Chapter 6 Qualitative Research Designs

The World of Qualitative Research Qualitative Research designs Scientific Adequacy Of Qualiative Research Advantages & Limitations of qualitative Approaches

Defining Qualitative Research

use words rather than numbers to describe findings assume a dynamic reality emphasize seeing the world from the perspective of the participants goal is understanding rather than prediction emphasize the subjective dimensions of human experiences holistic rather than reductionistic associated with the interpretive approach which is discovery oriented, explanatory, descriptive, and inductive in nature

Major Paradigms in Nursing

TOTALITY -reality exists independent of the knower humans are viewed as the sum of their parts cause & effect relationships health is a continuum quantitative research approaches positivist tradition SIMULTANEITY- reality is
a mutual process b/w human s & the environment humans are > & different from the sum of their parts study is conducted not to control the human being but to gain insights into understanding the personal meaning of experience researchers study the universal lived experiences of health or patterns of the whole qualitative research approaches & the interpretive tradition

Qualitative research is complementary to quantitative research. Both processes produce different kinds of knowledge that are valued by the profession and both are needed to promote excellence in practice

Core Activities in Qualitative Research

Literature Review- a cursory review may be done initially to focus the study, otherwise it is conducted after the data has been collected and analyzed.

Rationale for delaying the L.R. is to avoid leading the participants in the direction of what has already been discovered.
Purpose of L.R. is to show how current findings fit into what is already known

Explicating Researchers Beliefs

Bracketing - setting aside ones biases and personal views on a topic Investigator keeps a diary of personal thoughts and feelings about the topic

Purpose is to make known to the researcher her/his beliefs about the topic so that the researcher may approach the topic honestly

Setting for Data Collection

The field is the natural world where participants live The field requires reciprocity in terms of decision making The participant & researcher determine what data will be shared Participants must understand & be willing to share their thoughts & feelings about the phenomenon Contrast this with quantitative studies where data are collected in controlled settings & the researcher is removed from the subject

Selection of Participants
Participant or informant refers to the individual who informs the research study (vs subjects or respondents) They are active participants & equal partners Must have 1st hand experience with research phenomenon (vs random selection) They want to help others understand their lives & the social contexts in which they live & create meaning

Purposive Sampling
Participants must have first hand experience with the research experience and be able to talk about it Researcher establishes clear criteria & rationale for sample selection Goal is not generalization of findings but rich descriptions of phenomenon by those who have experienced it

Saturation
A situation in data collection in which participants descriptions become repetitive & confirm previously collected data
An indication that data collection is complete Similar to adequate sample size in quantitative research

Data Analysis
Researcher immerses self in data to bring order & meaning to vast narrative Begins with 1st data collection episode Reading, rereading, intuiting, analyzing, synthesizing & reporting on data Cyclical & recursive process that requires an extensive amount of time

Scientific Adequacy
RIGOR in qualitative research is less about the adherence to rules and more about fidelity to the spirit and standards of qualitative work (Sandelowski, 1993)

Data Analysis (contd)

Data from interviews are continuously reviewed to identify additional questions Data from earlier interviews are routinely returned to participants for clarification/elaboration
Investigator must look for meaning in the data as it is reviewed

Data Analysis (Contd)

At conclusion of study a protracted period of data immersion in which conclusions are reviewed in the context of the whole study
Data similar in meaning are clustered together into preliminary categories

4 Criteria of Trustworthiness
Credibility Transferability Dependability Confirmability

Credibility
Refers to the accuracy of the description Is the description plausible & recognized by those who experienced it. Enhanced by prolonged time in the field Repeatedly observing & interacting with participants Triangulation of data sources, methods, data type, investigators, & theories Member checks-participants involved with data analysis

Dependability
Refers to the stability & trackability of the changes in data over time & conditions Reflects the reality that peoples situations change & reality differs for people Want to determine the extent to which another researcher with similar training & rapport with participants would make the same observations This is determined by an audit trail

Transferability
Concerned with generalizability or fittingness of findings to other settings, populations, & contexts
Report must provide sufficient detail so that readers can assess this Lack of transferability is often viewed as a weakness of qualitative methods

Confirmability
Basic issue here is one of neutrality Do conclusions depend upon the subjects & conditions of inquiry rather than on the researcher Would 2 independent researchers agree about the meanings emerging from the data An audit trail is used researcher must explicate how personal biases may have come into play and consider alternative explanations

EXERCISE
Use the questions in Box 6.8 to assess the qualitative rigor of an assigned research study

Contemporary Standards of Quality in Qualitative Research

Fidelity to the spirit of qualitative work OR Did we get it right? positionality community voice critical subjectivity reciprocity sacredness of relationship sharing privileges

Advantages & Limitations

Focus on the whole of the human experience & the meanings ascribed to them by participants they provide nurses with deep insights that would not be possible using quantitative methods exclusively The major strength of qualitative work is the validity of the data it produces Participants true reality is likely to be reflected

Advantages & Limitations (contd)

Major limitation is its perceived lack of objectivity & generalizability Researchers become the research tools and may lack objectivity

Phenomenology
Describes the meaning of the lived experience from the perspective of the participant Seeks to achieve a deep understanding of the phenomenon by rigorous, systematic examination of it
Its purpose is to describe the essences of lived experiences

ESSENCES
ELEMENTS RELATED TO THE TRUE MEANING OF SOMETHING THAT GIVES COMMON UNDERSTANDING TO THE PHENOMENON UNDER STUDY

Philosophical Tenets
Whatever is known must appear in consciousness Consciousness provides access to the world
All phenomenologists believe in multiple realities constructed by individuals within the social context of their lives

Developing the Question

Focus is to describe the meaning of the lived experience from the perspective of the participant
Broad question: What is the meaning of ones lived experience? Central overarching question & subquestions

Role of Researcher
Is the instrument for data collection Establishes good rapport with participants Explicates beliefs through bracketing

The meaning of the lived experience is interpreted from the participants stories

Sample
Small purposive sample
Participants are able & willing to talk about their experience and describe their feelings

Large enough to get a rich description of the research phenomenon

Data Collection
In-depth interviews Written descriptions of experiences in diaries & journals Observations Multiple interviews with same participants to reflect the meaning of the lived experience from the participants perspective

Data Analysis
Immersion with the data Read, re-read transcripts, may return to participants for clarification or description Comparative analysis to identify themes in data Look for similarities & differences in data to identify themes Reduce data into smaller & smaller number of categories to arrive at a consistent description of the meaning of the lived experience Share description with participants for verification

Review of Literature
Conducted after data collection & analysis are complete Places findings within the context of what is known about the phenomenon

Findings
reports the essence of the experience reader should get an understanding of what it is like to experience the phenomenon

Grounded Theory
Goal is to develop a theory about the processes (social behaviour or scene) under investigation in a natural setting Useful in areas where little is known or when a new perspective is needed Tries to identify the core process and subsidiary processes in the situation

G.T. - Philosophy
Symbolic interactionism humans react to things on the basis of meanings that events have for them in everyday life meanings are derived from social situations meanings are shaped by dealings with others

G.T. - Developing the Question

Question may not be explicitly stated but can be implied from the purpose Question is broad & may change several times as data are analyzed Basic social process Gerund (noun ending in ing ) What is the process of ...

G.T. - Role of Researcher

Studies the behavior & the social setting that influences the interaction Is a participant & observer No effort is made by researcher to put aside assumptions. On the contrary the researcher uses past experiences and assumptions to better understand the processes being observed.

G.T. - Sample
Participants who are experiencing the social process under study Size determined by theoretical sampling (collects, codes & analyzes data & then decides what additional data are needed)
Saturation- inability of new data to add new codes

G.T. - Data Collection

Data collection & analysis are concurrent Observation & audio-taped interviews Field notes Researcher participates in the social group, observes & records data relevant to study purpose Broad open-ended questions Ask participants to share stories of their experiences

G.T. _ Data Collection

Everything to the grounded theorist is data Data are obtained through a combination of: participant observation, interviews with informants, reading the literature on the study questions, and self-reflection

Data Analysis
Data collection, coding & analysis occur simultaneously Constant comparative method Early data are coded with words that describe the action in the setting Codes get revised & data recoded Categories develop from the clustering of codes Categories are then linked to develop a tentative theory or conceptual framework

G.T.-Literature
Review of the literature in the substantive area of the study is reserved until after the theory begins to emerge from the study data
Researcher integrates the literature with the emerging theory during saturation, sorting memos, & report writing

ETHNOGRAPHY
Aims to understand human behavior in the cultural context in which it is embedded
Aims to understand the way in which people live from the emic (insiders) perspective vs the etic (researchers or outsiders) perspective

Ethnography
The work of describing a culture (Spradley, 1980)
Culture includes a way of life (all the ways a group of people solve problems, a pattern of living that guides thoughts, actions, sentiments as reflected in language, dress, food, traditions, customs, etc. Purpose is to make explicit what is implicit within a cultural group

Ethnonursing
the study & analysis of the indigenous peoples point of view, beliefs, & practices about nursing care phenomena & processes of designated cultures
Provides a means to study cultural variations in health& illness, & nurses & their clients as subcultures of society

Ethnonursing
Mini ethnography - a small scale ethonography focusing on a narrow area of inquiry, limited time period, published as an article
Maxi ethnography - comprehensive study of a designated culture. Have a broad focus of inquiry, extend over a long period of time (years), & are published in book form

Ethnography- Philosophy
Roots in cultural anthropology (study of the origin of people, their past, & strategies for surviving through time) Involves learning from people rather than studying them. The researcher must become a student & the participants of the culture the teachers Researcher adopts an attitude of conscious ignorance about the culture

Three Phases of Ethnographic Research

Prefield Work Field Work

Postfield Work

Developing the Question

Focuses on some pattern of behavior, lifestyle, custom, or belief of the culturesharing group e.g.- the health beliefs of immigrant Hong Kong women Nurses may focus on an aspect of life in the community that impacts the health experience of its members

Role of Researcher
Is the primary data collection tool Enters the world for an extended period of time, asking questions, observing, participating, & collecting whatever data are available Observe behavior but go beyond it to inquire about the meaning of it researchers role is to make inferences from their observations & then to test these inferences over time with their population until they are confident they have an adequate description of the culture Must set aside biases & explicate beliefs

Sample
A cultural group that has experience with phenomenon of interest
Informant vs subject

Gatekeeper
Key Informants

Data Collection
Participant observation Formal & informal interviews Focus groups Collection of artifacts & documents Field notes Other sources (demographic data, maps, genealogies, life histories)

Ethnography Data Analysis

Follows a cyclical pattern Data collection, recording, analyzing, returning tot he field to collect more data

Proceeds through 4 levels: domain analysis, taxonomic analysis, componential analysis, & theme analysis Goal is to discover cultural patterns in the data people are using to make sense out of their experiences

Ethnographic Findings
A two-step process 1. A cultural inventory 2. A final descriptive report that may be a book or monograph