data, interpretation, and methods usedto ensure the quality of a study (Pilot & Beck, 2014). Ineach study, researchers should establish the protocolsand procedures necessary for a study to be consideredworthy of consideration by readers (Amankwaa, 2016).Although most experts agree trustworthiness is neces-sary, debates have been waged in the literature as towhat constitutes trustworthiness (Leung, 2015).

Criteria outlined by Lincoln and Guba (1985) areaccepted by many qualitative researchers and will be thefocus of this column. These criteria include credibility,dependability, confirmability, and transferability; they lateradded authenticity (Guba & Lincoln, 1994). Each of thesecriteria and the typically used procedures will be out-lined. Not all procedures are used in each study.

CredibilityCredibility of the study, or the confidence in the

truth of the study and therefore the findings, is the mostimportant criterion (Polit & Beck, 2014). This concept isanalogous to internal validity in quantitative research.The question a reader might ask is, “Was the study con-ducted using standard procedures typically used in theindicated qualitative approach, or was an adequate jus-tification provided for variations?” Thus a groundedtheory study should be conducted similar to othergrounded theory studies. Techniques used to establishcredibility include prolonged engagement with partici-pants, persistent observation if appropriate to the study,peer-debriefing, member-checking, and reflective jour-

naling. Evidence also should be presented of iterativequestioning of the data, returning to examine it severaltimes. Negative case analysis or alternate explanationsshould be explored as well.

DependabilityDependability refers to the stability of the data over

time and over the conditions of the study (Polit & Beck,2014). It is similar to reliability in quantitative research,but with the understanding stability of conditionsdepends on the nature of the study. A study of a phe-nomenon experienced by a patient may be very similarfrom time to time. In a study of a program instituted ata hospital, however, conditions will change. Proceduresfor dependability include maintenance of an audit trailof process logs and peer-debriefings with a colleague.Process logs are researcher notes of all activities thathappen during the study and decisions about aspects ofthe study, such as whom to interview and what toobserve.

ConfirmabilityConfirmability is the neutrality or the degree find-

ings are consistent and could be repeated. This is analo-gous to objectivity in quantitative research (Polit &Beck, 2014). Methods include maintenance of an audittrail of analysis and methodological memos of log.Qualitative researchers keep detailed notes of all theirdecisions and their analysis as it progresses. In somestudies, these notes are reviewed by a colleague; in otherstudies, they may be discussed in peer-debriefing ses-sions with a respected qualitative researcher. These dis-cussions prevent biases from only one person’s perspec-tive on the research. In addition, depending on thestudy, the researcher may conduct member-checkingwith study participants or similar individuals. For exam-ple, Nickasch and colleagues (2016) presented theirfindings at a national research conference and receivedfeedback indicating the presented issues were similar forother nurses.

TransferabilityThe nature of transferability, the extent to which

findings are useful to persons in other settings, is differ-ent from other aspects of research in that readers actual-ly determine how applicable the findings are to their sit-uations (Polit & Beck, 2014). Although this is consideredanalogous to generalization in quantitative research, it

Understanding Research Lynne M. Connelly

November-December 2016 • Vol. 25/No. 6436

is different from statistical generalization. Qualitativeresearchers focus on the informants and their storywithout saying this is everyone’s story. Researchers sup-port the study’s transferability with a rich, detaileddescription of the context, location, and people studied,and by being transparent about analysis and trustwor-thiness. Researchers need to provide a vivid picture thatwill inform and resonant with readers (Amankwaa,2016).

AuthenticityAuthenticity is the extent to which researchers fairly

and completely show a range of different realities andrealistically convey participants’ lives (Polit & Beck,2014). Selection of appropriate people for the studysample and provision of a rich, detailed description areways the researchers address this criterion (Schou,Høstrup, Lyngsø, Larsen, & Poulsen, 2011). No analogyto authenticity exists in quantitative research; this arearepresents the advantage of qualitative research to por-tray fully the deep meaning of a phenomenon toincreases readers’ understanding.

Other IssuesThe above criteria are mainstays of qualitative trust-

worthiness, but additional considerations exist as well.The ethical implications of a study also affect its integri-ty and useful. Recruiting procedures are important inobtaining a group of people who can articulate theirexperiences. Conduct of data analysis is another impor-tant issue that can affect trustworthiness. These itemsmay be described in different sections of the researchreport, but they are important to review when reading

Understanding Research

and critiquing an article. In addition, the proceduresused for trustworthiness must fit the research design.Trustworthiness procedures and protocols used in a phe-nomenological study may be similar but not identical togrounded theory, ethnography, or qualitative descrip-tive studies (Cope, 2014).

In this brief overview of trustworthiness, all proce-dures could not be discussed in detail. Readers arereferred to the references or a qualitative research text iffurther information is needed. Trustworthiness or rigoris crucial to the confidence readers have in the findingsof any study, so this is an area readers should examinewhen reading a research report.

REFERENCESAmankwaa, L. (2016). Creating protocols for trustworthiness in qualita-

tive research, Journal of Cultural Diversity, 23(3), 121-127.Cope, D.G. (2014). Methods and meanings: Credibility and trustworthi-

ness of qualitative research. Oncology Nursing Forum, 41(1), 89-91.

Guba, E.G., & Lincoln, Y. (1994). Competing paradigms in qualitativeresearch. In N. Denzin & Y. Lincoln (Eds.), Handbook of qualitativeresearch (pp. 105-117). Thousand Oaks, CA: Sage.

Leung, L. (2015). Validity, reliability and generalizability in qualitativeresearch. Journal of Medicine and Primary Care, 4(3), 324-327.

Lincoln, Y.S., & Guba, E.G. (1985). Naturalistic inquiry. Newbury Park,CA: Sage.

Nickasch, B.L., Marnocha, S., Grebe, L., Scheelk, H., & Kuehl, C.(2016). ‘What do I do next?’ Nurses’ confusion and uncertainty withECG monitoring. MEDSURG Nursing, 25(6), 418-422.

Polit, D.F., & Beck, C.T. (2014). Essentials of nursing research:Appraising evidence for nursing practice (8th ed.). Philadelphia,PA: Wolters Kluwer/Lippincott Williams & Wilkins.

Schou, L., Høstrup, H., Lyngsø, E.E., Larsen, S., & Poulsen, I. (2011).Validation of a new assessment tool for qualitative articles. Journalof Nursing Scholarship, 68(9), 2086-2094.

Copyright of MEDSURG Nursing is the property of Jannetti Publications, Inc. and its contentmay not be copied or emailed to multiple sites or posted to a listserv without the copyrightholder's express written permission. However, users may print, download, or email articles forindividual use.

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