A Meaning Question Needs a Different Design

In practice

The repositioning schedule is adopted and adherence is poor overnight. The intervention question has been answered, and the new question is why, and what the schedule is like for the patients on the receiving end. That is a meaning question, and no trial answers it. Hierarchies are question-specific, so the pyramid that put trials at the top for the intervention question does not rank the evidence for this one — treating a single hierarchy as universal is the error that leads clinicians to dismiss qualitative work as weak. The search looks for phenomenology and grounded theory. A phenomenological study of inpatients' experience of night-time care is found. Trustworthiness replaces validity as the standard. Were participants chosen in a way that fits the phenomenon, which here means people who lived through it rather than a random sample. Is the phenomenon plainly identified. Are data collection and analysis described well enough to follow. Are the findings presented so a reader recognises the experience, with meanings given in context rather than as isolated quotations. The study reports that patients experienced the two-hourly turn as an interruption of the only sleep they were getting, and concealed their wakefulness to avoid being turned again.