Not everything that can be counted counts and not everything that counts can be counted.

1. The conduct of Qualitative Research: Overview and Common Essential Elements Adopted By: Prof. Inaam Khalaf & Prof. Susan A. LaRocco Not everything that can be counted counts and not everything that counts can be counted. ( Albert Einstein )

2. Session objectives Upon completion of this session, you will be able to: • Explore the history of qualitative research in nursing • Define qualitative research • Differentiate between qualitative and quantitative research • Explore why we need to conduct qualitative nursing research • Identify the basis for the use of a qualitative methodology • Discuss the most important features of qualitative research.

3. History • Qualitative research was one of the first forms of social studies but in the 1950s and 1960s - as quantitative science reached its peak of popularity – • it was diminished in importance and began to regain recognition only in the 1970s.

4. History • The phrase 'qualitative research' was until then restricted as a discipline of anthropology or sociology, and terms like • ethnography, • fieldwork, • participant observation and • Chicago school (sociology) were used instead.

5. History • During 1970s and 1980s qualitative research began to be used in other disciplines, and became a significant type of research in the fields of • education • social work • women's studies, • disability studies, • information studies, • management studies, • nursing service studies, • psychology, • communication studies, and • consumer products industry.

6. History • In the late 1980s and 1990s new methods of qualitative research evolved, to address the perceived problems with reliability and imprecise modes of data analysis. • In the last thirty years the acceptance of qualitative research by journal publishers and editors has been growing.

7. What is qualitative research? Any kind of research that produces findings not arrived at by means of statistical procedures or other means of quantification." (Strauss & Corbin, 1990) To care for people and promote change in behavior, it is required to understand in-depth concepts such as • experience, • believes, • motivations and • intentions. So, listening and observing may give more information than sending questions.

8. What is qualitative research? (cont.) • Qualitative research is an approach which seeks to understand, by means of exploration, • human experience, • perceptions, • motivations, • intentions and • behavior.

9. What is qualitative research? (cont.) • It is interactive, • inductive, • flexible, • holistic and • reflexive method of data collection and analysis.

10. Why qualitative research in Nursing • Nursing has traditionally focused on the individual and the holistic nature of the person. • This value system is more consistent with qualitative research, the individuals perspective is very important whereas in quantitative research, the focus is on the group or population rather than on the individual.

11. Distinctions from quantitative research • sampling is purposive. • The role of the researcher is key. Researchers must reflect on their role in the research process and make this clear in the analysis. • Data analysis differs considerably. • Researchers must carefully code data and discern themes in a consistent and reliable way. • Exploratory (i.e., hypothesis-generating),

12. Distinctions from quantitative research • Qualitative research speaks to content validity -- do measures measure what a researcher thinks they measure? • Qualitative data cannot always be put into a context that can be graphed or displayed as a mathematical term. • Qualitative data may be useful to explain puzzling quantitative results, or may be used to generate additional variables to include in an analysis.

13. Distinctions from quantitative research • Highly useful in policy and evaluation research, • Qualitative research can yield useful insights about program implementation • A specialized form of qualitative research is cognitive testing, used to develop survey items.

14. Main features of Qualitative Research • Exploration • Inductive approach • Interactive and Reflective • Holistic • Flexible

15. Main features of Qualitative Research( cont. ) • Exploration is the essential feature of qualitative approach in order to understand the perceptions and actions of participants. • Exploration is to discover new people, customs, and to learn from them. • Exploration is a difficult task that requires training and experience.

16. Main features of Qualitative Research( cont. ) • Inductive approach: • The purpose of qualitative approach is to develop concepts and generates hypothesis. • The researcher is open to ideas which emerge from listening or observing people. • The inductive approach is useful when little is known about the topics one wants to study.

17. Main features of Qualitative Research( cont. ) • Interactive and Reflexive process • To avoid bias in quantitative approach, the researchers try to study phenomena in a detached way. • In qualitative studies, researchers use interaction between them and participants to get closer to the topic under study. • The researcher becomes an instrument of data collection. • The researchers probe, facilitate, and note tone, hesitations and repetition in participants responses.

18. Main features of Qualitative Research ( cont. ) • Interactive and Reflexive process (cont.) • There should be trust between participants and researchers. • The qualitative research should be reflexive i.e. examining not only what people say and do, but also why they say and do so.

19. Main features of Qualitative Research ( cont. ) • Holistic exploration • In quantitative research, the researcher is constrained by a number of variables to be studied. • In qualitative research, participants are allowed to put their responses in context.

20. Main features of Qualitative Research( cont. ) • Flexible methods Qualitative research relies on personal, intimate and private world of participants. • So flexible, • imaginative, • creative and • varied strategies are used to facilitate this process.

21. Data collection methods in Qualitative Research Data collection methods include; • interviews, • observations, • group discussion, • analysis of video recording, • letters, • diaries and • other documents.

22. Types Of Qualitative Research • Phenomenological studies : • It examine human experiences through the descriptions that are provided by the people involved.“ live experiences ”. • Subjects are asked to describe thin experience as they perceive them. e.g “ what is it like for a mother to live with a teenage child who is dying of AIDS ?. ”

23. Ethnographers interview people who are most knowledgeable about the culture ( key informants ) Data are collected through participant observation, interviews, genealogy, demography, and life histories.

24. View nursing and health care in the context in which it occurs. Examine health from the point of view of health careconsumers, rather than from the perspective of health care providers.

25. Grounded Theory Studies : Data are collected and analyzed and then a theory is developed that is grounded in the data. Uses both an inductive and a deductive approach to theory development. Constructs and concepts are grounded in the data and hypotheses are tested as they arise from the research.

26. At this research, purposeful sampling is used the researcher looks for certain subjects who will be able to shed new light on the phenomenon that is being studied. Diversity rather than similarly is sought in the people are sampled . Data collection primarily of participant observation and interviews and data are recorded through handwritten. Notes and tape recordings, the generation rather than the testing of hypotheses.

27. Historical Studies: To examine the roots of nursing through historical research. Historical studies concern the identification, location, evaluation, and synthesis of data from the past.

28. It relate these past happening to the present and to the future. Some historical research are descriptive research. The data for are usually found in documents or in Relics and artifacts printed material

29. Examine the types of equipment used by nurses in another time period. Historical data can also be obtained through oral reports. The material found in Libraries, archives, or in personal collections.

30. Case Studies : In-depth examinations of people or groups of people. A case study could also examine an institution such as hospice care for the dying. A case study may be considered as a quantitative or qualitative research study.

31. To be consider as qualitative, the researcher must be interested in the meaning of experiences to the subjects theme selves rather than in generalizing results to other groups of people .

32. Case studies are not used to test hypotheses but hypotheses may be generated from case studies. Data may be collected in case studies through questionnaires interviews, observations, or written accounts by the subjects.

33. A nurse researcher might be interested in how people with diabetes respond to an insulin pump, one person or a group of people with diabetes could be studied for a time … Diaries might be used for the day-to-day recording of information then the researcher analyze these diaries and try to interpret the written comments.

34. Content analysis is used in evaluating the data from case studies. The researcher searches for patterns and themes . E.g “ release from self – inflicted pain “. “ freedom from rigid schedule”. Avoid selection bias. Case studies are time consuming and costly Subject dropout may occur.

35. Students Activities • Each group consist of 3 participants… • Group (1): Explain the study design, and the theoretical foundation used in the article… • Group (2): Identify the study objectives, research questions, and methods of data collection, time needed to collect the data, the number of participants … • Group (3): The reliability and validity of the study, method used in data analysis, limitations of the study…

36. Qualitative Research in Nursing and health Research • explore patients’ experience and behavior. • explore the experience and behavior of nurses and other health professionals. • evaluate intervention and services. • explore core concepts relevant to nursing and health.

37. Data collection in qualitative studies • Qualitative researchers, typically rely on four methods for gathering information: • participation in the setting, • direct observation, • in depth interviews, and • analysis of documents and materials • focus groups and key informant interviews.

38. In addition to the following methods Open – ended questionnaires. Life histories. Diaries. Personal collections of letters and photographs. official documents.

39. Qualitative researchers may use different approaches in collecting data, such as Thegrounded theorypractice, Narratology storytelling, classicalethnography, or shadowing.

40. The amount of time is generally specified when a study begins. In grounded theory methodology data collection continues until the data are saturated. The researcher stops collecting data when no new information is being obtained from subjects. After 5 people or more than 100. The number of subjects interviewed is quite small.

41. Reliability and validity of qualitative data • The reliability and validity are often viewed with skepticism. • The generalizability of findings is not present to the same extent as in quantitative studies. • Qualitative research are generally not replicated because knowledge of the findings of one study could bias the results of another study, (Each situation is unique).

42. Analysis of qualitative Data Analysis involves • an examination of words rather than numbers as is done in quantitative studies. • Then form an impression, • and report their impression in a structured, many times, quantitative form. • These impressions can be the final conclusion of the analysis, or some quantitative characteristics of the data to be further analyzed using some quantitative methods.

43. Frequently a massive amount of data, in the from of words … The task of analyzing all these data can be over whelming. The researcher begins interpreting data as data are collected. Content analysis is a common method of analyzing data.

44. Content analysis involves creating categories of data and developing rules for coding data into these categories. Data may be analyzed manually or through computer programs, Several software packages designed for qualitative data analysis enable complex organization and retrieval of data. Among the most widely used are QSR NUD*IST and ATLAS.ti. The benefits of these types of programs are mostly limited to storing and segregating data, rather than in processing or analyzing them.

45. Five stages of data analysis in the framework approach • Familiarization immersion in the raw data (or typically a pragmatic selection from the data) by • listening to tapes, • reading transcripts, • studying notes and so on, in order to list key ideas and recurrent themes

46. Identifying a thematic framework identifying all the key issues, concepts, and themes by which the data can be examined and referenced. This is carried out by drawing on a priori issues and questions derived from the aims and objectives of the study as well as issues raised by the respondents themselves and views or experiences that recur in the data. The end product of this stage is a detailed index of the data, which labels the data into manageable chunks for subsequent retrieval and exploration

47. Indexingapplying the thematic framework or index systematically to all the data in textual form by annotating the transcripts with numerical codes from the index, usually supported by short text descriptors to elaborate the index heading. Single passages of text can often encompass a large number of different themes, each of which has to be recorded, usually in the margin of the transcript

48. Chartingrearranging the data according to the appropriate part of the thematic framework to which they relate, and forming charts. For example, there is likely to be a chart for each key subject area or theme with entries for several respondents. Unlike simple cut and paste methods that group verbatim text, the charts contain distill summaries of views and experiences. Thus the charting process involves a considerable amount of abstraction and synthesis

49. Mapping and interpretationusing the charts to define concepts, map the range and nature of phenomena, create typologies and find associations between themes with a view to providing explanations for the findings. The process of mapping and interpretation is influenced by the original research objectives as well as by the themes that have emerged from the data themselves

50. Limitations of Qualitative Research • It is anecdotal (stories told for dramatic quality without critical evaluation) • Unscientific • Producing findings that are not generalizable • Impressionistic (vague) • Subjective