Qualitative Research

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Qualitative Research

• Katrina M Turner
• Research Fellow
• Primary Health Care
• University of Bristol

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Presentation

• Types of study questions
• Methods used
• Use in primary care
• Sampling
• Data collection
• Data analysis
• Summary

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Qualitative research

• Why, what and how questions
• Why do patients seek alternative and
  complementary therapies?
• What do patients think of the NHS?
• How do individuals feel when they are diagnosed
  with a chronic condition?
• Open not closed questions
• Gather data that will give an in-depth
  understanding of peoples views, beliefs, actions
  etc.

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Methods of Data Collection

• One-to-one interviews (in-depth interviews)
• Focus groups (discussion groups or group
  interviews)
• Observations
• Settings, events, interactions
• Analysis of documentary sources
• Pre-existing, e.g. medical notes
• Generated for the research, e.g. diaries, stories
• Today interviews and focus groups

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One-to-one interviews

• Researcher and interviewee
• Semi-structured
• Interview guide used
• List of prompts or questions
• Ensures key topic areas are covered
• Increases comparability across the data
• Flexible to allow participants to raise issues

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One to one interviews 2

• One to one nature allows the researcher to
• Focus on the individual
• Gain a detailed insight into his/her
• Attitudes, beliefs and values
• Perception and understanding of a particular
  situation, event or topic
• Explore the rationale behind views expressed
• Appreciate the meanings s/he attaches to specific
  events etc

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Receiving aromatherapy

• It picks you up and makes you feel human again,
  that you can do things. Its like a medication,
  as if you had taken a bottle which gave you
  strength. Whether it is the oils, the contact,
  or the personality of the therapists, I dont
  know.
• When you have been through chemotherapy, you
  become obsessed with the disease and it affects
  your whole outlook. Its great to have something
  totally away from medication and thats
  invigorating in itself.

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One-to-one interviews 3

• Data collected - product of the context and
  interaction
• Interviewing relatively small numbers of
  purposefully sampled individuals
• Limited generalisability
• Detail
• Data collection and analysis process
• Characteristics of the participants
• Make theoretical rather than empirical
  generalisations
• Same for focus groups

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Focus groups

• Group discussions organised to explore a specific
  set of issues
• Researcher, note taker and 4-8 participants
• Interaction between group members not primarily
  between researcher and participants
• Participants can act as co-researchers
• Groups can be sites of collective remembering
  (pre-existing group)

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Participants as co-researchers

• I couldnt have an abortion. (Kate)
• Why? (Hannah)
• I just, well, in English we done like a
  discussion essay on it some of the things you
  find out, its totally barbaric, its horrible.
  (Kate)
• Aye but thats just one side of the story.
  (Hannah)
• Aye that is just one side of the story but its a
  side which totally put me off it. (Kate)
• Aye but when you get an abortion the baby is no
  even a baby yet. (Hannah)
• Some of them are. Some of them like can feel pain
  and that. (Kate)

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Collective remembering

• What a friend of yours got pregnant?
  (Interviewer)
• Aye. (group)
• She is in the year above us. (Diana)
• And there is that wee lassie in the year below
  us. (Pat)
• Aye and she has just had a wee boy. (Ali)
• And has she left school then? (KT)
• Aye. (group)
• But that Karen came back to school. (Diana)
• Aye but her parents supported her. (Sandra)

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Focus groups 2

• Encourage participation from those reluctant to
  be interviewed
• Collect data from a number of individuals
• Time efficient
• Assess the range of views held
• Tap into social/group norms
• When a practical outcome is desired
• e.g. Agreement about content of a questionnaire

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Focus groups 3

• Less rapport built with individuals
• Public than personal accounts
• Might not be appropriate for sensitive subjects
• Depth may be traded for breadth
• Keeping some control over the discussion is more
  challenging

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Qualitative Methods in Primary Care

• Stand alone
• Before quantitative
• After quantitative
• Alongside quantitative

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Stand alone

• Families and CAM study
• Focus groups
• Use within a family context
• Compare in situ the views of different family
  members
• Interviews
• Individual experiences and views

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Before or after

• Conduct interviews to inform development of an
  intervention or questionnaire
• TREAD
• Survey then hold focus groups to illuminate
  reasons for the findings
• GPs willingness to manage obesity

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Alongside

• Qualitative studies nested within RCTs, e.g.
• Early ACTID
• Initial interviews to assess participants views
  of recruitment, randomisation, implementation and
  content of the trial
• Findings used to
• Improve recruitment and the intervention
• Inform decisions about outcome measures

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Alongside continue

• Later interviews to
• Assess how and to what extent participants are
  using the information
• Identify factors facilitating and hindering this
  process
• Findings will
• Illuminate possible explanations for the
  quantitative findings
• Detail processes, e.g. how individuals are making
  lifestyle changes
• Provide new insights, e.g. newly diagnosed
  patients experiences of self management

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Alongside focusing on the same issue

• Survey and interview patients about GP treatment
• Increases the confidence with which conclusions
  can be drawn
• Each data set provides something different
• Quantitative frequencies, percentages
  associations, strength of relationships
• Qualitative detailed descriptions of views
  held, rationale behind the views expressed

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Sampling interviews and groups

• The sample
• Who do you need to talk to?
• Plan recruitment strategy
• How are you going to approach people?
• Purposive sampling usually used
• Information rich participants, people with
  experience of the topic in question

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Data collection interviews and groups

• Number of interviews/groups
• No set rules
• Reach saturation
• What can be done?
• Location
• Comfortable, private, accessible, quiet
• Audio tape the interview/group
• Have the tape transcribed verbatim

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Data analysis interviews and groups

• Data collection and analysis interwoven
• Reading and re-reading of transcripts
• Asking questions and noting emerging themes
• Thematic or biographical approach
• Content analysis, focus on language used
• Software package to aid analysis, e.g. ATLAS.ti
• Focus groups
• Analysis at the level of the group, not the
  individual

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Summary

• Qualitative methods why, what, how questions
• Gather in-depth, detailed data
• Can be use independently, before, after or
  alongside quantitative approaches
• At each stage, think of your research question
• Guide your sampling, data collection and analysis
• Ensure you can address the aims of the research

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Contact Details

• Dr Katrina Turner
• Academic Unit of Primary Health Care
• University of Bristol
• Cotham House
• Cotham Hill
• Bristol
• BS6 6JL
• Email katrina.turner_at_bristol.ac.uk