Qualitative research methods, inductive and deductive: Valuable approaches to nursing knowledge development for practice

Theory serves to offer a meaningful account of events and circumstances. In the practice discipline of nursing, theory, research, and practice are interrelated member elements of an essential triad. The process of theorizing can begin at any position in the triad and can move in either direction to connect with the other two elements. For example, one can pose an idea about nursing, interrogate that idea in research, and examine the research-refined idea in practice, or one can note a circumstance in practice, wonder about that circumstance through research, and formalize an idea about the circumstance through theorizing, or one can notice a circumstance in practice, interrogate that circumstance in research, and formalize an understanding as theory. The point is that in nursing, all three elements are always present and interrelated as nurses strive to make meaning in nursing. This statement holds, whether we are addressing theory development, research investigations of quantitative, qualitative, or mixed methods type, or practice, whether direct care, education, or management of work. We believe that a key contextualizing framework for thoughtful work in nursing—whether in practice, research, teaching, management, or any other role—is the idea of nursing as both a discipline of developed knowledge and a field of professional human service. Each component of this contextualizing framework offers vision and boundaries to stimulate and guide nursing as a dynamic, relevant human enterprise in a changing world. Highlighting the differences between inductive and deductive approaches, these understandings form the background for our discussion of the role of nursing theory in qualitative research efforts for the discipline. The authors' experiences of employing unique processes of nursing practice support the assertion that qualitative research has a role in nursing with a long-standing history of scholarly literature supportive of the discipline. A ground-breaking two-part article published in 1968 in Nursing Research opened the door to legitimacy of qualitative research in nursing, with Dickoff, James, and Wiedenbach's (1968 a,b) “Theory in A Practice Discipline” proposing a four-level approach to theory development. In 1993, Burns advanced a comprehensive set of standards for qualitative research in nursing. Mitchell and Cody's (1993) paper was an early depiction of the role of theory in qualitative research. Qualitative research can contribute to formalized nursing knowledge in a range of ways: identifying new concepts and relationships; deepening an understanding of the lived experience of health and healthcare; grounding theories in the real world of nursing practice; considering the perspectives of those being cared for and offering care; identifying the strengths and weaknesses of existing theories, refining existing theories, and developing new theories. The authors' experience with theory development confirms the values of qualitative research in relation to nursing theory development. We offer several examples related to the middle-range theory of Technological Competency as Caring in Nursing and to the general or grand theory of Nursing as Caring. In preparation for those examples, we find it important to briefly address two general approaches to qualitative research—deductive and inductive. In qualitative research, the term deductive generally refers to a systematic approach wherein codes or categories of meaning are predetermined, derived from an explicit theoretical framework in order to confirm, expand, or refine the framing theory, whereas in an inductive approach, categories and structure of meaning emerge from the dataset rather than being imposed from an existing theory. It must be said, however, that most qualitative research involves both approaches at some point in the work (Bergdahl Finfgeld-Connett, 2001; Thomas, 2003). In a 2022 article in the Nursing Philosophy journal, Bergdahl and Bertero, proponents of a deductive approach, addressed the issue of theory creation as a critical characteristic of theory construction and development, with theory justification as a consequent or particularly “an other” and corollary sequential process of theory construction and development. “As in a creative endeavor, the inspiration for theory creation can come from many sources, including previous research and existing theory” (p. 1). From the perspective of Bergdahl and Bertero, legitimizing theoretical framings through justification by testing is a critical phase in the iterative process of the advancement of a discipline and professional practice such as nursing. “Knowledge development is a deductive trial-and-error process where theory creation is followed by testing” (p. 1). Furthermore, qualitative deductive approaches play vital positions in theory creation. For example, guided by and supported with tenets and assumptions of the theory of Technological Competency as Caring in Nursing (TCCN), theoretical frameworks and models with subsequent practice processes have been uniquely created to foster their theoretical fitness to value nursing as a discipline of knowledge that grounds unique processes of nursing practice, and the practice of the discipline in real-life situations of caring. The Transactive Relationship Theory of Nursing (TRETON) (Tanioka, 2017) is one of the models of articulated theories derived from the assumptions and tenets of the TCCN theory and the Nursing as Caring theory. Highlighted in this practice theory is the articulation of research findings for furthering theoretical frameworks and models toward future nursing and novel research methodologies to remain relevant. TRETON underscores the communicative engagement between and among human persons, humanoid nurse robots (HNR), and persons nursed. Guiding nursing practice is the process of technological knowing (Locsin thus, the HNR is an active “participant” in the nursing care process). Thomas (2003) asserts that the primary purpose of the inductive approach is to “allow research findings to emerge from the frequent, dominant, or significant themes inherent in raw data, without the restraints imposed by structured methodologies” (p. 2). Key features in a general inductive approach include condensing extensive raw text data into a summary form; establishing clear links between research objectives and findings; and developing a model or theory of the underlying structure of the experiences or processes uncovered in the analysis/synthesis. To continue the framing of this editorial from the perspective of the theory of Nursing as Caring, we cite several relevant examples of inductive qualitative research. One example is a study that used the inductive approach explored the everyday meaning of caring in the life of adolescents (Schoenhofer et al., 1998). In a group phenomenology approach (Schoenhofer, 2002), participants each shared a story that exemplified the meaning of everyday caring in their lives, the group then worked together to create a meaningful title to the story, and the researcher group worked with the raw data and the story titles to uncover key themes in the data as well as a structural description of the phenomenon of the meaning of everyday caring in the lives of adolescents. The editorial focused on the utility of qualitative research to nursing knowledge development, and its relevance whether through inductive or deductive processes, even when AI and HNR become significant parts of the equation in knowledge development, and how nursing theory relates to qualitative research. In the Tanioka (2017) study, offered as an exemplar of the deductive approach to qualitative research, the question and the thematic categories were taken from an existing theory to create a new theory. However, the qualitative data analysis exhibited aspects of induction. In the Schoenhofer et al. (1998) study, the research question arose from a specific nursing perspective, articulated as the theory of Nursing as Caring (Boykin thus, one might acknowledge an element of deduction in that study. In conclusion, it is our assertion that qualitative research, whatever the specific methodological details, has been shown to have made important contributions to nursing knowledge to guide theory, research, and practice, and will continue to do so. Rozzano C. Locsin: Conceptualization; writing – original draft; writing – review and editing; data curation. Savina O. Schoenhofer: Conceptualization; writing – original draft; writing – review and editing; data curation. None declared. Data sharing is not applicable to this article as no new data were created or analyzed in this study.