Qualitative Research in Nursing and Healthcare (eBook)

Immy Holloway is Professor Emerita in the Faculty of Health and Social Sciences at Bournemouth University in the United Kingdom. Kathleen Galvin is Professor of Nursing Practice in the School of Health Sciences at the University of Brighton, United Kingdom.

Cover 1
Title Page 5
Copyright Page 6
Contents 7
Preface 15
About the Authors 17
Acknowledgement 19
Part One Introduction to Qualitative Research: Starting Out 21
Chapter 1 The Essentials of Qualitative Research 23
What is qualitative research? 23
The characteristics of qualitative research 23
The primacy of data 24
Contextualisation 25
Immersion in the setting 25
The ‘emic’ perspective 26
Thick description 27
The research relationship 28
Insider/outsider research 29
Reflexivity 29
The place of theory in qualitative research 31
The use of qualitative research in healthcare 31
Choosing an approach for health research 33
References 34
Further Reading 36
Chapter 2 The Paradigm Debate: The Place of Qualitative Research 37
Theoretical frameworks and ontological position 37
The natural science model: positivism, objectivism and value neutrality 38
The paradigm debate 39
The interpretive/descriptive approach 41
Focus on postmodernism and social constructionism 43
Conflicting or complementary perspectives? 44
Final comment 45
References 45
Further Reading 46
Chapter 3 Initial Steps in the Research Process 47
Selecting and formulating the research question 47
The question must be researchable 49
The topic should be relevant and appropriate 49
The work must be feasible 50
The research should be of interest to the researcher 50
Practical issues 51
The research design and choice of approach 51
The literature review 52
The use of literature in qualitative research 53
Practicalities 55
Writing a research proposal 55
Structure of a proposal 56
Working title 56
Abstract of proposal 57
Introduction 57
The problem statement and rationale 57
Context and setting 57
The aim of the research 57
The literature 58
Resources 59
The research design and methodology 59
Limitations of the study 59
Sample selection and procedure 59
Data collection and analysis 60
Ethical and entry issues 60
References 60
Timetable and costing 60
Dissemination 60
Access and entry to the setting 61
The choice of setting 62
Access to gatekeepers 63
Summary 64
References 64
Further Reading 65
Chapter 4 Ethical Issues 67
The foundational ethical framework for research 69
Ethics in qualitative research 72
Introduction 72
Ethics in research with patients 72
Interviews and observations 73
Informed consent and voluntary participation 76
Anonymity and confidentiality 78
The participant information sheet 80
Researching one’s peers 82
The research relationship 82
The dual role 82
Research in the researcher’s workplace 84
The role of research ethics committees 84
Reviewing the research project 86
Key ethical questions: audiotaped interviews 86
Summary 90
References 90
Further Reading 92
Chapter 5 Supervision of Qualitative Research 93
The responsibilities of supervisor and student 94
Writing and relationships 96
Practical aspects of supervision 98
Single or joint supervision 99
Problems with supervision 100
Academic problems 101
Final notes 102
Summary 103
References 103
Further Reading 103
Part Two Data Collection and Sampling 105
Chapter 6 Interviewing 107
Interviews as sources of data 107
The interview process 108
Preparing for the interview 109
Types of interview 109
The unstructured, non-standardised interview 109
The semi-structured interview 110
The structured or standardised interview for demographic data 111
Types of questions in qualitative interviews 111
Practical considerations 112
Probing, prompting and summarising 113
The social context of the interview 114
Unexpected outcomes: qualitative interviewing and therapy 115
Length and timing of interviews 115
Recording interview data 116
Digital recording 116
Note taking 118
The interviewer–participant relationship 118
Peer interviews 118
Problematic issues and challenges in interviewing 119
Interviewing through electronic media 120
Online research and e-mail interviews 120
Telephone interviews 122
Ethical issues in interviewing 123
Strengths and weaknesses of interviewing 123
Advantages and limitations 124
The interviewer effect and reactivity 124
Summary 125
References 125
Further Reading 126
Chapter 7 Observation and Documents as Sources of Data 127
Participant observation 127
The origins of participant observation 128
Immersion in culture and setting 128
Focus and setting 129
Types of observation 131
The complete participant 132
The participant as observer 132
The observer as participant 133
The complete observer 133
Specific ethical issues in observation 133
Progression and process 134
The ‘who’ questions 134
The ‘what’ questions 134
The ‘where’ questions 134
The ‘when’ questions 135
The ‘why’ questions 135
Process 135
Problems in observation 136
Technical procedures and practical hints 137
Documentary sources of data 138
Images as sources of data 141
Summary 142
References 142
Further Reading 143
Chapter 8 Focus Group Research (FGR) 145
The nature and features of focus group research 145
The origin and purpose of focus groups 147
Focus group research in healthcare 147
Sample size and composition 148
Conducting focus group discussions 151
The involvement and tasks of the researcher/facilitator/moderator 152
Research with online or virtual focus groups 153
Recording, analysing and reporting focus group data 154
Advantages and problems of focus groups 156
Critical comments on focus group research in healthcare 158
Summary 158
References 159
Chapter 9 Sampling Strategies 161
Sampling decisions 161
Purposeful (or purposive) sampling 163
A variety of sampling types 165
Homogeneous sampling 165
Heterogeneous sampling 166
Total population sampling 166
Chain referral or snowball sampling 167
Convenience or opportunistic sampling 167
Maximum variation sampling 167
Theoretical sampling 168
Other types of sample selection 168
Inclusion and exclusion criteria 170
Sampling parameters 170
Sample size 171
Saturation 172
Giving a label to the participants 173
Summary 174
References 174
Further Reading 175
Part Three Approaches in Qualitative Research 177
Chapter 10 Ethnography 179
The development of ethnography 180
The cultural context 180
Ethnographic methods 182
Ethnography in healthcare 183
The main features of ethnography 185
Data collection through observation and interviews 185
The use of ‘thick description’ 186
Selection of key informants and settings 186
The emic–etic dimension 187
Fieldwork 189
The ethnographic record: field and analytic notes 190
Micro- and macro-ethnographies 191
Doing and writing ethnography 192
Description 192
Analysis 192
Steps in the analysis 193
Interpretation 194
Pitfalls and problems 195
Summary 196
References 196
Further Reading 197
Chapter 11 Grounded Theory Methodology 199
History and origin 200
Symbolic interactionism 201
The main features of grounded theory 201
Data collection, theoretical sampling and analysis 203
Data collection 203
Theoretical sensitivity 204
Theoretical sampling 205
Data analysis: coding and categorising 206
The core category 208
Constant comparison 208
The three main approaches 209
Using the literature 210
Integration of theory 212
Theoretical memos and fieldnotes 212
Pitfalls and problems 213
Glaser’s critique and further development 215
Which approach for the health researcher? 216
Summary 217
References 217
Further Reading 219
Chapter 12 Narrative Inquiry 221
The nature of narrative and story 221
Narrative research 222
Narratives in health research 222
The everyday story 226
Autobiographical and biographical stories 226
Cultural stories 227
Collective stories 227
Illness narratives 228
The restitution narrative 229
The chaos narrative 230
The quest narrative 230
Narrative interviewing 231
Narrative analysis 232
Thematic and holistic analysis 233
Structural analysis 234
Dialogic/performance analysis 235
Visual analysis 236
Ongoing debates about narrative 236
Summary 238
References 238
Further Reading 240
Chapter 13 Phenomenology 241
Intentionality and the early stages of phenomenology 242
Phases and history of the movement 243
The German phase 244
The French phase 246
Schools of phenomenology 247
The phenomenological research process: doing phenomenology 248
Grounding 248
Reflexivity and positional knowledge 249
‘Humanisation’ and the language of experience 249
Phenomenology and health research 251
Topics for phenomenological approaches 252
Choice of approach: descriptive or interpretive phenomenology 253
Procedures for data collection and analysis 255
Summary 258
References 258
Further Reading 261
Chapter 14 Action Research 263
The origins of action research 264
Critical social theory 265
Action research in healthcare 266
The main features of action research 267
The methodological continuum 268
Practical steps 270
Trustworthiness in AR 272
Problems and critique 273
Summary 275
References 275
Further Reading 276
Chapter 15 Additional Approaches 279
Case study research 279
Overview 280
Features and purpose of case study research 280
Conversation analysis 282
The origins of conversation analysis 283
The use of conversation analysis 283
Discourse analysis 285
Critical discourse analysis (CDA) 287
Performative social science 289
PSS in health research 290
Summary 291
References 292
Further Reading 295
Discourse Analysis 295
Further Reading 296
Performative Social Science 296
Further Reading 297
Part Four Data Analysis and Completion 299
Chapter 16 Data Analysis: Strategies and Procedures 301
Transcribing and sorting 303
Taking notes and writing analytic memos 304
Ordering and organising the data 305
Analytical styles 306
Coding and categorizing 307
Thematic analysis 308
Meaning and Gestalt 309
Problems of QDA 309
Inferential leaps and ‘premature closure’ 309
Collaboration in the process of analysis and interpretation 310
Computer-aided analysis of qualitative data 310
The reasons for computer use 311
Storing, annotating and retrieving texts 312
Locating words, phrases or segments of data 312
Naming or labelling 312
Sorting and organising 312
Identifying data units 313
Preparing diagrams 313
Approaches to qualitative computer analysis 313
Language-oriented 313
Descriptive/interpretive approaches 313
Theory building 314
The practicalities of using computer-aided analysis 314
Advantages of computer use 315
Problems and critique of computer analysis 315
Summary 316
References 317
Further Reading 318
Chapter 17 Establishing Quality: Validity and Trustworthiness 319
Quality 319
Conventional criteria 320
Rigour 320
Reliability 320
Validity 321
Generalisability or external validity 322
Objectivity and subjectivity 323
The concept of validity in qualitative research 324
An alternative perspective: trustworthiness 325
Dependability 325
Credibility 325
Transferability 325
Confirmability 326
Authenticity 326
Strategies to ensure trustworthiness 327
Member checking 327
Searching for negative cases and alternative explanations 329
Peer review 330
Triangulation 330
The audit or decision trail 331
Thick description 332
Prolonged engagement 332
Reflexivity 333
Quality and creativity 333
Summary 334
References 334
Further Reading 335
Chapter 18 Writing up and Publishing Qualitative Research 337
The research account 337
Use of the first person 338
The format of the report 339
Title 340
Abstract 341
Acknowledgement and dedication 343
Contents 343
Introduction 343
Background and rationale 343
Initial literature review (or overview of the literature) 344
Entry issues and ethical considerations 344
Methodology and research design 345
Description and justification 345
The sample and setting 345
Specific techniques and procedures 345
Data analysis 346
Trustworthiness 346
Findings/results and discussion 346
Telling the tale 346
The use of quotes from participants 347
The use of quotations from the literature 348
The use of diagrams and flow charts 348
Conclusion and implications 348
Reflections and reflexivity 349
Referencing 350
Appendices 350
Critical assessment and evaluation 351
Guide to research evaluation 351
Publishing and presenting the research 352
Books 353
Articles 353
Types of article 354
Articles for academic colleagues 354
Articles for practitioners 355
Articles for the lay reader 355
Student articles 355
Alternative forms of presenting or disseminating the research 355
Summary 356
References 356
Further Reading 357
Final Note 359
Glossary 361
Index 367
EULA 380