A Reflective Review on

1
A Reflective Review on

• A case for case studies exploring the use of
  case study design in community nursing research .
  
• Bergen A. and While A. (2000) .
• An analysis of the effectiveness of focus groups
  as a method of qualitative data collection with
  Chinese populations in nursing research.
• Twinn S. (1998)

By Moshe Ebenstein Gila Kadosh-Dadon Nir
Shani Joseph Waks
2
Introduction

• Two research methods will be Introduced as
  presented in two Readings
• Reading 1 - The use of case study design in
  community nursing research. Overview, analysis.
• Reading 2 Focus groups as a method of
  qualitative data collection. Overview, analysis
• A reflective comparative evaluation , validation
  and analysis between the two readings.
• Summary and Conclusions

3
A case for Case Study

• This paper
• Explores the suitability of community nurses for
  the role via a case study research method.(
  research question)
• Clarifies the Case Study research method through
  its characteristics and other issues arising by
  its use.
• Refers to the theory of Case Study Method,
  literature and arguments concerning the issue.
• Discusses the relationship of the case study to
  theory construction.
• Concentrates on issues arising from the
  definition of case study research method , used
  in a study by R.K.Yin (1993,1998) with reference
  to design in community nursing research.
• Explores the use of case study and Puts Emphasis
  on the research method theory rather then on the
  case itself.

4
Yins Approach

• A case study Investigates a contemporary
  phenomenon within its real-life context, when the
  boundaries between phenomenon and context are not
  clearly evident.
• Copes with the technically distinctive situation
  in which there will be many more variables of
  interest than data points, and as one result
• Should Rely on multiple sources of evidence, with
  data converging in a triangulating fashion.
• Benefits from the prior development of
  theoretical propositions to guide data collection
  and analysis.
• The case research has to be designed carefully
  and accurately.
• A case design requires attention for the issues
  

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Case Study Design

• Case and context A clear definition of the case
  (unit of analysis the case itself). Sources of
  data collection (sub-unit) subjects or
  variables to be measured.
• External validity Searching for external support
  to the theory, creating theory generalization
  process.
• Triangulation (multiple methods of data
  collection) documentation, archival records,
  direct observation, participant observation,
  interviews and physical artifacts.
• Relationship to theory The theory has to be
  developed, prior to the data collection, and
  evolved if findings contradict tit

6
Analysis

• This article focuses on Case study design based
  on Yins approach.
• Definition of the case ,context ,units of
  measurement and analysis are not clear enough.
• There is no reference and no answer to the
  research question.
• Triangulation is a valuable resource of research
  reliability.
• Yins approach is suitable for the specific
  research. (but since the research conducted in
  one method only it could not be compared to other
  methods)

7
Focus groups

• Focus groups interviews are now used in
  exploratory studies the evaluation of health
  programs
• A focus group is a group of people with a common
  area of interest, occupation, opinion etc.
  gathered to discuss this subject.
• The Article explores the contribution of focus
  groups as a qualitative method of data collection
  amongst Hong Kong Chinese women.
• The Research conducted in two concurrent
  projects. focused on different subjects.
• In both projects the participants grouped into
  groups between 3-9 members in each group.
• As a result The focus is a suitable method to get
  quality data on Chinese population .

8
The research design and process

• Data collected from 2 research projects
• both used a case study design and each study used
  focus groups as a major method of data
  collection. In addition both studies involved
  samples of Hong Kong Chinese women
• Project A
• Multiple embedded design case study design in 3
  stages
• 1st stage focus group interviews
• 4 community clinics 26 nurses
• 9 focus groups- 3 to 9 members each
• Homogeneity groups Registered nurses- Nursing
  officers
• Project B
• Multiple embedded design two case studies in 3
  stages
• 12 focus groups- 6 related to each case study,
  size 3-8 members

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Factors Influencing the quality of data in focus
groups

• Recruitment of participants.
• Group Homogeneity.
• Dominant participant.
• Number of participants in a group.( Not too small
  not too big 4-6).
• Group guide . Has to have leadership qualities.
• Language .(unique to this research)
• Interaction of the participants
• Contribution of individuals
• Relationships between participants and moderators

10
The advantage of Focus groups

• A major advantages of focus groups as a method of
  data collection results from the group process
  and the interaction of groups members
• The synergism created from the interaction is
  considered significant to the stimulation of new
  ideas and high levels of energy in discussion.
• This approach to data collection provides the
  opportunity of collecting in depth-information
  about complex topics in a relatively short space
  of time particularly since the aim of focus is
  not necessarily to achieve consensus amongst
  group members.

11
Analysis

• There is no definition of focus group( in this
  research context).
• There is no reference to the research question
  (deliberately).
• The technique used to compare between the 2
  concurrent researches is unclear.
• What is quality data?
• The theoretical base ground of focus groups
  method is not solid.
• No mention about validity reliability .
• The generalization of the case results is not
  evident.
• The research conducted in one language the
  analysis in another one.

12
Common issues in the articles

• In Both There are two main subjects the research
  method and the research question.
• In Both the major conclusion refers to the
  research method.
• The authors (in both) claim that the research
  method used is suitable for the Conducted
  research, therefore they both deliver the
  required results.
• The Design method in Both embedded multi case
  design method.
• There is no hard evidence that the research gives
  the answers to the research question.
• There is no Description of the complete design
  process.
• Both apply to the research community in the
  areas of nursing ,education Ethnographic sciences
  and professionals in the nursing area.
• Both Generalize the research results.

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Differencescase Study focus group

• Introduces the theory and the debate on case
  study research method.
• Concentrates on the theory of the research
  process.
• Generalization Based on theory.
• Theoretical

• Introduces some references to questions in focus
  groups theory.
• Concentrates on the issues arising the research
  process in details .
• Generalization based on induction
• Descriptive recruitment, organization work
  frame

14
The Quest for Theory Generalization

• Projection from singularity to commonality.
• The importance a general theory is a source of
  knowledge and reference.
• A case study deals with local and limited sources
  of data.
• In order to generalize a theory, a lot of
  experiments and case study researches have to be
  conducted.
• Replication logic has to be taken into
  consideration as part of the solution, together
  with supporting and contradicting theories and
  external sources of data .
• Extend or change the theory in accordance to new
  Data, theories.
• Determine the Limiting conditions to the
  generalization.

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Summary

• What Can we learn from the articles ?
• what is required for a research method design
• Are those articles suitable for WBP?

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Research method design

• Accurate definition of the Phenomena, the case
  and its context.
• Definition of the research Objective/Question
  (What is the research for?).
• Theoretical approach and support (to the research
  method and to the research question).
• Participants (Who is involved? ).
• Reliability of Data and results .Triangulation,
  cross reference data methods and external
  validity .
• Define units of measurement.
• Design the research process, based on the factors
  mentioned. How to operate the research ?how to
  save data?
• Data analysis. (methods, theories)
• Conclusions.
• Generalization.

17
Conclusions

• Two different research methods.
• Both utilize the research as a vehicle for
  promotion reserch method in practice.
• Any research method requires careful definition,
  design and analysis.
• The research method is suitable for the conducted
  research .
• The preferred research method for WBP is the case
  method.

18
Thanks for Attention
19
Case and Context
20
Units of analysis
21
Case Study

• A case for case studies exploring the use of
  case study design in community nursing research .
  Bergen A. and While A. Journal of Advanced
  Nursing 2000,31(4),926-934.

22
Focus Groups

• An analysis of the effectiveness of focus groups
  as a method of qualitative data collection with
  Chinese populations in nursing research. Twinn S.
  (1998) Journal of advanced nursing, 28(3),
  654-661

23
WBP

• Reading 1
• A practical study
• Research design, findings conclusions fully
  described
• Descriptive recruitment, organization work
  frame
• Non explorative
• validity reliability unfounded scientific
  research base

• Reading2
• Clear research design data collection methods
• Fundaments a reliable case study research method
• Case studies examines objects as well as
  processes

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Comments Reading 2

• Reading 2
• No mention about validity reliability
• Two languages, diverse case studies
• Different Data analysis to find categories
  sub-categories
• Semi structured interviews matrices (Miles
  Huberman, 1994)
• Less structured interviews coding system (Polit
  Hunger,1995)

• Readg 2

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Case study The research design

• Case and context a clear definition of the case
  (unit of analysisthe case itself). Case within
  the case (teacher pupil in order to build the
  schools picture). Sources of data collection
  (sub-unit) subjects or variables to be
  measured.
• External validity not just case study
  approaches, is seldom an entirely new
  understanding of phenomena, but rather a
  refinement of understanding. by counter
  example each case study invites modification of
  the generalization.
• Pattern matching whereby several pieces of
  information from the same case may be related to
  some theoretical proposition' (Yin 1994) the
  results of the entire case are compared both with
  other cases and with the proposed theory. Literal
  replication occurs where there are predicted
  similar results.
• Triangulation documentation, archival records,
  direct observation, participant observation,
  interviews and physical artifacts.
• Relationship to theory The role of theory
  development, prior to the conduct of data
  collection, is one point of difference, to Yin
  (1994), between case studies and related methods,
  such as ethnography and grounded theory,
  although, like these, the case study may also be
  used for theory-building.

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Focus group Research design

• Define the research Objective get quality data
  using focus groups.
• Participants Nurses, patients, Group leaders.
• How to recruit participants ? interviews,Lectures.
  
• The research process. How to operate it ?how to
  save data?( by tapes and semi structured forms).
• Data analysis.
• Summary and Conclusions