Ou Christine H K, Hall Wendy A, Thorne Sally E
School of Nursing, University of British Columbia, Vancouver, BC, Canada.
Nurs Philos. 2017 Oct;18(4). doi: 10.1111/nup.12173. Epub 2017 Feb 15.
The use of correlational probability values (p-values) as a means of evaluating evidence in nursing and health care has largely been accepted uncritically. There are reasons to be concerned about an uncritical adherence to the use of significance testing, which has been located in the natural science paradigm. p-values have served in hypothesis and statistical testing, such as in randomized controlled trials and meta-analyses to support what has been portrayed as the highest levels of evidence in the framework of evidence-based practice. Nursing has been minimally involved in the rich debate about the controversies of treating significance testing as evidentiary in the health and social sciences. In this paper, we join the dialogue by examining how and why this statistical mechanism has become entrenched as the gold standard for determining what constitutes legitimate scientific knowledge in the postpositivistic paradigm. We argue that nursing needs to critically reflect on the limitations associated with this tool of the evidence-based movement, given the complexities and contextual factors that are inherent to nursing epistemology. Such reflection will inform our thinking about what constitutes substantive knowledge for the nursing discipline.
在护理和医疗保健领域，使用相关概率值（p值）作为评估证据的一种手段在很大程度上未经严格审查就被接受了。有理由对不加批判地坚持使用显著性检验表示担忧，因为显著性检验源自自然科学范式。p值已用于假设和统计检验，例如在随机对照试验和荟萃分析中，以支持在循证实践框架中被描绘为最高水平的证据。在关于将显著性检验视为健康和社会科学中的证据这一争议的丰富辩论中，护理界参与极少。在本文中，我们通过审视这种统计机制如何以及为何在实证主义后的范式中成为确定何为合法科学知识的黄金标准，来加入这场对话。我们认为，鉴于护理认识论固有的复杂性和背景因素，护理需要批判性地反思与循证运动这一工具相关的局限性。这种反思将为我们思考什么构成护理学科的实质性知识提供参考。
