Qualitative Studies Flashcards
What features of a study or question would indicate qualitative data?
Refers to “understanding”, “attitudes” or “experiences” of the following:
- health literacy
- emotions
- social interactions
- decision making
Can be focused on patient or HCP
Are qualitative studies replicable? Why?
No
The outcomes are dependent on the context and the participants associated with that context
I.e. difference context would produce different outcomes
Why do we need qualitative data?
Explore patients’ and providers experiences in order to improve care
Describes and explains health behaviour
Improves quantitate research by informing questions to ask
Helps understand study findings
What are the different methods of gathering data in qualitative studies?
Interviews
Focus groups
Observations
Analysis of material produced by participants i.e. diaries
Written documents
What are the pros and cons of focus groups compared with interviews?
FOCUS GROUPS
Pros:
-more natural environment and conversation
-participant-centred format
-interactions and debates between group members can lead to consensus being reached and points being explored that might not have happened on individual level
Cons:
-not able to capture individual thoughts or feelings as indepth
INTERVIEWS
Pros:
-in-depth exploration of topic i.e. can ask more focused questions
Cons:
-artificial situation
-assumes interviewee is articulate and comfortable to talk
I.e. might feel intimidated by doctor due to them being in position of power
What is the method qualitative studies take to for data collection and analysis? What are the problems with this method? What does saturation mean in this context?
Interactive method
- repeating cycles of data collection and analysis until reached saturation
- data collection and analysis occur simultaneously
- can lead to study methods and question might change based on the analysis of data collected
- lead to refinement of data collection and analysis for future participants
Analysis of data alongside collection means that analysis might be subjective and prone to bias
Saturation= additional interviews or focus groups are not adding anything new or bringing up new themes
What are the features or requirements of an interview being conducted for a qualitative study?
Audiotaping interviews
Conducting interviews in private space or place to ensure what is discussed cannot be overhead
Raising sensitive issues if they are relevant to the research question
Use list of interview questions to guide discussion
What are the 6 different qualitative approaches?
Grounded theory:
-Developing theory grounded in the data from the field by using data gathered to build theory rather than forming hypothesis
Ethnography
-describing or interpreting culture or social group
Case study
-in-depth analysis of single case or multiple cases
Narrative
-eliciting meaning of experiences expressed as stories of individuals
Phenomenology
-understanding essence of experiencing a phenomenon
Generic/descriptive studies
What type of sampling is used in qualitative studies? How is diversity/variation achieved in this type of sampling?
Purposive sampling:
- information rich participants recruited who are related to research topic of interest
- susceptible to bias because the research has chosen the group of people to question
Recruit participants with:
- range of different characteristics
- anticipated difference in experiences related to topic
What are the aims of sampling for a qualitative study?
How can this be achieved?
Aiming for wide range of perspectives on focused area rather than being representative of wider population
-encourage people from different backgrounds who might not normally take part in studies due to various barriers I.e. preventing middle-class people from dominating who might be more practiced in giving opinion
-want to have information rich participants
What 2 types of errors can occur in qualitative studies and why do they happen? How can these errors be minimised?
Type 1:
Finding something in the data which is not there
Due to:
-conflicts of interest i.e. wanting outcome of study to be something in particular for reason other than wanting to explore or further understand experiences/opinions etc
-forcing pre-defined model onto data
-selectively choosing quotes
Type 2:
Ignoring something that is in the data
Due to:
-oversimplifications of data
-ignoring contraindications or alternative perspectives
-overly influenced by researcher or interviewer
Minimised by researchers practising reflexivity so they are aware how they could potentially contribute to a type 1 or type 2 error
Produce audit trial to provide rationale behind each stage of data analysis to help portray that findings accurately represent participants responses
What type of analysis is used in qualitative research and what does this involve?
Thematic
Transcript coding
-topics and issues identified and labelled by coders so than can search for them in the rest of transcript
Main themes identified
-through searching coded words/themes to see if there is trend
What is coding and why is it better to have more than one coder?
Coding is using to identify key words or phrases or themes so that they can be used to search other transcripts to see if there is a trend
Having 2+ coders can lead to broader range of themes being identified which can lead to more complex data emerging
What is the difference between big Q studies and small q studies?
Big Q:
- health and social care viewed as dynamic social activity
- aims to develop theory which can explain why people behave the way they do
- critical approach to see if there is wider pattern outside the scenario
Small q:
- focus on something more specific i.e. health condition/ setting or intervention
- patients understanding/needs/experiences explored
- can be used alongside quantitative methods
How can qualitative studies be used in clinical practice?
Understanding experience of living with a condition
- meaning of illness to patient
- understanding experience of daily life
- importance to help with communication and care planning
Understanding help seeking behaviours
- understanding symptoms of condition and how they impact life
- what prompts people to seek help
- barriers to accessing care (embarrassment/language/disability/getting an appointment/economic)
- important to inform raising awareness campaigns + education
Part of clinical trial
- developing intervention
- assessing feasibility + acceptability to prevent lack of understanding being a confounder or source of bias
- experience of receiving or delivering intervention
- can be useful in explaining counter-intuitive outcomes i.e. why intervention might not have worked
Patient reported outcomes/measures (PRO/ PRM)
Guideline development
-used to inform decision making to go beyond purely looking at effectiveness
What components are involved in assessing the rigour of a qualitative study? (I.e. critical appraisal)
Checklist:
- Trustworthiness
- Credibility
- Reflexivity
- Relevance
Critical appraisal:
- Quality and appropriateness of design and methods
- Quality and rigor of collection
- Markers of equality (top 3 in list above)
- Authors able to describe and justify story about data
What is trustworthiness in context of qualitative study? What should you look for in a study?
How researchers establish that research study findings are credible, transferable, confirmable and dependable
- justification of intervention
- explanation of how conclusions reached
- quotations to support analysis
- invitation of participants to comment during analysis to ensure that what has been transcribed accurately represents what they were trying to say
- compare different perspectives
What is credibility in context of qualitative study? What should you look for in a study?
Whether research findings represent plausible information drawn from participants original data and is the correct interpretation of the participants original views
=done via member checking/validation
- demonstration that data fairly represented
- are contraindications or different perspectives discussed
- all available data has been analysed= no cherry picking
- use >1 coder to prevent one dimensional analysis where researchers perspective dominates
What is reflexivity in context of qualitative study? What should you look for in a study? When does reflexivity need to be assessed for?
Research identifying and reflecting on how own views, beliefs and attitudes may have influenced the research process
Explicit critical examination of researchers own role in research
I.e professional background, experience and personality can affect the research process
When assessed:
- formulation of research questions
- data collection
- relationship with participants
What is relevance/transferability in context of qualitative study? What should you look for in a study?
Assessing if study highlights importance issue and that studying findings can be applicable to other contexts
Ask does research findings:
- add to knowledge
- have potential to improve lives
- help to see role of healthcare in everyday life
- influence clinical practice
What is confirmability in context of qualitative studies? What can be done to demonstrate confirmability in a study?
Related to reflexivity
Degree of neutrality in researchers findings
I.e. how much the findings are based on the participants responses rather than any potential bias or personal motives of the researchers to try and skew the results to fit certain narrative or motive (type 1 error)
-Audit trial can be provided to highlight the steps of data analysis and rationale behind the decisions made to help establish research study findings accurately portray participants response
What is a discordant/disconfirming/divergent case? Why can they be helpful/important?
Case which differs from general pattern of observations
Can lead to further data being gathered to attempt to understand why they differ from the general trends
I.e. can add to increased depth of study data
What is member checking/validation?
Where data/results are returned to the participants to check for accuracy and to ensure that they are a true representation of what they were trying to say about their experience (resonance)
Used to explore credibility of results
What would you be looking at in the CASP appraisal of qualitative studies?
Research question:
- does it look for understanding rather than information?
- focus on actions/experiences of participants
Is it justified and appropriate?
- methods clearly described and justified
- evidence of purposive sampling
- do we know which questions were asked?
Researchers
- have researchers considered reflexivity
- relationship with participants i.e. some might see interviewer as authoritarian figure
- background, personality and experience
Ethics
- is there ethics approval
- confidentiality of the interview or focus group
- talking about sensitive subjects
- health provider vs researcher
Data analysis
- clear description of methods
- participants quotes used to link to themes
- strengths and limitations
- possible alternative interpretations
How valuable is the research?
- does it inform clinical practice/future research
- does it improve understanding
- applicability to practice
