Int J Clin Pharm
DOI 10.1007/s11096-015-0222-0
COMMENTARY
Narrative interviewing
Claire Anderson1 • Susan Kirkpatrick2
 Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie 2015
Abstract Introduction Narrative interviews place the
people being interviewed at the heart of a research study.
They are a means of collecting people’s own stories about
their experiences of health and illness. Narrative interviews
can help researchers to better understand people’s experi-
ences and behaviours. Narratives may come closer to
representing the context and integrity of people’s lives than
more quantitative means of research. Methodology
Researchers using narrative interview techniques do not set
out with a fixed agenda, rather they tend to let the inter-
viewee control the direction, content and pace of the
interview. The paper describes the interview process and
the suggested approach to analysis of narrative interviews,
We draw on the example from a study that used series of
narrative interviews about people’s experiences of taking
antidepressants. Limitations Some people may find it par-
ticularly challenging to tell their story to a researcher in
this way rather than be asked a series of questions like in a
television or radio interview. Narrative research like all
qualitative research does not set out to be generalisable and
may only involve a small set of interviews.
Keywords Narrative interviews
Qualitative research
methods
& Claire Anderson
Claire.Anderson@nottingham.ac.uk
1
School of Pharmacy, University of Nottingham, University
Park, Nottingham NG7 2RD, UK
2
Nuffield Department of Primary Care Health Sciences,
Health Experiences Research Group, University of Oxford,
Gibson Building, 1st Floor, Radcliffe Observatory Quarter,
Woodstock Road, Oxford OX2 6GG, UK
Impacts on practice
• Narrative interviews are a means of collecting people’s
own stories about their experiences of health and illness
and they can help researchers to better understand
people’s experiences and behaviours.
• This paper describes how narrative interviews may be
used to study peoples’ experiences of health and
medicines using the example of antidpepressants.
Introduction
Narrative interviews are a way of collecting people’s sto-
ries about their experiences. They align with a patient
centred approach to research and practice. People tell sto-
ries about events in their lives all of the time, it is one way
in which people make sense of their lives. The narrative
approach places the people being studied at the heart of the
study process and privileges the meanings that they assign
to their own stories. So when we are studying people,
observing their experiences, and trying to understand their
lives, narratives may come closer to representing the con-
text and integrity of those lives than do questionnaires and
graphs [1]. Narrative interviews have not often been used
in pharmacy research and Bissell et al. [2] challenged
pharmacy practice researchers, to begin appreciating how
narrative research can help then to understand patients’ use
of medicines, health professional training and behaviour
and much more.
Narrative interviews ask the how? why? and what?
questions that are common in qualitative research. In par-
ticular, narrative interviews provide an opportunity to pri-
oritise the story teller’s perspective rather than imposing a
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more specific agenda. For example, a narrative interview
might address the broad question about the experience of
living with asthma, rather than focusing on a more focused
question such as ‘Managing asthma medication’. Asking
the broader question may still provide insights into issues
about people’s use of medicines, but situated within each
person’s ‘story’. Narrative interviews can also be done
together with semi structured or structured interviews and
observations.
A Story usually consists of characters, a scene, a place
or context in which the story occurs and a crisis or event of
some sort that can provide dramatic tension. The events are
usually organised along a time line with a beginning,
middle and an end. There is often a point or a moral to the
story that provides value or meaning to the events that have
been described. Other forms of narratives may be bio-
graphical accounts and cover people’s whole life stories.
A narrative is not just a listing of events, but an attempt
by the narrator to link them both in time and in meaning. If
we consider events in isolation they may appear as simple
suggestions that describe independent events but if they are
composed into a story, the ways in which they are related
give the plot meaning and coherence. The plot also pro-
vides the context in which we understand each of the
events, actors, descriptions, goals, morals and relationships
that make up the story.
Methods of conducting narrative interviews
Researchers using narrative interview techniques do not set
out with a fixed agenda, rather they tend to let the interviewee
control the direction, content and pace of the interview. It is
the interviewees’ account and they choose what to say and
what not to say. The interviewer is not necessarily naı̈ve
about the topic of the interview for example, if they were
interviewing a series of people about experiences of asthma
they could well have prior knowledge of the subject, for
example through a preliminary review of literature on the
topic, and would of course develop more knowledge about
asthma as they interviewed more people. Reissman [3] talks
about the difficulties for the interviewer of giving up control
and not intervening while the interviewee is talking, espe-
cially if the contents of the story are emotional, traumatic or
personally sensitive.
Typically a narrative interview would start with open
questions for example, ‘Can you tell me about when you
first suspected there was something wrong, and what has
happened since then?’ The skills needed to be a good
narrative interviewer include being able to establish rapport
and trust early on in the interview, then being a very good
listener throughout, avoiding interruptions. In health rela-
ted research narrative methods might be combined with
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Int J Clin Pharm
semi structured interview techniques, where the researcher
may have developed a ‘topic guide’ (as opposed to specific
lines of questioning) which will indicate areas of interest,
typically these might be aligned with a particular focus of
interest, identified from the literature, or have arisen from
earlier interviews.
During the narrative interview, If the interviewer hears
something they want to return to they need to be able to
make a mental note of it to pursue later on. It is hard to
predict how long a narrative interview will last but
depending on the topic, context and the variety of ways that
people construct ‘stories’ it could be as short as half an
hour or go on for several hours. If the interviewee is unable
to talk for long periods of time due to their health, the
interview may need to spread over a number of sessions.
The interview can be divided into four sections.
1. Introduction and explanations about the research
Explaining the interview process for example that the
interview will be audio or video recorded (usually), that the
researcher would like to hear their story, in their own words
etc. and gaining consent.
2. The narrative
The interviewee begins telling their story; the inter-
viewer should use non-verbal encouragement, for example
smiles, saying hhmm and so on to encourage the inter-
viewee to talk freely. The interviewer should avoid inter-
rupting until there are clear signs that the interviewee has
finished their story.
3. Questioning phase (in a combined narrative/semi
structured interview)
This is when the active listening by the interviewer
becomes useful and the interviewer can use the partici-
pant’s own language to fill in any gaps or to ask for more
detail about an issue of interest The interviewer could ask
questions like ‘What happened then/before/after’, or ‘can
you say a bit more about…?’ rather than asking for opin-
ions or attitudes or even asking why questions..
4. Conclusion
Finally, the interviewer concludes the interview and
explains the next steps e.g. transcribing of interview,
whether the participant will have any further input and so
on.
Analysing narrative interviews
As in most qualitative research, narrative interviews are
audio recorded, and transcribed verbatim. With narrative
interviews it is very important that the richness of the
Int J Clin Pharm
accounts are not lost during the analysis; it is important to
identify the person’s story throughout the data. Close
attention should therefore be paid to the relationship between
the interviewee and the context of their story. Reisseman’s
model [3, 4] focuses on the fact that narratives are ambiguous
and incomplete representations of people’s experiences. She
highlights the way in which researchers are invisibly
involved in framing the narrative as they conduct the inter-
view and perform the analysis. So the researcher is encour-
aged to focus on the events as they are narrated, how the story
is structured and the meanings ascribed by the narrator.
Reissman’s model includes: attending, telling, transcribing,
analysing and reading but she emphasises that ‘‘interpreting
experience’’ happens at all five points in the model. Herman
[5] states that the analysis should focus on the performance of
the narrative, paying close attention to the context of the
narrative and the disposition of the interviewee and the
researcher. The researcher needs to assume a reflexive
stance. Herman’s four point model; situatedness, event
sequencing, world/making/world disruption and what its
like; is another useful framework for researchers to use when
reflecting on a narrative interview. Ziebland [6] states that
while its analytically sufficient to let interview extracts speak
for themselves the challenge for the analyst is to present
enough of the data that the line of argument and interpreta-
tion are convincing while situating the findings in the
appropriate theoretical and research literature.
So practically the analyst might ask a number of ques-
tions as highlighted by Ryan et al. [7]. What is the tone of
this person’s story? Is it optimistic, pessimistic or some-
thing else? What imagery has this person used in telling
their story and what is the significance of the imagery?
How has this person used language to construct their story?
What social/moral ‘‘work’’ is this story doing? What social,
cultural and political issues have they incorporated into
their story and what is the significance of these?
It is good practice to return the transcribed narratives to
the interviewees for checking and to ensure that on
reflection the participant agrees to allow use of the mate-
rial. Researchers may also decide to check their interpre-
tation of a narrative with interviewees but must then be
prepared for a different viewpoint.
Analysis across a data set
Thematic analysis is one of a number of approaches that
might be used in the exploration of narrative interview data.
Whatever the approach, the analysis usually involves iden-
tifying a story across the data set. Making sense of a quali-
tative dataset usually involves developing a coding
framework in order to reduce the volume of data to more
manageable sections (this could be themes, but might also be
concerned with other aspects of the narrative e.g. how the
account is structured, use of language, metaphors). Codes
may be developed ‘bottom up’ from the data itself, ‘top
down’ from prior knowledge for example from clinical
practice or a literature review, or a combination of both.
During the analysis all of the sections of the interviews that
cover a similar topic (for example ‘deciding to take a
medicines’ or being prescribed a medicine or taking the first
dose) are grouped together. When this ‘coding’ is finished
the researcher can then look at what everyone has said about
a particular topic, and, for example, explore similarities and
differences between the accounts. Often, a second researcher
might look at the same data independently to explore the
meaning and interpretation of the stories.
Limitations
Some people may find it particularly challenging to tell their
story to a researcher in this way rather than be asked a series
of questions like in a television or radio interview. Narrative
research like all qualitative research does not set out to be
generalisable and may only involve a small set of interviews.
Uses
We used narrative interviews with 36 people from across
the UK, for a Healthtalk.org study on peoples’ experiences
of using antidepressants.
Objectives
To explore peoples’ experiences of using antidepressants as
prescription and OTC medicines in the context of their
family, work and social lives; identify patients’ information
and support needs and their perspectives on other issues
about taking the medicines, including pharmaceutical
issues, for example, type of formulation and clinical issues
like adverse events; clarify what type of information people
want to find after being prescribed a medicine? and the
kinds of problems faced; disseminate the results, illustrated
with video and audio interview clips, via a new Healthtalk.
org website to improve public and professional under-
standing of patients’ experiences of using antidepressants.
Methods
We conducted most interviews in participants’ homes with
just the interviewer and participant present, using a narra-
tive style with subsequent prompting on topics including
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responses to a diagnosis of depression and being prescribed
an antidepressant. Initial interviews served as pilots and the
interview guides were pilot tested with the study advisory
groups which included people being treated for depression.
Participants were interviewed until no new themes arose.
Transcripts were returned to participants for comment and/
or correction.
Analysis
We used a qualitative interpretive approach combining
thematic analysis with constant comparison [8, 9]. The
textual data was entered into the NVivo software package,
which was used to organise and analyse anticipated and
emergent themes using constant comparison. The initial
analysis was carries out by the researcher who had done the
interviews. Close attention was paid to the relationship
between the interviewee and the context of their story. This
analysis was used to produce 25 summaries of topics for
the healthtalk.org website (http://www.healthtalk.org/peo
ples-experiences/mental-health/experiences-antidepressants/
topics) to reflect the most important themes and represent
the full range of experiences included in the interviews. In
order to ensure the quality and balance of the material
included in the site each topic summary was prepared by the
researcher, checked by a second researcher and reviewed by
at least one member of the advisory panel. Analysis and data
collection proceeded simultaneously and continued until
‘data saturation’ was reached to ensure that the widest
possible range of experiences had been included. In prac-
tice, this means that any person who is using medicines to
treat their depression should find that an experience or
perspective akin to their own is included in the relevant
topic summary, although this may not necessarily be
reported by a person of the same age, family situation or
social class as themselves. The interview transcripts were
returned to participants for approval, all approved.
[Further details about the research methods described
here can be found on http://www.healthtalk.org/research/
research-methods].
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Conclusion
Narrative interviews are widely used in qualitative health
research. This paper has described how they may be used to
study peoples’ experiences of health and medicines. The
narrative approach places the people being studied at the
heart of the study process and privileges the meanings that
they assign to their stories. Hearing about the experiences
of others can be a source of support for people and can help
them to make informed decisions about their health. With
the current emphasis on patient centred care, research that
focuses on the patient experience can also contribute to
service provision, design and improvement.
Funding None.
Conflicts of interest None.
References
1. Freeman M. Experience, narrative and the relation between them.
Narrat Inq. 1998;8:455–66.
2. Bissell P, Ryan K, Morecroft C. Narratives about illness and
medication: a neglected theme/new methodology within pharmacy
practice research. Part I: conceptual framework. Pharm World Sci.
2006;28:54–60.
3. Reissman CK. Narrative methods for human sciences. Los Angels
CA: Sage; 2008.
4. Riessman CK. Narrative analysis. London: Sage; 1993.
5. Herman D. Introduction narratologies. In: Herman D, editor.
Narratologies Columbus. Columbus: Ohio State University Press;
2009.
6. Ziebland S. Narrative interviewing. In: Ziebland S, Coulter A,
Calabrese J, Locock L, editors. Understanding and using health
experiences: improving patient care. Oxford: Oxford University
Press; 2013. p. 38–48.
7. Ryan K, Bissell P, Morecroft C. Narratives about illness and
medication: a neglected theme/new methodology within pharmacy
practice research. Part II: medication narratives in practice. Pharm
World Sci. 2007;29(4):353–60.
8. Silverman D. Interpreting qualitative data: methods for analysing
talk, text and interaction. Beverley Hills, CA: Sage; 2001.
9. Spencer L, Ritchie J, O’Connor W. Analysis, practices, principles,
processes. In: Ritich J, Lewis J, editors. Qualitative research
practice: a guide for social science students and researchers.
Beverley Hills, CA: Sage; 2007.