⚖️430: Research Methods QUALITATIVE Flashcards
What does nursing research generally focus on?
- Recipients of care
- Providers of care
- Health system
What does Evidence Based Practice (EBP) integrate?
- Best research practice
- Clinical expertise
- Patient characteristics/preferences
- Healthcare resources
- Clinical stage, setting, and circumstances
What are the limitations of EBP?
- Some forms of knowledge are marginalized
- Ignores clinical judgement and context
- Depends on availability of evidence
- Application of evidence to individuals is challenging
➡️ Shift to EVIDENCE-INFORMED PRACTICE
What are the 7 steps in the Evidence-Based Practice (EBP) process?
- Admit to uncertainty or different approaches may be possible
- Formulate clinical questions
- Search relevant evidence
- Critically appraise the evidence
- Integrate the evidence with clinical expertise + patient preferences + context
- Assess the effectiveness of the intervention
- Disseminate results
What are the two key paradigms in nursing research?
- Positivist/Post-Positivist Paradigm
2. Constructivist Paradigm
Positivist Paradigm
QUANTITATIVE = internal validity
- Research holds personal beliefs and biases in check
- Assumes findings are not influenced by the researcher
- Deductive processes
- Disciplined procedures to test ideas
- Emphasis on measured, quantitative info
Goal: seeks generalizations
Constructivist Paradigm
QUALITATIVE = TRUSTWORTHINESS
- Reality is not fixed - constructed by researcher + participant
- Reality exists within a context; many constructions are possible
- Emphasis on narrative information
RELATIVISM: no process by which the ultimate truth or falsity of the constructions can be determined
SUBJECTIVITY: interpretations of participants are key to understanding the phenomenon of interest
What are the phases of Quantitative research?
- Conceptual Phase
- Design and Planning Phase
- Empirical Phase
- Analytic Phase
- Dissemination Phase
What are the major classes of Qualitative research?
- Grounded theory
- Phenomenology
- Ethnography
- Generic qualitative approaches
- Others (eg. narrative inquiry, case study)
Generalizability
Quantitative research
The extent to which study findings are valid for those not in the study
Transferability
Qualitative research
The extent to which qualitative findings can be transferred to other settings
What are the 3 steps of formulating a focused clinical question to search for evidence?
- Start with an initial question
- Dissect the question into its component parts (PICO)
- Formulate the focused (PICO) questions
PICO(T)
- Population
- Intervention/Exposure
- Comparison
- Outcome
- Time
What are the levels of evidence?
- Systematic Reviews
- Single Randomized Controlled Trial
- Single Non-Randomized Trial
- Single Prospective/Cohort Study
- Single Case-Control Study
- Single Cross-Sectional Study (survey)
- Single in-depth qualitative study
- Expert Opinion, Case Reports, etc
Barriers to EBP
- Limited knowledge and skills
- Lack of mentors
- Inadequate resources
- Insufficient time to engage in the process
- Lack of inclusion/involvement in decision-making
Facilitators of EBP
- Appropriate knowledge and skills
- Organizational culture that supports evidence-informed practice and nurses’ participation in it
- Clinical practice Guidelines and pre-processed evidence
- Mentorship
Conceptual Model
Deals with abstractions, assembled in a coherent scheme.
Represents a more loosely structured attempt to explain phenomena that theories
Schematic Model
Visually represents relationships among phenomena and is used in both quantitative and qualitative research.
Health Belief Model
Health-seeking behaviour is influenced by a persons’ perception of the THREAT posed by a health problem and the VALUE associated with the actions aimed to reduce the threat.
- Perceived susceptibility
- Perceived benefits
- Perceived barriers
- Cue-to-Action
- Self efficacy
Health belief model Perceived susceptibility
Implications if one got this illness (medical consequences, social, etc)
What are limitations of the Health Belief Model?
- Doesn’t account for a persons attitudes/beliefs
- Doesn’t take account of habitual behaviours
- Doesn’t account for behaviours that are non-health related
- Doesn’t account for economic or environmental factors
- Assumes equal access to information on illness or disease
- Assumes “health” actions are the main goal
What are the 4 different theories in Qualitative Research?
- Substantive Theory
- Grounded Theory
- Ethnography
- Phenomenology
Grounded Theory
- Humans act toward things based on the meanings that the things have for them.
- The meaning of things is derived from the human interactions.
- Meanings are handled in, and modified through, and interpretive process.
What is the aim of theories and conceptual models?
Aim to describe the phenomena and the relationship ships among them
What is a framework?
Provides overall conceptual underpinnings of a study.
Can be based in theory or a conceptual model.
What do high quality studies demonstrate?
A fit between the framework and the study design and methods.
What are characteristics of Qualitative Research Design?
- Emic perspective
- Triangulating various data collection strategies
- Holistic
- Immersion of researchers in setting
- Requires reflexivity
- Emergent = data generation and analysis proceed together
Reflexivity
What we know is based on our subject positions. A critical self-reflection about ones own biases, preferences, and preconceptions.
What are the major Qualitative Research Traditions (designs)?
- Phenomenology
- Ethnography
- Grounded Theory
Ethnography
Describes and interprets “culture”. Seeks an emic perspective and to reveal tacit knowledge. Assumes culture guides the way people structure their experiences.
DATA SOURCES = wide spread, observations, interviews, focus groups, etc
PRODUCT = in-depth portrait of culture
Phenomenology
Focuses on description and interpretation of people’s lived experience
ASKS: what I’d the essence of a phenomenon and what does it mean?
DATA SOURCE: in-depth convos/interviews
MAIN TYPES: Descriptive and Interpretive
Descriptive Phenomenology
Describes human experience (Hussert)
BRACKETING = identifying and “parking” preconceived views. Acknowledging and removing biases.
Interpretive (Hermeneutic) Phenomenology
Interprets and understands human experience (not just a description) (Heidegger)
- Bracketing does NOT occur
- biases are not part of interpretation
- biases are used and embraced - Supplementary data sources:
- texts, artistic expression
Etic perspective
Outsiders view (that of the researcher)
Emic perspectives
Insiders view
Grounded Theory
Purpose: to generate theory that explains a pattern of behaviour of a defined group of people
Elucidates social processes and social structures.
CONSTANT COMPARISON used for theoretical refinement
Descriptive Qualitative Studies
Tend to be eclectic in their designs and methods. Analysis may include content analysis or thematic analysis of narrative data with intent of understanding important themes and patterns.
What is an approach to the study of social processes and social structures?
Grounded Theory
Which process is associated with descriptive phenomenology?
Bracketing
What are the 4 methods of sampling in Qualitative Research?
- Convenience (volunteer) sampling
- Snowball (nominated)
- Purposive (purposeful)
- Theoretical Sampling
Convenience (volunteer) Sampling
Uses the most conveniently available people as participants
Snowball (nominated) sampling
Early sample members are asked to refer others who meet the eligibility criteria
Purposive sampling
Researchers hand pick the cases that will best contribute to the study.
Can be classified into various types:
- Maximum variation
- Homogenous
- Extreme/deviant
- Typical
- Criterion
- Confirming/Disconfirming
Theoretical Sampling
Involves selecting cases/groups who can provide data that helps develop an emerging theory
How is Qualitative research sample size determined?
- Purpose
- Design
- Sampling strategy
- Data quality
- Other (time, access, etc)
Decisions to stop are guided by DATA SATURATION
Sampling by phenomenology
- Relies on very small samples
- Participants must have experienced the phenomenon of interest and be able to articulate that experience
- May also sample artistic or literary sources (interpretive phenomenology)
Sampling by ethnography design
- Mingling many members of culture (“big net” approach)
- Informal conversations with 25-50 informants
- Multiple interviews with smaller number of key informants
- Involves types of artefacts and foco of observation
Sampling by Grounded Theory Design
- Typically 20-30 participants
- Select participants who can best contribute to emerging theory
Usually begins with PURPOSIVE sampling then adjusted through theoretical sampling.
Which type of study would data saturation NOT be used?
Survey
Generating data in Qualitative Research
- Qualitative self-reports
(One-on-one, dudas, focus groups) - Unstructured observations
- Artifacts (objects, documents)
Field issues in Qualitative Research
- Gaining trust
- Pace of data collection
- Emotional involvement with participants
- Reflexivity
Common qualitative self-report techniques
- Unstructured interviews
- Semi-structured interviews
- Focus group interviews
- Others (diaries, photo elicitation, think-aloud methods)
Methods of recording unstructured observations
- Logs (field diaries)
- Field notes
- a) Descriptive (observational) notes
- b) Reflective notes:
- Methodologic notes
- Theoretical (analytical) notes
- Personal notes
Trustworthiness
The degree of confidence qualitative researchers have in their data and analysis
Qualitative studies are trustworthy when they accurately represent the experience/phenomenon under study
Lincoln and Guba’s Criteria for Trustworthiness
- Credibility
- Dependability
- Confirmability
- Transferability
Credibility
Confidence in the truth of data and interpretations
Dependability
Stability of data over time and conditions
Confirmability
Objectivity of the data; findings reflect the participants voices and conditions of the inquiry, not solely the researchers biases or perspectives
Transferability
The extent to which findings have meaning to others in similar settings
Strategies to enhance quality of Qualitative Inquiry during Data Collection
- Prolonged engagement
- Persistent observation: intensive focus in salience of data being gathered
- Reflexivity strategies
- Comprehensive and vivid recording
- Audit trail
- Member checking
Audit trail
A systematic collection of documentation and materials, and a decision trail that specifies decision rules
Member checking
Providing feedback to participants about emerging interpretations; obtaining their reactions
Data triangulation
The use of multiple data sources to validate conclusions
time, space, and person triangulation
Investigator Triangulation
The use of two or more researchers to make data collection, coding, and analysis decisions
Method Triangulation
The use of multiple methods of data collection to study the same phenomenon (eg, self-report + observation)
Theory Triangulation
The use of multiple theoretical positions to explore the same phenomenon
Negative case analysis
Specific search for cases that appear to discredit earlier hypotheses
Improves quality of qualitative inquiry
Inquiry audit
A formal scrutiny of the data and relevant supporting documents and decisions by an external reviewer
Improves quality of qualitative inquiry
Things to consider in interpreting research findings
- Credibility
- Meaning
- Importance
- Transferability
- Implications
Which type of self reporting involve the use of a discussion moderator?
Focus-group interviews?
Emergent
Qualitative characteristic = data generation and analysis proceed together
What are techniques for establishing credibility?
- Prolonged engagement
- Persistent observations
- Triangulation
- Peer debriefing
- Negative case analysis
- Referential adequacy
- Member Checking
What technique establishes transferability?
Thick description
What technique establishes dependability?
Inquiry audit
What techniques establish confirmability?
- Confirmability audit
- Audit trail
- Triangulation
- Reflexivity
Operational Definition in Quantitative Research
A precise statement of how a conceptual variable is turned into a measurable variable
What are the 2 classes of quantitative research?
- Experimental
2. Non-Experimental
What is a paradigm?
Perspectives of the real world