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Qualitative & Mixed-Methods Research

SohailBajammal, MBChB, MSc, FRCS(C), PhD(c)
Assistant Professor of Orthopaedics, Faculty of Medicine Vice Dean, Academic Development, Faculty of Dentistry Umm Al-Qura University, Makkah, Saudi Arabia ssbajammal@uqu.edu.sa

Quantitative
Numbers

Qualitative MixedMethods
Words Actions Reactions

Not everything that can be counted counts, and not everythingthat counts can be counted.
Albert Einstein

EBM
Research Evidence Patients Preferences

Clinical Expertise

Clinical Context
Haynes et al. BMJ 2002;324:1350

Everyday
‡ New Patient
± QUALITATIVE quantitative

‡ Follow-up Patient
± QUANTITATIVE qualitative

Questions
‡ How do trauma patients with quadriplegia in the Western region Saudi Arabia rehabilitate? ‡ What are the important aspects of quality of life for Saudi patients? ‡ What are the barriers to conduct RCTs in Saudi Arabia?

Learning Outcomes
By the end of the lecture, you will be able to: ‡ Identify:
± What is qualitative research? characteristics? ± When to use it?

‡ Identify:
± What is mixed-methods research? types? ± When to use it?

Qualitative Research

Types of Research Questions
‡ Quantitative: (cause, determine, relate, influence)
± Does A cause/correlate with B? ± Which is better A or B in terms of diagnosis, treatment, or prognosis?

‡ Qualitative: (discover, understand, explore, describe)
± What? ± How? ± Why?

Quantitative
Research Methods Closed-ended questions Pre-defined approaches Numeric data ‡ Test theories ‡ Variables to study ‡ Use standards of reliability & validity ‡ Unbiased approaches ‡ Statistical procedures

Qualitative
Open-ended questions Emerging approaches Text or image data ‡ Generate theories ‡ Collect participants meanings ‡ Study the context ‡ Bring personal values ‡ Validate accuracy of data ‡ Create an agenda for reform
Creswell J. Research Design. 2009

Features

Characteristics of Qualitative
‡ Natural settings ‡ Researcher as key instrument ‡ Multiple sources of data: interviews, observations, documents ‡ Inductive data analysis ‡ Participants meanings ‡ Emergent design ‡ Theoretical lens: sampling, saturation, integrating ‡ Interpretive ‡ Holistic account
Creswell J. Research Design. 2009

When to use qualitative?
1. Investigate complex phenomena that are difficult to measure quantitatively 2. Generate data necessary for a comprehensive understanding of a problem 3. Gain insights into potential causal mechanisms 4. Develop quantitative measurement instruments 5. Study special populations (those traditionally underrepresented in research, low literacy)
Curry et al, Circulation 2009

Investigate complex phenomena that are difficult to measure quantitatively

Generate data necessary for a comprehensive understanding of a problem

Common Strategies (Approaches) of Qualitative Research
‡ ‡ ‡ ‡ ‡
Ethnography Phenomenology Narrative research Case studies Grounded theory
Culture-sharing behavior of groups Individuals

Explore processes, activities, events

Data Collection Methods
‡ Observation field notes ‡ Interviews transcripts
± One-on-one: in-depth, open-ended ± Focus group

‡ Documents content analysis ‡ Audio-visual materials analysis

Qualitative Data Analysis
Data Collection

Data Analysis

Qualitative Data Analysis
Raw Data (transcripts, field notes, images) Organizing data for analysis Reading through all data Coding the data Themes Integrating themes, diagramming Interpreting

Data

Computer-Aided Qualitative Analysis
‡ ATLAS.ti ‡ NVivo ‡ MAXqda

NVivo

NVivo

www.researchsupport.com.au

Validity Strategies
‡ ‡ ‡ ‡ ‡ ‡ ‡ ‡ Rationale for choosing an approach Triangulation of methods Interviewers training Member checking Rich, thick description Reflectivity Peer debriefing Cross-coding Documentation External auditor

Mixed-Methods

What is mixed-methods research?
Combining qualitative & quantitative research
1960s

Aspects in Mixed-Methods
‡ Timing: sequentially or concurrently ‡ Emphasis:qualitative, quantitative, or both ‡ Mixing:integrating, connecting, or embedding

1. Sequential Explanatory
QUAN qual

Creswell J. Research Design. 2009

2. Sequential Exploratory
QUAL quan

Creswell J. Research Design. 2009

3. Concurrent Triangulation
QUAN
QUAN Data Collection

QUAL
QUAL Data Collection

QUAN Data nalysis Data Results Compared

QUAL Data nalysis

Creswell J. Research Design. 2009

4. Concurrent Embedded

qual

QUAN

Creswell J. Research Design. 2009

Lewin et al, BMJ 2009

Publishing

Resources

Books
‡ Research Design: Qualitative, Quantitative, and Mixed Methods Approaches. John Creswell. 3rd Edition. 2009. SAGE Publications.

Articles

People
‡ Look around in your university:
± Nursing ± Medical Educationalist ± Psychology ± Sociology ± Medical Geography

Questions
‡ How do Saudi patients with quadriplegia in the Western region rehabilitate? ‡ What are the important aspects of quality of life for Saudi patients? ‡ What are the barriers to conduct RCTs in Saudi Arabia?

Summary
‡ Patients talk, act & react not numbers ‡ Qualitative is helpful when nothing or little is known about a condition or environment ‡ GOOD qualitative research needs lots of work ‡ Be pragmatic
ssbajammal@uqu.edu.sa