Title

2015Qualitative ResearchPoints for Beginners

www.unisa.edu.au/caheWelcome to this presentation on qualitative research points for beginners1What is qualitative research?Qualitative approaches can help answer questions about how or whyHow do clinicians prioritise patients for inpatient rehabilitation services?Why dont patients with chronic low back pain stick to exercise recommendations?Quantitative research, in comparison, uses numerical data to helps answer about whatWhat is our current waiting time compared to previous years?What is the effectiveness of therapy A compared to therapy B?

What is qualitative research?Qualitative approaches can help answer questions about how or whyfor example How do clinicians prioritise patients for inpatient rehabilitation services?Why dont patients with chronic low back pain stick to exercise recommendations?

Quantitative research, in comparison, uses numerical data to helps answer. Usually about whatWhat is our current waiting time compared to previous years?What is the effectiveness of therapy A compared to therapy B?

2Qualitative dataQualitative research uses non-numerical dataThe data are words as spoken language, textOften collectedFrom healthcare consumers, their family carers or clinical staffThrough interviews with individuals or focus groupsFace-to-face or phone, skype Recorded - audio or visual and/or written notesAnalysis is enabled byTranscribing the interview recordingsSoftware is sometimes used to manage the data

Qualitative dataQualitative research uses non-numerical dataThe data are usually in the form of words. Either words as spoken language or in textThis language data is usually collected From healthcare consumers, their family carers or clinical staff who provide the relevant serviceIt can be collected Through interviews with individuals or in focus groupsEither Face-to-face or by phone, or technologies like skype

Conversations are Recorded - audio or visual recordings, and /or as written notesAnalysis of this data is enabled byTranscribing the interview recordings into textSoftware, such as Nvivo, is sometimes used to help manage the data 3Qualitative approaches used in health researchMany different methodological approaches For different purposes or underpinned by different theories or philosophical viewsMay differ in sampling, data collection, and analytical methodsPhenomenology Ethnography Grounded theoryDiscourse analysisFeminist researchAction research Descriptive qualitative.and more

Qualitative approaches used in health researchThere are Many different methodological approaches used for different purposes or underpinned by different theories or philosophical views.They may differ, to some extent, in their sampling, data collection, and analytical methodsThis presentation will not go into any detail here but a basic understanding of different approaches can help to understand where a research group is coming from - (the philosophical underpinnings of their work)Commonly encountered are: Phenomenology Ethnography Grounded theoryDiscourse analysisFeminist researchAction research Descriptive qualitative.and there are many more

4Qualitative analysisVarious analytical methods according to the approachText data are coded and sorted into categoriesThis analysis can be managed using software, or using low-tech strategies such as colour coding

Basically divide into:Inductive analysis (eg. Grounded theory)Deductive analysis (eg. Content analysis)

Qualitative analysisThere are various analytical methods used according to the approach chosenText data are coded and sorted into categories or groups of similar meaningThis analysis can be managed with the help of software, or using low-tech strategies such as colour coding on hard copiesAnalytical methods are basically divide into:

Inductive or deductive analysis

Inductive analysis (such as used in grounded theory) derives the codes and findings directly from the collected data. Researchers start analysis without a predetermined idea about which codes they will use in the process, or what themes they will look for.In Deductive analysis (such as content analysis), researchers start analysis with codes already in mind, based on previous research, a theoretical framework, or their own experience.

5Can qualitative research be trusted?Quality varies - we need to determine credibility, trustworthiness, applicability

Good qualitative research willTake steps to minimise the bias researchers views & experiences may bring to the findingsMake these steps explicit in the publication of their work

The COREQ checklist is helpful (Tong et al 2007)For determining quality of reporting & from that you can make decisions about acceptability of the workChecklist for planning and reporting a new qualitative study

Can qualitative research be trusted to inform a health care question?

The quality of this type of research varies, just as quantitative studies vary in quality We need to determine credibility and trustworthiness of a study, and whether the findings can be applied to our context, to understand whether it is useful to our needs

Qualitative studies will always carry some level of bias, but if the study is well reported we can see where bias may lieGood qualitative research willTake steps to minimise the bias researchers views & experiences may bring to the findingsMake these steps explicit in the publication of their work

The COREQ checklist is helpful for determining the quality of reporting within a publication, and from that you can make decisions about the acceptability of the work.COREQ can also act as a good checklist when planning and reporting your own new qualitative studies

6COREQ checklist

The CoreQ checklist considers 32 points under 3 different domains7(CORQ):1. Research team & reflexivityPersonal characteristics of the researchersWho conducted the interviews? Their credentials, occupation, gender, experience & training?These can all impact on the quality and type of data collectedRelationship of researchers with participantsInterviewer characteristics interests in the topic

The first domain to consider is the research team & reflexivityConsider the Personal characteristics of the researchers Who conducted the interviews? Is this reported? And what are their credentials?Things such as the interviewers occupation, gender, relevant experience & interview training may have an impact on the quality and type of interview data they collectFor example consider how interviews seeking the experiences of women who have been abused, may differ depending on these interviewer characteristics.

Consider the Relationship of researchers with participants. Was there a relationship prior to the interview such as a therapist interviewing their own clients? How might that influence the interview?

Interviewer characteristics in the publication, researchers should declare their potential bias, any assumptions they have and at least state their interests in the topic

8(CORQ):2. Study designTheoretical frameworkParticipant selectionSampling how were participants selectedMethod of approachSample size Non-participationSettingSetting of data collectionPresence of non-participantsDescription of sample

The 2nd domain considered in COREQ is Study designDoes the paper declare the Theoretical framework, methodological orientation and/or theory that underpins their work?Participant selectionSampling how were participants selected? It is important to know how this occurred, whether it was appropriate for the research question and whether it may have raised unnecessary biases. There are many sampling methods including random sampling, consecutive, purposive, convenience, snowball all have advantages and disadvantagesFor example sampling only patients with successful outcomes from a new surgical procedure, will not give a balanced consumer perspective of the procedure.How were participants approached? could there have been pressure to participate? Sample size how many participants were in the study? Although sample size calculations are not used in qualitative studies, the number of participants may be relevant depending on the research question to be answeredNon-participation there should be a report of how many invited participants refused, and how many dropped out of the study, and why. Rigorous attempts to recruit, and transparent reporting of non-participation help to reduce the risk of making unsupported claims in the findings. SettingThe Setting or context of data collection may be relevant. Were interviews conducted in the home, clinic, inpatient setting? This is relevant because patients may be inhibited in what they will disclose if interviewed in certain settings such as hospital. The Presence of non-participants during interviews may be relevant. A description of participants should be reported so that readers can determine whether the data may apply to their own context. For example basic demographic data such as gender, age, and relevant information health status, functional ability, or clinical interventions

9(CORQ):2. Study design contData collectionInterview guidesRepeat interviewsAudio/visual recordingField notesDurationData saturationTranscripts returned

Data collectionThe guides or prompts used during interviews should be provided by the authors so the reader can see how data were elicited. Ideally they would report piloting the interview Qs first. were repeat interviews conducted? Did the researcher use Audio or visual recording? Generally recording and transcription is more accurate than just note taking. If recording was not undertaken, did they explain why?Were Field notes made during the interviews? These can add additional data on context and non-verbal information.The Duration of interviews should be reported as it affects the amount of data collectedWas Data saturation discussed? Researchers should declare whether data was collected until no new relevant findings were obtained from new participants, to indicate the comprehensiveness of the processWere Transcripts returned to participants for comment or correction?

10 (CORQ):3. Analysis & findingsData analysisNumber of data codersDescription of the coding tree Derivation of themes (inductive or deductive)SoftwareParticipant checkingReportingQuotations presentedData & findings consistentClarity of major & minor themes

The 3rd domain in COREQ is Analysis & findings Data analysisThe Number of data coders (or analysts) should be declared. Multiple coders working independently then reaching consensus on their analysis adds rigor to the process. Providing a Description of the coding tree (or information about the process steps of developing themes from coded data) is important to establish the credibility of the findingsThe Derivation of themes should be explained were they inductively or deductively derivedWas Software usedParticipant checking, where participants are asked to review and comment on the research findings, is a way of validating the findings. ReportingIf Quotations from different participants are presented it adds transparency and trustworthiness to the findingsThere should be clear consistency between the Data & and the research findings Including the major & minor themes11References Murray C, Stanley M (Eds). (2015) Qualitative Research Methodologies for Occupational Science and Therapy. New York: Routledge

Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32 item checklist for interviews and focus groups. Int J Quality in Health Care. 2007; 19(6) 349-357

Hoffmann T, Bennett S, der Mar C. (2010) Evidence-based practice across the health professions. Elsevier Australia

Finlay L & Ballinger C (Eds). (2006). Qualitative research for allied health professionals: challenging choices. John Wiley & Sons.12

Thank you for accessing this Podcast on qualitative research Points for beginners, we hope you have found it helpful. Please visit the iCAHE online learning and research hubs for other freely available education and resources12