Clinical Scholarship Incorporating Documents Into Qualitative Nursing Research Fiona A. Miller, Kim Alvarado Purpose: To present an overview of how documents can be incorporated as key sources of data in qualitative nursing research. Methods: Analysis of the nature of documents and the distinctive features of any research strategy to analyze documents. Conclusions: Many different strategies can be used in the analysis of documentary sources that are relevant to nursing practice. A systematic approach to the analysis of these textual resources, using one or several of the analytic strategies described here, can support and advance nursing scholarship. JOURNAL OF NURSING SCHOLARSHIP , 2005; 37:4, 348-353. C 2005 SIGMA THETA TAU INTERNATIONAL. [Key words: research methodology, qualitative studies, document analysis, texts] * * * R egulatory policies, nursing registrations, patients’ case files, drug information leaflets, and profes- sional association newsletters are just a few of the documents that pervade nursing practice. Despite the im- portance of documents for nurses, and for the organization of contemporary societies more generally, social research methods are focused on the analysis of speech and action. Documents are often seen as inappropriate or secondary sources, unable to indicate sufficient insight into systems of social meaning and practice. Further, many researchers are cautious about using documents, given uncertainties about the most appropriate strategies to use and the limited guid- ance available in much of the qualitative methodological literature. In this paper we argue for greater attention to documents in qualitative nursing research, as primary or supplemen- tary sources of data. This discussion includes the nature of documents, distinctive dimensions of any research with doc- uments, how documents might be analyzed, a framework for considering the spectrum of available approaches, and examples of the use of documents to advance nursing schol- arship. Background Qualitative researchers value the “emic” perspective. They seek to understand the world from a participant’s point of view, by listening to or observing a person in a natural envi- ronment. By using documents, a researcher is placed at some distance from real people, so that human action and thought are interpreted through representations of reality. For those reasons, documents are an underutilized resource in qualita- tive research (Hodder, 2003; Prior, 2003; Silverman, 2001). Documents are most widely used when researchers have no other options. Historians, for example, are highly reliant on documents and other material artifacts, and have developed sophisticated techniques for their interpretation (Howell & Prevenier, 2001; Jordanova, 2000). But analysts of the con- temporary social world are generally reticent about using documents, and are most likely to use them as supplemen- tary sources of data. Documents can be used as important resources for data triangulation, to increase the compre- hensiveness and validity of any single study (Patton, 2002). However, documents can also be used as primary sources, providing the whole or majority of the data needed in con- temporary social research, or as objects of study in their own right. To gain some insight into the use of documents as sources for qualitative nursing research, the authors reviewed arti- cles published in the Journal of Nursing Scholarship for a Fiona A. Miller, PhD, Assistant Professor, Department of Clinical Epidemi- ology and Biostatistics and Member, Centre for Health Economics and Pol- icy Analysis; Kim Alvarado, RN, BScN, Iota Omicron, Doctoral Candidate and Clinical Manager, Cardio-Respiratory Care Unit and Medical Diagnos- tic Unit, University Medical Centre; both at McMaster University, Hamilton, Ontario, Canada. Fiona Miller is supported in part by a Career Scientist Award from the Ontario Ministry of Health and Long Term Care and from resources of McMaster’s Centre for Health Economics and Policy Analysis, which is funded in part by the Ontario Ministry of Health and Long Term Care. Correspondence to Dr. Miller, McMaster University, Health Sciences Centre 3H3, 1200 Main Street West, Hamilton, Ontario, Canada, L8N 3Z5. E-mail: millerf@mcmaster.ca Accepted for publication May 3, 2005. 348 Fourth Quarter 2005 Journal of Nursing Scholarship