1d Qualitative Research Methods

Question 1

What is the difference between qualitative and quantitative research?

Answer 1

Broadly speaking, qualitative research tends to answer the “why?” and “how?” questions surrounding public health topics, in contrast to quantitative methodologies which tend to focus on epidemiological estimates of prevalence and strength of associations between variables.

Quantitative research deals with numbers and statistics, while qualitative research deals with words and meanings.

Question 2

What is a “mixed method” approach to research?

Answer 2

One that uses both qualitivative and quantitiviative research together to gain a better overall undestanding of an area.

Question 3

In what ways is sampling different in qualitative research than quantitative research?

Answer 3

Qualitative research studies may have smaller sample sizes compared to quantitative research, and are not concerned with statistical power.

Qualitative research deliberately uses non-probability samples (as apposed the the probabiltiy based random sampels of quantitative research) for selecting the study population.

In this approach participants are selected purposely because of specific characteristics, which are of relevance to the research question; this is called purposive sampling. As explained by Patton, “the power of [purposive] sampling lies in selecting information-rich cases to study in depth. Information-rich cases are those from which one can learn a great deal about issues of central importance. For example, specific participant characteristics may be considered important for the research, such as a particular age range, gender, ethnicity, or belief system.

In qualitative research the inclusion criteria may be adjusted as the research proceeds, for example if the researcher feels it would be beneficial to include “outliers”, “extreme cases”, or “divergent cases” to add depth to the emerging theory. This is possible as qualitative analysis often occurs simultaneously with data collection, which allows the researcher to ensure the data are collected from the most appropriate population, and this may not be clear at the outset.

Question 4

Why does qualitative research generally have a smaller sample size than quantitative research?

Answer 4

There will come a point where very little new evidence is obtained from each additional fieldwork unit. This is because a phenomenon need only to appear once to be part of the analytical map. There is therefore a point of diminishing return where increasing the sample size no longer contributes new evidence. This is called theoretical saturation.

Second, statements about incidence or prevalence are not the concern of qualitative research. There is therefore, no requirement to ensure that the sample is of sufficient scale to provide estimates, or to determine statistically significant discriminatory variables.

Third, the type of information that qualitative studies yield is rich in detail. There will therefore be many hundreds of ‘bites’ of information from each unit of data collection. In order to do justice to these, sample sizes need to be kept to a reasonably small scale’.

Question 5

What is theoretiecal saturation?

Answer 5

Theoretical saturation is the term used to describe the point at which no new contribution to the emerging findings is obtained from further analysis of interviews/focus groups/observations. Qualitative researchers should aim to reach theoretical saturation before concluding data collection to ensure that the pertinent concepts have been retrieved.

Question 6

What is validity in terms of qualitative research?

Answer 6

In quantitative research, validity is defined as whether a particular measure does indeed measure what it is claimed to measure, as well as the quality and strength of the arguments that researchers put forward to substantiate claims about the reliability of their conclusions’.

Criticisms about its lack of generalisability, and the interpretive nature of analysis highlight misunderstandings about the qualitative methodology.

This validitiy can be assessed using:
Triangulation
Clear documentation of the research process
Supporting theory with quotes from the transcripts
Limitation
Falsification
Member Checking
Reflexivity

Question 7

What is triangulation in relation to qualitative research?

Answer 7

Triangulation refers to the use of multiple methods or data sources in qualitative research to develop a comprehensive understanding of phenomena.

It may also be used to enhance interpretation by providing additional insights into the experience, for example by combining findings from observations with participant interviews to reach a more complete understanding of the issue or topic under investigation.

Question 8

Why is clear documentation of the research process required in qualitative research?

Answer 8

Clear documentation of the methods involved in data collection and analysis, as detailed above, increases the trustworthiness of the research.

Question 9

Why is supporting theory with quotes from the transcripts required in qualitative research?

Answer 9

Evidence to support interpretations, using primary data in the form of participant quotes, helps ensure that readers can trust that the investigator’s interpretations remain grounded in the data. Consent to use anonymous quotes should be obtained from all participants beforehand.

Question 10

What is limitation in relation to qualitative research?

Answer 10

The process of testing how well the findings of the research (often known as the “theory” that has been generated from the primary data) fit the data, establishing the “limits” of the theory. It is accepted that the research findings will be relevant to certain contexts only, and by identifying and discussing “deviant” or “negative” cases – i.e. those that do not conform to the theory – it is possible to delimit the theory.

Question 11

What is falsification in relation to qualitative research?

Answer 11

This is the approach in which theory generated from the primary analysis is then “falsified” against each participant case within the dataset, one by one. This process is also described as a core component of “Analytic Induction”. If the individual case does not “fit” with the theory then the theory is modified or adapted to incorporate the case.

Question 12

What is member checking in relation to qualitative research?

Answer 12

When the analytical themes and interpretive findings are formally tested within the sample of participants from where the data arose in an attempt to enhance validity.

Whilst member checking can provide an opportunity to “test” early findings with participants, it also assumes a “true” reality that is fixed over time and can and should be corroborated by individual participants.

This stance conflicts with the interpretivist position that there is no objective “truth”; rather the learning and theoretical insight generated from the qualitative interviews should arise from the investigator’s immersion in the entire data.

It can be argued therefore that comparing the investigator’s interpretation with the participants’ understanding of their data is discordant with the interpretivist approach. Nevertheless, member checking is sometimes used as a means of enhancing the quality and reliability of qualitative research.

Question 13

What is reflexivity in relation to qualitative research?

Answer 13

All high quality qualitative research should involve a discussion of the researcher’s reflexivity. This is a subjective examination of the extent to which the investigator’s own relationship with the topic, the participants, or settings may influence the research findings.

Furthermore, any theory used by the researcher to approach the study should be explicitly considered and documented, as this will influence the analytical process and the ultimate findings of the research.

Question 14

What are Semi-structured interviews?

Answer 14

Semi-structured interviews are characterised by topic guides containing major questions that are used in the same way in every interview, although the sequence of the questions might vary as well as the level of probing for information by the interviewer.

Semi-structured interviewing is suitable when the researcher already has some grasp of what is happening within the sample in relation to the research topic.

Question 15

Why might semi-strcutured interviwwing not work?

Answer 15

If the interviewee has a lack of awareness/information or is not used to putting feelings into words.

If interviewees feel exposed by questions (in particular where attitudes are probed in sensitive topics such as political attitudes, sexual orientation, borderline or illegal behaviour).

If interviewees might feel that they need to present themselves in a specific way in order to fit in with their perception of the researcher’s requirements, or wish to bring in their own agenda of life-topics that do not fit easily with the aim of the interview.

Question 16

How can the interviewer and type of quesiton in a semi-structured interview redcue its limitations?

Answer 16

The researcher should ensure there is no danger of loss of meaning as a consequence of imposing a standard way of asking questions. This could be achieved by conducting pilot interviews (these use broad topic guides with few direct questions) prior to data collection.

The questions posed during the interview should be as open-ended as possible, in order to avoid yes/no or rehearsed answers.

The questioning techniques should encourage respondents to communicate their underlying attitudes, beliefs and values that are so central to this method.

Researchers should build a rapport with the interviewee before starting the interview so that both sides can feel more at ease.

Researchers should try posing questions in different ways and using probing and prompting help to elicit more information or steer the interview.

Question 17

What are narrative interviews?

Answer 17

Unstructured interviewing (aka narrative interviews) allows the respondent to tell their own stories in their own words, with prompting by the interviewer.

The objective of the unstructured interview has been summarised as, ‘to elicit rich, detailed materials that can be used in qualitative analysis.

Its objective is to find out what kind of things are happening rather than to determine the frequency of predetermined kinds of things that the researcher already believes can happen’.

In an unstructured interview, the researcher simply has a list of topics that they want the respondent to talk about. But the way the questions are phrased and which order they come will vary from one interview to the next as the interview process is determined by the responses (stories) of the interviewees.

Question 18

What are In-depth interviews?

Answer 18

In in-depth interviews the aim is to obtain a more detailed, rich understanding of the topic of interest. They usually comprise an ethnographic approach and complement participant observation or action research methods.

In in-depth interviews the participant’s experience, behaviour, feelings, and/or attitudes may be probed deeply to identify underlying concepts that the researcher analyses to generate a theory surrounding the research topic.

In-depth interviews are more structured than narrative interviews as the topic discussed will be directed by the researcher and they rarely involve stories or life histories. However in-depth interviews do allow the participant to communicate much more freely and to provide more detailed descriptions when compared to semi-structured interviews.

Sometimes interviewers do not reveal all the exact details of the research hypothesis when conducting in-depth interviews, as this may influence or “lead” the qualitative material obtained. Rather, the general area of interest is explained to the participant as part of recruitment and consent (see later in the chapter) and the interviewer directs the interview according to the responses.

Question 19

What is a focus group and what is its aim?

Answer 19

Focus groups are a form of group interview with the aim of capturing the interaction between the participants based on topics that are supplied by the researcher(8).

The main purpose of focus group research is to evoke a level of respondents’ attitudes, feelings, beliefs, experiences and reactions otherwise not available when using methods, such as observation or interviewing.

Question 20

When are focus groups most effective?

Answer 20

When attitudes, feelings and beliefs may be partially independent of a group or its social setting, but are more likely to be revealed via the social gathering and the interaction created in a focus group.

When there are power differences between the participants and decision-makers or professionals

When the everyday use of language and culture of particular groups is of interest

When one wants to explore the degree of consensus on a given topic

Question 21

What are the limitaitons of focus groups?

Answer 21

The researcher has less control over the data produced

The researcher has little control over the interaction other than generally keeping participants focused on the topic

The researcher can have difficulties in recruiting and assembling the focus group (e.g. finding a date and time for seven busy health care professionals, or resistance from people who are less articulate or confident)

The researcher cannot assure full confidentiality and anonymity as information is shared in the group.

Question 22

What are the practical steps to setting up a focus group?

Answer 22

1) Planning the recruitment process

2) Negotiating the date and time of the focus group

3) Choosing a venue (a neutral place is usually of advantage; where participants live/work too far apart the focus group can also be conducted via a telephone conference line)

4) Ensuring adequate recording facilities

5) Organising a co-moderator (e.g. to take notes and monitor recording equipment), deciding how many people should be in the focus group (usually six to ten)

6) Informing participants about the potential length of the focus group (usually one to two hours).

7) Being clear about the role of the moderator. This will require the researcher to provide clear explanations of the purpose to the group, ask questions and facilitate interaction between group members (e.g. allowing quieter participants to speak).

Question 23

What is action research?

Answer 23

A collaborative and cyclical (between practical action and research) approach to research, in which both practitioners (e.g. clinicians, nurses, public health specialists, etc.) and researchers (although they can potentially be one and the same) look for a solution to a practice-related problem or to bring about change in a particular setting.

Action research methodologies aim to integrate action and reflection, so that the knowledge developed in the research process is directly relevant to the issues being studied.

They include, among other approaches, “co-operative inquiry”, “participatory action research”, and “action science” or “action inquiry”.

Question 24

What is particpant observsation in relation to qualitative research?

Answer 24

Participant observation is a qualitivate data gathering method whereby the researcher adopts the perspective of those studied. For example, a study might be interested in the rules of the waiting room in a GP practice. The researcher in his/her observing role would observe patients in this setting. He/she would observe the interaction of the people present, e.g. the receptionist, other patients, cleaning staff, an occasional appearance of a nurse. However, this does not mean simply adopting a passive watching role; the researcher might also interact with those that he/she is observing.

Observation can involve a combination of methods, including e.g. unstructured conversations/interviews, notes on observations, recordings (audio and video) and illustrative material (floor maps, information material).

Question 25

What are the limitations of particpant observation?

Answer 25

Observer bias (the influence the observer’s presence might have on the situation he/she is watching).

The difficulty of replicating the data.

Question 26

What are the steps of particpant observation in qualitative research?

Answer 26

1) Selecting the field setting
2) Gaining access
3) Deciding whether participant observation will be concealed (e.g. gaining employment to field setting without informing anyone there about the observation) or open (i.e. being open about the observing role)
3) Recording the action - field notes
3) Validation of the observations

Question 27

In what ways can qualitative research contrubute to the field of public health?

Answer 27

Primary research
Can provide insights into research questions where quantitative methods may not be appropriate (such as understanding patient experience and behaviour). Focus groups, in-depth interviews, narrative interviews and observation are all appropriate techniques for this purpose.

Evaluation
Can support service evaluations and process evaluations of interventions. Methods such as observation and semi-structured interviews can complement outcome measures to provide rich understanding of the experiences.

Policy evaluation
Key stakeholders may be invited to in-depth interviews in which the policy under investigation is considered in terms of its effectiveness, efficiency, impact upon inequality, and acceptability. Policy evaluation tends to rely on mixed methods and qualitative methods are usually employed alongside standard quantitative measures.

Question 28

How is qualitiative data analysed?

Answer 28

The process of qualitative analysis is not a linear but rather continuous and iterative

There are a variety of approaches to analysis and interpretation. These reflect the particular theoretical perspectives or field within which the researcher is working.

They generally all try to:
* Review all the information, gaining an initial sense of the themes, these might be fed back to the informants for verification.
* Organise the data into a manageable form (called ‘reducing the data’), and usually involves coding or categorising.
* Presenting it in some form, e.g. tables, prose, or diagrams.
* Induction - Interpreting the data in order to derive some theoretical framework or working hypothesis of the social processes under investigation.

Question 29

What is simple content analysis in qualitative research?

Answer 29

Content analysis is a research tool used to determine the presence of certain words, themes, or concepts within some given qualitative data (i.e. text). Using content analysis, researchers can quantify and analyze the presence, meanings, and relationships of such certain words, themes, or concepts.

Question 30

What is coding in qualitative data anaylsis?

Answer 30

The process of coding is an essential first step in managing the analytical process. During coding, elements of the data that are conceived of as sharing some perceived commonality are indexed and linked.

Codes can be used to simplify or reduce transcript data to manageable levels, the purpose being to achieve a simple conceptual schema.

This process usually involves the exclusive index coding of segments of data text (“line by line coding”) in order to be able to eventually retrieve segments sharing a common code.

Alternatively, coding can be used as a method to open up the data, thus enabling the researcher to think or conceptualise beyond the data itself. This allows for more in-depth analysis.

Question 31

What are some examples of the methods used for qualitivate data anaylsis?

Answer 31

Thematic analysis
Framework building
Analytical Induction (AI)
Grounded theory
Constant-comparative approach

Question 32

What is the thematic analysis approach to qualitative data analysis?

Answer 32

This method involves the identification and reporting of patterns – called themes – which are retrieved from the primary qualitative data.

Thematic analysis has been described as an accessible form of qualitative analysis as it does not require development of theory.

Question 33

What is the framework building approach to qualitative data analysis?

Answer 33

An approach developed by the National Centre for Social Research. The term ‘framework’ derives from the ‘thematic framework’ which is the central component of this approach to data management and interpretative analysis.

This uses a thematic framework is utilised to classify and organise data according to key themes, concepts and emergent categories. Each research study requires its own distinctive thematic framework comprising of a series of main themes, subdivided by a succession of related sub-themes or topics.

These categories evolve and are refined (as an iterative process) through the researcher’s familiarisation with the raw data and the subsequent cross-sectional labelling. Once the researcher judges that they have a comprehensive list of main and sub-themes, each is then ‘charted’ or displayed in its own matrix.

The response of each research subject is then allocated a row with each column representing a separate subtopic. The final stage of this data management component or ‘framework’ involves summarising or synthesising the original data from each case (subject) within the appropriate parts of the thematic framework.

Question 34

What is the analytical induction (AI) approach to qualitative data analysis?

Answer 34

In analytical induction (AI) or `deviant case analysis’, each section of a transcript or set of notes is assigned a single code. Initially these codes will be generalised but they become progressively more elaborate as more data are examined.

Once coding is completed, systematic comparisons are made within and between the labelled transcript data. In AI, generalisability of the final conclusions is achieved by focusing on the `deviant’ or contradictory indexed items that emerge at this stage.

An attempt is made to modify the initial analytical themes in order to embrace these deviant cases.

This procedure is essential to guard against selective attention to data in order to provide a more systematic means of extending analytic thinking.

There are clear merits to this deviant case approach applied to interview data analysis, particularly in its drawing attention to the importance of contradictions as being indicative of an important dynamic at work rather than some aberrant occurrence or utterance that cannot be fitted into a code.

Question 35

What is the grounded theory approach to qualitative data analysis?

Answer 35

In grounded theory, a set of ideas (the “theory”) is generated from the concepts and constructs retrieved from the coding stages.

However, the theory remains grounded in the data, and is obtained from analysis of the codes and “memos” noted during the coding process, which come together to create an overall theory explaining the phenomenon under investigation.

Question 36

What is the constant-comparative approach to qualitative data analysis?

Answer 36

This is a method often employed as part of grounded theory and involves comparing newly acquired data with the dataset already collected.

In this way, each new “unit” of data (e.g. a new interview transcript) is considered in terms of how it changes the developing theory and what it adds to the emerging theory.

By using constant-comparative methods it is possible to identify when theoretical saturation is reached as the additional data add little to the established findings.

The simultaneous collection of data and analysis is an important feature of qualitative research and its iterative nature therefore allows the researcher to optimise the selection of participants based on features that may be of interested given the emerging findings.

Question 37

What should be included in the presentaiton of qualitative data?

Answer 37

A discussion in the report of the potential transferability of the qualitative findings to other settings.

A discussion of the methods utilised and the reasons why they were appropriate to the object under investigation.

Demonstrate that the conclusions drawn within the study are consistent with the evidence.

The interpretative analysis needs to be presented in a transparent way so that the reader can follow the processes leading to the conclusions.

Concsider the imaginative use of diagrams and other schematics to illustrate the analytical process and findings

Do not focus on one element of the findings (as this will ignore the complex and diverse social phenomena that the qualitiatve ata is good for)

Any apparent contradictions or inconsistencies that emerged need to be reported upon in as much detail as the recurrent themes found within the study.

Including verbatim quotes from the research subjects is a very useful way of illustrating the main themes that emerged from the study and in demonstrating the reliability of the conclusions. However, this can be overdone, resulting in an overlong narrative which distracts from the main findings.

Question 38

Which ethical issues may arise during qualitative research?

Answer 38

Informed consent
Anonymity and confidentiality
Protecting participants from harm
Protecting researchers from harm

Question 39

How should informed consent be obtained in a qualitative study?

Answer 39

Participants are required to give informed consent. This means that they should be informed about the purpose of the study, who is funding the study, who the researcher is, how the data will be used, what is required of the participants, how long their involvement will last and that their participation is voluntary (i.e. that they may withdraw from the study without giving a reason).

All this information should fit onto one page and allow enough space for the participant and the researcher to sign and date the form. It is good practice to give a copy of the consent form to the participant.

Studies requiring ethical approval will be advised on the wording and content of the consent form; examples are usually available from the ethics committees’ websites.

Question 40

Why is the ethical principle of confidentiality more nuanced in qualitative studies than quantitative?

Answer 40

The degree of required confidentiality is dependent on the research topic and the person in question. For instance, the identifying details of a person (name, place, age, occupation) may be changed to a degree that people who are not his/her friend/family member do not recognise him/her or to a degree that family and friend could not identify the interviewee or to such an extent that the participant him/herself could not recognise themselves?

Such decisions depend not only on the nature of the research study, but also on whether the participants themselves are public figures.

It is the researcher’s responsibility to explain to the participant how the data will be used (e.g. quotations from transcripts) and how the identity of the participant will be protected.

Question 41

How may qualitiative research cause harm to subjects and how can this be limited?

Answer 41

Studies that touch upon sensitive topics might uncover painful experiences and lead people to disclose information which they have rarely or never previously shared.

Interviews can have a certain seductive quality: participants may appear comfortable and may disclose information apparently willingly during an interview, but may later regret having been so open. They may also be left with feelings and thoughts stirred up by the interview long after the researcher has moved on.

How to limit it:
Confer an understanding of the study and what it involves and to allow the participant to ask questions.
The information provided to the participants however needs to be balanced by the consideration that they should not be too pre-informed about the issues of the study as this will impact on the results.
It is also advisable to provide the participant with a contact number so that he/she can contact the researcher after the interview. Some ethics committees require contact details of the organisation employing the researcher to allow participants to file a complaint.

Although researchers should be alert to the discomfort of an interviewee, and even offer to pause the interview, the researcher should not take on the role of an advisor or counsellor. However, it is appropriate to provide the interviewee with information of services and organisations that might be helpful.

In cases where the information disclosed by the participants indicates might revela they areat risk of being harmed pose serious ethical problems and researchers should discuss such possibilities and how to respond to them with their employers before embarking on the data collection.

Question 42

How might qualitative research cause harm to researchers and how can this be limited?

Answer 42

Although most ethical issues are concerned with the safety and benefit of the participants, the researcher, too, needs to be protected from harm.

In private face-to-face interviews, researchers can be less safe, e.g. when they take place at a participant’s home.

How to limit this:
Strike a balance between sensible caution and paranoia.
The level of safety procedures will vary depending on the research.
Where recruitment involves Internet resources, researchers should be more cautious and double check information provided by potential participants.
Gather information about the area you will be researching in.
Leave an itinerary of your movements with a colleague or friend and contact them when you have returned.
Assess the layout of the interview location and make a mental note of how to leave the building in an emergency.
Strike a balance between developing a rapport with the interviewee and how this might be misinterpreted.
Actively take decisions about the situation.

Question 43

What are the common problems with qualitiative research and how do you limit them?

Answer 43

Inadequate sample - Normally through attempts to pre-define the sample for the research in terms of size and composition).
How to limit - Use a constant-comparative sampling technique to continually update your sample.

Insufficient time for data collection and analysis - Focus groups and interviews take a long time. Furthermore, the transcription of interviews and focus groups may take many more hours than anticipated. This research is unpredictable and potentially lengthy timescales make it difficult to estimate resources required for qualitative studies.
How to limit - Use previous similar studies as a guide on timelines.

Using a quantitative approach to analysing the data - Very rarely it is useful to analyse qualitative data in a quantitative, deductive manner, such as the simple content analysis. However, this approach should be undertaken with caution as it may lead to a waste of rich data.
How to limit - Form a data analysis plan, carefully considered and reviewed by experienced qualitative researchers before the research begins.

Question 44

What are the common problems with qualitiative research and how do you limit them?

Answer 44

Inadequate sample - Normally through attempts to pre-define the sample for the research in terms of size and composition).
How to limit - Use a constant-comparative sampling technique to continually update your sample.

Insufficient time for data collection and analysis - Focus groups and interviews take a long time. Furthermore, the transcription of interviews and focus groups may take many more hours than anticipated. This research is unpredictable and potentially lengthy timescales make it difficult to estimate resources required for qualitative studies.
How to limit - Use previous similar studies as a guide on timelines.

Using a quantitative approach to analysing the data - Very rarely it is useful to analyse qualitative data in a quantitative, deductive manner, such as the simple content analysis. However, this approach should be undertaken with caution as it may lead to a waste of rich data.
How to limit - Form a data analysis plan, carefully considered and reviewed by experienced qualitative researchers before the research begins.

Question 45

What are the strengths and weaknesses of qualitative research?

Answer 45

Strengths of qualitative research:
* Collect rich data in an efficient manner
* Can generate new theories from unexpected findings
* When combined with quantitative methods, qualitative research can provide a much more complete picture.

Weaknesses of qualitative research:
* Requires a robust methodology in order to ensure high quality research.
* Qualitative research alone is often insufficient to make population-level summaries.
* Policy makers may not understand or value it
* Can be time and labour-intensive.