Chapter 11 Qualitative Research Methodology

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Qualitative Research
A systematic, subjective approach used to describe life experiences and give them meaning

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Qualitative Research
Useful in understanding such human experiences as pain, caring, powerlessness, and comfort

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The Logic of Qualitative Research
• •

Focuses on understanding the whole Consistent with holistic philosophy of nursing Provides means of exploring the depth, richness, and complexity inherent in phenomena

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World View

Reality
• •

There is not a single reality. Reality is based on perception and is different for each person. A person’s perception of reality changes over time.

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World View

Knowledge

What we know has meaning only within a given situation or context

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Reasoning Process in Qualitative Research

Involves perceptually putting pieces together to make wholes. From this process, meaning is produced. Because perception varies with the individual, including researchers, many meanings are possible.

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Frameworks For Qualitative Studies

Goal of qualitative research not theory testing Frameworks used in a different sense in qualitative research Each type of qualitative research guided by a particular philosophical stance

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Frameworks For Qualitative Studies

Philosophical base of a qualitative study directs:
questions asked • observations that are made • approach to interpretation of data

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Data From Qualitative Studies
• •

Subjective Incorporate the perceptions and beliefs of the researcher and the participants

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Findings From Qualitative Studies

Lead to understanding a phenomenon in a particular situation Not generalized in same way as those of quantitative studies

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Findings From Qualitative Studies

Understanding the meanings of a phenomenon in a particular situation gives insights that can be applied more broadly. Guides nursing practice Aids in the important process of theory development for building nursing knowledge.

• •

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Approaches to Qualitative Research
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Phenomenology

Both a philosophy and a research method Purpose is to describe experiences as they are lived

to capture the “lived experience” of study participants

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Phenomenological Philosophy
• • • •

The person is integral with the environment. The world is shaped by and shapes the self. Reality is subjective: thus, an experience is unique to the individual. The researcher’s experiences are unique to him/her.

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Phenomenological Philosophy

Truth
• • • •

is an interpretation of some phenomenon. is temporal. is cultural. May be a truth shared with others.

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Heideggarian Phenomenologist Beliefs
• •

The person is a self within a body - thus the person is referred to as embodied The person has a world that they have by virtue of being born into a culture • meaningful relationships
• •

meaningful practices meaningful language

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Heideggarian Phenomenologist Beliefs
• •

The person is situated - shaped by his or her world. The person is constrained in ability to establish meanings by • language • culture • history • purposes • values

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Heideggarian Phenomenologist Beliefs
• •

The person has only situated freedom, not total freedom A person’s world is so pervasive that generally it is not noticed unless some disruption occurs. The person can be understood only in the context of their unique body, world, and concerns.

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Heideggarian Phenomenologist Beliefs

Being-in-time

the person experiences being within the framework of time. The past and the future influence the now and are part of being-in-time.

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Phenomenology & Nursing Theory
• • •

Parse (1981) Theory of ManLiving-Health Paterson & Zderad (1976) Theory of Humanistic Nursing Watson (1985) Theory of Caring

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Phenomenology Methods

Broad question

What is the meaning of one’s lived experience?

The only reliable source of information to answer this question is the person
• •

Requires that the person interpret the action or experience for the researcher The researcher must interpret the explanation provided by the person.

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Grounded Theory
• •

Based on symbolic interaction theory Holds many views in common with phenomenology Explores how people define reality and how their beliefs are related to their actions.

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Grounded Theory Philosophy

Reality
• •

Reality is created by attaching meanings to situations. Meaning is expressed in terms of symbols such as words, religious objects, and clothing

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Grounded Theory Philosophy

Symbolic Meaning
• • •

Symbolic meanings are the basis for actions and interactions. Symbolic meanings are different for each individual. We cannot completely know the symbolic meanings of another individual.

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Grounded Theory Philosophy

Social Groups
Symbolic meanings are shared by groups and communicated to new members through socialization • Group life is based on consensus and shared meanings

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Grounded Theory Philosophy
• Social Groups

Interaction may lead to redefinition and new meanings • Social redefinition can lead to redefinition of self

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Grounded Theory Methods

Artinian’s Four Qualitative Modes of Nursing Inquiry
• • • •

Descriptive mode Discovery Mode Emergent fit mode Intervention mode

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Descriptive Mode
• • •

Provides rich detail Must precede all other modes Ideal for the beginning researcher

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Descriptive Mode

Research Questions
• • • • •

What is going on? How are activities organized? What roles are evident? What are the steps in a process? What does a patient do in a particular setting?

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Discovery Mode
• • •

Identification of patterns in life experiences of individuals Relates individual patterns to each other Generates a theory of social process (substantive theory) that explains a particular social world

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Emergent Fit Mode
• •

Used when substantive theory has been developed Purpose to extent or refine existing substantive theory

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Emergent Fit Mode

Enables researcher to
• • •

Focus on a selected portion of the theory Build on previous work Establish a research program around a particular social process

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Intervention Mode

Used to test the relationships in a substantive theory Research question: “How can I make something happen in such a way as to bring about new and desired states of affairs?” Demands deep involvement on the part of the researcher/practitioner

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Ethnographic Research
• • • •

Developed by anthropologists Mechanism for studying cultures Word means “portrait of a people” Seeks to understand people - ways of living, believing, adapting

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Ethnographic Philosophy

Culture
• •

• •

A way of life belonging to a designated group of people A blueprint for living which guides a particular group’s thoughts, actions, and sentiments All the accumulated ways a group of people solve problems Reflected in language, dress, food, traditions, customs

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Ethnographic Philosophy

Material Culture

All created objects Symbolic referents Network of social relations Beliefs Ideals

Nonmaterial culture
• • • •

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Ethnographic Research

Purpose
• • •

Describe a culture Study people’s origin, past ways of living, ways of surviving through time Discover the many parts of a whole culture and how these parts are interrelated Develop a picture of the wholeness of the culture

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Ethnonursing
• •

Theory of Transcultural Nursing - Leininger Focuses on how daily life conditions and patterns influence human care, health, and nursing care practices

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Historical Research
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Examines events of the past Greatest value of historical knowledge is increased selfunderstanding Increases nurses’ understanding of their profession

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Historical Philosophy
• • •

There is nothing new under the sun. One can learn from the past. Search for wisdom in what has been, what is, and what ought to be.

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Historical Philosophy

Goal to identify a developmental scheme for history to explain all events and structures as elements of the same social process.

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Historical Research
• • •

Search throughout history for generalities. Develop a theoretical explanation. Based on a world view.

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Historical Nursing Knowledge

How can we in nursing today possibly plan where we are going when we don’t know where we have been nor how we got here. Criterion of a profession is that there is a knowledge of the history of the profession that is transmitted to those entering the profession.

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Qualitative Research Methodology

Some methods similar to qualitative studies
• • • • •

Select a topic State problem or question Justify the significance of the study Design the study Identify sources of data such as subjects

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Qualitative Research Methodology

Some methods similar to qualitative studies
• • • • •

Gain access to sources of data Select subjects for study Gather data Describe, analyze and interpret the data Develop a written report of results

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Qualitative Research Methodology

Some methods unique to qualitative studies and sometimes to specific types of qualitative research

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Areas In Which Qualitative Research Methods Are Different
• • • • • •

Selection of subjects Researcher-participant relationships Data collection methods Data management Data analysis Interpretation

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Selection of Subjects Participants
• • •

Subjects referred to as participants May volunteer to be involved in the study May be selected by the researcher because of their particular knowledge, experience or views related to the study

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Purposive Sampling Methods

May select individuals typical in relation to the phenomenon under study May seek out individuals that are different in some way from other participants in order to get diverse perspectives Snowballing used

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Sample Size

Decisions regarding sample size are different than in quantitative studies.
• •

Based on needs related to study purpose Usually number of subjects is small in comparison to quantitative studies Case studies with one subject may be used 6 - 10 subjects not unusual

• •

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Decision to Stop Seeking New Subjects

Informational redundancy

When the researcher ceases learning new information When theoretical ideas seem complete

Theoretical Saturation

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Researcher-Participant Relationships
• •

Participants treated as colleagues rather than as subjects Researcher must have the support and confidence of participants in order to complete the study Maintaining relationships of utmost importance

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Researcher-Participant Relationships

In many studies, researcher observes social behavior and may interact socially with the participants. To varying degrees, the researcher influences the individuals being studied and, in turn, is influenced by them. The researcher’s presence may alter behavior of participants.

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Researcher-Participant Relationships

Participants often assist in
• • •

Determining research questions Guiding data collection Interpreting results

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Researcher-Participant Relationships

Researcher’s personality is key factor
• •

Skills in empathy Intuition

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The Qualitative Researcher

The researcher must become closely involved in the subject’s experience in order to interpret it. The researcher must be open to the perceptions of the participants, rather than to attach his or her own meaning to the experience.

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Qualitative Values

The researcher’s aims and means need to be consistent with those of the participants For example, if the researcher’s desire is to change the behavior of the participants, this must also be their desire.

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Data Collection Methods

Observation
• • • • • •

What is going on here Look carefully as well as listen Note routine activities Focus on details Note processes as well as discrete events Note unexpected events

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Data Collection Methods

Interviews
• • • •

Open-ended format Researcher defines the focus There is no fixed sequence of questions Questions asked tend to change as the researcher gains insights from previous interviews and/or observations

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Data Collection Methods

Interviews

Respondents encouraged to raise important issues not addressed by the researcher May use focus groups

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Data Collection Methods

Interviews

Researcher and participant are actively engaged in constructing a version of the world • Goal is to achieve mutual understanding

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Data Collection Methods

Interviews

Focus of interview is on obtaining an authentic insight into the participant’s experiences Dialogue between researcher and participant may continue at intervals across weeks or months

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Data Collection Methods

Interviews

Continued dialogue over time decreases the problem of fleeting relationships in which the respondent may have little commitment or may provide only information they believe the researcher wants to hear.

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Data Collection Methods

Interviews • Strategies to record interview information
Writing detailed notes immediately after interview • Recording the interview on tape

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Data Collection Methods

Text As A Source of Qualitative Data • Text may be written by participants on a particular topic at the request of the researcher • Text narratives may be solicited by mail rather than in person

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Data Collection Methods

Text As A Source of Qualitative Data • Text developed for other purposes, such as patient records or procedure manuals, can be accessed for qualitative analysis

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Data Collection Methods

Text As A Source of Qualitative Data

• •

Published text - books, newspapers, journal articles, Internet materials Transcripts of recorded interviews Text related to historical events

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Data Collection Methods

Text As A Source of Qualitative Data • Notes taken while reading written documents will be important to the analysis process.

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Data Management

Qualitative data analysis occurs concurrently with data collection rather than sequentially as is true in quantitative research. The researcher is simultaneously gathering data, managing a growing bulk of collected data, and interpreting the meaning of data.

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Data Management
• • •

Data must be stored in organized manner. Traditionally, data collection and analysis has been performed manually. Some qualitative researchers are now using the computer to make management and analysis of qualitative data quicker and easier without losing touch with the data.

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Qualitative Data Analysis

Because published qualitative studies tend not to describe the methodology in detail, many believe that qualitative analysis is free-wheeling.

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Qualitative Data Analysis

“Many believe that qualitative analysis can be done in a spirit of careless rapture, with no principles or discipline whatsoever. . . They think they will know what to do with the data once those data are collected. . . When they begin analysis, they find that things are not quite so simple” (Coffey & Atkinson).

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Qualitative Data Analysis

Stages:
Description • Analysis • Interpretation

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Qualitative Data Analysis

Descriptive stage of qualitative analysis is more critical in qualitative studies Researchers encouraged to remain in the descriptive mode for as long as possible

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Descriptive Analysis

Become familiar with the data
• • • •

Read and reread notes and transcripts Recall observations and experiences Listen to audiotapes View videotapes

Become immersed in the data

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Descriptive Analysis
• •

Focus of immersion is the question, “what is going on?” Grounded Theory Research - uses constant comparative process, in which every piece of data is compared with every other piece.

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Descriptive Analysis

During the data analysis process, a dynamic interaction occurs between the researcher’s self and the data, whether the data are communicated orally person-to-person or in writing.

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Descriptive Analysis

Reflexive Thought

The researcher explores personal feelings and experiences that may influence the study and integrates this understanding into the study. Requires conscious awareness of self.

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Descriptive Analysis

Bracketing

Used in some phenomenological research to help the researcher avoid misinterpreting the phenomenon as it is being experienced by the participants. Bracketing is suspending or laying aside what the researcher knows about the experience being studied.

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Descriptive Analysis

Data Reduction

Initial efforts at analysis focus on reducing the large volume of data acquired in order to facilitate examination. During data reduction, the researcher begins to attach meaning to elements of the data.

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Descriptive Analysis

Data Reduction
• • •

Researcher discovers classes of things, persons, events, and properties Notes regularities in the setting or the people Classifies the elements of the data, by using an established classification system or developing a new one

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Descriptive Analysis

Codes and Coding
• •

Essentially a way of indexing or identifying categories in the data. Codes may be placed in the data at the time of data collection, when entering data into the computer, and during later examination of the data. Data segments can then be retrieved by coding category.

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Data Displays

Equivalent to the summary tables used in quantitative studies Allow the researcher to convey succinctly the main ideas of the study Codes can be used to organize the display

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Data Analysis
• • •

Goes beyond description Uses methods to transform the data Extends the data beyond the description

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Data Analysis

Researcher identifies essential features and describes interrelationships among them. Emphasis is on identifying themes and patterns from the data.

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Data Analysis

Coding, used earlier for description, can also be used to expand, transform, and reconceptualize data, providing opportunities for more diverse analyses.

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Data Analysis

Memoing
• • •

Used to record insights or ideas related to notes, transcripts, or codes Move the researcher toward theorizing and are conceptual rather than factual May link pieces of data or use a specific piece of data as an example of a conceptual idea

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Data Analysis

Storytelling

“..an event or series of events, encompassed by temporal or spatial boundaries, that are shared with others using an oral medium or sign language” (Banks-Wallace, 1998)
Includes a sequence of events with a beginning, a middle and an end

Have their own logic and are temporal

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Data Analysis

Storytelling

“People sharing a story (storytellers) and those listening to a story (storytakers) and the main elements of storytelling.” (BanksWallace, 1998)

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Data Analysis

Storytelling • Can be instructive in understanding a phenomenon of interest. • Researcher may record stories shared by participants

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Data Analysis

Storytelling • In some qualitative studies, the focus of the research may be the gathering of stories.

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Data Analysis

Storytelling

Gathering of stories can enable health care providers to develop storytelling as a powerful means to increase insight and facilitate health promotion behaviors of clients.

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Data Analysis

Narrative Analysis
• •

A qualitative means of formally analyzing stories Researcher unpacks the structure of the story

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Data Analysis

Narrative Analysis

Can be used to determine how people tell stories
• • • •

how they give shape to the events they describe how they make a point how they “package” events and react to them how they communicate their stories to audiences

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Narrative Analysis
• • • • • • •

Structure Question Abstract-----What is this about? Orientation-- Who? What? When? Where? Complication--- Then what happened? Evaluation--So what? Result--------- What finally happened? Coda---------Finish narrative

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Narrative Analysis

Abstract

Initiates the narrative by summarizing the point of the study or giving a statement of the proposition the narrative will illustrate.

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Narrative Analysis

Orientation

Provides an introduction to the major events central to the story Continues the narrative, describing complications in the event that make it a story.

Complication

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Narrative Analysis

Evaluation

The point of the narrative Gives the outcome or resolution of events Ends the story, and is the transition point at which talk may revert to other topics

Result

Coda

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Narrative Analysis
Can focus on social action imbedded in the text • Can examine the effect of the story

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Narrative Analysis

Purposes of Stories
• • •

May make a point or be moralistic May be success stories May be a reminder of what not to do or how not to be with guidance in how to avoid the fate described in the study May be used to understand cultural values, meanings, and personal experiences

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Narrative Analysis

Purpose of analysis • Examine multiple stories of key life events and gain greater understanding of the impact of these key events • May assist in understanding the relationship between social processes and personal lives

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Narrative Analysis

Purposes of analysis

May be used to examine issues related to power, dominance, and opposition Through stories, silenced groups can be given voice

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Interpretation

The researcher offers his or her interpretation of what is going on. The focus is on understanding and explanation beyond what can be stated with certainty.

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Interpretation

May focus on the usefulness of the findings for clinical practice May move toward theorizing

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Interpretation

As the study progresses, relationships among categories, participants, actions, and events begin to emerge. The researcher will develop hunches about relationships that can be used to formulate tentative propositions.

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Interpretation

• •

The researcher gains increasing understanding of the dynamics involved in the process under study. This understanding might be considered a tentative theory. The tentative theory is often expressed as a map.

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Interpretation
• •

The validity of predictions developed in the tentative theory must be tested. One strategy sometimes used is to predict outcomes expected to occur 6 months after completion of the study. These predictions are sent to informants who respond to the accuracy of the predictions.

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Rigor in Qualitative Research

Rigor needs to be defined differently in qualitative research because the desired outcome is different.

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Rigor in Qualitative Research

Characteristics of Rigor in Qualitative Studies
• • • •

Openness Scrupulous adherence to a philosophical perspective Thoroughness in collecting data Consideration of all of the data in the subjective theory development phase

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Rigor in Qualitative Research

Evaluation of rigor is based, in part, on the logic of the emerging theory and the clarity with which it sheds light on the phenomenon studies.

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Rigor in Qualitative Research

Causes of lack of rigor
• • • •

Inconsistency in adhering to the philosophy of the approach being used Failure to get away from older ideas Poorly developed methods Inadequate time spent collecting data

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Rigor in Qualitative Research

Causes of lack of rigor
• • •

Poor observations Failure to give careful consideration to all the data obtained Inadequacy of theoretical development from the data

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Decision Trails

Strategies by which other researchers, using the same data, can follow the logic of the original researcher and arrive at the same conclusions.

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Decision Trails

Requires that the researcher establish decision rules for categorizing data, arriving at ratings, or making judgments.

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Decision Trails
• • •

A record is kept of all decision rules used in the analysis of data. All raw data are stored so that they are available for review if requested. Thus, evidence is retained to support the study conclusions and the emerging theory and is made available on request.

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Decision Trails
• • •

Some qualitative researchers are opposed to the idea of decision trails. Of concern is that data analysis would become too mechanistic. Some qualitative researchers are opposed to the expectation that other researchers would come to the same conclusions since one would expect each researcher’s work to be unique.

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