Qualitative approaches to research Dr Dean Whitehead SoNM Why - - PowerPoint PPT Presentation

Qualitative approaches to research

Dr Dean Whitehead SoNM

Why qualitative research?

The post-modernist ‘backlash’

• Post-modernism

(anti-positivism)

• Different worldviews

– science versus philosophy – phenomenology /existentialism

Nursing versus medicine…

How do quant/qual differ?

Qualitative - it’s all in the narrative!!

• What do people do,

think, say, believe, value, experience,

• bserve etc…

What does it broadly do then?

• What is the most

common qualitative approach in nursing and midwifery?

Qualitative descriptive exploratory – ‘free form’

• The least theoretical

/ philosophical approach

Uses generic principles

• Usually interviews /

focus groups

• Content/thematic

analysis

‘Traditional methodologies’

• Phenomenology –

hermeneutics

• Grounded theory
• Ethnography

How do they differ?

Different philosophers / theorists

Husserl

• Descriptive (realist) –

Transcendental

• Epistemological
• ‘What do we know…’ (about

the world)

• Bracketing – suspending belief

Heidegger

• Interpretative
• Ontological
• ‘What is the nature and

meaning of ‘being in the world’

• Hermeneutics – moving from

parts to the whole

• Gadamer
• van Manen
• Crotty

Grounded theory

• For theoretical clarity
• Theory is developed

(conceptual model) – not tested

• Coding – open, axial,

selective – theoretical saturation

• Blumer’s theory of Symbolic

Interactionism – and

• bjectivism

• Constructivism

movement

• Corbin
• Sharmaz

Ethnography

• Stems from

anthropology

• Observing cultural

groups and sub-groups

• Emic / etic –

insider/outsider

• Positioning – overt /

covert

• Realist ethnography
• Critical ethnography
• Case studies
• Auto-ethnography
• Ethnomethodology

Case study

• In-depth narrative

case-studies – small numbers

• Vignettes

What’s in and out of fashion?

Historical research

Not much to say really!!

• Cycles of history
• Documentation,

letters, photo’s, paintings etc - all inform a story or narrative

My original PhD topic – the origins of public health nursing in the UK

• 1890s-1960s
• PRO – Kew
• Royal College of

Nursing – Edinburgh/London

• Wellcome Institute
• MoH minutes /

microfisch

• Nursing Times / Nursing

Mirror

Feminist research

Hhhhmm – what about masculine research?

• Popular in 60s-80s
• The anomaly of

midwifery!!

• Medicalisation of

normal, healthy child-birth

Critical – emancipatory paradigm – critical social theory

• Explores power

imbalances – systems,

• rganisations, gender,

ethnicity etc

• Questions the status

quo of social institutions

• Seeks change and

emancipation

Narrative analysis

• Concept analysis
• Discourse analysis

Concept analysis

• Rodgers
• Morse
• Walker and Avant

Discourse analysis

Jacques Derrida

Quick break!!

A criticism of qualitative research

• Can be seen as

‘wooly’, fluffy and ‘navel-gazing!!

• Rigour
• Hierarchies of

evidence

I think – therefore I am…

• Rigor is the

methodical commitment to experimental procedure, to the need of controlling all parameters that can affect the results of our tests.

Qualitative - Trustworthiness

• Credibility
• Transferability
• Dependability
• Confirmability

National Health and Medical Research Council - 2009

https://www.nhmrc.gov.au/_files_nhmrc/file/guidelines/developers/nhmrc_levels_grades_evidenc e_120423.pdf

Bridging the paradigmatic tension – the answer is…

Qualitative meta-synthesis

Two birds – one stone etc

Thinking outside the box… problem-solving – pragmatic…

More than one worldview…

Mixed methods – a no-brainer!

Is it qualitative?

• Hhhmmmm – third

paradigm!!

Action research (AR)

Critical – emancipatory paradigm – critical social theory

• Explores power

imbalances – systems,

• rganisations, gender,

ethnicity etc

• Questions the status

quo of social institutions

• Seeks change and

emancipation

Term first coined by Kurt Lewin – 1946. Died 1947!! Also coined related terms – force field analysis, group dynamics & change process (unfreezing, change, refreezing)

What does it look like?

Figure 1: ‘An organisational-change action research cycle’. Adapted from: Whitehead D et al. (2003) Action research in Health Promotion Health Education Journal 62: 1. (with kind permission from Health Education Journal) DIAGNOSIS PLANNING FURTHER ACTION DISSEMINATION REFLECTION / EVALUATION ACTION FEEDBACK DATA ANALYSIS RESEARCH PARTICIPANTS AND ORGANISATION

• Identify problem/s to be addressed and proposed solutions /

interventions.

• Review the associated literature for evidence-base.
• Identify structural / organisational systems and processes.
• Ascertain structural / organisational barriers / opportunities.
• Forge constructive relationships with potential participants.

Clarify and validate problem/s with potential participants.

• Possible pilot study to investigate validity of action research

activity and to highlight the most appropriate participants for main study.

• Investigate ethical considerations / constraints.
• Initial interpretation of collected

data occurs.

• Collaborative analysis and

measurement of outcomes takes place.

• Validation of problem/s against

analysed data.

• Data analysis informs draft

action-change programme.

• Collaborative discussion and

examination of data outcomes leads to agreement on draft and final change programme.

• Change targets and outcomes are

agreed.

• Individual commitment to change

process and roles are agreed, whilst parameters of ‘ownership’ are established.

• Intentions / interventions are discussed

with relevant stakeholders. Any necessary systems / policy changes are formalised.

• The programme is communicated and

implemented according to agreed protocols.

• Participants are supported and developed in

their change-management role.

• Progress is recorded at regular intervals.
• All changes are monitored and recorded.
• Effectiveness of programme

is measured against agreed

• utcomes, targets and

success criteria.

• Methods and approaches are

reviewed for validity and reliability.

• Critical reflections of

participants are collated.

• The dissemination and

publication of outcomes to relevant local / national audiences occurs.

• Participants decide if further

interventions are required, either as an extension of the existing programme or as a separate add-

• n programme.
• Further action becomes part of a

continuous cycle of reflexive practice.

• Programme may ‘complete’ here

with the consent of participants. DATA COLLECTION

• Establish the nature and range of

the most appropriate data collection methods.

• Determine documentation and

recording methods.

Advantages?

• Not research for research

sake – navel-gazing or

• therwise.
• It seeks organisational /

community change

Delphi Technique

• The Delphi is named with reference to the Ancient

Greek God Apollo, whose Delphic oracle was viewed as his most truthful and trustworthy expert informant – and who spoke to mortals from his Delphi sanctuary

Delphi technique

• The Delphi is named

with reference to the Ancient Greek God Apollo, whose Delphic

• racle was viewed as

his most truthful and trustworthy expert informant – and who spoke to mortals from his Delphi sanctuary

Delphi Technique

• Consensus study – expert driven – where theory,

research or practice is ‘sketchy’

• Classic two-round
• First-round – qualitative interviews
• Second and further rounds – quantitative - descriptive

surveys

Case study / Q-methodology

Phew!!

• That’s it folks.

Qualitative methodology and mixed methods in 1 hour – and 67 slides!!

Any questions