THE QUALITATIVE APPROACH

Qualitative approaches refer to research that is both descriptive and systematic. It allows
the researcher to examine relationships between activities, situations, and materials

DATA CAPTURE AND DATA COLLECTION

The qualitative approach focuses on activities in the steps of the research process that differ
greatly from the quantitative methods in fundamental sources of data, collection techniques,
coding, analysis, and interpretation.

The computer becomes a different kind of tool for the researcher in most aspects of the research.
It can be used to record the observations, narrative statements of subjects, and memos of the
researcher in initial word processing applications for future coding.

 OmniPage 18 - It one of the Software applications that aid researchers in transcription

tasks include text scanners.
 Dragon Naturally Speaking 12 - used by the researcher to input the information into text
documents just by speaking into a microphone without typing.
 New digital recorders - are also on the market that use sophisticated and higher cost
voice recognition software.

From these technologies, researchers or transcriptionists can easily manipulate the recording
and type the data verbatim. These narrative statements, can be either programmed for use in
other applications or subjects’ responses can be entered directly into the computer.

Qualitative Data Collection

Audiotaping is often used for interviews in qualitative studies, whereby the content is
transcribed into a word processing program for analysis. The narrative statements are stored for
subsequent coding and sorting according to one’s theoretical framework. Through analysis,
categories from the data emerge as interpreted by the researcher.

Using the Internet for indirect and direct data collection in qualitative studies can also provide a
vehicle for data analysis that yields a quantitative component as well as the qualitative analysis.
Many new online technologies are providing functionality for qualitative studies

Aside from that many new online technologies are providing functionality for qualitative
studies: for example, Audacity an open-source free audio recording package, can edit captured
voice and export audio data to be analyzed; conversely, online survey packages such as
SurveyMonkey can now export participants’ free text data into qualitative software packages
DATA CODING AND DATA ANALYSIS

Some specific software packages developed for qualitative data analysis (QDA) interface
directly with the most popular word processing software packages. The early application
program Ethnograph was one of the first packages developed specifically for the purpose of
managing some of the mechanical tasks of qualitative data analysis.

Qualitative research, like quantitative research, is not a single entity, but a set of related yet
individual traditions, aims, and methods. Some individual traditions within qualitative research
are ethnography, grounded theory, phenomenology, and hermeneutics. The distinguishing
feature of qualitative research is that the goal is to understand the qualities or essence of
phenomena and/ or focus on the meaning of these events to the participants or respondents in
the study.

Ethnography refers to the scientific description of the customs of individual peoples and
cultures.

Grounded theory which involves the collection and analysis of data, that means the analysis
and development of theories happens after you have collected the data.

Phenomenology refers to the study of structures of consciousness as experienced from the first-
person point of view.

Hermeneutics a theory and methodology of interpretation, especially the interpretation of

biblical texts, wisdom literature, and philosophical texts.

 Forms of data- are usually the words of the respondents or informants rather than
numbers.
 Computerization- is especially helpful to the researcher in handling large amounts of
data.
 Synthesis of the data- is still the interpretive work of the researcher.

COMPUTER APPLICATION PROGRAMS

A number of general-purpose or specific software packages can be used in qualitative analysis:

one package is a free text retrieval program such as that available in a word processing
program; another is any number of standard database management or indexing programs; third
is a program specifically developed for the purpose of qualitative analysis.

GENERAL PURPOSE SOFTWARE

Word processing programs offer a number of features useful to the qualitative researcher in the
early stages of analysis. In addition, such features as cut and paste; linking texts; insertion of
pictures, tables, and charts; and the inclusion of video and audio data enhance the application.
Add-on applications specific to integrating multiple elements help the researcher organize a
range of data and materials for analysis.

This software is also called off the shelf. You can buy it at a shop or download it on line. The
software is written for a wide audience and not all of the features are used. The software is
relatively cheap and usually well tested.

SPECIAL PURPOSE SOFTWARE

Special purpose application software is a type of software created to execute one specific task.
For example, Movie editor, sound editor, photo editor, web page design and development.

The researcher can have the program to produce a file that numbers each line of the narrative
data. From this line file, the researcher can begin to assign each line or paragraph a category.
The researcher keeps track of the category definitions and is alert to dimensions that emerge.
Through the use of a search command, the computer program can be made to search for data
segments by categories throughout the typed document. The latest version of NVivo 10 also
allows researchers to import exported data from other applications such as the online survey
tool, Survey Monkey, as well as bibliographic management programs, Facebook and Twitter.

Conceptual Network Systems

A system known as concept diagrams, semantic nets, or conceptual networks is one in which
information is represented in a graphic manner. The objects in one’s conceptual system (e.g.,
age and experiences) are coded and represented by a box diagram (node). The objects are linked
(by arcs) to other objects to show relationships. Semantic network applications may be useful in
model building and providing a pictorial overview.

Like rule-based systems, semantic nets have been widely used in artificial intelligence work. In
order to view the relationships of an object in the system, the researcher examines the node in
the graph and follows the arcs to and from it.

Decision Explorer (Banxia, 2014) offers the user a powerful set of mapping tools to aid in the
decision-making process for audience response activities. The software has many practical uses,
such as gathering and structuring interview data and as an aid in the strategy formulation
process. The software is primarily described as being a recording and facilitation tool for the
elicitation of ideas, as well as a tool to structure and communicate qualitative data. It allows the
user to gather and analyze qualitative data and thus make sense of many pieces of qualitative
data in order to achieve a coherent picture of a given issue or problem.

Data Analysis for Qualitative Data

Qualitative data analyses often occur on an ongoing basis with data collection in a reflexive and
iterative fashion. The process of obtaining observations, interviews, and other data over a
period of time results in a vast body of narrative that may include hundreds or thousands of
pages of field notes and researcher memos.

Researchers can only use the tools to help in creating composites described by methodologists
in coding levels and categorical clusters.

 Determined which parts can be tagged as categories, dimensions, and coded up through
levels.
 Engage in constant comparison.
 Continue until the researcher determines that the categories are internally consistent, fit
with the data, and are saturated.

Strauss and Corbin (1990)- the researcher may engage in axial coding that elaborates and
explains key categories, considering the conditions under which the event occurs, the processes
that take place, and possible consequences.

Glaser (1978)- indicated that the researcher may engage in theoretical sampling, which is a
deliberate search for episodes in incidents that enlarge the variances of properties and place
boundaries around categories.

Using software, these cognitive processes are applied by the researcher in data analysis of
narrative interviews, field notes, and supplementary data.

Uses and Caution

Software programs exist for qualitative research to save time doing file management, reducing
the manual labor of cutting, pasting, sorting, and manual filing. Qualitative analysis is a
cognitive process, not a mechanical one.

The essence of qualitative research is the meaning and interpretation of the data within context.
While computer programs facilitate coding, organization of data, and preparation of the data
for interpretation, they cannot replace the thinking and decision-making that is at the heart of
qualitative analysis. As in all research, the burden of analysis and interpretation rests with the
researchers.
DISSEMINATION OF RESULTS

While dissemination of results continues to occur by traditional means such as presentations at

professional meetings and publication in journals and monographs, online reporting is
becoming increasingly common.

Nursing forums sponsored by various professional nursing organizations often allow

participants to chat online with presenters or authors of certain articles on designated dates
during scheduled times.

This chapter has summarized the processes of quantitative and qualitative research. The
following section highlights examples for three categories of research on computer use and
nursing informatics in:

 Electronic data
 Web Based interventions
 Specialized computer applications in clinical practice.

The nurse researchers inevitably used a variety of software tools in the proposal development,
data collection, measurement of variables, analysis, and dissemination activities.

EXAMPLES OF RESEARCH STUDIES

Clinical Interventions with Computers

Internet applications have been introduced into practice and tested in a variety of clinical trials
aimed to improve conditions for patients.

 Personal Patient Profile-Prostate (P3P)

Web-decision support system for men newly diagnosed with prostate cancer. The
studies showed that decision support was feasible with the technology support.
Decision regret was significantly influenced by personal characteristics and post-
treatment symptoms, although the P3P was not itself significant on the outcomes
measured in the study.

 In another Web-based intervention, caregivers were randomly assigned to one of two

types of online support groups and compared to inactive participants on their
depressive symptoms, caregiver burden, and quality of life.
In this study, both types of online support groups reduced depressive symptoms and
improved quality of life over non-active participants.
Technology, Electronic Data, and Electronic Documentation Research

There are several different studies that highlight using electronic data and electronic health
records in data mining or care documentation.

I. Secondary Analysis of Large Data Sets

Large public data sets are becoming more available to nurse researchers to explore
health-related questions.

The sites that provide tutorials and assistance, making them more accessible for secondary
analyses like for example

 Agency for Healthcare Research and Quality (AHRQ) - provides health services
investigators with the tools and data sources for a variety of health-related systems. One
data source is the Medical Expenditures Panel (MEPS) database.

Ang Medical Expenditures Panel o MEPS ang the most complete source of data on the
cost and use of healthcare and health insurance coverage.

Another collection used by a variety of nurse researchers is the HCUP data from AHRQ.

 HCUP data from AHRQ - includes the largest collection of longitudinal hospital care
data that enable research on a broad range of health policy issues, including cost and
quality of health services, medical practice patterns, access to healthcare programs, and
outcomes of treatments at the national, State, and local market levels.

The electronic health records (EHRs) today is frequently providing source data for
studies. These hospital systems have been used in the literature.

II. Computerized Documentation of Nursing Care Plans.

 Moss and Saba (2011)- studied the utility of costing out nursing care with the CCC
terminology on five most commonly executed interventions.

Using an observation study of nurses performing routine care on an acute-care unit,

investigators collected data with a specialized data collection program entered directly into the
PC database. A total of 251 interventions were observed, coded, and analyzed. The study
demonstrated the feasibility of valuating the nursing care given to patients based on the
standardized CCC terminology.
In a randomized trial on electronic documentation of nursing care plans

 Saba, and Feeg (2008)- tested the quality of nursing student care planning using a
standardized nursing terminology in a specially designed Microsoft Access database
program.

Students were randomly assigned to one of the two versions of electronic nursing
documentation formats. Students documented care for each patient they were assigned
to in their clinical rotations. Results continued to show that the coded language and PC
care planning method was efficient and effective.

III. Web-Based Tools and Interventions

A significant body of research has been conducted on using the Internet as a tool for conducting
research, as well as studies on Web designed interventions for clinical problems.

 Yen and Bakken (2009)

They’ve tested the usability of a Web-based tool for managing open shifts on nursing
units. Using observational and interview approaches, they evaluated a Web
communication tool, then used specialized software to capture screens and vocal
utterances as they completed three subtasks associated with the open-shift management
process. After task completion, they were asked about the process and their responses
were recorded. Their data were managed and coded using Morae, specialized software
developed for usability testing.

 Nystrom and Ohrling (2008)

Created a series of e-meetings for new fathers of children under one year old to “meet”
in parental support groups. The researchers identified three categories from the
transcripts:

(1) being unfamiliar and insecure talking about fatherhood

(2) sharing experiences and being confirmed

(3) being supported and limited by the electronic encounters

 Andersen and Ruland (2009)

 Studied an Internet-based online patient–nurse communication (OPNC) service to
support patients with prostate and breast cancers. Two main themes emerged:

(1) concerns about physical symptoms and treatment side effects

(2) worries and questions about treatment and follow-up.

They concluded that the OPNC service can meet patients’ needs for advice and information,
thus improving the quality of care.

 Lichenstein, McDonough, and Matura (2013)

98 participants who self-identified as caregivers for a person with pulmonary
hypertension (PH) engaged in an online discussion board posted by the Pulmonary
Hypertension Association over an 18-month period. Thematic analysis yielded four
themes, the fear and frustration, questions and concerns, someone to listen to, and
moving on with life.

Results showed that caregivers of people with pulmonary hypertension may be ill equipped to
care for their loved one because of lack of knowledge or psychological distress.

IV. Specialized Computer Applications in Clinical Care

Computer-based administration of assessment is a reliable means of collecting patient

assessment data.

Vawdrey and colleagues (2011) pilot tested a tablet computer application for patients to
participate in their hospital care. Mobile technologies have also proliferated in health-related
applications today. For example, systems that support medication management of patients with
SMS texting and Web-based interface programs have emerged using simple cell phones and
sophisticated smartphones.

The MyMediHealth (MMH) is a medication management system that includes a medication

scheduler and a medication administration reminder engine and sends text messages to patient
phones.
References:

Saba, V.K., McCormick, K.A. (2015). Essentials of Nursing Informatics. New York,

NY: McGraw-Hill Education

Mason, S. A. (2013). Qualitative Versus Quantitative Approaches. SpringerLink.

https://link.springer.com/referenceworkentry/10.1007%2F978-1-4419-1698-3_167?

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