Mixed method nursing studies: a critical realist critique.

Mixed method study designs are becoming increasingly popular among nurse researchers. Mixed studies can have advantages over single method or methodological investigative designs. However, these advantages may be squandered where researchers fail to think through and justify their theoretic decisions. This paper argues that nurse researchers do not always pay sufficient heed to the philosophic and theoretic elements of research design and, in consequence, some mixed study reports lack argumentative coherence and validity. It is here suggested that Hempel's concept of equivalence can be stretched to usefully illustrate one of the main threats to argumentative coherence in mixed study design. The critical realist theory of Roy Bhaskar is then introduced and this, it is proposed, offers one means by which Hempel's equivalence dilemma can be overcome. Critical realists recognize the existence of logical connections between the ontological, epistemological, and methodological premises that underpin their work. They are therefore more likely to produce coherent studies than uncritical pragmatists who ignore such linkages and, paradoxically, critical realists can be epistemological pluralists because, in re-conceptualizing the ontological basis of inquiry, problems associated with the mixing of alternative metaphysics are circumvented.