1.  Houser, J. (2012) Nursing Research: Reading, Using and Creating Evidence (2 nd Ed.). Chapter 16.  Polit, D. & Beck, C. (2010). Essentials of Nursing Research: Appraising Evidence for Nursing Practice (7 th Ed.). Chapter 10 QUALITATIVE DESIGNS & APPROACHES

2. Goal of Qualitative Inquiry Identify the meaning of a phenomenon, event or experience for an individual

3. Qualitative Research as Evidence for Practice Qualitative studies are best for identifying patient preferences, aggregating clinician experiences, and for identifying trends in the recommendations of clinical experts.

4. Naturalistic vs Positivist  Naturalistic paradigm  Reality is not fixed.  Reality cannot be known…it is constructed by each individual.

5. Characteristics of Qualitative Research Design  Flexible, elastic  Holistic  Intense researcher involvement  Emergent: ongoing analysis guiding design decisions  Bricolage: merging various data collection strategies

6. Characteristics of Qualitative Research Design, Cont.  No comparison group  Focus is to describe & explain new phenomenon  Non statistical methods  The Researcher:  becomes intimate with subjects  may remain in field for long periods of time  is the research instrument.

7. Characteristics of Qualitative Research Design, Cont.  Data analysis:  is ongoing.  may lead to changes in data collection.  strives for an understanding of the whole.  Flexible approach to data collection  No set plan that needs the researcher needs to stick to as with quantitative  Researcher does not know how study will evolve.

8. Why is it important to nursing?  Nursing is:  Humanistic  Holistic  Studying human experiences related to health and wellness can provides a wider prospective regarding how patient’s respond to & manage problems related to healthcare.

9. Advance Planning and Activities in Qualitative Studies  Selecting a research tradition  Selecting a study site  Identifying gatekeepers, gaining entrée  Identifying needed equipment for the field  Analyzing personal biases

10. Overview of Qualitative Research Traditions  Anthropology (Domain: Culture)  Ethnography; Ethnoscience  Philosophy (Domain: Lived Experience)  Phenomenology; Hermeneutics  Psychology (Domain: Behavior)  Ethology; Ecological psychology

11. Overview of Qualitative Research Traditions  Sociology (Domain: Social Settings)  Grounded theory; Ethnomethodology  Sociolinguistics (Domain: Communication)  Discourse analysis & Content analysis  History (Domain: Past Events, Conditions)  Historical research  Medicine/Psychology: Case Study

12. Ethnography  Describes and interprets a culture and cultural behavior  Culture is the way a group of people live—the patterns of activity and the symbolic structures (for example, the values and norms) that give such activity significance.  Relies on extensive, labor-intensive fieldwork  Culture is inferred from the group’s words, actions, and products.  Assumption: Cultures guide the way people structure their experiences.  Examines interrelationship between people, environment, culture, & health.

13. Types of Ethnography  Macroethnography (broadly defined cultures)  Microethnography (narrowly defined cultures)  Auto-ethnography/insider research (the study of one’s own culture)  Ethnonursing research (the intersection of nursing concerns and human culture)

14. Phenomenology  Focuses on the description and interpretation of people’s lived experience  Asks: What is the essence of a phenomenon as it is experienced by people, and what does it mean?  Acknowledges people’s physical ties to their world: “Being in the world”  Four key aspects of experience: Lived space, lived body, lived time, lived human relation  Main data source: In-depth conversations with a small number of participants who have experienced the phenomenon

15. Descriptive Phenomenology  Describes human experience  Based on philosophy of Husserl  Steps: Bracketing, Intuiting, Analyzing, Describing  Bracketing (identifying and holding in abeyance preconceived views)  May involve maintaining a reflexive journal

16. Interpretive Phenomenology  Emphasis on interpreting and understanding experience, not just describing it  Based on philosophy of Heidegger: Heideggerian hermeneutics  Bracketing does not occur.  Supplementary data sources: texts, artistic expressions

17.  Example: Hughes, A., Gudmundsdottir, M., & Davis, B. (2007). Everyday struggling to survive: Experiences of the urban poor living with advanced cancer. Oncology Nursing Forum, 34(6), p. 113-118.

18. Grounded Theory  Focuses on the discovery of a basic social psychological problem that a defined group of people experience  Elucidates social psychological processes and social structures  Has a number of theoretical roots—e.g., symbolic interaction  Originally developed by sociologists Glaser and Strauss

19. Grounded Theory Methods  Primary data sources: In-depth interviews with 20 to 40 people; may be supplemented with observations, written documents  Data collection, data analysis, sampling occur simultaneously

20. Grounded Theory Analysis  Constant comparison used to develop and refine theoretically relevant categories  Focus is on understanding a central concern or core variable  A basic social process (BSP) explains how people come to resolve the problem or concern

21. Alternative Views of Grounded Theory  Glaser and Strauss (generation of explanatory theory linking related concepts); called Glaserian methods  Strauss and Corbin (full conceptual description)  Nurse researchers have used both approaches

22.  Example:  Pain management decision making among long term care physicians & nurses” (Kaasalairens et al., 2007)

23. Case Studies  Not all qualitative studies are conducted within a disciplinary tradition. Examples include:  Case studies  These focus on a thorough description and explanation of a single case or small number of cases.  Cases can be individuals, families, groups, organizations, or communities.  Data often are collected over an extended period.

24. Narrative Analysis (Content Analysis)  Texts that provide detailed stories are sometimes analyzed through narrative analysis.  There are numerous approaches to analyzing texts.  One example is Burke’s pentadic dramatism: analyzes 5 elements of a story (act, scene, agent, agency, purpose); meant to be analyzed in ratios, such as act:agent

25. Descriptive Qualitative Studies  Many studies do not claim any specific type of approach or disciplinary tradition.  Such descriptive studies seek to holistically describe phenomena as they are perceived by the people who experience them.  The researchers may say that they did a content analysis of the narrative data with the intent of understanding important themes and patterns.

26. Research With Ideological Perspectives  Critical theory research:  Such research is concerned with a critique of existing social structures and with envisioning new possibilities.  Transformation is a key objective.  Ethnographies are especially likely to be critical.

27. Research With Ideological Perspectives  Feminist research:  Focuses on how gender domination and discrimination shape women’s lives and their consciousness  Participatory action research (PAR):  Produces knowledge through close collaboration with groups or communities that are vulnerable to control or oppression

28. Traditional Qualitative Research vs. Critical Research

29. Literature Review  2 approaches  Conduct after the study to prevent undue influence  Conduct before the study to provide some focus on the research problem

30. Entry Select & gain entry into research sites.  Make contacts with “gatekeepers” regarding how to access subjects  Get permission to conduct the study  Decide on setting for data collection.  “Real world site”  May occur in same setting for all participants “ home”  May differ from one participant to another.

31. Ethics Ethical practices  IRB application  May present more challenges due to intimate nature of research

32. Sampling Strategies  Participants  Informants  Respondents  Participants

33. Sampling  Purposeful sampling  Researcher identifies criteria for the type of informant most likely to provide information needed for the study  Informed consent  Snowball sampling  As participant is identified they in turn identify others. Useful for sensitive populations  Extreme case:  Unusual or special case – superior or worse case

34. Saturation  The point at which no new information is being generated and the sample size is determined to be adequate. The goal is saturation.

35. Data Collection Methods  Interviews  Focus groups  Direct observations  Field notes  Direct quotes  Non verbal communication  Setting

36. Data Collection & Ethics  Audio tapes  Video tapes