School of Nursing, Queensland University of Technology Content prepared by Carol Windsor Contents Page Recommended reading and supplementary references 5 Module 1: Introduction to qualitative research 7 Module 2: Qualitative research in context 9 Module 3: Sociological research approaches 17 Module 4: Critical research approaches 1 25 Module 5: Critical research approaches 2 31 Module 6: Philosophical research approaches 35 Module 7: Research Methods: the research question to sampling 39 Module 8: Research Methods: data collection 47 Module 9: Research Methods: data analysis to rigour 51 Module 10: The qualitative research proposal 57 Conclusion: 63 * * * * * Recommended reading and supplementary references The activities in the Study Modules are based on suggested readings for this unit. Use these references as a starting point only in your study. As each module is studied your understanding of the qualitative research approach will develop and ensure that you are prepared for your assignment work. The following texts will introduce you to practical and theoretical issues related to qualitative research. A good overview of qualitative research in the health sciences is provided in any of the editions of the following text. Liamputtong, P. (2013). Qualitative research methods. Oxford University Press: Melbourne. Further books that provide overviews of areas of qualitative research Alvesson, M. and Sköldberg, K. (2009). Reflexive methodology: New vistas for qualitative research. Los Angeles: Sage. Charmaz, K. (2014). Constructing grounded theory.: London:Sage. Flick, U. (2002). An Introduction to Qualitative Research. London: Sage. Glaser, B. & Strauss, A. (1967). The discovery of grounded theory: strategies for qualitative research. New York: Aldine De Gruyter. Grbich, C. ( 2009). Qualitative data analysis. London: Sage Hesse-Biber, S.N. & Leavy, P. (2006). The practice of qualitative research. California: Sage. Jones, S.R., Torres, V. & Arminio, J. (2006). Negotiating the complexities of qualitatiuve research in higher education. New York: Routledge. May, T. (2002). Qualitative research in action. London: Sage. Rose, G. (2002). Visual methodologies. London: Sage. Silverman, D.(2000). Doing Qualitative Research: A Practical Handbook. London: Sage. Silverman, D. (2006). Interpreting qualitative data. London: Sage. Silverman, D. (2007). A very short, fairly interesting and reasonably cheap book about qualitative research. London: Sage. There are also many qualitative research books and articles available that focus on data generation strategies (interviews, observation, document analysis) and data analysis. There should be little difficulty in locating a resource in the library at Kelvin Grove Campus. The Health Liaison Librarian is Sarah Howard; [email protected] Module 1: Introduction to qualitative research Topics • Introduction • What is qualitative research? • Concepts and terminology in qualitative research • Qualitative research methodologies and application • Qualitative research approaches and evidence-based practice. Objectives When you have completed this module, you should be able to: 1. Identify and understand a range of definitions and concepts in qualitative research. 2. Briefly discuss the purpose of the main research methodologies. 3. Understand the assumptions that underscore qualitative research. 4. Critically reflect on the assumptions about ‘evidence-based care’. 5. Demonstrate improved critical inquiry skills. Introduction In this module, definitions, concepts and terminology associated with qualitative inquiry are introduced. An overview of qualitative research methodologies is presented and examples given of their applicability to the social world of health and illness. The broad aims of qualitative research are also explored and finally, comment on evidence-based care in the context of qualitative research is made. It should be noted that there is a plethora of qualitative research methodologies and methods and, as these derive from a range of disciplinary areas, the terminology employed may not always be clear. However, an understanding of the main approaches will enable you to appreciate variations in terminology. The social sciences and philosophy are the disciplines central to the development of qualitative research. The disciplines and their respective research methodologies are: • Sociology, which underpins the interpretive approaches of ethnography, symbolic interactionism, grounded theory and focus groups. • Social and political sciences, which underpin the critical approaches of action research, discourse analysis, feminist research, postmodernism and post-structuralism. • Philosophical traditions out of which have developed phenomenology and hermeneutics. What is qualitative research? Qualitative approaches seek to explore, discover, describe and explain those qualities or features about the social world that cannot be clearly defined, measured or quantified. These features include values, beliefs, the meaning of language and the perceptions that people hold about their experiences. They also refer to the processes whereby our social worlds are constructed. In the case of health care disciplines, the qualitative researcher is concerned with investigating these non-quantifiable elements in the micro and macro-social worlds of health and illness. Qualitative research is a multidisciplinary area of knowledge. The disciplines of sociology, anthropology, history, the critical social sciences and philosophy have all made and continue to make substantial contributions. While these disciplines remain active in investigating the social world, newer disciplines have begun to engage in the research approach. This breadth of knowledge has given rise to many concepts, nomenclature and methods. In your reading you will encounter numerous labels for qualitative research and these may give rise to some confusion. Other terms are: naturalistic inquiry, postpositivism, ethnography, phenomenology, hermeneutics or interpretivism, life history and humanism. It is worth remembering, therefore, that the expression ‘qualitative inquiry’ is an umbrella term that refers to the full range of approaches. It is important also to be aware that some qualitative texts use the terms ‘methodology’ and ‘method’ interchangeably. Normally, in qualitative research the term methodology refers to the theoretical framework (philosophical/ sociological assumptions), which informs a study, and method refers to how the study is actually conducted. Definitions Definitions are always useful in introducing a new area of study. In our case they help us understand the dimensions of qualitative research and provide insight into how other researchers perceive its meaning and envisage its application.   Activity 1.1 Definitions 1. Create a list of points that you consider characterise qualitative research. 2. Attempt to formulate your own definition of qualitative research. Do this before turning to those presented below. This task is especially important because what constitutes the theory and practice of qualitative research means different things to different people. 3. Now turn to the definitions below and compare them with your understanding of what qualitative research constitutes. 4. Think about the points argued below and consider what they might mean for the practice of qualitative research. Sources Liamputtong (2013, p. ix) argues that qualitative research: Is research that has its focus on the social world instead of the world of nature. Hesse-Biber, S.N. & Leavy, P. (2006, p. ix) wrote: Qualitative research is a complex process that intimately links epistemology, theory, and method. And Alvesson and Sköldberg (2009, pp.2-8) suggest that: The great array of books on ‘qualitative method’ does not differ decisively from the quantitative literature on this score…(and)…it is not the methods but ontology and epistemology which are determinants of good social science. The points made by Hesse-Biber and Leavy and Alvessön and Skoldberg point to the critical place of theory in qualitative research and the importance of understanding the range of possible perspectives that one might bring to research. A variety of disciplines and knowledge areas make up the body of ‘qualitative’ research approaches and bring a range of ideas, theories and research methods to interpretations of the social world. Concepts and terminology in qualitative research Activity 1.2 1. You will need to familiarise yourself with some of the key concepts and terms associated with qualitative research. The next module will assist you in this learning activity. 2. We suggest you create a glossary of terms and consider obtaining a dictionary that deals with this subject area. Meanwhile, find out the meaning of any unclear terms seen so far. Below are some dominant concepts that you will need to be able to recognise and understand: Positivism (a term that relates to quantitative inquiry)—a branch of philosophy concerned with the verification of phenomena through reliance only on our senses (and not theory)—that is, scientific verification. Psychologism—a term introduced in the 19th century reflecting a belief that the mind, consciousness and psychology are amenable to laws. Epistemology—a branch of philosophy concerned with the study of the nature of knowledge. Inductive—a term commonly used in qualitative research to mean working from the data, in a specific instance, to reach a more generalised conclusion. Deductive—a term which refers to reaching a conclusion from known, supposed, or pre-determined principles or theories. Verstehen— a German verb that means ‘to understand’ the non-quantifiable aspects of social behaviour. Hermeneutics— means ‘to interpret’ the significance of human interaction as text and to consider the narrative in terms of an ongoing dialogue between the parts and the whole. Ontology—a branch of philosophy concerned with the study of Being. Dasein—a German word for ‘being there’ that is to say that human beings are immersed in the every day realities of living. Lebenswelt—a German word for the ‘life world’ or ‘everyday lived world’. Qualitative research methodologies and application The examples below illustrate how qualitative research approaches grounded in sociology, critical studies and philosophy, may be applied to a health/illness issue.   The interpretive research approach The emphasis in interpretive studies is on making sense of social processes at the micro-social level. These approaches seek to show how people use language, gestures, symbols and interactions to construct meanings and their social worlds. An outcome of an interpretive approach might be to understand the meanings that people have for health/illness and how these meanings come to be constructed within particular social contexts. Application Interpretive research on health or illness issues focuses on the social setting and begins with the question—what is going on here? The purpose may be to identify the actions and strategies that actors/humans employ to cope with an illness. The outcome may be the generation of a theory (or theoretical proposition) that could be more generally applicable. The critical research approach Critical inquiry is explicitly political. This is because a key objective is to argue (with supporting evidence) changes required to improve the health and wellbeing of society at both the micro and macro levels. Critical research does so by exposing and challenging existing social constraints. The research areas which fall within this category, such as critical social science, action research, feminist research and discourse analysis, are about exposing power relations, bringing about change and alleviating oppression. This approach, very broadly, has the objective of challenging conventional views and practices that produce and sustain inequalities and injustices. Application A critical approach to issues of health and illness might be contextualised in terms of feminist theory. An emphasis could be on how and why society has constructed the experiences of women as illnesses (for example, childbirth, menopause, etc.). The purpose of the research might be to reveal and explain those influences that are exploitative and impact upon women’s lives. The philosophical research approach Philosophically based studies are also generally termed interpretive. They do not have as their main purpose the bringing about of broadly based social change. For example, the philosophical based approach of phenomenology seeks to explore the fundamental or essential meanings of the health/illness experience. Thus here the researcher’s objective is to gather and analyse data in order to reveal commonly shared meanings held by the participants. Application In adopting a phenomenological approach to the investigation of the experience of illness the researcher considers the participants as self-interpreting. As such the researcher collects experiential narratives from participants in order to identify shared (or essential) features of the experience. Further to this, the qualitative researcher is the research instrument and conducts the project on the basis of an unstructured interview format. A typical question that would drive a phenomenological study is—what is it like for you being ill? Suggested reading Tracey, S. J. (2010). Qualitative quality: Eight “big-tent” criteria for excellent qualitative research. Qualitative Inquiry, 16(10), 837-851. Silverman, D. (2013). What counts as qualitative research? QSR, 9 (2), 48-55. Activity 1.3 1. What are the key characteristics of the different knowledge traditions that fall within the areas of qualitative inquiry? 2. What constitutes good qualitative research? 3. Explore Silverman’s critique of the “Interview Society”. Qualitative research approaches and evidence-based practice (EBP) A final introductory comment is necessary here about the current emphasis on EBP in the workplace. EBP practice is relevant to all health care fields and as an idea will mostly likely extend to other workplace facilities beyond health. Throughout your reading in this Unit you are encouraged to reflect on how the various qualitative approaches may or may not fit with the concept of evidence-based practice. As knowledge and new ways of practice must always be contested, in order to promote commitment to life long learning you are asked to give consideration to issues raised in the literature about EBP. Suggested reading Little, M. (2003). “Better than numbers…”: A gentle critique of evidence-based medicine. ANZ Journal of Surgery, 73, 177–182. Rycroft-Malone, J. (2006). The politics of the evidence based practice movements: Legacies and current challenges. Journal of Research in Nursing, 11(2)95-108. Whitely, R., Rousseau, C., Carpenter-Song, E. & Kirmayer, L. (2011). Evidence-based medicine: Opportunities and challenges in a diverse society. Can J of Psychiatry, 56(9), 514-522. Activity 1.4 1. Drawing on Little’s article, consider how EBP is defined. 2. What are some of the tensions that Whitely et al. raise around diversity and the use of EBP? 3. As Rycroft-Malone and Whitely et al point out EBP overtly suggests a hierarchy of research evidence. Where does qualitative research fit and what are the implications of this? References Alvesson, M. & Sköldberg, K. (2009). Reflexive methodology. Los Angeles: Sage. Hammersley, M. (1990). The dilemma of qualitative method. London: Routledge. Hesse-Biber, S.N. & Leavy, P. (2006). The practice of qualitative research. California: Sage. Liamputtong, P. (2009). Qualitative research methods. Melbourne: Oxford University Press. Little, M. (2003). ‘Better than numbers…’ A gentle critique of evidence-based medicine. ANZ Journal of Surgery, 73, 177–182. Rice, P. L., & Ezzy, D. (1999). Qualitative research methods: A health focus. Melbourne: Oxford University Press. Rycroft-Malone, J. (2006). The politics of the evidence based practice movements: Legacies and current challenges. Journal of Research in Nursing, 11(2)95-108. Silverman, D. (2013). What counts as qualitative research? QSR, 9 (2), 48-55. Tracey, S. J. (2010). Qualitative quality: Eight “big-tent” criteria for excellent qualitative research. Qualitative Inquiry, 16(10), 837-851. Whitely, R., Rousseau, C., Carpenter-Song, E. & Kirmayer, L. (2011). Evidence-based medicine: Opportunities and challenges in a diverse society. Can J of Psychiatry, 56(9), 514-522. Module 2: Qualitative research in context Topics • Introduction • Historical context: quantitative and qualitative research:  The contribution of the positivists  The contribution of the idealists • Historical focus on the main ideas in qualitative research. Objectives When you have completed this module, you should be able to: 1. Account for the presence of quantitative and qualitative dualism in the literature. 2. Assess the relationship between the historical development of the ideas in qualitative research and the introduction of data generation strategies. 3. Demonstrate an understanding of the assumptions underlying qualitative research. Introduction It is important to appreciate research as an ongoing process conducted within a historical context. The reason is that this greatly enhances our understanding of how and why research alternatives to the scientific model have developed. The existence of so many qualitative research papers and texts is bound up with a challenge to the dominance of quantitative research and, for our purposes, in the health care area. The qualitative view argues that there are phenomena inaccessible to measurement, control and prediction. For instance culture, an essential feature of human phenomena, is not amenable to quantitative methods of analysis. Nor, arguably, is consciousness. Hence this module provides an explanation of why there are two major research ‘paradigms’—the quantitative (otherwise known as positivism or empiricism) and the qualitative. In addition, the module demonstrates the significant link between the historical development of the concepts in qualitative research and the evolution of data generation strategies. Historical context: quantitative and qualitative research It is important to have some knowledge of the background to the two broad research approaches because it informs our understanding of today’s theory and practice issues in qualitative health care research. The historical approach, therefore: • reveals the origins of ideas that inform health care research practices today • clarifies the concepts and practices which have been introduced, adopted and adapted by the many social science disciplines in search of the best systematic method to study society • demonstrates the relationship between the quantitative and qualitative research Background knowledge provides an invaluable context for further reading, discussion, and assignment and research proposal preparation. Qualitative research arose from debates that took place between two major European schools of philosophical thought—the rationalists (also known as positivists or realists) and the idealists. Central to the debate is the issue of whether the scientific (or quantitative) method is appropriate for the study of the social world. The rationalists argued that it was and the idealists that it was not. The idealist argument is that social phenomena cannot be readily measured or quantified. Below are the important ideas of the main contributors to the development of the respective research approaches. Those of the positivist school of thought are presented first because it was generally in response to their arguments that qualitative schools of thought emerged. 1. The contribution of the positivists The French and English philosophers, Descartes, Bacon, Hume, Saint Simon, Auguste Comte and Emile Durkheim are recognised for theoretically informing the practices of empirical science or quantitative research. Note that the great advances in scientific development from the 17th century on were an important influence on the development of positivist thought. Rene Descartes (1596–1650) Descartes argued a split between the mind and the body and therefore between the mind and the world. This implies an objective world independent of the mind. In other words, it suggests an objective world that can be scientifically or empirically studied, free from any influence of the mind (or subject). This idea is fundamental to scientific inquiry. Francis Bacon (1561–1626) Bacon argued that science was the most important source of knowledge and he was an early advocate of ‘the scientific method’—a series of steps designed to verify observations of objects. Bacon emphasised empirical observation and experiment to provide data from which general laws could be derived in order to explain natural phenomena. Bacon’s conception of method was scientific but also inductive. Hume (1711–1776) This English philosopher extended the thinking of Descartes and Bacon. He proposed that all knowledge about the world could only be gained through the senses. In other words Hume dismissed philosophy, theory and/or any other ideas and beliefs as a valid source of knowledge. The French philosophers, Saint Simon (1760–1825), Auguste Comte (1798–1857) and Emile Durkheim (1858–1917), took account of the works of their predecessors and argued that if universal laws governed the natural world, and if humans were considered as part of that world, then laws which governed human behaviour ought to be discoverable. 2. The contribution of the idealists The counter arguments to the positivist position came initially from German scholars working in the area of philosophy from the 1840s onwards. This was followed by an independent development in American sociology in the late 19th and early 20th centuries. Both movements were important to the development of qualitative research. The chief argument against the empiricists is that they do not take into account the nature of human beings and social interaction. The German philosophers asserted that humans possess consciousness and are capable of reflection, of creating diverse cultures and of self-interpreting the social world. The positivist method, used for analysing the physical world, was therefore not applicable. They and American sociologists argued that other methods had to be found which could show the ways whereby humans interpret and construct their every day social interactions. Historical focus on the main ideas in qualitative research In Module 1 you were introduced to the broad epistemological positions in qualitative research. In relation to knowledge traditions phenomenology has its origins in philosophy; ethnography in anthropology; symbolic interactionism and grounded theory in sociology and action research, post structuralism, postmodernism, discourse analysis and feminist research in the broad areas of the critical social sciences. The essential concepts that inform the research modes and the scholars who espoused them are discussed under the following headings: 1. The 19th century German philosophers and phenomenology 2. The 19th century German philosophers and sociology 3. The 20th century American philosophers and sociology 4. The 20th century European philosophers and critical theory. 1. Philosophy: 19th century German philosophers and phenomenology Husserl (1859–1938) is regarded as the founder of phenomenology. Husserl’s chief concerns related to epistemological issues. He was primarily concerned about the nature of consciousness and how human beings acquire knowledge. Heidegger (1889–1976) was concerned with ontology or how the very existence of ‘being human’ could be revealed. His work came to focus on language as the vehicle whereby questions around the nature of being could be addressed. 2. Sociology: 19th century German philosophers and sociology Kant (1724–1804) introduced the idea that the mind structures experience. Hegel (1770–1831) emphasised the spiritual and cultural diversity of human nature. Marx (1818–1883) argued that observation of the social world was not enough and we need to interpret the social forces and social relationships that underpin change. Marx brought together history and economics to explain social change. Dilthey (1833–1911) considered that the best way of interpreting the social world was through the method of hermeneutics, which in turn, led to verstehen. Verstehen, in rejecting positivism, means understanding the meaning of actions from the actor’s point of view. Weber (1864–1920) similarly argued that understanding the meaning of social actions could be achieved by examining both the objective (causes) and subjective (values) aspects. The 19th century Neokantians pursued Kant’s idea that the mind structures experience. In connecting this to the diversity of values and interpretations that people hold about the world these philosophers concluded that there exist multiple realities. German works contributed much to the development of qualitative research in terms of social theories that are strongly associated with the nature of being human. However, it was the Americans who introduced a method or a systematic process of investigation that could be applied in the field to describe and explain the social world of meanings and actions. The following is a brief introduction to the important influence of the Chicago School of Sociology on the evolution of qualitative research. 3. Sociology: 20th century American philosophy and sociology The Chicago School The Chicago School of Sociology has been influential in the development of two commonly applied qualitative research approaches: symbolic interactionism and grounded theory. Both are concerned with the interpretation of social action and are therefore referred to as interpretive approaches. The Chicago School in the early decades of this century was aware of European debates about what ‘method’ the social scientist could adopt to convey the nature of the everyday lived world and took up the challenge. The sociologists also adopted from the anthropologists the ethnographic methods of investigation. Thus, data generation strategies employed by many qualitative researchers today comprise: • interviews • observation • documents. George Herbert Mead (1863-1931) and Herbert Blumer (1900–1987) are important names associated with the Chicago School. In the mid1930s, as a student of Mead and drawing on Mead’s (largely unpublished) work, Blumer coined the term symbolic interactionism to reflect a view on the ways in which people attach meaning to their social interactions through the use of verbal and nonverbal symbols (language, gestures etc). Blumer also highlighted the significance of exploring and describing the “natural setting” of the participants’ social world. Symbolic interactionism influenced the early works of Glaser and Strauss who developed grounded theory as a research approach and reflected in their 1967 work The Discovery of Grounded Theory. The intention of grounded theory is to explore, identify and analyse social processes. Grounded theory was designed as essentially an inductive research approach. In other words, Glaser and Strauss, in echoing Blumer, proposed a method of research that starts with the data and generates theoretical interpretations of key social processes. In this way social theory is produced from the data. You will see in a later module that grounded theory has evolved in a number of ways. Most notably, the inductive label has been well challenged. Activity 2.1 Answer the following questions: 1. How is ‘interpretive’ research defined? What are some key features that interpretive research approaches share? 2. There are a number of interpretive research approaches. Identify some issues of difference between them. 3. Give some examples of the application of different interpretive approaches. Look, for example, at how research questions might differ depending on the approach. 4. Philosophy: 20th century European philosophers and critical social theory The basis for critical research is the understanding that the social world is characterised by inequality and exploitation. Consequently, the purpose is to reveal circumstances that produce and sustain inequalities and argue for change. There are many notable names associated with the development of critical thought including Hegel, Marx, Weber, Freire, Foucault, and feminists such as Dorothy Smith, Harding and Irigaray. These names represent only a small portion of critical works produced over the last century and a half and there are vast differences between their approaches. The point here is that there is no one critical body of work that informs research. Nonetheless, an important influence in critical inquiry into health and social issues has been the work emanating from The Frankfurt School. In the early part of this century there was much concern about the rising influence of science and technology at the expense of social justice and the alienation of the human being. This dominance is often referred to as scientism—the belief that science can redress all the ills of society. Concerned with the ever-growing influence of positivism, a group of social philosophers established the Institute of Social Research in 1923 as an affiliate body of the University of Frankfurt and thus—The Frankfurt School. There are many names associated with this development, but the better-known names are Max Horkheimer (1895–1971), Theodor Adorno (1903–1969) and Herbert Marcuse (1898–1973). These philosophers were concerned with critiquing mass culture and human existence in industrial society for the purposes of raising social consciousness. After World War II, a second generation of Frankfurt critical theorists appeared. The early work of Jurgen Habermas, a central figure, was concerned with the ways in which knowledge is constituted by certain interests. Habermas argued for example, that scientific knowledge was concerned with prediction and manipulation, interpretive knowledge with everyday practices and critical knowledge with emancipation. Habermas argued for the use of communication or knowledge, without the constraints of particular interests, to reach a rational decision on an issue. The point of reaching a rational decision was termed ‘ideal speech’. The focus on ‘communicative action’ or consensus decision making has contributed (along with other theories) to action research. The outcome of debates over appropriate methods to inquire into and analyse social and cultural issues is generally represented as two research paradigms. Frequently these are portrayed in the literature in terms of their respective epistemological positions: Quantitative Qualitative Objective knowledge about the socio-cultural world is attainable. An emphasis on interpreting and explaining the nature of the socially constructed world. Reality is unitary. Multiple realities – reality is interpreted. Data is gathered using objective and pre-tested instruments. Data generation is focused on the meanings that humans attach to their social worlds, or social processes that are not readily observed. Generates laws/independent of context. Meaning is dependent on context. Prediction and explanation is based on numbers. Emphasis is on understanding the social world based on language and action. As a result of its interdisciplinary nature there is a range of ideas that now characterise qualitative research and these will be presented either implicitly or explicitly in your reading. The assumptions are as follows: • the idea of humans as social actors • the idea that reality is a social construction • the idea that experience holds meaning • the idea that social interaction is based on beliefs and values • the importance of language and gesture in constructing reality • the idea that there is a ‘taken for grantedness’ about everyday life • the idea that change and emancipation are possible • the idea that complex social processes must be observed, described, recorded, interpreted and understood. Activity 2.2 1. How would you describe the difference between the realist and idealist traditions in terms of the purpose of research? 2. How would you summarise the differences between quantitative and qualitative approaches to research? Suggested reading Silverman, D. (2006). Interpreting qualitative data. London: Sage. (First two chapters – for a start) Activity 2.3 1. Make clear the difference between the terms methodology and methods. 2. Identify the points argued by Silverman (or others) that support the ‘sense’ of qualitative research. 3. What does Silverman have to say about combining qualitative and quantitative methods? 4. Why does Silverman put emphasis on ‘thinking theoretically’? Note that any work by David Silverman is worth looking at (in relation to qualitative research) and there is a range of texts and articles. References Blumer, H. (1969). Symbolic interactionism. Englewood Cliffs, NJ: Prentice Hall. Flick, U. (2002). An introduction to qualitative research. Thousand Oaks, CA: Sage. (pp. 1–13). Glaser, B., & Strauss, A. (1967). The discovery of grounded theory: Strategies for qualitative research. New York: Aldine De Gruyter. Hammersley, M. (1992). Deconstructing the qualitative–quantitative divide. What's wrong with ethnography? London: Routledge. Silverman, D. (2006). Interpreting qualitative data. London: Sage. (pp33-61) Module 3: Sociological research approaches Topics • Introduction • Ethnography • Symbolic interactionism • Grounded theory • Focus group interviews Objectives When you have completed this module, you should be able to: 1. Discuss the main sociological research approaches. 2. Understand the types of research questions that are driven by these approaches. 3. Assess the value of a sociological research approach for your area of practical interest. 4. Demonstrate improved critical inquiry skills. Introduction This module introduces you to the more frequently used qualitatively based sociological research approaches in the health field—ethnography, symbolic interactionism, grounded theory and focus groups. Some discussion of each approach is provided and the Readings are accompanied by learning activities so you may explore further what these types of approaches have to offer. A first reading provides a concise overview of the role of social theory in qualitative health research. Suggested readings Willis, K. et al. (2007). The essential role of social theory in qualitative public health research. Australian and New Zealand Journal of Public Health, 31 (5), 438-443. Ethnography Ethnography has its origins in anthropology. Early ethnographers typically studied small-scale non-Western cultures for the purpose of understanding ways of life that Western society knew little about. Recognition of the eurocentric bias of this type of study (and all that implies) has seen ethnography increasingly applied to the study of Western societies and groups within those societies. Traditionally, ethnography has been defined as the work of faithfully describing a culture. Because many have challenged the claimed ‘authenticity’ of ethnographic works, contemporary ethnographers place much greater emphasis on interpretation than description. The argument here is that all researchers bring assumptions to their research. For example, ethnographers from different disciplines may emphasise different aspects of a culture under study. In other words different ethnographers will apply different theoretical approaches in depicting a culture. The following article takes an interactionist approach to ethnographic data analysis: Wästefors, D. (2012). Analyzing social ties in total institutions. QSR, 8(2), 12-27. Other suggested readings Koro-Ljungberg, M. & Greckhamer, T. (2005). Strategic turns labelled ‘ethnography’: from description to openly ideological production of cultures. Qualitative Research, 5 (3), 285-306. Nader, L. (2011). Ethnography as theory. HAU: Journal of Ethnographic Theory, 1(1), 211-219. Rosenthal, A. (2007). Battling for survival, battling for moral clarity: “Illegality” and “illness” in the everyday struggles of undocumented HIV + women migrant workers in Tel Aviv. International Migration, 45(3), 134-156. From the above readings (and elsewhere) consider the differences in objectives between a description of culture and an overtly theoretically informed study of culture. The assignment question on ethnography is asking you to explore this issue in further depth. Data gathering Ethnographers employ a range of research methods from observation and interview to the use of historical documents. Much data is gathered in the course of fieldwork and involves the researcher spending a lot of time in the study setting getting to know people, places and activities extremely well. While the ethnographic interview has purpose and direction, it is informal and friendly. In other words the interview is unstructured. This allows the ethnographer to explore complex subject matter in a way that structured interviews or surveys do not allow. The number of informants in this type of study is important to the extent that the informants can provide the necessary depth and breadth of information. This differs from quantitative research where the sample size, to be considered valid, needs to be statistically representative. The sampling in ethnography is generally referred to as purposive sampling. Participant observation is another method of data generation whereby the researcher participates at some level, and carries out and records observations, in the study setting. Ethnographers use field notes to document what is observed in the research setting. Field notes contain both descriptions and the researcher’s interpretations of what is observed and experienced. Some questions that might be posed in the ethnographic process are as follows: • What is happening here? • What is important in the lives of the people here? • How would they describe their lives? • What is the language they would use to do it? • What are the meanings of the non-verbal cues/gestures? Suggested reading Messac, L., Ciccarone, D., Draine, J. & Bourgois, P. (2013). The good-enough science-and-politics of anthropological collaboration with evidence-based clinical research: Four ethnographic case studies. Social Science & Medicine, 99, 176-186. Shaffir, W. (1999, December). Doing ethnography. Journal of Contemporary Ethnography, 28(6), 676–687. Activity 3.1 1. What is the purpose of doing ethnography? 2. Explain how sampling is conducted in this type of research and what issues might arise? 3. What are some other concerns about the practicality of doing ethnography? How might such challenges be addressed? 4. Messac et al. (2013, p.183) argue that “Statistically discrete variables by definition confound complex social processes…”. What do the authors mean? 5. Shaffir (1999) discusses the nature and significance of the relationship between participant and researcher in ethnographic studies. What are the issues here? 6. Describe the process of ethnographic data analysis. Provide examples. Symbolic interactionism Symbolic interactionism holds a flexible place in qualitative research because some researchers use it as a distinct research approach similar to ethnography and grounded theory. So it is worthwhile to note that in some studies symbolic interactionism appears in the title as well as in the content. For example: Hollingsworth, L. D. (1999). Symbolic interactionism, African American families, and the transracial adoption controversy. Social Work, 44(5), 443–454. But, in other studies it might appear in the content as follows: De Klerk, H. M. & Ampousah, L. (2003). The physically disabled women’s experience of self. Disability and Rehabilitation, 25(19), 1132–1139. Symbolic interactionism is about understanding the ways in which meanings are constructed. The key idea is that human beings construct their social worlds through interaction with others in particular contexts. The evolution of symbolic interaction dates back to the pragmatists of the late 19th and early 20th centuries. In its early development (1930s) Herbert Mead was an important theoretical figure whose ideas informed symbolic interaction as articulated by Herbert Blumer. Symbolic interactionism has since evolved into a smorgasbord of ideas. Yet the three key premises articulated by Blumer (1969, pp.3-5) as follows continue to have relevance: 1. Human beings act toward objects on the basis of the meaning that these have for them. 2. Meanings are derived from social interaction between and among individuals. This includes verbal and non-verbal language and the effect on human behaviour. 3. Meanings are modified by the person through an interpretive process. In other words, meanings are checked or revised through interaction with others in particular contexts. As noted earlier, symbolic interactionism formed the basis for the development of grounded theory. Suggested readings Conroy, A. (2014). ‘It means there is doubt in the house’: perceptions and experiences of HIV testing in rural Malawi. Culture, Health & Sexuality, 16 (4), 397-411. Zhang, J. (2006). Public diplomacy as symbolic interactions: A case study of Asian tsunami relief campaigns. Public Relations Review, 32, 26-32. Activity 3.2 Questions 1. What is the purpose of a symbolic interactionist (SI) study? 2. What assumptions do the above (or other SI) studies make about the social world? 3. Explain the research strategies used in SI studies using the above and/or other examples. 4. Why do SI researchers apply both inductive and deductive processes? What are the advantages (and disadvantages)? Handberg, C., Thorne, S., Midtgaard, J., Nielsen, C. & Lomberg, K. (2014). Revisiting symbolic interactionism as a theoretical framework beyond the grounded theory tradition. Qualitative Health Research, DOI: 10.1177/10497323145544231 Symbolic interaction is closely associated with grounded theory below. The authors argue here for a disentangling of grounded theory and symbolic interaction. This is interesting given a growing body of criticism of grounded theory as a methodology. Grounded theory Grounded theory, like symbolic interactionism, has its origins in the North American tradition of sociology. Glaser and Strauss developed grounded theory as an inductive research approach. This means that the researcher starts with the data and derives a conceptual framework or ‘theory’ from the data. The researcher, in other words, works from the ground up. This was a challenge to much of the sociological research of the time that applied pre-existing theories to data. Glaser and Strauss were critical of the process of moving from the general (the theory) to the specific (the data). Like Blumer, the authors argued that the application of existing theories limited the potential of research to discover new knowledge. It is important to be aware that grounded theory has evolved in a number of directions. Glaser and Strauss (1967), Strauss and Corbin (1990) and Charmaz (2006, 2014) are the noted theorists in the development of this area but there are significant (and contentious) differences across the works of these authors. There is also a strong body of criticism of grounded theory that must be considered in the application of this approach. The following readings give some insight to such criticism and provide very good background material on grounded theory. Suggested readings Grekkhamer, T. & Koro-ljungberg, M. (2005). The erosion of method: examples from grounded theory. International Journal of Qualitative Studies in Education, 18 (6), 729-750. Seldén, L. (2005). On grounded theory-with some malice. Journal of Documentation, 61 (1), 114-129. Thomas, G. & James, D. (2006). Reinventing grounded theory: some questions about theory, ground and discovery. British Educational Research Journal, 32(6), 767-795. Recent Charmaz articles reflect significant shifts in her grounded theory approach: Charmaz, K. (2014). Grounded theory in global perspective: Reviews by international researchers. Qualitative Inquiry, 20 (9), 1074-1084. Charmaz, K. (2016). The power of constructivist grounded theory for critical inquiry. Qualitative Inquiry, 23(1), 34-45. Data gathering The sources of grounded theory data are similar to those applied across qualitative approaches. Unstructured interviews and field observations as well as documentation of all kinds may be used. Multiple sources of data may strengthen grounded theory research. In most research, data gathering takes place prior to data analysis. In grounded theory, however, data generation and analysis occur simultaneously. This allows the researcher to change direction or focus in data gathering, depending on provisional analysis. This is in keeping with the discovery or inductive focus of grounded theory. Activity 3.3 1. What are the purposes of grounded theory as a social research approach? 2. What is distinctive about grounded theory data generation methods? 3. What do you understand about generating research findings? 4. How do the earlier works of Glaser and Strauss fundamentally differ from the later works of Charmaz? 5. What are some argued limitations of grounded theory research? Focus groups The focus group is a popular research method in the health sciences. But it is important to note that focus groups constitute a method for collecting data and not a methodology. The use of focus groups without a theoretical framework is unsound research. Krueger (1994, p. 16) defined focus groups as a group of people (6–10) brought together because they share certain characteristics in common and the facilitator or researcher conducting the study needs to gain knowledge of qualitatively based viewpoints. Disclosure is encouraged through open-ended questions and the provision of a comfortable environment. Focus groups may be used as a self-contained method for data generation or a method supplementary to other research methods. Focus groups were especially popular in the 1950s and 1960s among marketing and business agencies interested in eliciting consumer opinions about products. More recently, they have come to occupy a place in health studies partly because data can be collected more quickly and less expensively than offered by one-to-one interviews. Yet there are some persuasive theoretical arguments for the use of the focus groups. Smithson refers to the possibilities of the focus group in eliciting public discourse as opposed to the private discourse captured by individual interviews. Suggested readings Lehoux, P., Poland, B. & Daudelin, G. (2006). Focus group research and “the patient’s view”. Social Science & Medicine, 63, 2091-2104. Ivanoff, S. & Hultberg, J. (2006). Understanding the multiple realities of everyday life: Basic assumptions in focus-group methods. Scandinavian Journal of Occupational Therapy, 13, 125-132. Activity 3.4 From your reading what have you found out about: 1. The structure of focus group research? 2. Issues in planning for a focus group study? 3. Issues related to conducting focus groups? 4. Guidelines for analysing focus group data? Suggested reading Smithson, J. (2000). Using and analysing focus groups: limitations and possibilities. International Journal of Social Research Methodology, 3(2), 103-119. Activity 3.5 1. What point is author making about the concept of “natural” discussion? Argue why this argument is (or is not) persuasive. 2. Why do you think the analysis of focus group data could be considered controversial? 3. What issues does the author raise about the position or role of the researcher in focus group research? 4. What strategies would you consider important in presenting findings from focus groups? Use examples of published research. References Armstrong, K. L. (1999). Nike’s communication with black audiences: A sociological analysis of advertising effectiveness via symbolic interactionism. Journal of Sport and Social Issues, 23(3), 266–286. Blumer, H. (1969). Symbolic interactionism. Englewood Cliffs, NJ: Prentice Hall. Charmaz, K. (2006). Constructing grounded theory. London:Sage. Charmaz, K. (2014). Constructing grounded theory.: London:Sage. Charmaz, K. (2014). Grounded theory in global perspective: Reviews by international researchers. Qualitative Inquiry, 20 (9), 1074-1084. Charmaz, K. (2016). The power of constructivist grounded theory for critical inquiry. Qualitative Inquiry, 23(1), 34-45. Conroy, A. (2014). ‘It means there is doubt in the house’: perceptions and experiences of HIV testing in rural Malawi. Culture, Health & Sexuality, 16 (4), 397-411. De Klerk, H. M., & Ampousah, L. (2003). The physically disabled women’s experience of self. Disability and Rehabilitation, 25(19), 1132–1139. Glaser, B., & Strauss, A. (1967). The discovery of grounded theory: Strategies for qualitative research. New York: Aldine De Gruyter. Glaser, B., & Strauss, A. (1987). Theoretical sensitivity: Advances in the methodology of grounded theory. Mill Valley, CA: Sociology Press. Handberg, C., Thorne, S., Midtgaard, J., Nielsen, C. & Lomberg, K. (2014). Revisiting symbolic interactionism as a theoretical framework beyond the grounded theory tradition. Qualitative Health Research, DOI: 10.1177/10497323145544231 Ivanoff, S. & Hultberg, J. (2006). Understanding the multiple realities of everyday life: Basic assumptions in focus-group methods. Scandinavian Journal of Occupational Therapy, 13, 125-132. Koro-Ljungberg, M. & Greckhamer, T. (2005). Strategic turns labelled ‘ethnography’: from description to openly ideological production of cultures. Qualitative Research, 5 (3), 285-306 Lehoux, P., Poland, B. & Daudelin, G. (2006). Focus group research and “the patient’s view”. Social Science & Medicine, 63, 2091-2104. Messac, L., Ciccarone, D., Draine, J. & Bourgois, P. (2013). The good-enough science-and-politics of anthropological collaboration with evidence-based clinical research: Four ethnographic case studies. Social Science & Medicine, 99, 176-186. Murdaugh, C., Russell, R. B., & Sowell, R. (2000). Using focus groups to develop a culturally sensitive videotape intervention for HIV-positive women. Journal of Advanced Nursing, 32(6), 507–1513. Nader, L. (2011). Ethnography as theory. HAU: Journal of Ethnographic Theory, 1(1), 211-219. Reed, J., & Payton, V. (1997). Focus groups: Issues of analysis and interpretation. Journal of Advanced Nursing, 26, 765–771. Seldén, L. (2005). On grounded theory-with some malice. Journal of Documentation, 61 (1), 114-129. Smithson, J. (2000). Using and analysing focus groups: limitations and possibilities. International Journal of Social Research Methodology, 3(2), 103-119. Strauss, A., & Corbin, J. (1990). Basics of qualitative research: Grounded theory procedures and techniques. Newbury Park, CA: Sage. Thomas, G. & James, D. (2006). Reinventing grounded theory: some questions about theory, ground and discovery. British Educational Research Journal, 32(6), 767-795. Wästefors, D. (2012). Analyzing social ties in total institutions. QSR, 8(2), 12-27. Willis, K. et al. (2007). The essential role of social theory in qualitative public health research. Australian and New Zealand Journal of Public Health, 31 (5), 438-443. Zhang, J. (2006). Public diplomacy as symbolic interactions: A case study of Asian tsunami relief campaigns. Public Relations Review, 32, 26-32. Module 4: Critical research approaches 1 Topics • Introduction Section 1 • Poststructuralism/postmodernism Section 2 • Discourse and discourse analysis Objectives When you have completed this module, you should be able to: 1. Identify the characteristics of discourse, discourse analysis, poststructuralism/postmodernism. 2. Summarise the major critical social theory arguments that inform the research approaches. 3. Assess the relationship between the health/illness social problems identified and the research approaches adopted. 4. Further develop critical thinking and inquiry skills. Introduction In this module you are introduced to the research approaches known as poststructuralism/postmodernism and discourse analysis. These approaches fall within the category of critical research because they present challenges to the ways we may currently think about political, social, cultural and practical issues in the health field. Such challenges encourage us to consider the possibilities for change in the way we think about doing things. The first section concentrates on discourse and discourse analysis. The second section gives an introduction focused on post structuralism/postmodernism. First, it is useful to remind ourselves that a fundamental feature of qualitative research is the conceptualisation of the meaning of health or related social issues occurs in words and not numbers. Hence, we need to be aware of the many ways researchers may present the same concepts and their implications for practice. Lupton, for instance, draws attention to the terms ‘discourse’ and ‘discourse analysis’ and notes that they are nebulous terms and may be applied in varying ways. What follows are some definitional comments and opportunities to apply your understanding of them in the learning activities. In this module the learning activities are centred on a series of quotes and questions. Section 1: Poststructuralism/postmodernism Schwandt (1997, p. 120) and others consider postmodernism synonymous with post-structuralism. Both terms refer to a scepticism about and denial of the ideas of certainty, objectivity and, in general, empirical science. The background to these shared beliefs can be traced to a European intellectual movement of the seventeenth and eighteenth centuries referred to as ‘The Enlightenment’. This movement fostered belief in the infallibility of instrumental reason, certainty, grand theory and truth. Postmodernists reject these explanations and argue that ‘facts’ and/or ‘truths’ are constructions and there is, therefore, the possibility of competing or contradictory ‘truths’. Postmodernism/post-structuralism is a developing and far from unified area of knowledge. In the 20th century, French theorists were largely responsible for the fertilisation of this broad area of knowledge. Arguably, the most influential of these theorists in the health care area is Michel Foucault and his work in relation to power and knowledge. For example, Foucault’s work on the treatment of the mentally ill looks at the link between rational discourse (or rational knowledge) and the social practice of incarcerating the mentally ill (or the irrational). The focus of interest then is on how knowledge constitutes practice. Reading 4.1 Wall, S. (2008). A critique of evidence-based practice in nursing: Challenging the assumptions. Social Theory and Health, 6, 37-53. Activity 4.1 1. Read the article by Wall. 2. Undertake the quotes and questions exercise. 3. Consider your views about the appropriateness of the research approaches of poststructuralism/postmodernism in exploring health/illness social issues. Quotes and questions exercise Quote 1 (p. 42) A post-structuralist perspective allows for a rethinking of the influence of the influence of nurses’ individual attributes in evidence-based practice discourse. Question How does Wall explain the de-emphasis of the subject in poststructuralism? Quote 2 (p. 47) Through the analysis of discourses and discursive fields, feminist poststructuralism is able to explain the workings of power on behalf of specific interests that are in opposition to the means and ends of women. Question Explain why language (discourse) is so important to poststructuralism and postructuralist research. Quote 3 (p. 52) Starting with questions raised by a feminist/post-structuralist analysis of evidence-based practice, nurses can begin to circulate their own discourse(s) and open up a discursive space from which to resist dominant ideologies. Question How does Wall explain the entrenchment of a hierarchy of discourses? What keep a hierarchy of discourse in place? Readings 4.2 Cheek, J. (1999). Influencing practice or simply esoteric? Researching health care using postmodern approaches. Qualitative Health Research, 9(3), 383–392. Hayter, M. (2007). Nurses’ discourse in contraceptive prescribing: an analysis using Foucault’s ‘procedures of exclusion’. Journal of Advanced Nursing, 58 (4), 358-367. Activity 4.2 1. Why do those who claim to use a postmodern approach define ‘postmodernism’ so poorly? Why is it important to provide adequate explanations of the understanding of the postmodernist position in use? 2. How does Cheek establish a working definition of a postmodern approach? 3. How might a postmodern theoretical perspective inform a health research topic? Find some examples and summarise. 4. What are some implications of postmodern thought for the role of the professional ‘expert’ in the health care area? Section 2: Discourse and discourse analysis While the concept of discourse is central to poststructuralist thought, discourse analysis does not have to be poststructuralist. Yet regardless of the perspective from which it is applied, discourse analysis always assumes a relationship between power and knowledge/language. Discourse analysis, then, is an approach that looks at language production and how that language is used in a community or social group at any given time, what it is used for and the social context in which it is used. The concern is with ways by which discourses construct realities. For example, the discourse of medicine shapes health care practices in a particular way. Thus, the essential purpose of undertaking a discourse investigation is to uncover the power bases imbedded in language as they appear verbally, non-verbally or in written text. Another factor to keep in mind is that discourse analysis seeks to make explicit that which is not so transparent by exposing the power agenda in talk and text. It is important to remember that researchers can engage in discourse analysis from a range of theoretical perspectives. Feminists, Marxists and poststructuralists will each produce quite different analyses of discourse. Presented below are some extracts from the sources about discourse and discourse analysis that will help elucidate their meanings. Heslop (1997, p. 53) suggests how the method of discourse analysis may be used as an analytic framework to guide research studies: Discourse analysis provides for a critical analysis of language that reveals power/knowledge relations. It is a method of reading and then interpreting the textual data to show how language is used to sustain certain social practices into constellations of duties, rights, power and knowledge. Bishop’s 2001 article, ‘Old dogs, new tricks? An ideological analysis of thematic shifts in television advertising for diet products, 1990–2000’ is an example of the approach (see full reference at the end of this module). Suggested readings Finn, R., Learmonth, M. & Reedy, P. (2010). Some unintended effects of teamwork in healthcare. Social Science & Medicine, 70, 1148-1154. Sha, J. & Kirkman, M. (2009). Shaping pregnancy: Representations of pregnant women in Australian women’s magazine. Australian Feminist Studies, 24 (61), 359-370. Thornborrow, T. and Brown, A. (2009). ‘Being regimented’: Aspiration, discipline and identity work in the British Parachute regiment. Organization Studies, 30, 355-376. Activity 4.3 1. Discuss the assumptions (or world view) that inform/s discourse analysis (DA). 2. Using the above and/or other research examples, describe the methods of discourse analysis. 3. What data analysis strategies are used in this type of research? 4. From your reading can you identify ways in which researchers seek to demonstrate rigour in discourse analysis? Conclusion Reflect on the critical research approaches of discourse, discourse analysis and poststructuralism/postmodernism. What have you learnt about the significance of these research approaches to health/illness investigations? Write down one researchable topic from each approach applicable to your area of practical interest. References Bishop, R. (2001). Old dogs, new tricks? An ideological analysis of thematic shifts in television advertising for diet products, 1990–2000. Journal of Communication Inquiry, 25(4), 334–352. Gannon, K., Glover, L., & Abel, P. (2004). Masculinity, infertility, stigma and media reports. Social Science & Medicine, 59, 1169–1175. Finn, R., Learmonth, M. & Reedy, P. (2010). Some unintended effects of teamwork in healthcare. Social Science & Medicine, 70, 1148-1154. Parton, N. (1994). “Problematics of government” (post) modernity and social work. British Journal of Social Work, 24(1), 9–32. Rudge, T., & Morse, K. (2001). Re-awakenings?: A discourse analysis of the recovery from schizophrenia after medication change. Australian and New Zealand Journal of Mental Health Nursing, 10, 66–76. Sha, J. & Kirkman, M. (2009). Shaping pregnancy: Representations of pregnant women in Australian women’s magazine. Australian Feminist Studies, 24 (61), 359-370. Thornborrow, T. and Brown, A. (2009). ‘Being regimented’: Aspiration, discipline and identity work in the British Parachute regiment. Organization Studies, 30, 355-376. Wall, S. (2008). A critique of evidence-based practice in nursing: Challenging the assumptions. Social Theory and Health, 6, 37-53. Module 5: Critical research approaches 2 Topics • Introduction • What is critical research? • Action research • Feminist research. Objectives When you have completed this module, you should be able to: 1. Identify characteristics of action research and feminist research. 2. Appreciate the major critical arguments that inform the research approaches. 3. Assess the value of these research approaches to the nursing/health field. 4. Further develop critical thinking and inquiry skills. Introduction This module introduces two other critical research approaches—action research and feminist research. These are considered critical because the outcome of such investigations is to produce social interventions to improve the lives of oppressed or marginalised groups. The starting assumption is that inequality is inherent to our society. The aim therefore of this type of research is to expose prejudice, oppressive activity and oligarchic cliques that exercise control in such a manner that the many are left disempowered and denied a voice. What is critical research? Denzin (2017, p. 8) argues that critical qualitative inquiry “addresses inequities in the economy, education, employment, the environment, health, housing, food, and water, inquiry that embraces the global cry for peace and justice (and uses) multiple research strategies.” Denzin (2017) also points out that critical researchers use participatory, constructivist, critical, feminist and cultural approaches (among others) and use a broad range of research strategies from ethnography to case study, grounded theory, historical etc. Action research The American social psychologist Kurt Lewin introduced the process of action research directly after World War II as a strategy for studying group or organisational processes and at the same time attempting to change them. Lewin argued that the most effective way of dealing with conflicts or issues of leadership or process within organisations was to bring researchers and participants together to unify knowledge and expertise. Thus the ideas crucial to Lewin’s work are group decision making (collaboration) and the group’s commitment (cooperation) to the improvement of social conditions. Lewin’s main concern was with democratic decision making and his study focus was group dynamics and group behaviour. Lewin is criticised for his lack of attention to the wider society. For example, decision making at the group level may appear to be democratic but may also be influenced by economic or management interests. Action research has been, and is, used in many contexts but its contemporary adherents agree that it should be participatory and focused on improving the lives of the less powerful in our society. The theory that informs action research varies according to the discipline. But contemporary action researchers are more likely to draw on critical works, such as that of Habermas, rather than psychology. Action research as an emancipatory form of research is linked to the 1960s upsurge of interest in community development programmes in lesser-developed countries. People such as Paolo Freire, who wrote the Pedagogy of the Oppressed (1972), linked knowing (education or research) to action and change. The emphasis here is on empowerment of disadvantaged groups, through knowledge and education, to bring about change. So you can see that the term action research implies a process whereby some form of change is initiated. But it does have quite different applications. In the health care area action research is usually confined to specific contexts and the emancipatory objective therefore is difficult to argue. Two extracts from Burns provide definitions of action research that apply to much contemporary action research. Burns (1994, pp. 293–294) defined this approach as: the application of fact finding to practical problem solving in a social situation with a view to improving the quality of action within it, involving the collaboration and co-operation of researchers, practitioners and laymen (sic). The focus in action research is on a specific problem in a defined context, and not on obtaining generalizable scientific knowledge. Action research is considered a methodology rather than a research method. In other words, it is an alternative way of seeing the world and producing knowledge. There is no one prescribed method for carrying out this type of research and action research may involve both qualitative and quantitative methods. Many authors, however, refer to the cyclical nature of the approach because it involves diagnosis of an issue, intervention and evaluation. Participatory Action Research (PAR) is a quite different approach that has its origins in community and political movements in developing countries. PAR is overtly ideological and committed to social, political and economic change. Suggested readings Campbell, J. (2002). A critical appraisal of participatory methods in development research. International Journal of Social Research Methodology, 5(1), 19-29. Khanlou, N. & Peter, E. (2005). Participatory action research: considerations for ethical review. Social Science & Medicine, 60, 2333-2340. Schurr, C. & Segebart, D. (2012). Engaging with feminist colonial concerns through participatory action research and intersectionality. Geographic Helvetica, 67, 147-154.   Activity 5.1 Questions 1. Campbell’s (2002) article is about participatory research. How does participatory action research differ from ‘action research’? 2. What are some issues related to sampling in this form of research? 3. How is data analysis undertaken in AR (or PAR)? 4. If you recognised the need for an AR (or PAR) project in the workplace what in your opinion could be the difficulties in initiating such a study? And why? Draw on research examples as evidence and read Khanlou and Peter (2005). 5. What issues of rigour are relevant to this methodology? Feminist research Feminists are not united in their interpretation of the world and therefore differ in their approaches to research. It is therefore more apt to speak of feminisms. There are, however, some shared assumptions that drive feminist research. First is the recognition of the existence of inequality between the sexes. The shared view is that we live in a patriarchal world that is exploitative and oppressive. Second is the belief that what occurs in women’s personal lives is political (the personal is political is the popular phrase). In other words, the study of personal experiences of women is important in explaining the social and political organisation of a patriarchal society. A third assumption is that the forms of knowledge that dominate in our society reflect and reinforce masculine interests. An example in health care is the ever-expanding medicalisation of women’s lives. The study by Gattuso et al (2005), starts from the assumption that depression is a strongly gendered phenomenon and moves on to explore how popular culture constructs meanings around depression in women that reinforce invidual responsibility for the condition. Suggested readings Gatenby, B., & Humphries, M. (2000). Feminist participatory action research: Methodological and ethical issues. Women’s Studies International Forum, 23(1), 89–105. McCormick, K. & Bunting, S. (2002). Application of feminist theory in nursing research: The case of women and cardiovascular disease. Health Care for Women International, 23, 820-834. Gattuso, S., Fullagar, S. & Young, I. (2005). Speaking of women’s ‘nameless misery’: The everyday construction of depression in Australian women’s magazines, Social Science & Medicine, 61, 1640-1648.   Activity 5.2 1. What criticisms, from a feminist perspective, can be made of traditional policy research? 2. Outline the key assumptions that feminists bring to their research? 3. Discuss and give examples of research methods adopted in feminist research? Consider what methods are appropriate to feminist research and why. 4. Should feminist research always be conducted by women? Why or why not? 5. In what ways would feminist researchers use quantitative data? Use research examples. 6. Describe data analysis processes that you consider appropriate to feminist research. What are key feminist considerations? 7. What research validation processes have you noted in feminist research? 8. What are some methodological and ethical issues that might emerge in feminist research? References Burns, R. (1994). Introduction to research methods. Melbourne: Longman Cheshire. Campbell, J. (2002). A critical appraisal of participatory methods in development research. International Journal of Social research Methodology, 5(1), 19-29. Gatenby, B., & Humphries, M. (2000). Feminist participatory action research: Methodological and ethical issues. Women’s Studies International Forum, 23(1), 89–105. Gattuso, S., Fullagar, S. & Young, I. (2005). Speaking of women’s ‘nameless misery’: The everyday construction of depression in Australian women’s magazines, Social Science & Medicine, 61, 1640-1648). Kemmis, S., & McTaggart, R. (Eds.). (1988). The action research planner. Melbourne: Deakin University Press. Khanlou, N. & Peter, E. (2005). Participatory action research: considerations for ethical review. Social Science & Medicine, 60, 2333-2340. Lewin, K. (1988). Group decision and social change. In S. Kemmis & R. McTaggart (Eds.), The action research reader. Melbourne: Deakin University Press. (Original work published 1952). McCormick, K. & Bunting, S. (2002). Application of feminist theory in nursing research: The case of women and cardiovascular disease. Health Care for Women International, 23, 820-834. Nichols-Casebolt, A., & Spakes, P. (1995). Policy research and the voices of women. Social Work Research, 19(1), 49–55. Schurr, C. & Segebart, D. (2012). Engaging with feminist colonial concerns through participatory action research and intersectionality. Geographic Helvetica, 67, 147-154. Module 6: Philosophical research approaches Phenomenology Topics • Introduction • The phenomenology of Edmund Husserl (1858–1938) • The phenomenology of Martin Heidegger (1889–1976) • Phenomenology, psychology and nursing research. Objectives When you have completed this module, you should be able to: 1. Distinguish between the phenomenology of Husserl and Heidegger. 2. Recognise the concepts of Husserl and Heidegger in the analysis of phenomenological data. 3. Discuss the relationship between phenomenology and psychology. 4. Reflect critically on the utilisation of the phenomenological approach in research practice. Introduction In the philosophical literature, phenomenology is recognised as a field of endeavour that eludes precise definition. Stewart and Mickunas in Exploring Phenomenology (1990, p. 4) stated that: Phenomenology is not a rigid school or uniform philosophic discipline. There is great diversity in the points of view of thinkers who could be classified under the general rubric phenomenology, and the most proper description of this way of approaching philosophy is the ‘phenomenological movement’... However, there are two German philosophers associated with this movement who have exercised considerable influence on the development of health care research and on humanistic psychology—Husserl and Heidegger. Hence this Module addresses the influence of these philosophers and introduces a critique by Crotty (1996) of the ways that health care research has utilised their work. The young discipline of psychology, in the nineteenth and early twentieth centuries, was intrigued with the nature of human consciousness and knowledge acquisition of things. Psychology searched for laws that governed these human capacities in order to make them amenable to quantification. Psychologism is the term used to describe this effort. Husserl opposed psychologism on the grounds that consciousness is ‘a state of mind’ and that its associated processes of knowledge acquisition could not be measured. Suggested readings Dowling, M. (2007). From Husserl to van Manen. A review of different phenomenological approaches. International Journal of Nursing Studies, 44, 131-142. Todres, L., & Wheeler, S. (2001). The complementarity of phenomenology, hermeneutics and existentialism as a philosophical perspective for nursing research. International Journal of Nursing Studies, 38, 1–8. Activity 6.1 1. Describe the differences between the descriptive phenomenology of Husserl and the interpretive phenomenology of Heidegger. 2. Given these differences, how would you describe the purpose of (a) a Husserlian phenomenological study, and (b) a Heideggerian phenomenological study? Use research examples to demonstrate the differences. The phenomenology of Edmund Husserl (1858–1938) Husserl’s concern was to demonstrate the role of consciousness in how human beings acquire knowledge of the world of objects. He argued a philosophically based method to address these issues. Husserl took the idea of Cartesian dualism—the world comprises the subject (I, self) and the object (things external to one’s body)—but rejected Descartes’ absolute distinction between object and subject. For Husserl, the consciousness actively constitutes the objects of experience. Central to this view is the intentionality of consciousness, i.e. that consciousness is always intentionally directed towards objects (and an object is always an object for someone). This led Husserl to assert that one must return ‘to the things themselves’ in order to reveal how the essential structure of objects were originally perceived (Stewart and Mickunas, 1990, pp. 22–23); that is, how an object, or the world, was perceived before we learned how to see it. Husserl held that the essential structure of the experience would be the same for all people. Thus, there are several significant components to Husserl’s phenomenology. First, there is a subject and object world. But importantly the relationship between the two is not passive and therefore there is no clear distinction. This is because second, consciousness is always directed towards an object or phenomenon. And third, the essence (original structure) of the phenomenon experienced can be retrieved. In Husserl’s terms, this is achieved by bracketing culturally derived meanings and returning to the ‘essential object’. The major concepts of intentionality, bracketing, essence of the structure and description form the theoretical framework ideas that would underpin a Husserlian based nursing/health research study. The phenomenology of Martin Heidegger (1889–1976) Heidegger’s intention was to reveal the meaning of ‘being in the world’, which he believed was more in need of attention than Husserl’s epistemological pursuits. Heidegger concentrated on the nature of ‘being’ and what ‘being in the world’ meant and so is associated with ontology—a branch of philosophy dealing with the notion of ‘being’. A point to be aware of is that Heideggerian studies are perceived as interpretive because human beings are capable of self-interpretation and the researcher and the researched are able to freely interact on this basis. In contrast, Husserlian studies are normally considered as descriptive since the researcher is regarded as being an objective instrument in the interviewing process, in the data analysis phase and in the discussion of findings. Heidegger rejected Husserl’s phenomenology. The fundamental reasons were that it is not possible to bracket preconceptions (to be able to do so is a presupposition itself) and that the world is not constituted in terms of the subject/object position. The wholistic concepts Heidegger brought to ontology are that: • human beings are situated in the world • human beings are self-interpreting • human beings place value on things • human beings are embodied and, therefore, can act in the world (social actor) • human beings are situated in time and, therefore, are temporal beings. In reference to method and data analysis in Heideggerian studies, the notion of hermeneutics is significant. Hermeneutics, an ancient Greek term which means to interpret a written text, was innovatively adapted by Dilthey and later Heidegger and applied to human social behaviour. This meant that human social activity could be ‘read as text’. Thus a Heideggerian study of a health/illness issue would be informed by the concepts noted above and the data analysed in terms of the hermeneutic mode. Suggested readings Koch, T. (1995). Interpretive approaches in nursing research: The influence of Husserl and Heidegger. Journal of Advanced Nursing, 21, 827–836. Wojnar, D. & Swanson, K. (2007). Phenomenology: An exploration. Journal of Holistic Nursing, 25, 172-180. Activity 6.2 1. How might phenomenological research be judged to be rigorous? 2. Identify criteria for evaluating phenomenological research from (a) a procedural perspective, and (b) a theoretical perspective. Activity 6.3 1. Identify key points concerning data analysis in phenomenological studies? 2. The methods of phenomenological data analysis are commonly undertaken by researchers who theoretically ground their projects in the works of Husserl (descriptive phenomenology). How might data analysis techniques differ from researchers who ground their projects in the works of Heidegger (interpretive phenomenology)? Phenomenology, psychology and research The theses of Husserl and Heidegger influenced the development of psychology in several ways. Husserl’s exploration into the world of consciousness and connected epistemological problems impacted on perception studies in psychology, and Heidegger’s search for ontological meaning became an essential part of psychotherapy. These notions further contributed to the emergence and popularity, especially in America, of humanistic psychology in the 1960s. Around this time, the use of phenomenology as a research approach was introduced into nursing by American nurse scholars (Anderson in Morse, 1989, p. 16). These researchers regarded the approach a suitable way of investigating health/illness issues because of the belief that phenomenology, through its association with psychology, would yield ‘subjective’ research results. Such research would assist the nurse and other health care workers to empathise more sensitively with the patient/client’s subjective feelings and needs and supply appropriate interventions. However Crotty, in Phenomenology and nursing research (1996), challenged the basis of nursing’s understanding of phenomenological research. Crotty’s thesis is that neither Husserl nor Heidegger envisaged their philosophical tenets had anything to do with the subjective nature of people’s feelings. Husserl was interested in how the structure of an experience or phenomenon actually appeared to consciousness, not what people felt about it. Similarly, Heidegger in search of existential meaning in the everyday lived world was not concerned with how people felt. Crotty (1996, p. 3) distinguishes between the nursing and classical phenomenologies by referring to them as the ‘new’ and the ‘mainstream’. Crotty does not suggest that nursing abandon ‘phenomenological’ research only that it is really inappropriate for nursing to regard it as phenomenology. Crotty calls for nursing research to be more cautious and explicit in the utilisation of the ‘new’ phenomenology. Consequently, it is most likely that ‘phenomenological research’ in nursing will continue to evolve and take into account the newly emerging dimensions. References Dowling, M. (2007). From Husserl to van Manen. A review of different phenomenological approaches. International Journal of Nursing Studies, 44, 131-142. Crotty, M. (1996). Phenomenology and nursing research. Melbourne: Churchill Livingstone. Koch, T. (1995). Interpretive approaches in nursing research: The influence of Husserl and Heidegger. Journal of Advanced Nursing, 21, 827–836. Todres, L & Wheeler, S. (2001). The complementarity of phenomenology, hermeneutics and existentialism as a philosophical perspective for nursing research. International Journal of Nursing Studies, 38, 1–8. Walters, J. (1994). Phenomenology as a way of understanding in nursing. Contemporary Nurse, 3, 134–141. Wojnar, D. & Swanson, K. (2007). Phenomenology: An exploration. Journal of Holistic Nursing, 25, 172-180. Module 7: Research Methods: from the research question to data generation Topics • Introduction • Deciding on a research question • The literature review • Theoretical frameworks • Participant selection methods • Ethical issues. Objectives When you have completed this module, you should be able to: 1. Identify the early steps in the qualitative research process. 2. Understand the interrelationship between these early steps. 3. Assess the role of theoretical frameworks in qualitative studies. 4. Describe participant selection methods. 5. Demonstrate an understanding of the relevance of ethics in research. Introduction The topics discussed in this module represent the early part of the research data generation process. Once these areas have been attended the qualitative researcher shifts attention to the major ethnographic data generation strategies: the interview, observation and documents. What these latter activities involve is presented in the next module. The early phases of data generation consist of: 1. Deciding on a question 2. Undertaking a review of the literature 3. Choosing a theoretical framework 4. Selecting the participants 5. Giving attention to ethical issues. 1. Deciding on a research question The first step is to decide on a topic area and the second is in deciding what you want to know about this topic. Crucial to successful research is that the topic must excite curiosity and offer a challenge. In qualitative research the choice of question can help determine the selection of the methodology or, the methodology can inform of shape the question. Once the researcher clarifies the nature of the knowledge being sought and considers the type of question required then further engagement in the research process is easier. Note that the research question/purpose in qualitative research is generally posed in broad terms. This is because qualitative research is about exploring, discovering and/or analysing a topic area in an in-depth manner. The questions are about ‘how’ and ‘why’ rather than ‘what’ and ‘who’. Qualitative research questions therefore do not pre-empt research outcomes. Note the differences between the following research questions. The purpose of the research is to explore the perceptions of the elderly who use day centre services (a how and why question/purpose). The purpose of the research is to analyse the management strategies employed in day care centres for the elderly (again, a how and why question/purpose). The purpose of the research is to establish the satisfaction of elderly people who use day-care centres. This latter research purpose focuses on the ‘what’ question and suggests quantitative methods. Ideas for research—applied or conceptual Ideas for research projects come from many sources including personal observation, work experiences, conversations with others and from knowledge you already have about your area of practice. You might have noticed problems in a work setting that need attention, for example, an organisational issue, a current policy that needs updating, or a professional practice that needs review. Another source of ideas is the literature itself. Browsing through the literature relevant to your profession may reveal areas in knowledge that need to be addressed or readdressed. For instance, there might be only a few studies on transcultural health care and the difficulties that patients/clients from non-English speaking backgrounds may face when accessing health service facilities. An applied study could be done that involved interviewing health care professionals to explore their perceptions of issues and change. You might have an interest in health care policy formulation at a federal, state or organisational level. Such a study could involve interviewing key players or it could be a conceptual study. The latter might mean undertaking a critical analysis of key policy concepts, their origins and implications. A conceptual study is another way of contesting knowledge and, in turn, improves understanding of the discipline and its practice base. The textual analysis approach may influence theory and practice to such an extent that new ways of thinking about health issues may result and inform improved health care delivery practices. It is important to emphasise that conceptually based research work is not ‘just’ a review of the literature. Rather it is an in-depth analysis of the ideas, assumptions and arguments in the literature that have a strong influence on health theory and practice issues. An example is Koch’s (2000) study, Life quality vs “quality of life: assumptions underlying quality of life instruments in health care planning. Activity 7.1 1. Identify a health/illness issue or workplace concern that you think may be suitable for a qualitative research project. 2. Formulate a question/ purpose and identify a methodology. Justify your choice. 2. The literature review The literature review is a written piece of work that analyses and critiques the research undertaken in the area of knowledge related to the topic of investigation. The purpose of the literature review is to: • find out what is already known about the topic area • find out if the research has already been done to avoid re-inventing the wheel • show where the proposed research fits into existing knowledge • justify the research to be undertaken and the methodology and the methods. In other words, the literature review argues the gaps and limitations evident in an existing body of knowledge. But note that the place of the literature review in qualitative research is contentious. Some argue that the literature review should take place after data analysis. This is particularly so in inductive research where the researcher may want to avoid imposing preconceived ideas on to the data. Still, it is difficult to imagine a research grant application being successful in the absence of a thorough literature review. Hence there are no hard and fast rules (as always!). The researcher will decide and argue what is appropriate in relation to the research purpose and methodology. The task of seeking out the literature may take place in the library or via the computer. If the Internet is used make certain that you only access electronic refereed journal papers. 3. Theoretical frameworks Theory needs to be explicit in qualitative research because theory and argument are essential to the validity of qualitative studies. This is in contrast to the methods-based quantitative research where rigid rules and techniques apply. The assumption in quantitative research is that if the right methods are put in place then the research will produce the ‘truth’. In qualitative research, methods are characteristically flexible because the emphasis is on discovery and interpretation. It is useful to think of a theory simply as a systematic explanation. A more formal definition is that theory consists of a set of coherently interrelated concepts that provides a certain perspective to a research study. For instance, we saw in Module 1 how the case of anorexia nervosa would appear when underpinned by the concepts of the respective research approaches. Two important points to remember for the purpose of producing a soundly theoretically grounded qualitative study are as follows: • the research question must be consistent with the concepts in the chosen theoretical framework; and • every other component of the study must be consistent with the theoretical framework. The place of theoretical frameworks and their relationship to qualitative research is illustrated in the extracts below: 1. Chamberlain (2009): It is ironic that, given the reaction of qualitative research against notions of variables, measurement and statistics, we continue to perpetuate many of the problems from the quantitative research arena through a focus on and privileging of method. Methodolatry promotes security of a sort, but … it is a false security (p.294). 2. Alvesson & Sköldberg (2009): The recognition that all research work incudes and is driven by an interpreter…provides the key to a qualified methodological view. Thus method cannot be disengaged from theory …since assumptions in some sense determine interpretations (p. 11). Central to the views of Chamberlain and Alvesson and Sköldberg and many others is the critical importance of the role of theory in the production of a soundly based qualitative study. In other words, theory is integral to qualitative research and we should not over burden our research with methods. Suggested readings Chamberlain, K. (2009). Methodolatry and qualitative health research. Journal of Health Psychology, 5 (3), 285-296. Harding, G., & Gantley, M. (1998). Qualitative methods: Beyond the cookbook. Family Practice, 15(1), 76–79. Seibold, C. (2002). The place of theory and the development of a theoretical framework in qualitative study. Qualitative Research Journal, 2 (3), 3–15. Activity 7.3 1. What are some key criticisms of a ‘methods only’ approach to qualitative research? 2. What role does the theoretical framework play in qualitative research? How does this differ from quantitative research? 3. Explain the relationship between the theoretical framework and research methods. Give some examples of this relationship. 4. Participant selection methods Once the research question is formulated, the literature review commenced and the methodology selected, the next step is to decide on a participant selection method or sampling procedure. Note that a sample may not be appropriate for all studies (e.g. a conceptual or historical study). But, if so, there are some factors to be taken into account when recruiting participants for a qualitative research study. Hints Qualitative researchers may not have a predetermined sample size. This is because simultaneous data generation and data analysis is a popular method in qualitative research and this is regardless of the theoretical framework that informs the study. This makes sense if we think of qualitative research as developing knowledge about a phenomenon or issue. Quantitative research, on the other hand, is about applying knowledge to test or measure an existing phenomenon. While the sample size might not be precise the researcher must still justify the characteristics of any sample. Decisions on sampling methods will depend both on the study purpose and the theoretical framework. In the first instance qualitative sampling is purposive. The aim is to select participants who can provide in-depth data relevant to the research topic. The sample may then be chosen on the basis of maximum variation, particular selection criteria, critical cases or minimal variation. The researcher might engage in snowball sampling where an initial respondent or group of people provides further contacts. Snowballing is often used when the research poses a potential risk for the individual or social group under study (for example, IV drug users). Other strategies include opportunistic sampling and perhaps, the least effective, convenience sampling. After initial recruitment of participants, many qualitative researchers engage in what is termed theoretical sampling. This method is most readily associated with grounded theory but can be used across qualitative research. Theoretical sampling refers to the process whereby ongoing data analysis directs the sampling. The qualitative researcher does not know the full dimensions of the research at the outset and the research may take an unexpected direction after initial data analysis. The sampling then is based on theoretical developments not numbers. For a more in-depth discussion of sampling methods read Liamputting (2013) or a similar text. Suggested reading Curtis, S., Gesler, W., Smith, G., & Washburn, S. (2000). Approaches to sampling and case selection in qualitative research: Examples in the geography of health. Social Science & Medicine, 50 (2000), 1001–1014. Activity 7.4 1. The authors argue that sampling in qualitative research is characteristically ‘conceptually driven’. Describe what this means and give an example/s. 2. Describe the difference between purposeful and theoretical sampling. 3. Why is rigour in sampling important in qualitative research and how can this be achieved? 4. Outline sampling criteria that might apply to qualitative research. 5. Describe and justify the sampling approach you might use in investigating the research purpose/question you identified above. 6. How do you decide on a sample size? 3. Ethical issues Ethical concerns in qualitative research revolve around the issues of consent, harm, privacy and confidentiality. However, there are no easy rules to follow in relation to these issues. For example, the importance of trust and rapport between the researcher and the participants is often stated as the basis for a successful study. This is because trust fosters the willingness of the participants to disclose the information you are seeking. But trust implies an equal relationship between researcher and participant and it is difficult in a research situation for this to occur. Furthermore, in an unstructured interview, the participant may not have a clear idea about the direction of the interview and thus there might be unanticipated self-revelation. The unstructured interview format also means that informed consent is difficult to secure. This is also relevant to participant observation research where the success of the research is often dependent upon the researcher’s silent role. The major safeguard in relation to privacy is confidentiality. But much qualitative research involves publication of extracts of interview data. Researchers refer, therefore, to anonymity rather than confidentiality. It is still crucial to ensure that the published data extracts do not create any risk for the participants. Observation methods also raise privacy issues. It is unlikely in the case of participant observation that all being observed will have been informed about the research. In fact, to do so would probably ruin the research. The researcher therefore needs to consider carefully the implications of the research being undertaken. Because there is no one ethical path to follow in qualitative research, ethical consideration must be ongoing in this type of research. The researcher’s chief ethical responsibility is to make certain that no harm will come to the participants. Suggested readings Bengry-Howell, A. & Griffen, C. (2012). Negotiating access in ethnographic research with ‘hard to reach’ young people: establishing common ground or a process of methodological grooming? International Journal of Social Research Methodology, 15(5), 402-416. Khanlou, N. & Peter, E. (2005). Participatory action research: considerations for ethical review. Social Science & Medicine, 60, 2333-2340. Malone, S. (2003). Ethics at home: informed consent in your own backyard. Qualitative Studies in Education, 16(6), 797–815. Parry, O. & Mauthner, N. S. (2004). Whose data are they anyway? Practical, legal and ethical issues in archiving qualitative research data. Sociology, 38(1), 139–152. Activity 7.5 1. Outline the broad ethical issues to be addressed in qualitative research. 2. Discuss issues related to anonymity and confidentiality in qualitative research. You might return to the Khanlou and Peter (2005) article on PAR. 3. Address some difficulties surrounding informed consent in qualitative research (particularly ethnography). 4. Parry and Mauthner (2004) raise some interesting issues about ownership of data. Why is this problematic and can it be addressed? References Alvesson, M. and Sköldberg, K. (2009). Reflexive methodology: New vistas for qualitative research. Los Angeles: Sage. Bengry-Howell, A. & Griffen, C. (2012). Negotiating access in ethnographic research with ‘hard to reach’ young people: establishing common ground or a process of methodological grooming? International Journal of Social Research Methodology, 15(5), 402-416. Chamberlain, K. (2009). Methodolatry and qualitative health research. Journal of Health Psychology, 5 (3), 285-296. Harding, G., & Gantley, M. (1998). Qualitative methods: Beyond the cookbook. Family Practice, 15(1), 76–79. Khanlou, N. & Peter, E. (2005). Participatory action research: consdierations for ethical review. Social Science & Medicine, 60, 2333-2340. Koch, T. (2000). Life quality vs “quality of life”: Assumptions underlying prospective quality of life instruments in health care planning. Social Science & Medicine, 51, 419–427. Kvale, S. (1996). Interviews: An introduction to qualitative research interviewing (p. 10). Thousand Oaks, CA: Sage. Malone, S. (2003). Ethics at home: Informed consent in your own backyard. Qualitative Studies in Education, 16(6), 797–815. Parry, O., & Mauthner, N. S. (2004). Whose data are they anyway? Practical, legal and ethical issues in archiving qualitative research data. Sociology, 38(1), 139–152. Module 8: Research Methods: data generation Topics • Introduction • Interviews • Observations • Documents. Objectives When you have completed this module, you should be able to: 1. Understand the relationship between the preliminary data generation phase and the collection strategies in the major phase. 2. Describe the distinctions between interview types. 3. Identify the use of interview techniques to qualitative research. 4. Describe the types of observation strategies. 5. Identify how data can be collected through observation. 6. Discuss the value of documents as a strategy for research. Introduction In the previous module you were introduced to some aspects of the qualitative research process. In this module you are introduced to key data generation methods including interviews, observations and documents. Interviews Interviews are the most frequently used strategy for data generation and involve the collection of information by verbal communication. In qualitative research, the researcher uses semi-structured, unstructured or in-depth interviews. This is because the emphasis in qualitative research is on depth of data. The structured interview, on the other hand, is associated with quantitative research and this is where the questions are prepared beforehand and organised in a set order. This structure allows for statistical analysis. Beginning qualitative researchers are often concerned that they may not be able to elicit sufficient information, which, in turn, will limit data analysis. However there is a range of open-ended questions to draw on as well as a variety of prompts. For example, it is useful to start off with descriptive ‘questions’, such as: • Describe your experience in the outpatient’s department. • Describe the health and safety model applied in your organisation. Other questions may seek out views on particular issues, for example: • What is your view about the government’s policy on this issue? • How do you explain management’s decision to impose a top-down policy on health and safety in your area? Examples of prompts are as follows: tell me more …, is that so …, what happened then, why do you feel that way? Because the interview is unstructured the researcher has to strike a careful balance between ensuring some focus to the interview and not being overly directive or intrusive. Interviews are usually taped with the consent of the participants and the advantage of this is that the exact words are preserved. The tapes are then transcribed as a start to the process of analysis. Read the following article for an interesting and persuasive critique of an over-reliance on the participant ‘voice’ as evidence. Suggested reading St. Pierre, E.A. (2008). Decentering voice in qualitative inquiry. In A. Jackson & L. Mazzei (Eds). Voice in qualitative inquiry: Challenging conventional, interpretive, and critical conceptions in qualitative research (pp 231-236). Hoboken, Routledge. Observations Where interviews construct data, observation finds it. Observational research is appropriate in a group or cultural setting where social processes are the focus of study. The collection of observational data requires researchers to immerse themselves in the research setting or the culture under study. However, the degree of involvement of the researcher in the setting varies; the researcher may be either a participant or non-participant observer. A participant observer engages in the activities of the group under study. A non-participant observer may be completely inconspicuous (through the use of audiotaping or videotaping, for example) or a peripheral member of a group and so one who is known to the group members but not actively involved in the activities under study. There are advantages and disadvantages to each method. The decision on what observational role to assume will depend on the researcher’s credentials and the research question. Documents There are two main types of documents important to the qualitative researcher. There are those that the researcher compiles during the fieldwork and there are those generated by others. First, the researcher’s documents—most texts on qualitative research refer to the fact that researchers write notes to themselves as an integral part of the research process. This document may be referred to as a diary, a journal, a fieldwork log or a notebook. The purpose is to record insights, beginning understandings and later ones arrived at during the process, which then contributes to the analysis process. The second type of document data consists of written documents and records created either by the participants or some organisational body. These might consist of personal diaries, letters, autobiographies, official documents, newspapers, etc. The researcher treats the documents like transcriptions of interviews or observations. Suggested reading Liamputtong, P. & Ezzy, D. (2005). Qualitative Research Methods. Melbourne: Oxford University Press. (Read Chapters 3-5). Or Liamputtong, P. (2009). Qualitative Research Methods. Melbourne: Oxford University Press. (Read Chapters 3-5) Activity 8.1 1. Describe key interview strategies. 2. What do the authors have to say about in-depth interviews. 3. Explain some strengths and weaknesses of the unstructured and semi-structured interview. 4. What are the important features of a ‘good’ focus group? 5. Summarise the advantages and limitations of the focus group method. Suggested reading Mulhall, A. (2003). In the field: notes on observation in qualitative research. Journal of Advanced Nursing, 41(3), 306–313. Activity 8.2 1. Discuss some benefits and difficulties for the researcher when using observation as a strategy. 2. Summarise the different approaches to observation as a research method. Can you provide examples of research contexts in which each approach might be used and explain why? 3. Explain the processes whereby researchers might collect/record observational data. Activity 8.3 1. Why are documents important as a qualitative data source? 2. Describe the kinds of documents that may be useful to the researcher. 3. Discuss the difficulties the researcher may experience in accessing documents. References Liamputtong, P. & Ezzy, D. (2005). Qualitative Research Methods. Melbourne: Oxford University Press. Liamputtong, P. (2009). Qualitative Research Methods. Melbourne: Oxford University Press. Mulhall, A. (2002). In the field: Notes on observation in qualitative research. Journal of Advanced Nursing, 41(3), 306–313. Module 9: Research Methods: data analysis to rigour Topics • Introduction • Data analysis • Trustworthiness of data/rigor • Triangulation • Computers and qualitative research analysis. Objectives When you have completed this module, you should be able to: 1. Discuss qualitative data analysis and the types of research approaches. 2. Account for the relevance of trustworthiness in qualitative analysis. 3. Assess the value of triangulation to qualitative analysis. 4. Understand issues in the use of computers in qualitative studies. Introduction This module introduces key points about data analysis in qualitative research with reference to the analysis process in phenomenological and grounded theory studies. Data analysis can be a challenge because every research study is unique and as qualitative research is also regarded as flexible in design. The combination of these two elements means that there are not any ‘fixed rules’. Other issues explored relate to the trustworthiness of the data, the role of triangulation in qualitative analysis and the application of computers in data analysis. Data analysis Generally, qualitative data analysis is considered as a process employed to reduce the interview text, and/or observation and/or documents, to a representative record of the phenomenon studied. Yet, it can be a ‘chaotic’ process because the researcher does not presume to know what will be discovered and nor exactly how. Qualitative data analysis occurs throughout the research process as the researcher interprets the cumulative data including the literature review. Research texts do refer to different methods of analysis such as content analysis, thematic analysis, comparative analysis and semiotic analysis. It is for the researcher to describe and justify the approach and to link the method of analysis to the research question and methodology. For example a simple content analysis might identify frequently occurring issues/actions/codes. This may be appropriate in a study where the data is used to support (or challenge) an argument constructed by the researcher. In a study, however, where the analysis starts with data, a simple counting method would lack depth in interpretation of data. Note that the term ‘thematic analysis’, while very liberally used by researchers, is problematic because it encourages description rather than interpretation. Careful use of “the theme” is recommended. Grounded Theory data analysis Suggested reading Waitzkin, H., Jasso-Aguilar, R. & Mountain, C. (2005). Global trade, public health, and health services: Stakeholders’ constructions of the key issues. Social Science & Medicine. 61:893-906. Activity 9.1 1. Is the data analysis approach outlined in the above research (in your view) appropriate? Support your answer. 2. What world view is applied in this research? In qualitative research, the grounded theory method has become popular, regardless of the theoretical framework, because it provides a well-structured process. In fact, data analysis is the most distinctive feature of grounded theory. This is because, as noted earlier, the process is not linear. Data generation and data analysis occur concurrently. The terms ‘constant comparison’ and ‘theoretical sampling’ refer to this process. Constant comparison means the researcher constantly compares codes and categories and so moves back and forward to the data. Theoretical sampling refers to the process whereby the emerging theory drives ongoing data collection. So the categories that emerge in early data analysis provide further direction for the study and therefore ongoing direction for sampling. These two processes are applied until analysis produces no new examples or properties of a category. This is known as theoretical saturation. From your reading you will note that this latter concept is difficult to apply in practice. Suggested reading Boeije, H. (2002). A purposeful approach to the constant comparative method in the analysis of qualitative interviews. Quality & Quantity, 36, 391–409. Ong, B. (2012). Grounded theory method (GTM) and the abductive research strategy (ARS): A critical analysis of their differences. International Journal of Social Research Methodology, 15 (2), 417-432.   Activity 9.2 1. Explain the constant comparative method and give an example of how this would work. 2. What is the relationship between theoretical sampling and constant comparison in GT? 3. What advice does Boeije (2002) offer in relation to the constant comparison method? 4. Explain the different approaches to data analysis in grounded theory research. 5. What are the strengths and limitations of abductive analytical approach (see Ong above)? Suggested readings Aguinaldo, J.P. (2004). Rethinking validity in qualitative research from a social constructionist perspective: From “ Is this valid research?” to “What is this research valid for?” The Qualitative Report, 9(1):127-136. Trustworthiness and/or rigour of data There is much disagreement on how to verify qualitative data. What one discovers in reading about qualitative studies is that, in order to demonstrate rigor, terms conventionally associated with the quantitative paradigm such as bias, generalisability, validity and reliability are frequently used in relation to qualitative results. In the health sciences this reflects the influence of quantitative research. Although to some extent progress has been made, disagreement stemming from the earlier debates about the applicability of quantitative concepts to qualitative research data remains. But generally it is argued that the concepts of bias, reliability and generalisation are not relevant to qualitative research on epistemological grounds. In pursuit of criteria to verify the outcomes of qualitative research, various terms have been introduced, such as trustworthiness, credibility, dependability, transferability and confirmability. The below puts an alternative set of criteria. Tracey, S. J. (2010). Qualitative quality: Eight “big-tent” criteria for excellent qualitative research. Qualitative Inquiry, 16(10), 837-851. Triangulation Some authors argue that the qualitative process of analysis and the findings from qualitative research can best be substantiated through the use of a method known as triangulation. This is a term that has its origins in surveying and refers to the use of multiple reference points to accurately locate a third position. Yet, this term is as complex as most other research terms mentioned in the modules because it refers to a range of techniques including method triangulation, data triangulation and investigator triangulation. Suggested readings Razum, O., & Gerhardus, A. (1999). Methodological triangulation in public health research—advancement or mirage? Tropical Medicine and International Health, 4(4), 243–244. Messac, L., Ciccarone, D., Draine, J. & Bourgois, P. (2013). The good-enough science-and-politics of anthropological collaboration with evidence-based clinical research: Four ethnographic case studies. Social Science & Medicine, 99, 176-186. Flick, U. (2017). Mantras and myths: The disenchantment of mixed methods research and revisiting triangulation as a perspective. Qualitative Inquiry, 23 (1), 46-57. Activity 9.4 1. What is meant by triangulation? 2. Outline some strengths and weaknesses of triangulation? 3. Is there any value in the use of triangulation in qualitative research and, if so, what value? Computers and qualitative research analysis In the latter half of the twentieth century the value of technology and its application to society has been seriously questioned and remains controversial. However, it is evident from the literature that the bias is towards its increasing usage. The nursing and health literature reflects similar disputation especially in relation to the data analysis phase of qualitative studies. Suggested reading Pilkington, F. B. (1996). The use of computers in qualitative research. Nursing Science Quarterly, 9(1), 5–7. Activity 9.5 1. How do you consider the use of computer packages can contribute to qualitative data analysis? 2. Pilkington asks: The question raised here is whether computers could ever mechanically replicate the creative conceptualisation process of the human researcher? 3. What are some implications for qualitative research and the qualitative researcher in the increasing use of computer packages? References Aguinaldo, J.P. (2004). Rethinking validity in qualitative research from a social constructionist perspective: From “ Is this valid research?” to “What is this research valid for?” The Qualitative Report, 9(1):127-136. Boeije, H. (2002). A purposeful approach to the constant comparative method in the analysis of qualitative interviews. Quality & Quantity, 36, 391–409. Koch, T. (1994). Establishing rigor in qualitative research: The decision trail. Journal of Advanced Nursing, 19, 976–986. Messac, L., Ciccarone, D., Draine, J. & Bourgois, P. (2013). The good-enough science-and-politics of anthropological collaboration with evidence-based clinical research: Four ethnographic case studies. Social Science & Medicine, 99, 176-186. Ong, B. (2012). Grounded theory method (GTM) and the abductive research strategy (ARS): A critical analysis of their differences. International Journal of Social Research Methodology, 15 (2), 417-432. Pilkington, F. (1996). The use of computers in qualitative research. Nursing Science Quarterly, 9(1), 5–7. Punch, K. (1998). Introduction to social research: Quantitative and qualitative approaches. London: Sage. Razum, O., & Gerhardus, A. (1999). Methodological triangulation in public health research—advancement or mirage? Tropical Medicine and International Health, 4(4), 243–244. Sale, J., Lohfeld, L., & Brazil, K. (2002). Revisiting the quantitative-qualitative debate: Implications for mixed-methods research. Quality & Quantity, 36, 43–53. St. Pierre, E.A. (2008). Decentering voice in qualitative inquiry. In A. Jackson & L. Mazzei (Eds), Voice in qualitative inquiry: Challenging conventional, interpretive, and critical conceptions in qualitative research (pp 231-236). Hoboken, Routledge. Tracey, S. J. (2010). Qualitative quality: Eight “big-tent” criteria for excellent qualitative research. Qualitative Inquiry, 16(10), 837-851. Waitzkin, H., Jasso-Aguilar, R. & Mountain, C. (2005). Global trade, public health, and health services: Stakeholders’ constructions of the key issues. Social Science & Medicine. 61:893-906. Module 10: The qualitative research proposal Topics • Introduction • Overview: generic structure of a research proposal • Details: qualitative research proposals • Preparation of a research proposal. Objectives When you have completed this module, you should be able to: 1. Understand the components that constitute the generic process in qualitative research. 2. Plan a qualitative research study. 3. Write a qualitative research proposal. Introduction This module is designed to help you understand the steps involved in the preparation of a qualitative research proposal, vis-à-vis Assignment 3 in the Unit Information booklet. Throughout the modules references have been made to the various components integral to the qualitative research process or method. The aim of this module is to draw these threads together and to provide guidelines on how to prepare a qualitative research proposal. Modules 7, 8 and 9 are especially pertinent to the development of a research proposal. In Module 7, discussion centred on the identification of a researchable question, the role of the literature review in terms of the topic to be researched and the chosen theoretical framework, the selection of the participants and the associated ethical concerns. If a conceptual study is to be undertaken, the focus is on the question, the topic literature and the theoretical framework literature. After these steps, a conceptual study would consist of a series of chapters germane to the question. Module 8 concentrated on the qualitative research strategies of data collection, namely, the interview, observation and documents. Module 9 directed attention to strategies and issues in data analysis. The issues relate to the trustworthiness of the data, triangulation as a method of validating data and the role of computers in analysing qualitative data. The remainder of this module presents the structure of a generic research proposal. It provides further details about what is involved under the respective generic headings to complement those in Module 7. Finally, the readings provide informative mention on funding issues and what is involved in the ‘writing up’ phase of a qualitative proposal. Overview: generic structure of a research proposal 1. Research question/context of research. 2. Literature review/conceptual framework. 3. Methodology/theoretical framework. 4. Describe and justify research site. 5. Detail and justify the sample selection approach, the characteristics of the sample and the process of gaining access to the sample. 6. Describe and justify data generation strategies. 7. Describe and justify data analysis strategies. 8. Address ethical issues. Details: qualitative research proposals This section teases out further details related to the content of research proposals relevant to your assignment. Preparation of a research proposal For Assignment 3 you are asked to identify a question relevant to your professional and practice interests and to prepare a research proposal related to that question. The preparation of a proposal is to help you think about what it is you would like to know and do in order to conduct a research study. The generic structure of a research proposal presented below demonstrates the steps that the researcher needs to address. You are not expected to follow through with the proposal in this unit. If you are undertaking higher degree studies now or if you decide to do so in the future, and in an area of qualitative research, then this exercise should be a valuable experience. There are several readings provided to guide your understanding. 1. Introduction Set out an introduction that explains what is being studied and the context of the study. The introduction provides a rationale for the research. 2. Literature review/contextual review Undertake a literature review that justifies the study topic and provides some context to the study. Note, however, that the form that this review takes in qualitative research may vary depending upon the theoretical perspective. 3.Question/ Purpose State the research question/purpose. You should also set down research aims. The aims tell the reader exactly what will happen in the research. For example: The aims of this research are to: Explore the perceptions of … Critically analyse professional documents related to… Generate analytical conclusions around the… Argue the implications of… In doing the above, consider the theoretical framework (methodology) that will be applied in the study. The question/purpose and aims and the theoretical framework must ‘match up’ to ensure the soundness of qualitative research investigations. 4. Theoretical framework Develop an argument for chosen theoretical framework and explain and justify the assumptions that underpin the theory. This is important because the concepts that make up the framework will inform the analysis. Strongly justify the use of the theoretical ideas. It is important also that you use primary sources in this discussion. In other words, draw on the works of key theorists in the area. 5. Research site Explain and provide a rationale for the site selection. The site may be a natural setting of the everyday world, a policy document, or a scientific study (as the object of study). Give sufficient detail about the site. 6. Sample The number of participants will vary with the type of study (or methodology) chosen. Usually in phenomenological studies a small number is required because a considerable amount of rich data is gathered. However, in grounded theory, the ongoing data analysis dictates the number of participants. The point at which data generation ceases in grounded theory is often referred to as saturation. This is where ongoing data generation and analysis produces no new information. Note that the concept of saturation is contentious. Many researchers state but do not/cannot demonstrate saturation. It is also difficult to imagine complete saturation of any research topic. Here is where you explain how the sample will be selected (theoretical, purposive, convenience etc). Describe the characteristics of the sample and explain why these sample features are important to the research. Describe the process of recruiting participants. Demonstrate that the sample is appropriate to the research question/purpose/aims. Take note of the sampling options outlined in a previous module and read about this issue. The most important point here is that the researcher must provide a supporting argument for the sample choice. 6. Data generation strategies In respect to the data generation strategies in qualitative research refer to Module 8. In qualitative research it is well established that there are three main data generation strategies: • Interviewing • Observation • Documents—for example, medical records, information brochures, diaries from participants or policy documents, photos, paintings etc. Describe and justify the data generation methods to be used in your assignment. 7. Data analysis Explain and justify the process of analysis to be applied. Make sure it fits with the methodology. The analysis of data in phenomenological studies is more straightforward than in grounded theory research. In respect to the method of data analysis in a sociological based study, such as grounded theory, revisit the relevant module. Other forms of data analysis are applied in feminist and discourse analysis research. The key to this section is to justify choice of analytical process. 8. Ethical issues As noted earlier, to protect participants who have agreed to be in the study, it is very important that the researcher maintains anonymity. The researcher also ensures that participants are informed about the study, that they may withdraw from the study at any time, and that they are guaranteed privacy and anonymity. Suggested reading Liamputtong, P. (2013). Qualitative research methods. Melbourne: Oxford University Press. (pp 264-282). This reading presents a thorough account of the details a researcher needs to know about before entering the field. The authors provide learning activities and you are encouraged to give them attention, as these will further strengthen understanding of qualitative research proposal preparation. Activity 10.1 1. Outline the topic upon which you have based your qualitative research proposal. 2. Describe the purpose of your chosen research topic from a philosophical perspective. 3. Describe your chosen research project from a sociological perspective. 4. Describe your chosen research topic from a critical perspective. Activity 10.2 1. What is a research proposal? 2. What process led you to your research topic/question? At what point and why did you decide on the methodology? 3. What factors did you consider in determining the sampling approach? 4. Summarise what you know about data analysis and how you justify your approach. 5. Rice and Ezzy refer to the internal and external consistency of a research proposal. Explain what this means and give some examples from your own research proposal. 6. What ethical considerations are relevant to your proposal and how will they be dealt with? Suggested reading Sandelowski, M. (1998). Writing a good read: Strategies for re-presenting qualitative data. Research in Nursing and Health, 21, 375–382. Activity 10.3 1. Explain some of the problems that Sandelowski refers to in the presentation of data findings in qualitative research. 2. Summarise some of the decisions the researcher must make in writing up qualitative research. 3. Outline some strategies noted in this paper for structuring a qualitative research report. 4. What does Sandelowski mean by her reference to the importance of ‘form’? References Liamputtong, P. (2013). Qualitative research methods. Melbourne: Oxford University Press. (pp 264-282). Sandelowski, M. (1998). Writing a good read: Strategies for re-presenting qualitative data. Research in Nursing and Health, 21, 375–382. Conclusion Introduction In this unit we have explored and considered the many types of qualitative research approaches and their associated methods. We have emphasised throughout the relevance of qualitative research to the micro and macro social worlds of health and illness. Thus, each module was designed to build on our previous understanding of what it means to engage in this broad field of inquiry. You will have noted by now that there are no definitive rules when it comes to qualitative research. There is a flexibility that can be daunting when starting out in one form or other of this broad area of research. But the key is theoretical rigour that co-exists with a flexible research framework. It is theoretical rigour that gives qualitative research legitimacy and depth. In view of the module content the last reading seems appropriate. Suggested reading McPherson, K. & Leydon, G. (2002) Quantitative and qualitative methods in UK health research: then, now and…? European Journal of Cancer Care, 11:225-231. Conclusion In conclusion, we hope from your study in this multidisciplinary qualitative health unit that several important things have been achieved. First, that your imagination, or your ways of thinking about professional learning and practical experiences, has been challenged. Second, that you are inspired to pursue qualitative investigations in your area of professional interest and that this inspiration will result in research that brings about soundly based beneficial nursing/health interventions to the community and contributes to the skills and knowledge base of your specialist area.