Research methods continued Interviews Data collection, storage, analysis Documents Dealing with bad news Presenting your findings Findings into practice

Types of interview NOTE: A totally unstructured interview is impossible! Standard interview – the order and wording of the questions is identical for each respondent Non-schedule standardised interview – a list of issues and questions that the researcher can phrase and order according to the situation Non-standardised interview – no specific set of questions is asked.

Interviews

Interviews need practice and careful management Rehearse and be sure of your interview type e.g. : Standard interview – order and wording exactly the same for each respondent Non-scheduled standard – list of issues but researcher decides on phrases and orders questions Non-standardised – no specific set of questions is used Is the tape recorder working and switched on? Have you explained about the research? Informed consent, publication, anonymity?

Validity of interviews Do NOT approach the interview assuming you know the answer! (very common amongst nurses) Listen actively! Can we be sure that what a respondent says represents reality? We all present ourselves as sane and competent in managing our interactions (impression management, Erving Goffman) It is the consequences of the definition that is important in order to identify opportunities for health gain

Focus groups

Interviews need careful management

Challenge From your own experiences of interviews, professional or research, do you feel that your respondents always give you ‘true’ accounts or are they ‘managing their own account’ of reality?

Data management Remember that you will always have too much data! Transcribing tapes is a very long process Students rarely have secretarial help – all transcriptions should be anonymous with a unique code Students need the learning experience of listening to tapes - Identifying codes and categories, making changes, re-ordering themes and links Plan number of interviews/observations so that management is possible – this is a learning experience Have a ‘practice run’ with two interviews Research supervisors are crucial to this learning process Do not expect international publication of small scale studies

Data storage All data should be kept locked with researcher having key Links between identity of respondents and their research codes kept secure, known only to one (or two) persons Research supervisors have a responsibility to ensure that data is kept secure Supervisors also should advise on resources: – Are tape recorders available on loan? Are software programmes and related teaching available? Does the university have legal requirements for students? What financial resources are available to students?

Data analysis (1) Different terms may be used : interpreting, analysing, transforming, making sense of – Analysis of findings consists of three overlapping types: Based on language (discourse analysis) Based on description and interpretation (ethnography) Based on theory building (grounded theory)

Data analysis (2) Qualitative analysis tends to be iterative (done continuously and repeatedly) The findings of early field work may form the basis for later design modification In this sense, very different to quantitative studies where analysis is done at the end of data collection However, data software for qualitative analysis can reduce the data and make it more manageable; emerging categories can be ‘summed’ (is this still qualitative research?)

Data analysis (3) Three levels of analysis (frequently found in different papers presented for publication) Data without analysis – respondents ‘speak for themselves’ with little or no interpretation Analysis with descriptive commentary, which may be theoretical in nature Development of theory alongside the analysis; conceptualisation of data and relation of concepts forms a theoretical account of reality. NOTE: it is always important to identify disconfirming concepts – the exceptions to the rule- narrowing the range of the theory.

Documents All of the following may be used to inform the context of your findings: Historical records Official statistics: demographic, mortality, morbidity, birth rate, income, employment, public health issues, maps Access to services: hospitals, community clinics, costs, distances, public transport, non-medical support Specialist services: maternal and child health, school health, family planning, genetic counselling, cancer services, care for the elderly, mentally ill, learning disabilities Nursing records

Presenting your findings Post-graduate degrees always involve pressure to complete within an (impossible) timetable Huge mental effort is required in writing up We may eventually present the research process as a sequence but in reality it is iterative – going back repeatedly, changing and re-ordering things, gradually making deeper and deeper sense of the project we have undertaken The final understanding and theorising may come much later, after we have been awarded the degree!

My PhD process 1980 Research design, instrument development, permissions 1981 Data collection (all perinatal deaths and matched controls in one calendar year) 1982 Analysis and writing up for health district report 1983 Presentation of report, return to health visiting teaching, began writing up my PhD (in my own time!) 1985 Moved to Warwick University; set up research centre 1985 continued – given one day a week to complete PhD 1986 1 January, submitted PhD, April Viva, June awarded degree 1988 – 1992 minor articles – 1992 (2004) Chapter

Dealing with bad news Do NOT shoot the messenger (support the researcher) Well done health services research will inevitably identify examples of poor practice The research should attempt to identify the reasons and present a balanced view The problem with nurses researching nurses is that too often they present a list of complaints without analysis! Discussion should include possible explanations This is where theorising is important and has the potential for changing practice

Findings into practice This requires a change agent in the organization Different skills are needed (unless Action Research) Research findings do not ‘speak for themselves’ Organizations that commission research should learn this lesson; take the findings and decide what to do with them Good health services research should not be left to gather dust upon the shelves!

Now ….. As we say in English – Dip your toe in the water!