Bergen A, While A
Community Nursing, Research in Health and Social Care Section, Florence Nightingale School of Nursing and Midwifery, King's College London, England.
J Adv Nurs. 2000 Apr;31(4):926-34. doi: 10.1046/j.1365-2648.2000.01356.x.
The case study has become an accepted vehicle for conducting research in a variety of disciplines. However, the meaning behind the term is not always made explicit by researchers and this has given rise to a number of assumptions which are open to challenge, and to questions about the robustness of the method. This paper explores some of the issues arising from one particular definition of case study research, used in a study by Yin which examined the practice of case management in community nursing. Four main areas are discussed. First, defining 'case' is seen to pose questions about the relationship of the phenomenon to its context, the degree of researcher control over case definition, the limits to what may constitute a 'case' and what is meant by the term 'unit of analysis'. Second, the relevance of external validity to case study research is supported through the use of a number of tactics, in particular Yin's concept of replication logic, which involves generalizing to theory, rather than to empirical data. Third, the use of method triangulation (multiple methods of data collection) is advanced as a means of enhancing construct validity in research where data converge around a particular theory. Finally, the relationship of the case study to theory construction, through the prior development of 'propositions' is discussed. Each of these issues is applied to the design and conduct of a research study based closely on Yin's multiple case study framework. Thirteen 'cases' were selected of case management practice and data were collected through interviews and examination of literature and documentation, to explore the suitability of community nurses for the role. It is concluded that, given the appropriate subject matter, context and research aims, the case study method may be seen as a credible option in nursing research.
案例研究已成为各学科进行研究的一种公认手段。然而，研究人员并非总能明确该术语背后的含义，这引发了一些值得质疑的假设，以及关于该方法稳健性的问题。本文探讨了尹在一项研究中使用的案例研究的一种特定定义所引发的一些问题，该研究考察了社区护理中的病例管理实践。文中讨论了四个主要方面。首先，定义“案例”会引发关于现象与其背景的关系、研究人员对案例定义的控制程度、构成“案例”的界限以及“分析单位”一词含义的问题。其次，通过运用多种策略，特别是尹的复制逻辑概念（即归纳至理论而非实证数据）来支持外部效度与案例研究的相关性。第三，提出采用方法三角测量法（多种数据收集方法）作为在数据围绕特定理论汇聚的研究中提高结构效度的一种手段。最后，讨论了案例研究与理论构建的关系，即通过预先提出“命题”来实现。这些问题均应用于一项紧密基于尹的多案例研究框架的研究设计与实施中。选取了13个病例管理实践的“案例”，并通过访谈以及查阅文献和文档来收集数据，以探究社区护士是否适合该角色。得出的结论是，鉴于合适的主题、背景和研究目的，案例研究方法在护理研究中可被视为一种可靠的选择。
