Lecture 6: Qualitative Studies

Question 1

KNOW: Qualtitiative research includes behaviors, attitudes, experiences, how each of these influence heatlth - things that we cant put into #’s
* We want to know the why or the how

Can inform practitioners about
* The patients experiences (do they think their diagnosis is really bad or serious? or do they not think its bad or serious enough and not do anything about it)
* Clinician experience (this is understanding physical activity protion in physiotherapy practice - maybe some barries that PT’s are feeling in promotion of phiscal activity)

These are just 2 different examples of qualititative research

Question 2

What is the main reason we do qualtitiaive research?

Answer 2

To investigate complex Phenomena
* Looking at not only expierences that other phenomena that can occur - looking for aptterns that we can’t really put a # on

Question 3

Access to care based on socioculturl factors is called

Answer 3

Sociocultural influences
* “Does care and access to that care based on someones economic/scoial background”
* This is one of those complex phenomena that is well measured w/ qualtitaitve data (hard to put a # on)

Question 4

What are our 3 complex phenomena that hard best measured w/ qualitiative research methods?

Answer 4

1) Sociocultural influences
2) Organizational Processes
3) Special Populations

Question 5

Breakdown of hospital internal supply chain (this is an example lots of are done in hospitals)
* essentially how we order the right amount of supplies and in what time frame do we do that to have it on hand (while minimizing waste).

Answer 5

Organizational Processes
* Complex Phenomena

Question 6

Experiences of newly diagnosed pts w/ parkinsons disease (PD)
* So what are their experiences, are they nervous? Does it change other aspects of their life - just kind of their experience
* This is just an example

Answer 6

Special populations
* Complex Phenomena (you can see how it would be hard to only use quantitative to measure this)

Question 7

What are the four main types of qualitative research?

Answer 7

1) Ethnography
2) Phenomenology
3) Grounded Theory
4) Case Studies

Question 7

What is Ethnography?
* What kind of research is it?

Answer 7

Normally done w/ anthroplogy studies but can be done in the healthcare setting. Its where the researcher fully emersises himself into a subjects experience
* meaning the researcher may follow a pt through their healthcare journy
* Maybe following someone whose poor through their healthcare journey (what its like for someone sociaoeconmically disadvatnatged)
* Then doing it w/ someone who has money

Its a type of of qualitative research

Question 8

What is Phenomenology
* What kind of research is it

Answer 8

instead of actaully jumping into the life of your subject you’re just using your subjects explaination to find meaning
* This can be through interviews / surveys - just not actaully following the pt - just talking to them instead
* Maybe talking to them about challenges in the discharge process at a skilled nursing facility

Qualitative research

Question 9

What is grounded theory?
* What kind of research is it?

Answer 9

“Grounded in evidence”

Meaning were basing our hypothesis/what we want to know on current evidence thats out there
* If we know that stroke pts show signs of depression / abnormal mood, and are often perscribed antidepressents after a stroke, than maybe we want to do a qualtitiative research study based on their emotional experience
* So we have quantitative data to support what were studying here

Constatn comparision of new information to current data

Qualtitative study

Question 10

What is case studies?
* what kind of research

Answer 10

Individual cases and only a handful of people. Collecting similar data between these people.

Constant data collection across multiple individual subjects
* She saids probs no more than 10

Gain insight basd on their specific experiences

good for smaller populations, or the data we want to collect is very dense (we want a full understanding of it) - very time consuming to collect

Qualitative Research

Question 11

KNOW: Just like quantiative data, qualitative data also has data that needs to be collected, it just doesnt have #’s that go along w/ it

Collected through:
* Observation - watching the pt - can be trhough videos or first hand accounts and writing down the useful info (maybe thats body langauge, time spoken, just whatever you’re trying to observe
* Surveys - doesnt have to be quantiative (on a scale from 0-10 etc..). It could be questions more like “what was your experience w/ this hospitals” - just need to be more open ended questions that get a response from the client
* Interviews - can be group or individual or structured or semi structured (structed = im the researching and I ask a question and you answer and we keep going back and forth like that. Semi structured = more open ended, where yes I have some talking points and things I need to addrss, however, I really let the converstation go anywhere - good for something the pt might be less confident in - turns it into more of a converstation.
* Structure is good when we need to know specific thigns
* Semi structured is good for when we need to build a relation w/ that subject and the topic is challenging (or we need to follow a pts story)

Question 12

What are the 3 ways we sample for out pts in qualtiative research (ways we collect the subjects were going to use)

Answer 12

1) Theoretical
2) Information-Rich
3) Maximum Variation

Question 13

What is theoretical sampling?

Answer 13

Individuals are recruited to help develop a theory, then they’re chosen to be included in the study

If my theory is that pts w/ total shoulders are having an excelerated expierence (meaning they don’t have a lot of time to understand the process thats going on - kind of rushed through their therapy)
* Them I’m going to select those w/ an exerlerated protocal. and that those percautions are followed as well

NOTE: Its not random sampling but more of a purposeful sampling method
* However, i can also select those w/o a exeercelreated protocal to balance it out

Process of selecting participants, data, or cases based on their potential to contirbute to the development of a theory or conceptual understanding, rather than on statistical representativeness or predefined categories. The goal of theoretical sampling is to refine and develop theoretical concepts or explantaions, and it is an iterative process, meaning researchers continuously adjust their sampling strategy as the analysis progresses.

Question 14

What is information rich sampling?

Answer 14

individuals chosen based on how much information they will be able to provoide

If I want to gain a lot of information about skilled nursing. Maybe instead of selecting pts who were in a skileld nuring home at one time or another I want to select those that have been in skilled nuring facilities lots of times (= more information because they were there longer)

Question 15

What is maximum variation sampling?

Answer 15

Representing all the variation within my target population

If I want to know about challeneges w/ discharge in skilled nursing facilities. Whats the discharge like for someone who stays a week vs someone who stays a month? Are their different challenges that each of those individuals runs into?
* really comes down to the purpose of these studies - really need to make sure the sampling method matches the intition

EX: If im doing a case study (not many people in the study) Im going to want to be using information rich sampling to get the most out of those few people as I possibely can (because there arent many people). However, if were able to reach out to lots of individuals lets do max variation and see the differnces within that cohort - thers a right time for all of them, we just need to make sure it matches the intitutions of that study.

method used in qualitiative research to gather a wide range of perspectives or experiences on a particular topic. The goal is to include people or cases that represent a broad range of diffreences-whether its in age, gender, background, experience, or other factos
* In summary, maximum variation sampling is a way to make sure that your study includes as many different viewpoints as possible, so you can get a full, rich picture of the topic you’re researching.

Question 16

Data analysis
* So we’ve collected out data at this point (through observations, surveys etc.) and now we need to analyze it.

Whats the #1 way to analyze our data and explain what it is?

Answer 16

Coding
* Pulling out common phrases or words from interviews, obsevrations, or surveys
* Also done through content analysis

They will also pull out themes
* Top themes were “fincial barrieries, social support barries, misunderstanding of medical diagnosis, lack of medical equipment” - could be common themeses pulled out of the interviews they had. Doesnt mean its a complete picture but the most common part of it

Then perform a conent analysis - analyze the data we have for its credibility, tranferability, depdenability, confirmability
*

Question 17

When doing coding we also perform a content anylsis. What 4 things does a content anylsis look at?

Answer 17

1) Credibility
2) Transferability
3) Dependability
4) Confirmability

Question 18

Making sure what a subject says or does is truthful or reflects whats actaully happening
* what part of a content anlysis is this?
* What are the 3 methods to assing this?

Answer 18

Credibility

So if a pt is saying a challenge is fincial, yet their insurance is covering all of it - than that doesnt reflect what the pt is saying
* we need to make sure the information is credible

3 methods to test this:
* Triangulation
* Negative Case Analysis
* Member Checking

Question 19

Triangulation is one way of assesing credibility. What is it?

Answer 19

Comparing varying sources of data
* Observation = looking at records and comparing that w/ their interview / survey. If pt is saying they had a horrible experience but are laughing etc - we see theres a mismatch here
*

Question 20

Negative Case Analysis is one way of assessing credibility. What is it?

Answer 20

Examining cases or data that don’t support or go against current themes
* kind of like an outliar analysis
* If we have 30 pts in our study and one of the cases just isnt matching up with what the other cases are saying
* Auther should speak to this in their study

Question 21

member checking is one way of assesing crediability. What is it?

Answer 21

Allowing participants to verify or clarify meaning behind what was said/done

So in triangulation the example was that they were saying it was a horrible expereience however, during the interview they were laughing and joking around. With member checking we can check back with them and say “he in observation you were laughing and having a good time, but in observation you said it was horrible - maybe they would say they just get along with the one nurse they saw them with, but the CNAs are horrible” shows why their might be discrpencies in the data

Question 22

What is tranferability?
* 2 ways to check?

Answer 22

How well the results can apply to other individuals in a similar situation
* So if were talking about discharge experiences in skilled nursing. A study w/ high transferbaility would look at the experiences of other people in skilled nursing and see if it matches up

2 ways to check
* Thick description
* Purpose Sampling

Question 23

One way of assesing transferability is Thick description. What is this?

Answer 23

Fully describing the aspects of the situation and study population
* If we are very specific and saying this is a skilled nursing facility in a low socioeconomic area and the study pop was retired farm workers - well this is going to be very specific to them and their experiences - not an urban situation where most of the pts have been on benefits for several years. There are going to be tihgns applicable to both, however, its going to limit the transferability. However, since we’ve been specific we can really hone in on who this data is representatitve of. And its tranferability. How well they can apply.

Giving a really detailed and clear picture of wahts going on in a study. Its not just saying what happened, but also explaining how it happened and why its important.
* in terms of transferability, thick description helps people decide whether the findings of your study could apply to other situations.

Question 24

Another way of assesing transferability it purpose sampling. What is it?

Answer 24

Selecting participants specifically to allow for transferability
* Meaning, if I want this data to be transfered to most people in skilled nursing. Than I’m going to have to draw a sample that is representitive of that (think rural, city, low and high economic). Going to have to draw form all populations to make sure it is representitive of that population. however, if I wanted it to be transfred to only a specific population (think suburban affluent) than that is the specififc subgroup of people I should draw from. - either way I have a purpose behind the pts I am selecting

Used to select specific cases or participants that will best help answer the research questions and provide rich, in-depth data.

allows the reseachers to choose participants or cases that provide the most relevant and varied insights into the phenomenon under study. By selecting participants or cases based on specific charcteristics or criteria that align w/ the reseach aims, the reseachers can build a richer, more nuanced udnerstanding that my be applicable to other similar contextes.

Question 25

What is dependeability? (2)
* What are the two ways to check

Answer 25

How well the study could be replicated

how stable the data is over time
* this data should hold up
* Doing a qualititaive study during the covid pancemic is probs going to generate a whole different set of experiences than one done after the era

2 ways:
* Audit Trail
* Triangulation

Question 26

One way of assesing depdenability is an audit trail. What is this?

Answer 26

Documenting methodology of a study
* How information presented was selected, rationale behind participant selection. (w/ qualtitaive this can get a little fuzzy - loss of structure)
* Out of all the qualititative information that was collected why did they researchers present waht they did? Why did they chose to focus on some things and not other things (maybe only hose things that support their POV) - helps us fully understand how this study was done

Think of this as your detailed recod or paper trail of how you conducted your study. Its a way of showing your work so that others can check how you arried at your conclusions.

Question 27

Another way of assesing depdenability is triangulation. What is this?

Answer 27

comparing variabous sources of data to make sure the data is matching up
* If were doing observation and an interview on our subjects, and its not mathcing up for anyone, or were getting very inconsistent answrs w/ everyone and that doesnt match up w/ what they’re saying. Than the depdenability of that data goes down. Are we leaving it too variable here?

In research, triangulation is a way of checking the reliability and consistency of your findings by using multiple methods, data sources, researchers, or theories to look at the same thing from different angles. It helps make sure that your conclusions are solid and not just a result of one particular approach.

Question 28

What is confirmability?
* One kind?

Answer 28

That the conclusions of the author are based on the participants experiences, thoughts, actions, etc. - not based on authers bias / opnion
* Want to say this is the authoers expierence and what they’re thinking - not what the authoer says (dont say “the patient thinks it was a big deal, but it probs wasnt, the patient was probs reading into things a little too much”)
* It would be betteer if we can find a way to blind the researcher

Not based on the authors bias/opinion
* When were doing qualitative research its very easy for the researcher to become biased, and put that into their data (much easier than with quantitaive, but we can even have bias w/ quantative data)

Kind:
* reflexivity

Question 29

Reflexivity is good at assesing confirmability. What is it?

Answer 29

Systematic consideration of how a researcher’s opinions shape the article

And how the qualitative data shape the researchers opnions

We want to look at how the how the researchers opnions could influence. And we want to do this in a systematic way. We also want to look at how the data could shape the researchers opinions.

reflexivity is the process of reflecting and critially examining how your own perspeccties, biases, assumptions, and influences shape your research or inquiry. In qualitative research, it involves an awareness of how the researchers role, identity, and personal experiences may imapct the dta collection, interpretation, and analysis.

Question 30

Questions you want to ask of the qualtitative artical you are reading\