Case study is a long-established research tradition which predates the recent surge in mixed-methods research. Although a myriad of nuanced definitions of case study exist, seminal case study authors agree that the use of multiple data sources typify this research approach. The expansive case study literature demonstrates a lack of clarity and guidance in designing and reporting this approach to research. Informed by two reviews of the current health care literature, we posit that methodological description in case studies principally focuses on description of case study typology, which impedes the construction of methodologically clear and rigorous case studies. We draw from the case study and mixed-methods literature to develop the DESCARTE model as an innovative approach to the design, conduct, and reporting of case studies in health care. We examine how case study fits within the overall enterprise of qualitatively driven mixed-methods research, and the potential strengths of the model are considered.
AbmaT. A.StakeR. E. (2014). Science of the particular: An advocacy of naturalistic case study in health research. Qualitative Health Research, 24, 1150–1161.
2.
AltmanD. G. (2015). Making research articles fit for purpose: Structured reporting of key methods and findings. Trials, 16(1), Article 53. doi:10.1186/s13063-015-0575-7
3.
AnafS.DrummondC.SheppardL. A. (2007). Combining case study research and systems theory as a heuristic model. Qualitative Health Research, 17, 1309–1315.
4.
AndersonR.CrabtreeB.SteeleD.McDanielR. J. (2005). Case study research: The view from complexity science. Qualitative Health Research, 15, 669–685.
5.
AntonyS.JackS. (2009). Qualitative case study methodology in nursing research: An integrative review. Journal of Advanced Nursing, 65, 1171–1181.
6.
BazeleyP. (2010). Computer assisted integration of mixed methods data sources and analyses. In TeddlieC.TashakkoriA. (Eds.), Handbook of mixed methods in social & behavioral research (2nd ed., pp. 431–467). Thousand Oaks, CA: Sage.
7.
BazeleyP. (2012). Integrative analysis strategies for mixed data sources. American Behavioral Scientist, 56, 814–828.
8.
BegleyC.ElliottN.LalorJ.CoyneI.HigginsA.ComiskeyC. (2013). Differences between clinical specialist and advanced practitioner clinical practice, leadership, and research roles, responsibilities, and perceived outcomes (the SCAPE study). Journal of Advanced Nursing, 69, 1323–1337.
9.
BorbasiS.GalvinK.AdamsT.TodresL.FarrellyB. (2013). Demonstration of the usefulness of a theoretical framework for humanising care with reference to a residential aged care service in Australia. Journal of Clinical Nursing, 22, 881–889.
10.
BowskillD.TimmonsS.JamesV. (2013). How do nurse prescribers integrate prescribing in practice: Case studies in primary and secondary care?Journal of Clinical Nursing, 22, 2077–2086.
11.
BrannenJ. (2005). NCRM methods review papers, NCRM/005. Mixed methods research: A discussion paper. Retrieved from http://eprints.ncrm.ac.uk/89/
12.
BrymanA. (2006). Integrating quantitative and qualitative research: How is it done?Qualitative Research, 6, 97–113.
13.
ByrneD. S.RaginC. (2009). Handbook of case study methods. London: Sage.
14.
CalleryP.KyleR.BanksM.EwingC.KirkS. (2013). Enhancing parents’ confidence to care in acute childhood illness: Triangulation of findings from a mixed methods study of community children’s nursing. Journal of Advanced Nursing, 69, 2538–2548.
15.
CollinsK. T.OnwuegbuzieA. J.JohnsonR. B. (2012). Securing a place at the table: A review and extension of legitimation criteria for the conduct of mixed research. American Behavioral Scientist, 56, 849–865.
16.
CrottyM. (1998). The foundations of social research: Meaning and perspective in the research process. London: Sage.
17.
CurtisS.GeslerW.SmithG.WashburnS. (2000). Approaches to sampling and case selection in qualitative research: Examples in the geography of health. Social Science & Medicine, 50, 1001–1014.
18.
DalyK. J. (2007). Qualitative methods for family studies and human development. Thousand Oaks, CA: Sage.
19.
DamianakisT.WoodfordM. (2012). Qualitative research with small connected communities: Generating new knowledge while upholding research ethics. Qualitative Health Research, 22, 708–718.
20.
DenscombeM. (2008). Communities of practice: A research paradigm for the mixed methods approach. Journal of Mixed Methods Research, 2, 270–283.
21.
De RouckS.LeysM. (2013). Illness trajectory and Internet as a health information and communication channel used by parents of infants admitted to a neonatal intensive care unit. Journal of Advanced Nursing, 69, 1489–1499.
22.
DewinterJ.VermeirenR.VanwesenbeeckI.NieuwenhuizenC. (2013). Autism and normative sexual development: A narrative review. Journal of Clinical Nursing, 22, 3467–3483.
23.
DonnellyF.WiechulaR. (2013). An example of qualitative comparative analysis in nursing research. Nurse Researcher, 20(6), 6–11.
24.
ElliottN.HigginsA.BegleyC.LalorJ.SheerinF.CoyneI.MurphyK. (2013). The identification of clinical and professional leadership activities of advanced practitioners: Findings from the Specialist Clinical and Advanced Practitioner Evaluation study in Ireland. Journal of Advanced Nursing, 69, 1037–1050.
25.
EQUATOR Network. (n.d). Enhancing the QUAlity and Transparency Of health Research. Available from http://www.equator-network.org/
26.
EvaG.PaleyJ.MillerM.WeeB. (2009). Patients’ constructions of disability in metastatic spinal cord compression. Palliative Medicine, 23, 132–140.
27.
EvansD. (2003). Hierarchy of evidence: A framework for ranking evidence evaluating healthcare interventions. Journal of Clinical Nursing, 12, 77–84.
28.
GabbJ. (2009). Researching family relationships: A qualitative mixed methods approach. Methodological Innovations Online, 4(2), 37–52.
29.
GagnierJ. J.KienleG.AltmanD. G.MoherD.SoxH.RileyD. (2014). The CARE guidelines: Consensus-based clinical case report guideline development. Journal of Clinical Epidemiology, 67, 46–51. doi:10.1016/j.jclinepi.2013.08.003
30.
GeorgeA. L.BennettA. (2005). Case studies and theory development in the social sciences. Cambridge, MA: MIT Press.
31.
GerringJ. (2007). Case study research: Principles and practices. New York: Cambridge University Press.
32.
GerrishK.McDonnellA.KennedyF. (2013). The development of a framework for evaluating the impact of nurse consultant roles in the UK. Journal of Advanced Nursing, 69, 2295–2308.
33.
GonzalezM. T.KirkevoldM. (2013). Benefits of sensory garden and horticultural activities in dementia care: A modified scoping review. Journal of Clinical Nursing, 1-18, doi: 10.1111/jocn.12388.
34.
GreeneJ. C. (2007). Mixed methods in social inquiry. San Francisco: Jossey-Bass.
35.
GreeneJ. C. (2012). Engaging critical issues in social inquiry by mixing methods. American Behavioral Scientist, 56, 755–773.
36.
GreeneJ. C.CaracelliV. J.GrahamW. F. (1989). Toward a conceptual framework for mixed-method evaluation designs. Educational Evaluation and Policy Analysis, 11, 255–274.
37.
GrunbaumN. N. (2007). Identification of ambiguity in the case study research typology: What is a unit of analysis?Qualitative Market Research: An International Journal, 10, 78–97.
38.
GubaE. G. (1990). The alternative paradigm dialog. In GubaE. G. (Ed.), The paradigm dialog (pp. 17–27). Newbury Park, CA: Sage.
39.
GuestG. (2013). Describing mixed methods research: An alternative to typologies. Journal of Mixed Methods Research, 7, 141–151.
40.
GuilleminM.GillamL. (2004). Ethics, reflexivity, and “ethically important moments” in research. Qualitative Inquiry, 10, 261–280.
41.
HallB.HowardK. (2008). A synergistic approach: Conducting mixed methods research with typological and systemic design considerations. Journal of Mixed Methods Research, 2, 248–269.
42.
HoughtonC.CaseyD.ShawD.MurphyK. (2013). Students’ experiences of implementing clinical skills in the real world of practice. Journal of Clinical Nursing, 22, 1961–1969.
43.
HoweK. R. (1988). Against the quantitative-qualitative incompatibility thesis or dogmas die hard. Educational Researcher, 17(8), 10–16.
44.
HyettN.KennyA.Dickson-SwiftV. (2014). Methodology or method? A critical review of qualitative case study reports. International Journal of Qualitative Studies on Health and Well-Being, 9. doi:10.3402/qhw.v9.23606
45.
KeadyJ.JonesL.WardR.KochS.SwarbrickC.HellströmI.. . . WilliamsS. (2013). Introducing the bio-psycho-social-physical model of dementia through a collective case study design. Journal of Clinical Nursing, 22, 2768–2777.
46.
KilpatrickK. (2013). How do nurse practitioners in acute care affect perceptions of team effectiveness?Journal of Clinical Nursing, 22, 2636–2647.
47.
KilpatrickK.Lavoie-TremblayM.LamotheL.RitchieJ.DoranD. (2013). Conceptual framework of acute care nurse practitioner role enactment, boundary work, and perceptions of team effectiveness. Journal of Advanced Nursing, 69, 205–217.
48.
LuckL.JacksonD.UsherK. (2006). Case study: A bridge across the paradigms. Nursing Inquiry, 13, 103–109.
49.
MarshallA. P.WestS. H.AitkenL. M. (2013). Clinical credibility and trustworthiness are key characteristics used to identify colleagues from whom to seek information. Journal of Clinical Nursing, 22, 1424–1443.
50.
MasonJ. (2006). Mixing methods in a qualitatively driven way. Qualitative Research, 6, 9–25.
51.
MaxwellE.BaillieL.RickardW.McLarenS. (2013). Exploring the relationship between social identity and workplace jurisdiction for new nursing roles: A case study approach. International Journal of Nursing Studies, 50, 622–631.
52.
MaxwellJ. A.LoomisD. (2003). Mixed method design: An alternative approach. In TashakkoriA.TeddlieC. (Eds.), Handbook of mixed methods in social & behavioral research (pp. 241–271). Thousand Oaks, CA: Sage.
53.
MaxwellJ. A.MittapalliK. (2010). Realism as a stance for mixed method research. In TashakkoriA.TeddlieC. (Eds.), Handbook of mixed methods in social & behavioral research (2nd ed., pp. 145–168). Thousand Oaks, CA: Sage.
54.
MerriamS. B. (1988).Case study research in education: A qualitative approach. San Francisco: Jossey-Bass.
55.
MertensD. M.BledsoeK. L.SullivanM.WilsonA. (2010). Utilization of mixed methods for transformative purposes. In TashakkoriA.TeddlieC. (Eds.), Handbook of mixed methods in social & behavioral research (2nd ed., pp. 193–214). Thousand Oaks, CA: Sage.
56.
MilesM. B.HubermanA. M. (1994). Qualitative data analysis: An expanded sourcebook (2nd ed.). Thousand Oaks, CA: Sage.
57.
MitchellR.ParkerV.GilesM. (2013). An interprofessional team approach to tracheostomy care: A mixed-method investigation into the mechanisms explaining tracheostomy team effectiveness. International Journal of Nursing Studies, 50, 536–542.
58.
MooreJ.PrenticeD. (2013). Collaboration among nurse practitioners and registered nurses in outpatient oncology settings in Canada. Journal of Advanced Nursing, 69, 1574–1583.
59.
MorseJ. M. (1991). Approaches to qualitative-quantitative methodological triangulation. Nursing Research, 40, 120–123.
60.
NiasJ. (1993). Changing times, changing identities: Grieving for a lost self. In BurgessR. (Ed.), Educational research and evaluation (pp. 139–156). London: The Falmer Press.
61.
NoyesJ.LewisM.BennettV.WiddasD.BrombleyK. (2013). Realistic nurse-led policy implementation, optimization and evaluation: Novel methodological exemplar. Journal of Advanced Nursing, 70, 220–237.
62.
O’CathianA.MurphyE.NichollJ. (2008). The quality of mixed methods studies in health services research. Journal of Health Services Research & Policy, 13, 92–98.
63.
OnwuegbuzieA.CollinsK. M. T. (2007). A typology of mixed methods sampling designs in social science research. The Qualitative Report, 12, 281–316.
64.
PadgettS. M. (2013). Professional collegiality and peer monitoring among nursing staff: An ethnographic study. International Journal of Nursing Studies, 50, 1407–1415.
65.
PattonM. Q. (2002). Qualitative research and evaluation methods (3rd ed.). Thousand Oaks, CA: Sage.
66.
PayneS.FieldD.RollsL.HawkerS.KerrC. (2007). Case study research methods in end-of-life care: Reflections on three studies. Journal of Advanced Nursing, 58, 236–245.
67.
PolitD. F.BeckC. T. (2012). Nursing research: Generating and assessing evidence for nursing practice. London: Wolters Kluwer.
68.
PowellI. (2013). Can you see me? Experiences of nurses working night shift in Australian regional hospitals: A qualitative case study. Journal of Advanced Nursing, 10, 2172–2184.
69.
ProcterS.WilsonP.BrooksF.KendallS. (2013). Success and failure in integrated models of nursing for long term conditions: Multiple case studies of whole systems. International Journal of Nursing Studies, 50, 632–643.
70.
RaginC. (1987). The comparative method: Moving beyond qualitative and quantitative strategies. Berkeley: University of California Press.
71.
Ribbens McCarthyJ.HollandJ.GilliesV. (2003). Multiple perspectives on the “family” lives of young people: Methodological and theoretical issues in case study research. International Journal of Social Research Methodology, 6, 1–23.
72.
RihouxB.RaginC. (2009). Configurational comparative methods. Los Angeles: Sage.
73.
RohlfingI. (2012). Case studies and causal inference: An integrative framework. Basingstoke, UK: Palgrave Macmillan.
74.
RosenbergJ. P.YatesP. M. (2007). Schematic representation of case study research designs. Journal of Advanced Nursing, 60, 447–452.
75.
SandelowskiM. (1996). One is the liveliest number: The case orientation of qualitative research. Research in Nursing & Health, 19, 525–529.
76.
SandelowskiM. (2000). Combining qualitative and quantitative sampling, data collection, and analysis techniques in mixed-methods studies. Research in Nursing & Health, 23, 246–255.
77.
SandelowskiM. (2011). “Casing” the research case study. Research in Nursing & Health, 34, 153–159.
78.
SandelowskiM. (2015). A matter of taste: Evaluating the quality of qualitative research. Nursing Inquiry, 22, 86–94. doi:10.1111/nin.12080
79.
SeawrightJ.GerringJ. (2008). Case selection techniques in case study research: A menu of qualitative and quantitative options. Political Research Quarterly, 61, 294–308.
80.
SimonsH. (2009). Case study research in practice. London: Sage.
81.
StakeR. E. (1995). The art of case study research. Thousand Oaks, CA: Sage.
82.
StakeR. E. (2005). Qualitative case studies. In DenzinN. K.LincolnY. S. (Eds.), The SAGE handbook of qualitative research (3rd ed., pp. 443–466). Thousand Oaks, CA: Sage.
83.
StakeR. E. (2006). Multiple case study analysis. New York: Guilford Press.
84.
St LedgerU.BegleyA.ReidJ.PriorL.McAuleyD.BlackwoodB. (2013). Moral distress in end-of-life care in the intensive care unit. Journal of Advanced Nursing, 69, 1869–1880.
85.
TashakkoriA.TeddlieC. (1998). Mixed methodology: Combing the qualitative and quantitative approaches. Thousand Oaks, CA: Sage.
86.
TaylorR. (2013). Case-study research in context. Nurse Researcher, 20(4), 4–5.
87.
TeddlieC.TashakkoriA. (2012). Common “core” characteristics of mixed methods research. American Behavioral Scientist, 56, 774–788.
88.
ThomasG. (2011a). How to do your case study: A guide for students and researchers. London: Sage.
89.
ThomasG. (2011b). A typology for the case study in social science following a review of definition, discourse, and structure. Qualitative Inquiry, 17, 511–521.
90.
TobianoG.ChaboyerW.McMurrayA. (2013). Family members’ perceptions of the nursing bedside handover. Journal of Clinical Nursing, 22, 192–200.
91.
UnbeckM.SternerE.ElgM.FossumB.ThorJ.HärenstamK. (2013). Design, application and impact of quality improvement “theme months” in orthopaedic nursing: A mixed method case study on pressure ulcer prevention. International Journal of Nursing Studies, 50, 527–535.
92.
Van Der ZandeM.BaartA.VosmanF. (2013). Ethical sensitivity in practice: Finding tacit moral knowing. Journal of Advanced Nursing. doi: 10.1111/jan.12154.
93.
WalsheC. E. (2011). The evaluation of complex interventions in palliative care: An exploration of the potential of case study research strategies. Palliative Medicine, 25, 774–781.
94.
WalsheC. E.CaressA.Chew-GrahamC.ToddC. (2004). Case studies: A research strategy appropriate for palliative care?Palliative Medicine, 18, 677–684.
95.
WellsM.WilliamsB.TreweekS.CoyleJ.TaylorJ. (2012). Intervention description is not enough: Evidence from an in-depth multiple case study on the untold role and impact of context in randomised controlled trials of seven complex interventions. Trials, 13, Article 95. doi:10.1186/1745-6215-13-95
96.
WilliamsL.BurtonC.Rycroft-MaloneJ. (2013). What works: A realist evaluation case study of intermediaries in infection control practice. Journal of Advanced Nursing, 69, 915–926.
97.
YinR. K. (2009). Case study research: Design and method (4th ed.). Thousand Oaks, CA: Sage.
