qualitative research methods. introduction long history in the social sciences increasingly becoming...
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Qualitative research Qualitative research methodsmethods
IntroductionIntroduction
Long history in the social sciences
Increasingly becoming an essential component in HSR
Enable us to access areas not amenable to quantitative research such as lay and professional health beliefs
Prerequisite of good quantitative research, particularly in areas that have received little previous investigation
What are qualitative methods? (i)What are qualitative methods? (i)
Goal is to develop concepts which help us to understand social phenomena in natural (rather than experimental) settings
They do not seek to provide quantified answers to research questions
e.g. “What is X and how does X vary in different circumstances, and why? (rather than how many Xs are there?)
Selecting the right approach for Selecting the right approach for your questionyour question
Qualitative and quantitative approaches to research are intended to be different
It depends on the type of question that you’re asking (what sort of information you’re trying to find out)
e.g. RCTs are ‘gold standard’ for assessing effectiveness, but can’t be used for understanding the language people use or the way they think about the world
Quantitative ResearchQuantitative ResearchQuantitative research requires a large
number of participants in order to achieve statistical power
It looks for a very narrow range of information from the large sample population
Qualitative ResearchQualitative Research
Qualitative research looks at smaller samples in more depth
Analogy (i)Analogy (i)
If all the factors in a situation are like a threads in a weaving...
Analogy (ii)Analogy (ii)
then, quantitative approaches measure the
thread that they think is the most significant, to find out about it’s effect
(proving or disproving a hypothesis)
Analogy (iii)Analogy (iii)
and qualitative research looks a section of the weaving to understand what the threads are, how they all fit together and reflect the pattern overall
(hypothesis generating)
What are qualitative methods? (ii)What are qualitative methods? (ii)
Some of the main qualitative methods currently used in HSR are:
Interviews (in-depth and semi-structured)
focus groups or ‘group interviews’
observation
case studies
Research on diabetesResearch on diabetes Quantitative methods (including RCTs)
have contributed to advances in the treatment of diabetes
However, health professionals may need answers to additional questions, e.g. those concerned with patient behaviour
This is where qualitative research can be useful
How can qualitative methods How can qualitative methods complement quantitative ones?complement quantitative ones? Can be conducted as an essential preliminary
to quantitative research
Can be used to supplement quantitative work
Can be used to explore complex phenomena or areas not amenable to quantitative research
Example of qualitative methods Example of qualitative methods
supplementing quantitative researchsupplementing quantitative research Two stage investigation of the geographical
variation in the incidence of operations on the tonsils and adenoids (Bloor et al 1976)
Part one: Epidemiological study – documenting variations
- Analysis of 12 mths routine data on referral, acceptance, and operation rates for new patients
Part two: Sociological study – explaining how and why variations come about- observation of assessment routines undertaken in outpatient departments
Summary of findings (i) Summary of findings (i) Part one: Epidemiological study – documenting variations
Found significant differences between similar areas with regions in referral, acceptance, and operation rates that were not explained by disease incidence
Operation rates influenced, in order of importance, by:
- Differences between specialists in tendency to list for operations
- Differences between GPs in tendency to refer
- Differences between areas in symptomatic mix of referrals
Summary of findings (ii)Summary of findings (ii)
Part two: Sociological study – explaining how and why variations come about
Found considerable variation between specialists in their assessment practices:
- “High operators” – tendency to view a broad spectrum of clinical signs as important / to assert the importance of examination findings over child’s history
- “Low operators” – tendency to give examination less weight in deciding on disposal /to judge a narrower range of clinical features as indicating need to operate
How can qualitative methods How can qualitative methods complement quantitative ones?complement quantitative ones? Can be conducted as an essential
preliminary to quantitative research
Can be used to supplement quantitative work
Can be used to explore complex phenomena or areas not amenable to quantitative research
Qualitative interviews in HSRQualitative interviews in HSR
Much qualitative research is interview based
Types of interviews
- semi-structured (open ended questions)
- in-depth (or unstructured; one or two issues covered in great detail; questions are based on what interviewee says)
These can be contrasted with structured interviews
Aims of the qualitative interviewAims of the qualitative interview
To discover the interviewee’s own framework of meanings
To avoid imposing the researcher’s structures and assumptions (as far as possible)
To remain open to possibility that emerging issues may be different from those predicted as outset
Qualitative interview studies address different questions from those addressed by quantitative research
Example 1Example 1A quantitative epidemiological approach
to SIDS might measure statistical correlates of national and regional variations in incidence.
In a qualitative study you might interview mothers of young babies in different ethnic groups to understand their child rearing practices
Ref: Gantley M, Davis DP, Murcott A. Sudden infant death syndrome: links with infant care practices. BMJ 1993; 306:16-20
Example 2Example 2A quantitative study of singlehanded GPs might
compare their prescribing and referral rates, out of hours payments, list sizes, and immunisation rates with those of GPs in partnerships
In a qualitative study you might examine the concerns of singlehanded GPs (semi-structured interviews) and identify problems perceived by this group of doctors
Ref: Green JM. The views of singlehanded GPs: a qualitative study. BMJ 1993; 307: 607-10
Conducting interviewsConducting interviews
Qualitative interviewers try to:- be interactive and sensitive to language and concepts used by interviewee- go below the surface of the topic being discussed, explore what people say in as much detail as possible- uncover new areas or ideas that were not anticipated at the outset of research
Types of questions (i)Types of questions (i)
Behaviour or experience
Opinion or belief
Feelings
Knowledge
Background or demographic
Types of questions (ii)Types of questions (ii)The less structured the interview, the
less questions are determined and standardised before the interview occurs:- list of core questions that define the areas to be covered - the order in which questions are asked will vary- as will the questions designed to probe interviewee's meanings
Advantages of one-to-one Advantages of one-to-one semi-structured interviewssemi-structured interviewsThe opportunity to capture in depth the
views of one person, letting them take the lead
Accessing language and meaning that might be missed if using a structured interview
Privacy of interview makes them suitable for generating data on sensitive topics
Interview format familiar to most in UK from popular culture
Disadvantages of one-to-one Disadvantages of one-to-one semi-structured interviewssemi-structured interviewsEach interview represents the views of
only one person
One-to-one interviews might increase the possibility of acquiescence bias (interviewee saying what they think interviewer want to hear rather than what they really think or do)
Might be culturally inappropriate (to ask direct questions or meet one-to-one)
Focus groups in HSR: Focus groups in HSR: rationale and uses (i)rationale and uses (i)A form of group interview that capitalises
on communication between research participants in order to generate data
Not just a quick and convenient way to collect data from several people simultaneously
Explicitly uses group interaction as part of the method
Focus groups in HSR: Focus groups in HSR: rationale and uses (ii)rationale and uses (ii)People are encouraged to talk to one
another: asking questions, exchanging anecdotes and commenting on each others' experiences and points of view
Useful for exploring people's knowledge and experiences
And can be used to examine not only what people think but how they think and why they think that way
Examples of uses Examples of uses (focus groups)(focus groups)Popular method for assessing health
education messagesExamining public understandings of
illness and of health behavioursExamining people's experiences of
diseases and of health servicesEffective technique for exploring the
attitudes and needs of staff
Some advantages over semi structured one-to-Some advantages over semi structured one-to-one interviews (i)one interviews (i)
Group processes can help people to explore and clarify their views in ways that would be less easily accessible in a one-to-one interview
Helps researchers tap into the many different forms of communication that people use in day to day interaction (jokes, anecdotes, teasing, arguing)
Some advantages (ii)Some advantages (ii)Can encourage participation from those
who are reluctant to be interviewed on their own (those intimidated by formality and isolation of a one-to-one interview)
Can actively facilitate the discussion of taboo topics because the less inhibited members of the group break the ice for shyer participants
Some disadvantages of using focus Some disadvantages of using focus groups groups Possibility of ‘group-think’: when people
all agree in public, even though they might think differently
Some people may be shy of speaking in public
Some people may dominate the group discussions
Requires good facilitation skills and choice of materials (resource intensive)
Summary – focus groups Summary – focus groups and qualitative interviews and qualitative interviews
Flexible and powerful tools which can open up many new areas for research
Can enable researchers to investigate research questions which would be difficult to investigate with more quantitative methods
Assessing quality in qualitative Assessing quality in qualitative research research The status of all forms of research depends on the
quality of the methods used
Considerable debate over whether qualitative and quantitative methods can and should be assessed according to same quality criteria
Can be assessed with the same broad concepts of validity and relevance used for quantitative research, but these need to be operationalised differently
Assessing the validity of Assessing the validity of qualitative researchqualitative research
Triangulation
Clear exposition of methods of data collection and analysis
Reflexivity
TriangulationTriangulation
Compares the results from either two or more different methods of data collection (e.g. interviews and observation) or, more simply, two or more data sources (e.g. interviews with members of different interest groups)
The researcher looks for patterns of convergence to develop or corroborate an overall interpretation
Methods of data collection and Methods of data collection and analysisanalysisA clear account of the process of data
collection and analysis is important
Written account should include sufficient data to allow the reader to judge whether the interpretation offered is adequately supported by the data
ReflexivityReflexivity
Sensitivity to the ways in which the researcher and the research process have shaped the collected data
The effects of personal characteristics such as age, sex, social class, and professional status needs to be discussed
Attention to negative cases
Assessing the relevance of Assessing the relevance of qualitative researchqualitative researchResearch can be relevant when it adds to knowledge
or increases the confidence with which existing knowledge is regarded
Another important dimension is extent to which findings can be generalised beyond the setting in which they were generated- ensure research report is sufficiently detailed- theoretical sampling
Some questions about quality Some questions about quality that might be asked (i)that might be asked (i)Worth or relevance – was this work
worth doing at all? Clarity of research question – if not at
the outset of the study, was the research question clear by the end of the research process?
Appropriateness of the design to the question?
Context – Is the context or setting adequately described?
Some questions about quality Some questions about quality that might be asked (ii)that might be asked (ii)Sampling – Did the sample include a
wide range of possible cases or settings?
Data collection and analysis – were the data collection and analysis procedures systematic?
Reflexivity of the account – Did the researcher self consciously assess the likely impact of the methods used on the data provided?
SummarySummary
Qualitative methods can, and do enrich our knowledge of health and health care
They are not superior to other methods, but we need a range of methods to hand if we are to understand the complexities of health care
Data Analysis in Qualitative Data Analysis in Qualitative ResearchResearch
What is data analysis?What is data analysis?
A complex process that involves moving back and forth ◦between concrete bits of data and abstract
concepts◦between inductive and deductive reasoning◦between description and interpretation
Simply put: Data analysis is the process of making meaning from the data
Preliminary Exploratory AnalysisPreliminary Exploratory Analysis
Explore the data by reading through all of your information to obtain a general sense of the information
Memo ideas while thinking about the organization of the data and considering whether more data are needed◦Jot memos in margins of fieldnotes,
transcripts, documents, photos
EDUC 7741/Paris/Terry
Developing Descriptions & Developing Descriptions & Themes from the Data Themes from the Data (case study approach)(case study approach)
Coding dataDeveloping a description from the dataDefining themes from the dataConnecting and interrelating themes
Coding DataCoding Data
Open Coding◦Assign a code word or phrase that
accurately describes the meaning of the text segment
◦Line-by-line coding is done first in theoretical research
◦More general coding involving larger segments of text is adequate for practical research (action research)
Axial CodingAxial CodingThe process of looking for categories that cut
across all data setsAfter this type of coding, you have identified
your themesYou can’t classify something as a theme unless
it cuts across the preponderance of the data
ClusteringClustering
After open coding an entire text, make a list of all code words
Cluster together similar codes and look for redundant codes
Objective: reduce the long list of codes to a smaller, more manageable number (25 or 30)
EDUC 7741/Paris/Terry
Preliminary organizing schemePreliminary organizing scheme
Take this new list of codes and go back to the data
Reduce this list to codes to get 5 to 7 themes or descriptions
Themes are similar codes aggregated together to form a major idea in the database
Identify the 5-7 themes by constantly comparing the data (Constant Comparative Analysis)
Constant Comparative Analysis Constant Comparative Analysis (Glaser & Strauss; p. 86, (Glaser & Strauss; p. 86, The Art of Classroom InquiryThe Art of Classroom Inquiry))
A process whereby the data gradually evolve into a core of emerging theory
This core is a theoretical framework that further guides the collection of data
Major modifications are lessened as comparisons of the next incidents of a category to its properties are carried out (Merriam, 1998).
Why themes?Why themes?It is best to write a qualitative report
providing detailed information about a few themes rather than general information about many themes
ThemesThemes can also be referred to as CategoriesCategories
Naming the Themes or Naming the Themes or CategoriesCategories
The names can come from at least three sources:◦The researcher◦The participants◦The literature
Most common: when the researcher comes up with terms, concepts, and categories that reflect what he or she sees in the data
Themes should…Themes should…Reflect the purpose of the researchBe exhaustive--you must place all data
in a categoryBe sensitizing--should be sensitive to
what is in the data◦i.e., “leadership” vs. “charismatic leadership”
Be conceptually congruent--the same level of abstraction should characterize all categories at the same level◦For instance, you wouldn’t have produce,
canned goods, and fruit
Types of themesTypes of themes
Ordinary: themes a researcher expectsUnexpected: themes that are surprises and not
expected to surfaceHard-to-classify: themes that contain ideas that do
not easily fit into one theme or that overlap with several themes
Major & minor themes: themes that represent the major ideas, or minor, secondary ideas in a database◦ Minor themes fit under major themes in the write up
A DescriptionA DescriptionA detailed rendering of people,
places, or events in a setting in qualitative research
Codes such as “seating arrangements,” “teaching approach,” or “physical layout of the room,” might all be used to describe a classroom where instruction takes place
Narrative descriptionNarrative descriptionFrom the coding and the themes,
construct a narrative description and possibly a visual display of the findings for your research report
Use the assigned format (see syllabus)
Constructing the narrativeConstructing the narrative
Identify dialogue that provides support for themes
Look for dialogue in the participants’ own dialectUse metaphors and analogiesCollect quotes from interview data or
observationsLocate multiple perspectives & contrary
evidenceLook for vivid detailIdentify tensions and contradictions in individual
experiences
Conveying personal reflectionsConveying personal reflections Because qualitative researchers believe that
personal views can never be kept separate from interpretations, personal reflections about the meaning of the data are included in the research study◦ “David had been diagnosed with AD/HD and also with mild Tourette
Syndrome. He took medication for AD/HD. He was selected to participate in the project as a confirming participant because he was so involved with the project and so intense during the first observation. Unaware that he had AD/HD and Tourette Syndrome until I interviewed his mother during the second year of the project, I was surprised because he was the most focused student in the classroom.”(Terry, 2003)
Providing Visual Data DisplaysProviding Visual Data Displays
Qualitative researchers often display their findings visually◦Comparison table or matrix◦Hierarchical tree diagram that represents
themes and their connections◦Boxes that show connections between
themes◦Physical layout of the setting◦Personal or demographic information for
each person or site
Enhances Commitment, Attitudes,
and Student Development
Making comparisons with the Making comparisons with the LiteratureLiterature
Interpret the data in view of past researchShow how the findings both support and
contradict prior studies◦ “These findings are consistent with other studies in regard to duration.
It has been found that the length or duration of service learning projects has an impact on student outcomes, with the longer duration projects having greater impacts. However, significant differences are not found in projects lasting over 18 weeks (Conrad & Hedin, 1981). The project on which this study focused was examined over a year and a half period of time; thus it is considered to be long in duration which helps to explain its impact on student outcomes.”
Limitations of the studyLimitations of the study The researcher suggests possible
limitations or weaknesses of the study◦ “This study focused on one rural middle school in an area in
Northeast Georgia, Hartwell. It documented the methodology used in the service learning project and the effect of a certain type of service learning model, Community Action. Therefore, the study provides an in-depth look at a service learning project carried out by gifted students in just one middle school in a rural area situated in a Southern state. Transferability may be limited as a result” (Terry, 2001).
Future Research SuggestedFuture Research Suggested Researchers make recommendations for
future research◦ “In addition, further research is needed to determine
outcomes for a diversified culture of students, including, but not limited to African-American students and students diagnosed with AD/HD. Research is also needed to examine and validate existing frameworks before professing any general claims concerning the outcomes for students engaged in service learning activities” (Terry, 2003).
Validating the Accuracy of FindingsValidating the Accuracy of Findings At the end, the qualitative researcher
validates the finding by determining the accuracy or credibility of the findings. Methods include:◦Prolonged engagement & persistent observation in
the field◦Triangulation◦Peer Review◦Clarifying researcher bias◦Member Checking◦Rich, thick description◦External Audit
Addressing Research BiasAddressing Research Bias “I am not an impartial bystander when it comes to service learning so I
knew I had to enhance internal validity at the outset of the study. I have been involved with Community Action service learning projects for over 16 years as a teacher. I have co-authored a book on how to facilitate Community Action service learning projects which I have used to implement service learning projects in my own classroom. My students have been featured in Reader’s Digest and have been guests on the Phil Donahue Show because of their outstanding work in service learning. Being aware of this bias, I took extreme precautions to maintain objectivity during both the collection and analysis of the data thereby accurately representing the project fairly and accurately” (Terry, 2001).
Reliability or DependabilityReliability or DependabilityFrom a quantitative perspective, reliability refers to the
extent to which research findings can be replicatedFrom a qualitative perspective, dependability, (reliability) in
qualitative research is not based on outsiders getting the same results, but that outsiders concur that, given the data collected, the results make sense. In other words, the results are dependable and consistent (Lincoln & Guba, 1985).
External ValidityExternal ValidityConcerned with the extent to which the findings of one
study can be applied to other situationsQuantitative studies enhance external validity using a
priori conditions which are limiting in conducting qualitative research
External validity is problematic in qualitative research because “In qualitative research, a single case or small nonrandom sample is selected precisely because the researcher wishes to understand the particular in depth, not to find out what is generally true of the many” (Merriam, 1998, p. 208).
Applying external validity to Applying external validity to qualitative researchqualitative research
Think in terms of the reader of the studyWhat is the extent to which a study’s findings
can apply to other situations?This is referred to as Representativeness or Representativeness or
TransferabilityTransferabilityMerriam (1998) suggests: rich, thick
description and typicality, modal category, or multisite designs
“To enhance external validity in this study, these procedures were followed: