See discussions, stats, and author profiles for this publication at: https://www.researchgate.

net/publication/223993161

Focus groups in nursing research: Methodological perspectives

Article  in  Nursing outlook · March 2012

DOI: 10.1016/j.outlook.2012.02.001 · Source: PubMed

CITATIONS READS

95 2,449

1 author:

Rasika Jayasekara
University of South Australia
51 PUBLICATIONS   261 CITATIONS   

SEE PROFILE

Some of the authors of this publication are also working on these related projects:

best practice for midwives View project

NHMRC project on Norovirus View project

All content following this page was uploaded by Rasika Jayasekara on 29 November 2017.

The user has requested enhancement of the downloaded file.

 Available online at www.sciencedirect.com

Nurs Outlook 60 (2012) 411e416

www.nursingoutlook.org

Focus groups in nursing research: Methodological

perspectives
Rasika S. Jayasekara, RN, BA, BScN(Hons), PGDip Edu, MNSc, MClinSc, PhD*
School of Nursing and Midwifery, University of South Australia, Adelaide, SA, Australia

article info abstract

Article history: Focus groups have been increasingly used as a data collection method in nursing
Received 17 February 2011 research. The key feature of focus groups is the active interaction among
Revised 7 February 2012 participants to explore their views and opinions. In this respect, focus groups are
Accepted 15 February 2012 distinct from other methods such as Delphi groups, nominal groups, brain-
Online 29 March 2012 storming, and consensus panels, which seek to determine a consensus between
participants. Compared with other data collection methods, it can be concluded
that the real strength of focus groups is not simply in exploring what partici-
Keywords: pants have to say, but in providing insights into the sources of complex
Focus groups behaviors and motivations. The aim of this paper is to present an overview of
Nursing research the focus group as a research tool in nursing research, particularly in nursing
Education education.
Methodology Cite this article: Jayasekara, R. S. (2012, DECEMBER). Focus groups in nursing research: Methodological
perspectives. Nursing Outlook, 60(6), 411-416. doi:10.1016/j.outlook.2012.02.001.

Introduction Purpose and Rationale for Using Focus Groups as

Research Method

Focus groups have become an increasingly popular
method of data collection in nursing research. It is
well established that the focus group method is
a useful and effective mechanism in which the
researcher is interested in processes whereby a group
jointly constructs meaning about a topic.1,2 Several
researchers have critically analyzed the methodolog-
ical and pragmatic uses of this technique; however,
their relevance to nursing research is limited.3,4 The
purpose of this paper is to present an overview of the
focus group as a research tool in nursing research,
particularly in nursing education. This paper also
provides methodological perspective including design
of the focus groups and maintaining the reliability and
validity.
Morgan5 defines a focus group as “a research technique
that collects data through group interaction on a topic
determined by the researcher.” This definition
provides the 3 major components of the focus group
research: (1) A method devoted to data collection, (2)
interaction as a source of data, and (3) the active role of
the researcher in creating group discussion for data
collection.5 A focus group, however, is not the same as
a focused interview. A focused interview with a group
concentrates on what each group member feels or
thinks about a specific issue.1,2,5-7 In comparison, the
key feature of focus groups is the active interaction
among participants to explore their views and opin-
ions. In this respect, focus groups are distinct from
other methods such as Delphi groups, nominal groups,

* Corresponding author: Dr. Rasika S. Jayasekara, School of Nursing and Midwifery, University of South Australia, City East Campus,
North Terrace, Adelaide, SA, 5000, Australia.
E-mail address: rasika.jayasekara@unisa.edu.au (R.S. Jayasekara).
0029-6554/$ - see front matter Ó 2012 Elsevier Inc. All rights reserved.
doi:10.1016/j.outlook.2012.02.001
412 Nurs Outlook 60 (2012) 411e416
brainstorming, and consensus panels, which seek to
determine a consensus between participants.1,8,9
Focus group discussions are the most appropriate
method for the purposeful use of interaction to generate
meaningful opinions, suggestions, and feedback.3,10
Focus groups are not only used to gain new knowledge
or evaluate services and programs but also to seek
opinions, values, and beliefs in a collective context.6,10-
12
In particular, the focus group provides a means of
listening to the perspective of key stakeholders and
learning from their experiences of the phenomenon.13
Powell et al9 argue that focus groups are particularly
useful when current knowledge about a phenomenon is
inadequate and expansion is important. The focus
group method is important when the issue being
investigated is complex and when concurrent use of
additional data is necessary for validity.11 The ability to
observe the extent and nature of participants’ agree-
ment and disagreement is a unique strength of focus
groups.5 Thus, focus groups have clear potential when
the researcher is interested in processes, whereby
a group jointly constructs meaning about a topic.
A foundational premise of the focus group is that the
group dynamic can assist people in expressing and
clarifying their views in ways that are less likely to
occur in a one-on-one interview.10,14,15 In addition,
a homogeneous group provides the participants with
freedom to express thoughts, feelings, and behavior
candidly.16 It is believed that group situation may
reduce the influence of interviewer on the participants
by tilting the balance of power toward the group.
History and Theoretical Traditions of the Focus Group
as Method
The origin of the focus group can be traced back to the
time when social scientists first began using nondi-
rective interview techniques.4 In 1926, Bogardus17
originated the focus group technique as a tool for
understanding people’s attitudes and opinions about
different social issues (eg, race relations).11 However,
Morgan18 describes the history of the focus group as
being divided into 3 periods: (1) Focus group in social
science, (2) focus group in market research, and
(3) focus group as a widespread research method.
During the early 1940s, Robert Merton and Paul Laz-
arsfeld introduced the method of group interviewing
into the social sciences.12,18,19 They used focus group
interviews to evaluate the response of a group of
participants to wartime radio broadcasts at the Office
of Radio Research at Colombia University in 1941.12,19
Focus group interviews have been used consistently
in market research since the 1950s, although their use
in other applications waned until the late 1980s when
there was renewed interest in promoting the use of
focus groups in social science research and a wide
range of academic and applied research areas.12,13,18
Today, the focus group is used as a research method
in many fields, including social sciences, health, and
nursing, to explore a range of issues.
Historically, the focus group method developed and
matured outside of the major qualitative methodolog-
ical traditions.1 Although some early field researchers
(eg, Bronislaw Malinowski, 1914; William Foote Whyte,
1943) acknowledged using focus group interviews, they
did not explicitly reference it as a distinctive method-
ology.12 Krueger10 argues that the integration of quali-
tative techniques, especially the focus group into social
science, has been slow because of the emphasis on
quantitative methods for social inquiry.
In general, the qualitative research paradigm
includes a range of methodologies: Phenomenology,
grounded theory, ethnography, historical research,
philosophical inquiry, and critical social theory.15,20 In
most research literature, focus groups are described as
a qualitative data collection method. As a data collec-
tion method, the focus group involves the interaction
within a group to elicit rich experiential data 21 and this
strategy is not compatible with:
1. Phenomenology, which attempts to disclose the
essential meaning of participants’ lived experience
through in-depth individual interviews22;
2. grounded theory, which aims to generate theory that
is verified through systematic, concurrent data
generation and constant comparative data analysis
through several data collection strategies (eg, inter-
views, observation, documents)23; and
3. ethnography, which is the work of describing culture
and explores the meaning of action and events of the
culture using a continuous process of interviewing,
observing, reviewing, and analyzing data.24
It is clear that the focus group as a method was not
originally developed or integrated into any of the major
qualitative methodologies. However, the focus group
method is becoming popular in feminist and post-
modernist ethnographic studies.12 These researchers
contend that the focus group method recovers the voice
of members of marginalized groups in society.12,25 The
focus group method is also widely used in social
sciences and health sciences in combination with other
research methods (eg, survey research), enabling the
researcher to triangulate the data and enhance the
findings of the study.5,20 Kidd and Parshall1 suggested
that the findings of focus groups can be further
improved by conducting multiple groups (ideally from
multiple sites) and including other data sources.
The theoretical underpinnings of focus groups can
be traced to the assumptions of the interpretive para-
digm. Interpretive research generates new meaning
and information from the participants’ point of view,
thus it values human perceptions and subjectivity and
seeks to explore what an experience is like for the
people concerned.22 In this paradigm, intersubjectivity
(mutual recognition) between researcher and research
participants is fostered and valued.26 This paradigm
involves listening to people or watching what they do
and using the human imagination and understanding
of those participating to interpret their meaning.27 The
 Nurs Outlook 60 (2012) 411e416
researcher must understand the socially constructed
nature of the world and realize that values and interest
become part of the research process.28 In fact, the
values of researcher and participants can become an
integral part of the research.
Uses of Focus Groups in Health and Nursing
In health and nursing research, focus groups are
invaluable for guiding the development of interventions
and ensuring that these interventions meet consumer/
patient needs.29 The focus group method has been
commonly used in health care and nursing studies. It is
typically used in health care research to (1) Develop or
improve research instruments (eg, interviews guides,
questionnaires)11,30,31; (2) explore issues and generate
data32-34; and (3) evaluate and validate findings from
other research methods (or triangulation).35,36
The ability of focus groups to provide information
about complex and multifaceted topics is discussed
extensively in nursing education research, especially in
curriculum development. Several studies37-41 have used
the focus group method to explore the students’
perspective and experiences of teaching and learning.
The focus group method is also widely used in curric-
ulum development to obtain key stakeholders’ views and
opinions. The curriculum committee of the University of
San Diego, Philip Y. Hahn School of Nursing conducted
a study with focus groups comprised of nurses from
several different areas of practice to obtain information
for curriculum changes.42 Focus groups comprised of
nurses and community members were used to develop
and expand predefined themes of a primary health
careebased curriculum.43 The Australian Universities
Teaching Committee’s (AUTC) commissioned study
developed and implemented a framework to evaluate
nursing curricula, teaching strategies, assessment prac-
tices, and learning outcomes. The project team con-
sulted key stakeholders via 3 networks of experts, 21
national focus groups, and 4 surveys, and undertook
extensive document analyses of 26 current undergrad-
uate nursing curricula in Australia.44 Both the focus
groups and the academic network survey identified
strong support for the continuation of broad-based,
comprehensive, university-based bachelor’s degrees for
nurse education.44
There are several reasons for use of focus groups in
nursing and health care professional education.
Importantly, focus groups offer a more concrete
opportunity for participants and researchers to learn
from the process, being a powerful way of engaging
with professionals, policy makers, and end-users (ie,
students).45 Furthermore, participants’ views and
understandings are shared, debated, challenged, and
changed during the focus group discussion.
Design of the Focus Group
Authors in the literature suggest that each focus group
be comprised of homogeneous participantsdin terms
413
of the nature of their experience of the issuedto avoid
the generation of power issues and promote the
comfort of participants.10,18,46-48 Carey48 recommended
that focus groups be homogeneous in terms of age,
status, class, occupation, and other characteristics,
because they will influence whether participants
interact with each other. However, some researchers
reject the use of homogeneity in focus groups and
suggest using heterogeneous groups in exploratory-
type studies because it provides rich data and
explores different views of the topic investigated.11,37
Finally, the nature of the group depends on the avail-
able time, resources, and convenience for participants.
The interpretive approach allows the researcher to
select participants on the basis of suitability and diver-
sity of their experience with the topic under investiga-
tion using convenience or purposive sampling.49,50 It
is generally recognized that the sample recruited in
focus groups is not representative of the entire pop-
ulation but rather a snapshot. However, the size of the
group and the number of groups is dependent on the
purpose of the research and the type of participants.13,50
Despite the various suggestions for optimal partici-
pant numbers, it is important that the size of each
group is large enough to create discussion but not too
large that it prevents some members from sharing
their insights within the available time. Most authors
suggest that an adequate group size is from 4 to 12
participants, with the optimal size being between 5 and
10.10,18,51,52 However, it is argued that smaller groups
can be effective for complex topics, particularly with
expert participants enabling them to focus on the
topic.10 A few authors suggest that it is prudent to over-
recruit, usually by 2 participants, because of potential
late cancellations.13,18
The best number of focus groups to conduct
depends on the nature and complexity of the area
under investigation. Most authors support the use of 4
to 6 focus groups to generate adequate data.5,10,50 The
typical justification for this range is that the data
become saturated and further focus groups become
unnecessary.5,14,50,51
Reliability and Validity
It is well established that the focus group method is
a useful and effective mechanism for deriving collec-
tive opinions, values, and beliefs. However, several
researchers have noted the pragmatic use of this
method.8,53 In response, attention has been directed at
assessing the reliability and validity of focus group
data. In general, reliability is defined as the extent to
which the results of a study or a measure are repeat-
able in different circumstances, whereas validity refers
to the degree to which a study accurately reflects or
assesses the specific concept that the researcher is
attempting to measure. Although Patton54 argues that
validity and reliability are important in qualitative
research, others argue that the concept of reliability is
even misleading in qualitative research if a qualitative
414 Nurs Outlook 60 (2012) 411e416
study is discussed with reliability as a criterion; the
consequence is rather that the study is no good.55,56 In
reality, the quality of a study in each paradigm should
be judged by its own paradigm’s terms.57 For example,
although the terms reliability and validity are essential
criteria for quality in quantitative paradigms, in qual-
itative paradigms the terms credibility, neutrality or
confirmability, consistency or dependability, and applica-
bility or transferability are to be the essential criteria for
quality.58 However, the examination of trustworthi-
ness is crucial to ensure reliability and validity in
qualitative research. Seale59 states that establishing
the trustworthiness of a research report lies at the
heart of issues conventionally discussed as validity
and reliability, also being central to any conception
of quality in qualitative research. However, the
researcher would not normally have the insider
knowledge to know the extent to which narratives
reflect the realities of focus group discussions. Thus,
the capacity of group members to monitor and invigi-
late the authenticity of what is being revealed has the
potential to reinforce the trustworthiness of focus
groups.60 Furthermore, marginal voices within focus
groups may affect the trustworthiness of the dominant
group view emerging and even serve to moderate it.60
Kidd and Parshall1 discuss the reliability of the focus
group method using conventional terms of stability,
equivalence, and internal consistency. Stability refers
to the consistency of issues over time.1 With focus
groups, stability is an issue when the same group is
convened on more than one occasion, especially if
some members present on one occasion are absent on
another.1 Equivalence is a term used to describe the
consistency of the moderators or coders of the focus
group.1 Internal consistency of coding relates to the
importance of having one team member assume the
overall responsibility for analyzing the data.1
In qualitative research, validity receives more
attention than reliability.56 Maxwell61 identified 3 types
of validity that could be used to assess the validity of
the focus group method:
(a) Descriptive validity refers to the factual accuracy of
the account.
(b) Interpretative validity refers also to aspects of
accounts. These accounts must be grounded in the
language of the participants and rely as much as
possible on the respondents’ own words and
concepts. The jump from the words and actions
of participants to the accounts constructed by
researchers is always a matter of inference.
(c) Theoretical validity refers to the function of
accounts as explanation and more exactly to the
inference from data to report. This also applies to
the postulated relationships between concepts, so
that it is also called internal or concept validity.
Several authors provide standards for quality focus
group research, applying concepts of validity and
reliability.1,5,62
 While preparing the focus groups, it is important to
develop a manual. If there is no manual, the research
does not conform to a basic requirement for
replicability.
 A lack of precise and consistent research questions
damages, in particular, the theoretical internal val-
idity of focus groups. Clarity of research questions
can both provide relevant answers to the research
and ensure that it is repeatable.
 The moderator must be sufficiently involved in the
group to fulfill the role of facilitator, but not so
dominant as to bias or inhibit discussion.
 Descriptive validity (factual accuracy) and interpre-
tative validity (grounded in the language of partici-
pants) requires a recording technique that is as
accurate as possible. The best way is to use audio-
taping that is subsequently transcribed literally;
however, it could be helpful to take “minutes” as an
instrument for a first analysis of the relations between
discussed issues (theoretical validity).
 The analytic plan is contextual and not statistical,
which means that the quality of the responses and
their association are more relevant than their
frequency.
 Writing a report of the focus group responses requires
a balance between the direct connotations of partici-
pants (descriptive validity) and the scientific interpre-
tations (theoretical validity) of those connotations.
Limitation of Focus Groups
As with any other research method, focus groups have
some limitations. As previously mentioned, focus group
methods are usually not used to build consensus.14,50,63
Some researchers feel that focus groups are less useful
for investigating sensitive topics such as sexual activi-
ties or behaviors that may be considered socially
deviant, such as drug use or sexual misconduct,
because participants are reluctant to talk about such
issues as a group.13,18,50,64 However, other researchers
argue that focus group methods were successful in
addressing sensitive topics because they enabled
participants to share their experience within the group
in a mutually comforting and reassuring environ-
ment.12,65 In terms of facilitating such discussion, small
groups may be used in studies of sensitive behavior.
Group interaction is limited by the personal character-
istics of participants and social factors such as class,
gender, and race.50 The interaction of the participants
might be limited if power differentials exist between
participants of the focus group, because participants in
the less powerful situation might indicate agreement
with their more powerful colleagues to avoid perceived
reprisals.4,10 The potential domination of the group by
one or a small number of participants may suppress an
emerging group view and group interaction.4,66,67
In addition, there are inherent practical limitations
with conducting focus groups. Compared with indi-
vidual interviews, a focus group is usually more
 Nurs Outlook 60 (2012) 411e416
difficult to arrange, and bringing participants together
requires energy, time, and money.6,10,66 In addition,
a group situation can lead to uncontrolled tangential
discussion producing irrelevant responses and data,
especially when a moderator is less experienced.10,50,66
Transcription is more complex and costly as well.
Conclusion
It is evident that the focus group method is an effective
data collection method for a range of issues, in partic-
ular where the researcher seeks opinions, values, and
beliefs in a collective context. The real strength of focus
groups is not simply in exploring what participants
have to say, but in providing insights into the sources of
complex behaviors and motivations. In health and
nursing research, focus groups are invaluable for
guiding the development of interventions and ensuring
that these meet consumer needs. There are several
ways to improve the validity and reliability of focus
groups; however, nursing researchers should be aware
of possible limitations of the focus group method.
references
1. Kidd PS, Parshall MB. Getting the focus and the group:
enhancing analytical rigor in focus group research. Qual
Health Res 2000;10:293e308.
2. Shaha M, Wenzel J, Hill EE. Planning and conducting focus
group research with nurses. Nurse Res 2011;18:77e87.
3. McLafferty I. Focus group interviews as a data collecting
strategy. J Adv Nurs 2004;48:187e94.
4. Happell B. Focus groups in nursing research: an appropriate
method or the latest fad? Nurse Res 2007;14:18e24.
5. Morgan DL. Focus groups. Annu Rev Sociol 1996;22:129e52.
6. Curtis E, Redmond R. Focus groups in nursing research. Nurse
Res 2007;14:25e37.
7. Ruff CC, Alexander IM, McKie C. The use of focus group
methodology in health disparities research. Nurs Outlook
2005;53:134e40.
8. Webb C, Kevern J. Focus groups as a research method:
a critique of some aspects of their use in nursing research.
J Adv Nurs 2001;33:798e805.
9. Powell RA, Single HM. Focus groups. Qual Assur Health Care
1996;8:499e504.
10. Krueger RA, Casey MA. Focus groups: a practical guide for
applied research. 3rd ed. Thousand Oaks, CA: Saga; 2000.
11. Powell RA, Single HM, Lloyd KR. Focus groups in mental
health research: enhancing the validity of user and provider
questionnaires. Int J Soc Psychiatry 1996;42:193e206.
12. Madriz E. The focus group in feminist research. In:
Denzin NK, Lincoln YS, editors. Handbook of qualitative
research. 2nd ed. Thousand Oaks, CA: Sage; 2000. p. 835e50.
13. Halcomb EJ, Gholizadeh L, DiGiacomo M, et al. Literature
review: considerations in undertaking focus group research
with culturally and linguistically diverse groups. J Clin Nurs
2007;16:1000e11.
14. Jamieson L, Williams LM. Focus group methodology:
explanatory notes for the novice nurse researcher. Contemp
Nurse 2003;14:271e80.
415
15. Burns N, Grove SK. The practice of nursing research: conduct,
critique, and utilization. 5th ed. St. Louis, MO: Saunders;
2005.
16. Morrison RS, Peoples L. Using focus group methodology in
nursing. J Contin Educ Nurs 1999;30:62e5. quiz 94-5.
17. Bogardus ES. The group interviews. J Appl Sociol 1926;12:372e83.
18. Morgan DL. The focus group guide book. Thousand Oaks, CA:
Sage; 1998.
19. Puchta C, Potter J. Focus group practice. London: Sage; 2004.
20. Speziale HJS, Carpenter DR. Qualitative research in ursing:
advancing the humanistic imperative. 4th ed. Philadelphia:
Lippincott Williams & Wilkins; 2007.
21. Asbury J. Overview of focus group research. Qual Health Res
1995;5:414e20.
22. van Manen M. Researching lived experience; human science
for an action sensitive pedagogy. New York: State University
of New York; 1990.
23. Strauss A, Corbin J. Basics of qualitative research: grounded
theory procedure and techniques. Newbury Park, CA: Sage; 1998.
24. Spradley JP. Participant observation. New York: Holt Rinehart
& Winston; 1997.
25. Clark MJ, Cary S, Diemert G, et al. Involving communities
in community assessment. Public Health Nurs 2003;20:
456e63.
26. Horsfall JM. Madness in our methods: nursing research,
scientific epistemology. Nurs Inq 1995;2:2e9.
27. Pearson A, Vaughan B, Fitzgerald M. Nursing models for
practice. Sydney: Butterworth-Heinemann; 2005.
28. Fitzgerald M. Interpretive and critical research in nursing.
Adelaide: The University of Adelaide; 2000.
29. Morgan DL. Focus groups as qualitative research. 2nd ed.
Thousand Oaks, CA: Sage; 1997.
30. Arnetz JE, Hoglund AT, Arnetz BB, et al. Staff views and
behaviour regarding patient involvement in myocardial
infarction care: development and evaluation of
a questionnaire. Eur J Cardiovasc Nurs 2008;7:27e35.
31. DeVellis RF, Patterson CC, Blalock SJ, et al. Do people with
rheumatoid arthritis develop illness-related schemas?
Arthritis Care Res 1997;10:78e88.
32. Gray-Vickrey P. Gerontological research: use and application
of focus groups. J Gerontol Nurs 1993;19:21e7.
33. Capitulo KL. Improving patient satisfaction through focus
group interviews. Nurs Leadersh Forum 1998;3:124e9.
34. Songstad NG, Rekdal OB, Massay DA, et al. Perceived
unfairness in working conditions: the case of public health
services in Tanzania. BMC Health Serv Res 2011;11:34.
35. Lansbury G. Chronic pain management: a qualitative study of
elderly people’s preferred coping strategies and barriers to
management. Disabil Rehabil 2000;22:2e14.
36. Milne JL, Moore KN. Factors impacting self-care for urinary
incontinence. Urol Nurs 2006;26:41e51.
37. MacIntosh JA. Focus groups in distance nursing education.
J Adv Nurs 1993;18:1981e5.
38. Ranse K, Grealish L. Nursing students’ perceptions of learning
in the clinical setting of the Dedicated Education Unit. J Adv
Nurs 2007;58:171e9.
39. Chaboyer W, Dunn SV, Theobald K, et al. Critical care
education: an examination of students’ perspectives. Nurse
Educ Today 2001;21:526e33.
40. Duke M. On the fast track: speeding nurses into the future:
a two-year bachelor of nursing for graduates of other
disciplines. Collegian 2001;8:14e8.
41. Matthew-Maich N, Mines C, Brown B, et al. Evolving as nurse
educators in problem-based learning through a community of
faculty development. J Prof Nurs 2007;23:75e82.
42. Clark MJ. Nursing education: focus on flexibilityda focus
group study to obtain data needed to inform curriculum
revision. J Nurs Educ 1997;36:108e13.
416 Nurs Outlook 60 (2012) 411e416
43. Kooker BM, Shoultz J, Sloat AR, et al. Focus groups. A unique
approach to curriculum development. Nurs Health Care
Perspect 1998;19:283e6.
44. Clare J, White J, Edwards H, et al. Learning outcomes and
curriculum development in major disciplines: nursing.
Adelaide: School of Nursing and Midwifery, Flinders
University; 2002.
45. Field J. Researching lifelong learning through focus groups.
Journal of Further and Higher Education 2000;24:324e35.
46. Morgan DL, Krueger RA. When to use focus groups and
why. In: Morgan DL, editor. Successful focus groups:
advancing the state of the art. Thousand Oaks, CA: Sage;
1993. p. 3e19.
47. Clarke A. Focus group interviews in health care research. Prof
Nurse 1999;14:395e7.
48. Carey M. The group effect in focus groups: planning,
implementing, and interpreting focus group research. In:
Morse J, editor. Critical issues in qualitative research
methods. London: Sage; 1994. p. 225e41.
49. Hollowaay I, Fulbrook P. Revisiting qualitative inquiry:
interviewing in nursing and midwifery research. NT Research
2001;6:539e50.
50. St. John W. Focus group interviews. In: Minichiello V,
Sullivan G, Greenwood K, et al., editors. Handbook of research
methods for nursing and health science. 2nd ed. French
Forest: Pearson Education Australia; 2004. p. 448e61.
51. Sim J. Collecting and analysing qualitative data: issues raised
by the focus group. J Adv Nurs 1998;28:345e52.
52. Beyea SC, Nicoll LH. Learn more using focus groups. AORN J
2000;71:897e900.
53. Chioncel NE, van der Veen RGW, Wildemeersch D, et al. The
validity and reliability of focus groups as a research method
in adult education. Int J Lifelong Educ 2003;22:495e517.
View publication stats
54. Patton MQ. Qualitative evaluation and research methods. 3rd
ed. Thousand Oaks, CA: Sage; 2002.
55. Stenbacka C. Qualitative research requires quality concepts
of its own. Management Decision 2001;39:551e5.
56. Flick U. An introduction to qualitative research. 3rd ed.
London: Sage; 2006.
57. Healy M, Perry C. Comprehensive criteria to judge validity and
reliability of qualitative research within the realism
paradigm. Qualitative Market Research 2000;3:118e26.
58. Lincoln YS, Guba EG. Naturalistic inquiry. Beverly Hills, CA:
Sage; 1985.
59. Seale C. Quality in qualitative research. Qual Inq 1999;5:465e78.
60. Hyde A, Howlett E, Brady D, et al. The focus group method:
insights from focus group interviews on sexual health with
adolescents. Soc Sci Med 2005;61:2588e99.
61. Maxwell JA. Understanding and validity in qualitative
research. Harvard Educational Review 1992;62:279e300.
62. Chioncel NE, van der Veen RGW, Wildemeersch D, et al. The
validity and reliability of focus groups as a research method
in adult education. International Journal of Lifelong
Education 2003;22:495.
63. Carey MA. Comment: concerns in the analysis of focus group
data. Qual Health Res 1995;5:487e95.
64. Kitzinger J. The methodology of focus groups: the importance
of interaction between research participants. Sociol Health
Illn 1994;16:103e21.
65. Strickland CJ. Conducting focus groups cross-culturally:
experiences with Pacific northwest Indian people. Public
Health Nurs 1999;16:190e7.
66. Bryman A. Social research methods. Oxford: Oxford
University Press; 2004.
67. Denzin N, Lincoin Y. Collecting and interpreting qualitative
materials. 2nd ed. London: Sage; 2003.