第5节 研究结果
质性研究论文的结果可分为类属型（categorization）或情境型（contextualization）。前者使用分类的方法，将研究结果按照一定的主题分门别类地陈述，具有较强的逻辑性和层次性；后者注重情境和过程，按照事件发生的时间序列或时间之间的逻辑关联进行描述。目前，护理研究中以类属型的结果汇报方式为主。
在论文撰写时，研究结果部分一般以一段高度总结性的文字来展现。这段文字将发现的主题（themes）以精简的语言串起来，以使读者对研究结果形成一个整体性印象。如示例4-20所示，结果部分，第一段总结了研究的现象和主要研究结果；并且使用图片更清晰地展示了研究结果。
示例4-20 对结果的概括性描述
In this section，we present our findings on frontline nurses'（IN）and ward nurse managers'（IWM）day-to-day experiences with implicit rationing of nursing care on their units.The fact that rationing occurs reveals a gap between the ideal and the reality of providing nursing care.According to the study participants，implicit rationing occurs when nurses have difficulty maintaining stability in complex situations.At the micro-level，nurses described various strategies they applied to prevent or reduce the need for rationing.Within each theme，we identified subthemes that nurses described as important factors influencing their decision-making，priority setting，and rationing decisions（see Fig.1）.
有时，研究者也会采用流程图的形式对研究结果进行立体、系统、清晰的展现。如示例4-21所示，作者采用主题图（thematic map）的形式，生动、全面地展示了急诊护士在决策、确定优先事项和护理配给这一过程中涌现出来的三个主题和亚主题。关于图表的应用及要点，将会在本章第7节中进一步阐述。
示例4-21 主题、亚主题及其关系的展示
需要注意的是，此处的主题（theme）具有抽象性（abstract）和概括性（generalized），不是研究问题或访谈问题的简单转换或凝练。如示例4-22所示，研究问题为“护士对急诊医院隐性护理配给的体会（nurses'experiences with implicit rationing of nursing care in acute-care hospitals）”。访谈问题围绕着以下方面开展：一线急诊科护士的隐性护理配给的经验（experiences as frontline nurses/nurse ward managers with implicit rationing of nursing care）、对临床决策和优先次序设定的看法（perceptions regarding clinical decisionmaking and priority setting）、以及对患者和（或）护理活动优先次序的看法（perspectives on prioritization of patients and/or care activities）。作者将研究结果归纳为3个主题，分别是：①在复杂情况下保持稳定（Maintaining stability within complexity）；②运用策略限制配给（Applying strategies to limit rationing）；③理想与现实之间的护理（Nursing care between ideal and reality）。每个主题均包含亚主题（sub-themes），如第一个主题的亚主题为：a.保持日常的生活规律（Keeping to a daily routine）；b.组织护理工作（Organizing nursing care）；c.对患者的不稳定因素做出反应（Reacting to patients'instability）。
示例4-22 研究结果中的主题及亚主题
3.1 Maintaining stability within complexity (https://www.daowen.com)
Clinical practice in acute-care settings is highly complex.Within the complexity of patient needs，care and work processes，and health care technologies，nurses seek to create and maintain stability within their environment.Stability is supporting by keeping to daily routines that help nurses exert control over their practice，for example by structuring the diverse and often competing demands of their patients and their work environment.
3.1.1 Keeping to a daily routine
In order to maintain stability under complex or otherwise stressful conditions，nurses reported following a predetermined daily routine of nursing care（IN2）...One nurse ward manager described how the nurses on her ward adhered to a routine focusing on nursing tasks：On a normal day we start in the morning by measuring the blood pressure；then we take care of the oral therapy and I start at room1.If there is nothing special，then I go room by room，from room 1 to 7and then from room 8 to13（IWM3）.
结果部分应当有足够的证据资料，强调“深入描述thick description”。一个好的“结果”能够提供大量、适宜、细节性的原始资料来支撑主题和亚主题［多通过引用（quotes）访谈者的原话来实现］。引用的可以是几段话、一段话、一句话、一个短语或一个单词；用引号标出（不同杂志的格式要求可能不同），并且标注来源（被访者代码、简单特征及访谈轮次等）。当研究结果包含主题和亚主题时（多数质性研究是这样的），主题多为headings，quotes则出现在亚主题中。如示例4-22所示，研究者在亚主题的段落部分，使用斜体来展现quotes，并在每一个quotes后面标注其来源。有的研究者会将quotes单独置于一段，以支撑整个或部分亚主题。如示例4-23所示，斜体部分为受访者的原话，作者将其以独立段落的形式呈现出来，用于支撑亚主题；同时，在段落开始，说明了quotes来源。
示例4-23 单独成段的quotes
3.1.2 Willpower
A theme that was repeatedly articulated by the participants dealt with self-determination.Participants expressed the need for free will in order to be motivated to incorporate modifications in their lifestylc.
67 years（Cardiac rehabilitation）“It's all about willpower，you shouldn't panic，it's willpower，thinking rationally.I understood that if I will not take care，I will suffer more.I must do something about it.A person must come to the conclusion by himself.Pushing or yelling wouldn't help.”
最后，值得注意的是，质性研究的主题和亚主题大多以名词或动名词的形式出现。如上文中提到的主题中，使用了名词“nursing care between ideal and reality”“adherence facilitators and barriers”“willpower”等，动名词“maintaining”“applying”“keeping”“organizing”“reacting”等；这些词都充分体现了质性研究主题的概括性和抽象性，也潜在地反映了质性研究的现象是身处其中的个体正在进行的真实生活体验（lived experience），质性研究结果具有“鲜活性”。