1. NURS3030H NURSING RESEARCH IN PRACTICE MODULE 2 ‘Qualitative approaches and methods’
©Janet Rush, RN, PhD, 2010

2. Objectives:
Review qualitative methods beyond the ‘descriptive’ level deeper, interpretive levels
Many fundamentals = same review provided
Focus: phenomenology, grounded theory, ethnography
Specify the design elements from question to dissemination
‘Design’/methods flow diagram
Ethical principles, consent forms

3. Qualitative Research… recall
Based on ‘naturalistic’ paradigm
Knowledge/learning from subjective stance
The researcher (involved)
Various methods – depends on the question
The ‘participant’ vs. ‘subject’
Sample size – usually smaller
Sample selection - purposive
Setting - natural, participant-selected or neutral if necessary
Data collection – words, observations
Rigor…is about truth-value
Data analysis – thematic, many methods
Conclusions/Results – transferable?

4. Qualitative ‘methods’
Use qualitative methods when:
Previous understanding = inadequate
Make sense of complex or changing phenomena
Learn about meaning, experience, interpretations
Discover theory in data
Understand detail … generally (descriptive) or ……deeply (interpretive)
Many ‘methods’ in qualitative projects
… Just like many ‘designs’ in quantitative projects
N2030

5. Phenomenon
Important fact, thing, experience, person, occurrence – rare or significant
Object or aspect known through the senses
Fact or event susceptible to scientific description or explanation
For qualitative research … describing, theorizing, suggesting meaning, titrating ‘essence’ … of a phenomenon, concept, situation, relationship

6. Examples: Types/Methods
Descriptive
Qualitative descriptive/description
Interpretive description
Interpretive:
Phenomenology
Grounded theory
Ethnography
Case study
Historiography
Discourse analysis
Critical social theory
Feminist theory
More +++
Course focus

7. Interpretive methods Recall/review example questions from Module 1
1. Phenomenology *
Focus – ‘lived experience’
R. Question – meaning, essence, perceptions
Participants – living the experience
SS – 5-10 (sometimes more R/T saturation)
Data sources – 1:1 conversations/interview, art forms
Analysis – theme’ing, reflective writing, memos, journals
Outcome/results – ‘essence’, reflective description … rich, compelling, vivid, visual
Why are phenomenological research studies of interest to nursing?
How would nurses and their interprofessional partners use the findings from phenomenological studies?
*1 : the study of the development of human consciousness and self-awareness as a preface to or a part of philosophy 2 a (1) : a philosophical movement that describes the formal structure of the objects of awareness and of awareness itself in abstraction from any claims concerning existence

8. Interpretive methods Ethnography
Paradigm, philosophical underpinning – anthropology/culture
Focus – cultural group (values, beliefs, practices, patterns, roles)
Participants – many - connected within culture
SS ~25-50+
Data sources – participant observation, field notes, photos, maps, genograms
Analysis – thick descriptions, coding, stories, cases, diagrams/structures, photographs
Outcomes – descriptions, structure, norms
Of what interest are ethnographic studies in health care?
How would the findings be used by nurses and their partners in health care?

9. Interpretive methods Grounded theory
Underpinnings: sociology, symbolic interactionism
Focus – processes, changing experiences, stages
Participants – individual + their relationships, ‘theoretical’ sampling
SS ~30-50
Data sources – interviews, focus groups, additonal ‘theoretical’ sampling, diaries, field notes
Analysis – concepts, coding, categories, constant comparative analysis
Outcomes – a grounded theory, a framework
When would a grounded theory approach be useful? How might the findings be used? Implications for health care?
SI: subjective meaning of human behavior, ‘social life’, the social process, and pragmatism (humans are pragmatic actors, always adjusting their lives)

10. Elements in the conduct of qualitative research
Question and Method
Study team – biases, experience, expertise
Modified literature review – about the issue, question, relevance
Design plan: sampling (inclusion criteria), sample size, data collection guideline, analysis strategy, bias/rigor considerations
REB approval
Obtain sample
Consent
Data collection
Data analysis
Interpretation & rigor
Conclusions, Discussion, Lit review #2
Implications for the profession
Dissemination

11. Flow diagram Research Question
Lit review #1, Forms development, pilot testing
REB Approval – full proposal
Sampling, Consent
Setting, Data Collection, Member-checks/validation
Analysis, Outcome/Conclusions, Triangulation (Lit Review #2)
Dissemination

12. Sampling: qualitative
Purposive/purposeful
[rarely random]
‘Information rich’ participant
Inclusion criteria – fit the question
Other sampling …
Snowball sampling
Theoretical sampling (Grounded Thoery, a hallmark)

13. Data collection Introduction – explanation, agreement, consent, safety
Context – individual/group in ‘natural’ or comfortable setting chosen by the participant
Grand touring question + probes (1:1 interviews)
‘Open ended’ questions
Semi Structured
Focus Groups: Ground rules, group roles, clear purpose/focus, group management, audio taping, video taping, other ways …
Note taking (interviewer/recorder)
Field notes
Journals/reflections
Pilot testing

14. Data Collection: the role of the interviewer
Grand Touring Question
Semi Structured Questions
Maintaining consistency
Introduction
Ground rules – why? when?
Concept of ‘reciprocity’, mutual gain
how close? how distant?
Safeguards
Consent
Assistance PRN

15. Interviews & Focus Groups
1:1, couple, family
Inclusion criteria
Introduction
Consent
Approach
Grand touring question
Probes and follow up
Interviewer and co-interviewer roles
Focus Group
Inclusion criteria, format, strategy
Consent
Groups management
Ground rules
Opinions and perspectives – how?
Interviewer and co-interviewer roles
Identifiable core issues? Processes?
Validation: member checks – fit, grab, work?
Adapted: Crooks, 2007, Trent, N305

16. Interview guide …script
Standard, consistent introduction, thank you
Comfort level, Consent, Confidentiality
Tapes or note taking
Issue/concept/experience of interest today
Questions:
Grand touring or 1st question
2-3 deliberate semi structured questions + probes
Review – feedback/validation … ‘member checking’
Conclusion – thank you, follow up (PRN)
CONSISTENT SCRIPT

17. Rigor in qualitative research
Truth value/credibility: (member checks, data saturation*)
Consistency (dependabilty): audit trail*, coding memos, bracketing*, quotes)
Applicability/confirmability (transferabiltiy: external validity, theoretical sampling, verbatim quotes support themes, triangulation*)
*Terms to recognize and use
saturation = when no ‘new’ data are apparent
triangulation = corroboration with participants, experts, other research reports
audit trail = providing examples to the reader about what key words became a category, what categories became a theme etc … depending on the method of analysis
bracketing = declaring the researcher’s personal beliefs or biases, up front and/or when describing the analysis methods

18. Data analysis
… about analyzing words (and sometimes behaviour, activities, pictures … depending on the question, method and resources)
Various methods and authors in data analysis
Most common method in descriptive studies is content analysis
Analysis may also involve some quantitative statistical computations for:
Describing the sample characteristics
Providing a ‘tally’ of similar responses (predominantly in descriptive levels or when 1-2 comments requested)
Usually ‘displayed’ in a publication (table, graph)

19. Results in qualitative - depends on the ‘method’
Outcome of the research
Descriptive level (Main themes that emerged)
Interpretive methods…
Essence
Theory
Framework/Figure
Thematic model
Final elements of the study:
Conclusions, discussion, implications, hypotheses or questions that emerged, tool development (once the concept is understood), dissemination

20. A word about consent form: components
All projects need ethics approval and signed participant consent
Components of the consent form
Title, PI(s), funding source, ‘REB’ approval
Introduction
Purpose of research/question
You have been asked to participate because….
What will be done/asked, when, where, how (data collection), follow up, feedback
Benefits and/or risks to the participant
Confidentiality – assure – how
Compensation?
Right to refuse without penalty/prejudice
Right to withdraw
‘The study has been explained …I agree to participate in…’
Signature, witness, date
Ethical Principles
RESPECT
BENEFICENCE
JUSTICE

21. Summary, Module 2 Qualitative paradigm: naturalistic
Qualitative methods
Review of basic elements and outcome(s) of a qualitative study
Attention to ‘rigor’
Ethical considerations