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508 Unit TWO The Research Process

The researcher as a whole person is lacking in nursing research. Observati made of


totally involved perceiving, reacting, peoples behaviour, but data a' physical
interacting, reflecting, attaching meaning, environment seldom are cod (pp. 307, 308)
and recording. Such is the case whether
the study involves observing and Hamilton and Manias (2007) studied
participating in social situations, as would the o methods of psychiatric nurses
occur in phenomenological, grounded and their ity in an acute inpatient
theory, ethnographical, or critical social setting. This excel not only gives you
theory research, or whether the study as reader a clear underst the careful
deals with written communications, as observation conducted during : but
might occur in phenomenological, it also enables you to understand
historical, philosophical, or critical social ho observation must be in a
theory studies. For a particular study, the qualitative study you a chance to
researcher may need to address data think about how you might your
collection issues related to relationships own observations. Hamilton and
between the researcher and the Marias described their study as
participants, reflections of the researcher follows.
on the meanings obtained from the data,
and management and reduction of large
volumes of data. Methods of gathering
data include making unstructured
observations, conducting unstructured
interviews, observing focus groups,
collecting stories, constructing life stories,
and interpreting case studies.
Unstructured Observations
Unstructured observation involves The postmodern approach used in the study was
spontaneously observing and recording by Foucault (1973. 1980, 1995, 1994) and by
what one sees with a minimum of after him (Fox, 1993; Rhodes, 1991; Silvermzz.
planning. Although unstructured A postmodern epistemology informed both
observations give the observer freedom, tioning of the first author during fieldwort
there is a risk that the observer may lose emphasis on discourses, power relations and
objectivity or may not remember all fcf concepts in data analysis. A postmodern
the details of the event. If possible, the ogy informed both the positioning of the first
researcher should take notes during the during fieldwork and the emphasis on
observation periods. If this is not possible,
power relations and particular concepts in
sis. In postmodern ethnography, the ethneg
the researcher needs to record the power in the portrayal of the field is made
observations soon afterward. You may (Alvesson, 2002). Accordingly the first author, a
even find it useful to photograph or enced psychiatric nurse, was cast as an objective:
videotape the observation period so that but as an active participant, recognizing and exr
you can examine it extensively at a later own subjectivity in shaping the research, (p. 35->
time (Harrison, 2002; Mullhall, 2002). The study was based in a 44-bed acute ps
Unstructured observations are not inpatient unit, on the site of metropolitan a ing
unsystematic or sloppy as the term might hospital in Victoria, Australia. Ethics gained from
suggest. Rather, unstructured means that the hospital, in accordance win: guidelines in
the researcher has few predetermined
Australia.
Ethnography has been widely used to study as
notions as to what he or she might subcultures (Silverman, 2005). This study the work
observe. What notions the researcher of 11 participating psychiatric nurses first author,
does have may change over time as data who worked part time as a psych: alongside the
are collected. As Mulhall (2003) pointed participants for 18 months. Fief:
out: were generated through: participant observant
13 individual interview's and two focus group
The way people move, dress, interact and use space participating psychiatric nurses: transcript file
is veiy much a part of how particular social settings notes and other documents related to asses the first
re constructed. Observation is the key method for authors journal that detailed 170h of
as a registered nurse in the unit. (p. 334) The
collecting data about such matter.... Observers have
ethnography focused on nurses activities
a great degree of freedom and autonomy regarding nurse-nurse and nurse-patient interaction:, xl
what they choose to observe, how the)' filter that chiatric nursing experience of the 11 nurse: rs
information, and how it is analysed.... Observation ranged from 2 to 30 years and ages ranged frm 67
also captures the whole social setting in which years. Six nurses were women, a gender rar: ing
people function, by recording the context in which w'ith the current psychiatric nursing woe Australia
they work.... Finally, observation is valuable (Clinton, 2001), which includes a r:
because it informs about the influence of the
physical environment. This aspect of observation is
quite
Chapter 23 Qualitative Research Methodology 509

of men than in other specialties of nursing, to frequently interrupt their own planned work. They were often
'cipants were positioned as key informants I drawn away from planned work to go and see the event or
insight into the social life of the unit (Riley *. person at the source of an interruption. Nurses scanned the unit
2006). Participant observations extended on arrival, when entering a different area of the unit, or when
xreipants rostered working shifts, through all returning after an absence, such as a tea break. Their scan was
: week and all three shifts (morning, afternoon brief, capturing the physical and social condition of the unit at
. in order to attend to a variety of contexts, that moment. From such activity, details were reported to
experiences and practices, (p. 334) colleagues, in snatches of conversation and handovers. Nurses
exercised the scan both as a baseline form of monitoring and as
~ESS OF ANALYSIS a prelude to more focused work with individuals and groups of
our analysis of how inpatient psychiatric df
patients, assisting them to determine work priorities and issues
served patients were the Foucauldian con- ' the
for the working shift, (p. 336)
gaze and of discipline, both given form in recursive
Nurses Probing Observations of Patients Nurses focused on
practices (Roberts, 2005). Analy- focused on
patients who were assigned to their care. As they scanned the
discursive practices of assessment, end to be the
micro-politics of nurses language sc (Fox, 1993, p. ward space and occupants, their attention was drawn also to
161). Everyday nursing prac- xned in the fieldwork patients who were assigned to other nurses. The probing
texts were highlighted :ve practices when we could observation of a patient was a distinctive activity in that nurses
show how these were imbued with power through stopped circulating, and looked in a more considered way at a
social, histor- roiitical conditions, and in the wider patients body7, social interactions and behaviour. From this
context of ' ~ discourse (Irving, 2002). (pp. 334- probing, nurses gleaned clues about the patients feelings,
335) thoughts and motivations, the patients ways of interacting, the
patients coping abilities or strengths, as well as evidence of
LTS symptoms. On occasions, nurses withdrew7 after a pe^od of
Jn: three identified modes of nurses obser- sharp observation, W'ithout interrupting the patients activity or
zurses scanning of patients, nurses obvious speaking at all.. .-(p. 337) Through observations, nurses
probing of patients, and nurses discreet and elicited evidence of symptoms and also absence of symptoms.
observations of patients. Nurses identified evidence of the person getting along in the
social sense with other patients, of the person coping with the
demands of an activity and even exhibiting prowess in the
--sing Scan activity. Nurses counterbalancing of psychiatric symptoms
:;an is used here to encompass nurses frequent 5 of
w'ith a lack of such symptoms, coping and prow'ess, in the
eyes across rooms, surfaces and spaces of taking in context of unstructured activity, was an element of nurses
features and contents of the space as impressions of assessment. Nurses accounts of symptoms, based in the
the people occupying it. Nurses K their sight, behaviour they observed in the unit, were potentially important
supplemented by other senses to the scan. Through accounts in the ongoing construction of illness by the treating
scanning, nurses monitored cal spaces and their team. (p. 337) Nurses Discreet Observation: Clinical and Civil
objects, commenting on zells and temperature, and Surveillance Nurses observations of patients in the acute
noticing and mov- ds. Nurses also scanned for psychiatry unit were shaped substantially by the legal status and
emotional tone in for potential areas of distress and admission circumstances of patients, most of whom were
conflict that ercompass patients, staff and visitors. detained and treated under the Mental Health Act (1986). The
The nurses loss of fundamental rights to freedom and choice in psychiatric
' in the demeanour and behaviour of individual treatment could cause great offence to patients, many of w7nom
and groups of patients. Nurses scanned in pass- flatly disagreed with the medical diagnosis and bitterly resented
-nts bodies, expressions, movements, gestures i being detained and given psychotropic medications. The w7ard
of voice... environment w7as a place where direct contact w'ith clinicians
ses visual observations were supplemented by Jng frequently provoked patients ire. Since nurses were the group
into sounds of movement, or listening in to - talk. of clinicians in most frequent and close contact with patients,
Whether in the office or circulating in the s were they w'ere attuned
alert to voices and other sounds in the -ironment.
Three nurses might all glance or move a doorway,
in response to a sound such as a heavy even as they
were engaged in other work. Nurses valuable
information about patients through this sf aural
surveillance (Riley, 2005), a partner to their
surveillance. Nurses embraced their scanning role,
extent that they permitted sounds and conversations
510 Un it T WO The Research Process

to and dealt with patients rising emotions by avoiding


interviewer. Unskilled interviewers ma how or
direct discussion about the terms and legitimacy of theirw'hen to intervene, when to en:: ticipant to
hospital admission, including discussion of symptoms, incontinue to elaborate, or v he another subject.
marked contrast to the probing of psychiatrists orThe interviewer mu;: handle intrusive questions.
psychologists. Evasion and distraction were commonEstablishing s Positive Environment for
strategies used by nurses, in the moment-to-moment andan interview When preparing for an interview,
daily work of maintaining civility and relative calmestabB ronment that encourages a comfortable If
among inhabitants of the unit, in the face of such ayou are going to audio- or videotape re make
perennial conflict of views.
sure that the recording equipment: trusively.
aim of not angering the patient, nurses often avoidedLikewise, using batteries rathe- sources of pow'er
In the process of examining a patient and with the main

looking directly at a patient, instead glancing briefly ortends to be less intr_


discreetly'.... A feature of surveillance was the nursestive microphone will allow you to pick
ability to tune in to patient conversations at someor distorted voices, thereby increasing ;
distance, or whilst engaged in another conversationmake an accurate transcription later.
themselves. Being the third party to patients talk gaveConducting an Effective interview
nurses material from which to construct two valued formsFor practice, conduct interview's w:tr who meet the sampling
of knowledge: patients' speech related to mental status andcriteria. These t help you to identify problems before study.
patients coping ability in social situations, (p. 338)
Practice sessions also allow you t:
realistic time estimate for the interview - There are pow'er issues
The authors concluded the following: in an inter researcher, you have the pow'er to shsx view
agenda. Participants have the po ar the level of responses they
Based on an ethnographic study of the assessmentwill prov ide begin the interview' by asking a broad as Describe
practices of 11 psychiatric nurses and the first author in an
for me your experience wkhr me about... Ideally, the participant
Australian hospital setting, we found that nurses
observations of patients were rich in situated assess-tu:L though she or he is telling a story. It is : the narrative be from
ment detail and a powerful strategy for producing civilthe participants, interview'ers, perspective. Ask your in:, speak
conduct among patients. While such discreet practice isfreely about their experiences. Once the interview begins, the
productive for everyday clinical work, the invisibility ofrole at viewer is to encourage the subject to con
nursing observations undermines the status of acuteNod your head or make sounds that inc: When it seems
inpatient psychiatric nurses. Devaluing of tacit practiceappropriate, encourage \ to elaborate further on a particular
may encourage experienced nurses to leave inpatientdime- topic (known as probing). Participants maj idation that
units, at a time when hospitals struggle to address nursingthey are providing the needed lion. Some participants may give
shortages worldwide. We recommend instead that the
productive value of diverse and situated practices beshorn you may need to encourage them to ela: interviewer
investigated and articulated, (p. 331) becomes a detective in his or
for important information. McEvoy 120) out that the interview'er
is not after factual tion. From the perspective of qualita::'-;
interviews generate socially construe:?; edge. The interview'er
influences the inter terms of how she or he listens, attends,
Unstructured interviews interrupts, digresses, initiates topics and
Unstructured interviews are usedresponses (p. 51).
primarily in descriptive quantitative and
qualitative studies. According to market
research, in-depth interviews provide
more quality data for less money than do
focus groups (Palmerino, 1999). However,
the interviewer seeks information from a
number of individuals, whereas the focus
group strategy is designed to obtain the
perspective of the normative group, not
individual perspectives.
Learning fo Interview
Interviewing is a skill. Researchers must
give themselves the opportunity to
develop this skill before they initiate an
interview' for a study. A skilled interviewer
can elicit higher-quality data than an
inexperienced
Chapter 23 Qualitative Research Methodolog}' 511

with interviewing difficulties. Interview's with children may


encounter some challenges during an inter- require special considerations (Deatrick &
mon problems include interruptions such as Ledlie, 2000). In some studies,
calls, stage fright that often arises when the interview'ers may be profoundly affected
nt realizes he or she is being recorded, by participants stories and may need
failure fish a rapport with your subject, debriefing. This need may extend to
verbose par and those who tend to wander those transcribing the interview's and to
off the subject, need to tactfully guide the researchers analyzing the data. Because
interview back to . If the participant is of privacy issues, study participants are
emotionally distressed as :: die interview, not able to share their feelings with those
remain with the individual until ::pant is able who usually provide support and
to restore his or her composure, and comfort. In these cases, a person or
interviewers tend to underestimate the time persons should be designated to address
required for an interview. If the partici- these needs (Moyle, 2002; Price, 2002;
aarried, the quality of data is affected. the Sullivan. 1998; Wilmpenny & Gass. 2000).
study focuses on families, issues arise J which Berg (1998) has identified the
members are interviewed. In some cases, followung ten commandments of
member is selected to represent the family. interviewing:
This biases the results because other family
members different perspectives of the 1. Never begin an interview cold. Remember to
situation. Select y members and interview' spend several minutes chatting and making
each separately. The igy. of course, is to small talk with the subject. If you are in the
interview each member sep- faut this subjects home, use whats there for this
requires an inordinate amount of time arid, chatting. Look around the room and ask about
Paavilainen, & Lenti. 2001). velar concerns such things as photographs, banners, books, and
arise when a researcher is inter- colleagues. so forth. The idea here is to set the subject at
The interviewer (an insider) lacks distance ease and establish a warm and comfortable
that facilitates a balanced, objective e. rapport.
Common experiences tend to be taken for 2. Remember your purpose. You are conducting an
spects of the social world that should be interview in order to obtain information. Try to
ques- ic overlooked. You may find it difficult keep lift, subject on track, and if you are
to ask about sensitive issues of someone in working with an interview schedule, always
your own oup. However, there are have a copy of it in front of you even though
advantages. Because of position, insiders are you should have your questions memorized.
familiar with the social thus can interpret 3. Present a natural front. Because your questions
and attach meaning that may outsider. As an are memorized, you should be able to ask each
insider, you may find that you een the lines one as if it had just popped into your head. Be
of participants comments rather sg them at relaxed, affirmative, and as natural as you can.
face value. This capability may be ;y 4. Demonstrate aware hearing. Be sure to offer the
important if the group under stud}' is a subjects appropriate nonverbal responses. If
minor- or otherwise marginalized (McEvoy, they describe something funny, smile. If they tell
2001). an ethical perspective, interview's tend you something sad, look sad. If they say that
to be as noninvasive and thus as posing no something upset them, try 10 console them. Do
threat xerv iewee. However, interview's are not present yourself as uninterested or unaware.
an inva- liie psyche. For some, this may be 5. Think about appearance. Be sure you have
therapeutic, c. an interview is capable of dressed appropriately for both the setting and
producing risks alth of the participant. the kind of subject you are working with.
Therefore, the internist always avoid inflicting Generally, business attire is most appropriate. If
unnecessary harm participant (Munhall, 1991: you are interviewing children, a more casual
Sullivan. 1998). data you obtain are affected appearance may be more effective. Remember to
by characteristics person being interview'ed. think about how you look to other people.
These may include Itnicity, gender, 6. Interview in a comfortable place. Be sure that
professional background. :ral level, and the location of the interview is somewhere the
relative status of interviewer riewee, as w'ell subject feels comfortable. If the
as impairments in vision \g. speech
impediments, fatigue, pain, poor
disorientation, emotional state, or lansuasre
512 Unit TWO The Research Process
subject is fearful about being overheard or being
The remaining 60% were entering the clinical ss
seen, your interview may be over- before it ever
(Munro, 2001) (p. 135) Purpose: The purpose of this
starts. Don't be satisfied with monosyllabic descriptive qnai tive study was to investigate how
answers. Be aware when subjects begin giving yes- PhD-prepared or describe and define their role
and-no answers. Answers like these will not offer within the clinical: Methods: Interviews were
much information during analysis. When this does conducted with 5 PhD who were all employed full
occur, be sure to probe with questions such as, time in the clinical: Interview notes were recorded,
Can you tell me a little bit more about that?" or transcribed, and arm using qualitative data analysis.
What else happened?" Even a simple pause and Recurrent themes emerged from the interviews were
an uncomfortable silence might yield additional identified, (p. 13- Redundancy with participants
information. Be respectful. Be sure the subject feels responses i- after interviews with 5 nurses. Given
the explcm nature of this study, the redundancy
that he or she is an integral part of your research
from pare;:? and the nature of the findings, it was
and that any answer he or she offers is absolutely determined 5 nurses were sufficient to form a base
wonderful. Often subjects will say things like, You for the prr nary results reported here. (pp. 135-136)
dont really want to know how I feel about that." Interviews were conducted by the principal im gator
Assure them that you really do! Practice, practice, either in person or via telephone with the pm ipants.
and practice some more. The only way to actually The interview began with a series of q_rs regarding
become proficient at interviewing is to interview. the current title and position of the . prepared nurse,
Although this book [Berg, 1998] and other manuals as well as their area of specialty, na of years the}'
can offer guidelines, it is up to you as a researcher have been in their position, and number years since
to develop your own repertoire of actions. The best having earned a PhD. Lastly, the parti, were asked
way to accomplish this task is to go out and do to describe their masters degree and i what
discipline they had earned their doctoral degre:
interviews. Be cordial and appreciative. Remember Using an interview schedule of 5 questions, the
to thank the subject when you finish, and answer were then asked to respond to the following state or
any questions he or she might have about the questionst(l) Describe your role and respor.sirf as a
research. Remember, you are always a research PhD-prepared nurse working in the hospital sec (2)
emissary. Other researchers may someday want to Compare these roles and responsibilities as a .
interview this subject or gain access to the setting prepared nurse with a CNS or NP working in this 1
you were in. If you mess things up through tion who does not have a PhD. (3) What are some i
inappropriate actions, you may close the door for advantages of having a PhD in your current posa (4)
future researchers. (Berg, 1998, pp. 87-88) What are some of the obstacles you have eaa tered
The following is an abstract of a study on Ph.D.- in the clinical setting because of your PhD? (5 " me
a story that best highlights what you consider :: one
prepared nurses in the clinical setting (McNett,
of your successes as a PhD nurse, (p. 135) Results:
2006). The 2 themes that emerged from the inn were
bridging the research/practice gap and serving ;
healthcare leader. All participants spoke to their
raid* leading, encouraging, or participating in
clinical ing research within their healthcare
institutions.! regarding leadership emerged
throughout each insen and reflected a number of
leadership responsibilities each participant had
within the healthcare environa* Conclusions: The
findings from this qualitative a provide insight into
the current role of the PhD-~s nurse in the clinical
Background: The emergence of new doctoral programs setting. This information can ix to guide additional
within the nursing discipline has stimulated dialogue research that might influence the d opment of future
regarding the role of the doctorally prepared nurse in the doctoral programs in nursing, (p. 13 All participants
clinical setting. National nursing organizations have in this study choose to make i a priority within their
cited the need for additional research that would provide various hospital roles and : sibilities. All
information regarding the current practice of doctorally participants are striving to advance i ing science
prepared nurses. A review of the literature reveals little through practice-based research, and 1. the
published information about the role of PhD nurses in importance of nurses being the principal investor in
the clinical setting. these study. This finding is especially sigmre
A survey from one university in the year 2000 because 4 of the 5 participants did not hold reseats:
revealed that only 40% of that universitys doctoral
nursing students planned to seek employment in the
academic setting.
Chapter 23 Qualitative Research Methodology 513

Group interviews are superior to


individual interviews. The facilitator can
istrative positions within their organizations. Rather, -ere
employed and practicing as CNSs or NPs with I degrees. This
finding differs from that of Sterling . McNally (1999), who help people recover forgotten
found that research did not have r profound influence on the information by focusing the interview. The
roles of all of the doctor- fr prepared nurses that they effective use of focus groups requires
interviewed, (pp. 137-138) careful planning. Questions that must be
addressed include the following: Tiat are
the aims of the focus groups? How many
Groups groups were designed to obtain the focus groups should be assembled? How
partici- perceptions in a focused area in a setting many individuals should be in each focus
that _ ' -we and nonthreatening. One of the assump- group? How will you recruit for the focus
ate deri ving the use of focus groups is that group groups? Can you locate sufficient people
ecus can help people to express and clarify' their for the focus groups? Are you selecting
~ ways that are less likely to occur in a one-to- the right people for the focus groups?
iew. The group may give a sense of safety pers" to Where should the focus groups meet?
those wary of researchers or those who groups are a What skills should the groups moderators
relatively recent strategy that si initially in nursing have? How will moderators interact with
studies in the late 1980s. they have been used in participants? What questions will the
other fields for a ie. The idea of focus groups moderators ask? How should the data be
emerged in the an approach for examining the analyzed? Many different communication
effective- marketing strategies. The concept forms are used in focus groups, including
reemerged pkorld War II with efforts to determine teasing, arguing, joking, anecdotes, and
ways e the morale of the troops. The technique s nonverbal approaches such as gesturing,
variety of purposes in nursing research. It med to facial expressions, and other body
perform qualitative studies (Twinn, take policy language. Kitzinger (1995. pp. 299-300)
analyses (Straw & Smith, 1995), rtfimer satisfaction, has sugge^ed that peoples knowledge
evaluate the quality of din & Pelletier, 1996), and attitudes are not entirely
examine the effec- :: public health programs, assist encapsulated in reasoned responses to
in profes- sci-ion making (Bulmer. 1998; Southern :!l . direct questions. Everyday forms of
develop instruments, explore patient care and communication may tell us as much, if not
strategies for developing effective inter- develop more, about what people know or
education programs (Halloran & >95), and study experience. In this sense focus groups
various patient popula- cmey & May. 1998; Goss, reach the parts that other methods
1998: Quine & 1995: Reed & Payton, 1997). It has cannot reach, revealing dimensions of
also ^jyed as a data collection strategy in partici- understanding that often remain
Kcarch. A focus group study might include 5>1 untapped by more conventional data
groups. collection techniques. (full text available in
towing assumptions underlie focus groups Health Source Nursing/ Academic
Peoples, 1999): jcciegeneous group provides the edition)Recruiting appropriate
participants freedom to express thoughts, feelings, participants for each of the focus groups
and i ors candidly. cals are important resources of - is critical, because recruitment is the most
an on. are able to report and verbalize their and common source of failure. Each focus
feelings. p's dynamics can generate authentic -uon. group should include 6 to 10 participants.
If there are fewer participants, the
discussion tends to be inadequate. In
most cases, participants are expected to
be unknown to each other. However,
when targeting professional groups such
as clinical nurses or nurse educators, such
anonymity usually is not possible. You
may use purposive sampling to seek out
individuals known to have the desired
expertise. In other cases, you may look for
participants through the media, posters,
or advertisements. A single contact with an
individual who agrees to attend a focus
group514 does notThe
Unit TWO Research
ensure that Process
this person will
attend the group session. You will need to
make repeated phone calls and remind the although some may extend to an entire a.
candidates by mail. Inform them at the time of continue as part of a series of meetings It
consent that you will be calling to remind them is important for the researcher : : aims of
of the group and to verify that the phone the focus groups and commu-f aims to
number they gave you is the best number to the moderators and the part::.p the
call. You may need to offer incentives. Cash group session. Instruct participants tbs of
payments are, of course, the most effective if view are valid and helpful and thjB should
the resources are available through funding. not have to defend their positions to the
Other incentives include refreshments at the group that the facilitators role is ate the
focus group meeting, T-shirts, coffee mugs, gift discussion, not to contribute. O the
certificates, or coupons. Overrecruiting may be questions that are to be asked d_r:ri
necessary; a good rule is to invite two more group, and, if time permits, pilot-test
potential participants than you need for the them! number of questions to those most
group (Morgan, 1995). sufficient time is left for discussion. Yoa to
Segmentation is the process of sorting give participants some of the quest::ns
participants into focus groups with common group meeting to enable them to give
characteristics. Selecting participants who are eu_ to their responses. Questions should
similar to each other in lifestyle or experiences, be pi a way that group members can
views, and characteristics facilitates more open build Ai
discussion. And you can increase the groups on
of others in the group, raise their : --r and
validity by conducting multiple focus groups question each other. Probes car. Be richer
and placing participants with differing details using questions such as
characteristics into separate groups. These that make a difference? or What mai
characteristics might be age, gender, social that? Why questions are not good r. tend
class, ethnicity, culture, lifestyle, or health to push a participant toward talur.g i
status. Strickland (1999) pointed out the defending it. Then it is difficult to ira ;
problems that could occur if differing cultural the stand if th^; group begins moving
groups are included in the same focus group. consensus. The act of questioning ::
Communication patterns, roles, relationships, ideas offers a stimulating learning exi
and traditions might interfere with the group members. Their thinking may be
interactions within the focus group. In some tested, and participants may be prsentai
cases, groups may occur naturally such as ways of thinking about a problem ( HoH
those who work together. Be cautious about & Goble, 2002).
bringing together participants with A common problem in focus group; is
considerable variation in social standing, into the topic of interest to the researct
education, or authority because some group emphasis on the interests of the partieip
members may hesitate to participate fully, the session, provide opportunities for .
whereas others may discount the input of express their view's on the topic of :
those with perceived lower standing (Kitzinger, proceed with the questions. Use probes r]
1995; Morgan, 1995). sion wanders too far. A good facilitator
Establish a setting for your focus group that questions into the discussion naturally
is relaxed. There should be space for tators role is to clarify, paraphrase, ami
participants to sit comfortably in a circle or U- what group members have said. Tf.es
shape and maintain eye contact with all tend to express group norms, and mif
participants. Ensure that the acoustics of the dissent may be stifled. However, wher
room will allow you to obtain a quality tape is on sensitive topics, the group may sca-
recording of the sessions. As with the one-on- the discussion because less inhibitec is
one interview discussed earlier, place your tape the ice for those who are more retieenu
or video recorders unobtrusively, and use may also provide group support for e
batteries rather than plugging your equipment ings, opinions, or experiences. Late is
into a power source as this is less invasive. Use the moderator may encourage group
a highly sensitive microphone. However, it may beyond the current discussion or define
be necessary for the moderator or assistant inconsistencies among participants an
moderator to take notes when the speakers own thinkina. The moderator can use
voice is soft or when several individuals are
speaking at once. Making notes on the
dynamics of the group is also useful. Note how
group members interact with one another.
Sessions will usually last 1 to 2 hours.
Chapter 23 Qualitative Research Methodology 515

[group members to encourage Kelly and Patterson (2006) conducted a


participants to study titled Childhood Nutrition:
points of view more clearly and Perceptions of Caretakers in a Low-
provide a :*:r their position Income Urban Setting in which they used
(Kitzinger, 1995). focus groups. The following abstract
describes their research.
* Role
SII effective moderators is as critical The incidence of overweight and obese children,
as select- priate participants. The especially those from low-income and minority
moderator must K participants to talk
backgrounds, continues to rise. Multiple factors
contribute to the rising rates. In order to gain an
about the topic. Sim Hunted out that understanding of factors contributing to obesity in low-
the focus group moderator Cuer.ee income families, a qualitative study was conducted with
powerfully the process of interaction the purpose of gaining knowledge of low-income urban
place, and the way in which the caretakers understanding and attitudes regarding
moderator ind the verbal and non- childrens nutrition. A focused ethnography was used as
verbal cues that he es to the group, a means of understanding behavior within the context of
are crucial in this respect _ Because a persons cultural environment. The sample was 17
expertise in the topic may make par- caretakers of children in the ls'-3rd grades. Four focus
groups were conducted. Two themes emerged from
leluctant to speak, the moderator caretakers perceptions: knowing the right things
should make "tit he or she is there to children should eat and balancing healthy nutrition with
learn from the group in some cases, unhealthy' choices. Four categories emerged regarding
you will want to include moderator influences on food choices: tradition, finances, time
as well as a moderator. Par- should constraints, and role models. Lastly, five barriers and
be encouraged to talk to one three facilitating factors emerged. Implications of the
another r addressing all comments to study findings for school nurses include the need, when
the rnodera- icessful moderator implementing healthy eating programs for school
encourages participants to wrh one
children, to gain information from caretakers about t sir
perceptions of childhood nutrition, (p. 345)
another, formulates ideas, and draws Procedure: A semistructured interview guide, based
:: e structures not previously on the health care literature and input from pediatric nurse
articulated, rs should remain neutral experts, was used to guide the focus groups. Four focus
and nonjudgmen- ; topic is sensitive, groups were conducted at an elementary school in a
moderators need to be able classroom at the end of school hours. The interviews were
rticipants at ease. To accomplish this audiotape-recorded and lasted from 1.5-2 hours. Although
goal, rifenttor with characteristics there were some challenges to conducting focus groups in
similar to those of participants.
this setting (Patterson & Kelly, 2005), participants
enthusiastically shared their views and thoughts about the
Extreme dominance
to: participants sayor extreme ss on nutrition. Healthy refreshments were served. The same
thempart participants interact will
of the moderator leadone
with to researcher conducted all focus groups. Field notes about
Kitzinger,
another 1995; Morgan.
curate attribution 1995; of observations in classrooms, the cafeteria, and surrounding
Morrison
quotations& to individual faarp community were recorded regularly. Data collection
members
continued until saturation was reached, (p. 247)
Section should not interfere with
c-ction
"the coordi- [thatthe
; recommended the group. Thebemethod
following data Collecting Stories
of data collection IRK have reactive During observation and interviewing, the
effects on the participants. 1998), citing researcher may record stories shared by
the work of Reinharz (1992) 1983), participants. Banks-Wallace (1998)
suggested using a computer group described a story as an event or series of
strategy, combining focus group events, encompassed by temporal or
interviewing esive observation to spatial boundaries, that are shared with
gather information. Partir: given a others using an oral medium or sign
web site where each indiv idual can language. Storytelling is the process or
or her thoughts. All participants have interaction used to share stories. People
access r__ .cipants comments and sharing a story (storytellers) and those
can enter their own espond to listening to a story (storytafcers) are the
comments of others. Thus, these main elements of storytelling (p. 17).
hguided focus groups in which the Stories can help researchers to
discourse synergistically created understand a phenomenon of
convergence of sriences (Berg, 1998,
p. 108).
516 Unit TWO The Research Process
interest. In some qualitative studies, the
focus of the research may be the
who is just 3 years old at the time, becomes
the way that.ehildren do and interrupts, forcing l
gathering of stories. Gathering of stories to pay some attention. Barbara is adept at shifdng
can enable health care providers to responding to Rhonda and picking up her r.arra.
develop storytelling as a powerful means Cheryl lacks Barbaras easy facility, but tries
to increase insight and promote health to keep Rhonda entertained while listening to
behavior in clients. For example, Nwoga story'. She also tries to keep the tape recorder ox
(1997, 2000) studied how African- das hands who gets curious about how it wccsa
American mothers use storytelling to has supplied Rhonda with some colored per..'
guide their adolescent daughters
since Rhonda loves to draw', (p. 9)
At the stage of the interview' excerpted beles
regarding sexuality. The stories could has been remembering the period of several
assist other mothers who are struggling which Rhonda has often been violently sic!:::
to help their daughters deal with sexuality ach, but no doctor has discovered anything :
issues.
The story is an obvious way for social actors, in talking
She then remarks:
to Coffey
strangers and
(e.g.,Atkinson (1996)to discussed So on Labor Day (pause) Labor Day, her C
the researcher), retell key
the
experiences and events. Stories serve astories
importance of capturing variety ofin
... and he was keeping her till the next mcmd
qualitative studies.
functions. Social actors often remember and order their
next morning, at 5 o clock, he called and said,
really vomiting bad." And I said, Bring her
careers or memories as a series of narrative chronicles, can take her," I said, I'm taking her to C.r
that is, as series of stories marked by lce\f happenings. So I said, Bring her here."
Similarly, stories and legends are told and retold by The very way that Barbara has phrased
members of particular social groups or organizations as a nals Cheryl that a significant moment is
way of passing on a cultural heritage or an organizational described. A key marker of a story is the :.
culture. Tales of success or tales of key event in a specific time. Barbara begins this p
leaders/personalities are familiar genres with which to conversation with specific temporal indiea::".
maintain a collective sense of the culture of an Labor Day (a 24-h time period) but even 5
organization. The use of atrocity stories and morality the morning. Here is the verbal SLjuivaiez
fables is also well documented within organizational and lens, which moves from a hazy distance ::
occupational settings. Stories of medical settings are ingly sharp focus on one particular moz;
especially well documented (Atkinson, 1992; Dingwall, Barbara is setting the stage and we know s
1977). Here tales of professional incompetence are used important is about to happen. A second -
to give warning of what not to do and what will happen significant story is about to unfold is Ba-
if you commit mistakes.... Narratives are also a common five strategy of recalling dialogue. She
genre from which to retell or come to terms with said, she said mode in which she not oah
particularly sensitive or traumatic times and events. the remembered phone conversation, >-r~
(Coffey & Atkinson, 1996, p. 56) conversation, but she even shifts her va
Mattingly and Lawlor (2000) described
the various characters, namely herself and re-
husband.
their research in which they solicit illness While, upon reading the transcript, it =
stories. These authors skillfully guide you Barbara is heading in an important direct:
in interpreting the process of the story, Cheryl seems a bit oblivious to these cine*
identifying key turning points as the story series of distracting questions, which 5a
progresses. answers.
C: Had you been to City Hospital ye: sc
During the first interview with Barbara, she told a B: No. Cause Icouldn t...
harrowing story of how she struggled time and time again C: Its a long trip.
to get health professionals to find out what was wrong B: And plus the job. I figured the ped:ar
with her little girl. The following extensive excerpt of this taking her to, that shes had ever since she
first interview gives a powerful picture of this struggle. that you know, they would handle it. and
Since it includes the interviewers (Cheryls) questions, it the kind of job that I couldnt, like, take
also illustrates the kind of questioning process often or, you know, I was always stressed tha: f
required to prompt someone to move from broad know, that I would lose my job, you kno* '
descriptions of situations to vivid and fine-grained stories C: Yeah.
of particular events, (p. 9) B: And, especially since I had got ser-x~
Three people are present in this interview, which takes I really couldnt afford to take no time.;
place in a hospital waiting room. Barbara, the mother, C: Yeah
Cheryd, the interviewer, and Rhonda, the ill child.
Rhonda,
Chapter 23 Qualitative Research Methodology 517

But then, tenacious storyteller that she is, when Bar- C: Tell me about this. Just describe that. Wlmt happened?
rara sees an opening she returns to her story as though B: Yeah. That evening, when I brought her um ... the
see had never been interrupted. doctor down there in the emergency, she um, came and
B: So, I was taking her, you know, to a lot of the emer- checked her, and I was telling her, shes really ... shes
gencies and to, you know, X Hospital and Y Hospital, constantly vomiting and having headaches really bad. And
mid I was taking her there, but then I started just say- she did her little checking, and she said, Well, I dont see
aig. forget it. [Barbara means here that she finds she is anything. And we did her urine, and, 7 don't see
mo: getting any helpful treatment for Rhonda and gives anything. I said, But Im not leaving here unless you guys
MC or. the idea of continually taking her to the doctors] tell me to do something because ... and then she started,
started taking her to my ex-husbands place. And so, he like, getting a little smart on me.
fri t bring her home that morning when he called me at C: Yeah, like what did she say? Just go... just go through
f t slock. He brought her home, like, later in the after- this.
. But by then, she stopped vomiting, okay? But later B: Okay. She was, like, saying, well, if you don't think that
mm that evening, it started back up. She just, like when Im doing my job, then you could just take her to the, um ...
MLi was drinking something, it would, like, just shoot Im gonna make you an appointment and you can take her
m out across the room. Just like how the Exorcist to the day hospital. I said, Oh, its not that I dont think you
C: Yeah, yeah. re doing your job; I just want my daughter to get help. You
: You know? And I wap like, really getting, um, crazy, know, as you understand, Ive been taking her eveiywhere
p ? had brought her down ... I called Z Hospital, and I and she still be doing the same thing constantly, over and
them that my daughter's like, vomiting and having over. And so then, she got a little upset, so she left...
itches, you know, and um, they said, well um, Bring C: What did she say?
You know, and then so I brought her to the emer- B: And she went across the hall and ... where her little
fctoy there. And then, um, I had a little confrontation office was ... when all that time, the door was open, you
ptbt the lady in there, okay? know, all the time she was seeing patients. But when she left
|5i tins passage Barbara begins the shift from general therefrom talking to me, she went over there and she closed
[2-: -:ion of her life to specific, vivid storytelling. She her door, and I guess she was telling the social worker ...
cs with an overview of her situation during this time because the social worker came down and came in there and
m tc Rhondas diagnosis in which she speaks about talked to me and was asking me, Whats going on? Is there
~rriculties in getting time off work and her continual something wrong?" I said, Yes, theres something wrong."
Ec various clinics in the area. But then she switches She said, Well, the doctor feels that you dont think shes
B specific highly dramatic incident, which she locates doing her job. I said, So, but why does she have to call the
specific time, that morning. Though her account is social worker on me?" You know? And then I started feeling
r infusing in detail, it is clear that something much like they was, um ... I felt like she thought that / was, like,
frightening is going on with Rhonda than has hap- kind of crazy or did something to my daughter myself. Thats
refore. Barbara uses a graphic image, vomiting the kind of feeling I got. I felt very uncomfortable. I said, Do
rise Exorcist to get her message across of what this you guys call the social worker on all people?" you know?
ce was like for her. And she ... and I was letting the social worker explain. No,
cs ooint, Cheryl had caught on that this is a piv- its not on all people. Its just when the parents feel that you
SELiide in Barbaras illness story. She suspects that re not happy with your doctor, and the doctor will call.
phrase little confrontation is the tip of an You know, but then, she kinda calmed me down. You know, I
wasn't arguing or ! wasnt saying any, you know, bad ...
anything ... 1 just wanted my baby to get help, you know?
1didnt want to take her home again and be like she was.
You know, shed done been through it too much.
C: Yeah. (p. 11)
This confrontation is repeated and amplified just 1
week later, in September, when Rhonda is again severely
ill and Barbara picks her up from school and rushes her
back to City Hospital. Again she has to fight with nurses,
doctors and other healthcare workers to get her child
seen. Barbara tells the story of this fateful day. She talks
to person after person, going from one department in the
hospital to another, telling them that nobody wants to
518 Unit TWO The Research Process
from observations may be important,
see my baby ... I said, Nobody wants to and peer documents such as diaries or
see my baby and shes really sick, and I historical records be used. Analysis
keep getting the run-around. She
remembers that they tell her, Well, involves more than just strita^ events
Rhondas appointment is not until the together; events should be linked in
21st, you know, of October, so you an pretation through w'hich the
have to wait. Finally, she gets one researcher car . theoretical sense.
administrative lady to listen to her and Materials are organized an; lyzed
this woman locates Dr. Romburg. And according to theoretical interests.
so he was doing a little history on Cor.rt ing a life story often requires a
Rhonda...I said, My baby keeps long-term :: and extensive
complaining of her headaches.
Just then, the doctor has Rhonda walk. Barbara recalls collaboration w'ith the par;;; (Frank,
her horror at what happens next. But she started walking 1996; Larson & Fanchiang, 1996; Male
like she couldnt walk by herself anymore you know? Kielhofner, & Mattingly, 1996).
And started walking, like, into the wall, you know, to the Roesler (2006) provided a life story'
right. And I said, Oh Lord! Something is really going of Herr 2 in an article describing a
on. The doctor then hurried up and ran and got another narratological ogy for identifying
doctor., .and he told her to walk for him, so she did the archetypal story patterns :r.
same thing for him. So then they went and talked and they
came back. They said to me, It seems like its some form biographical narratives. The article
The following transcript is taken from an au::
is
translate:
Herr BittnerGerman.
graphical interview with a person called Herr B.
of a mass or something, pressing down on her head to has been severely physically disable
give her headaches. So then I was saying, Oh Lord. As birth by spastic cerebral palsy. He has always beer.t
terrified as Barbara is, there is one phrase this doctor told dependent on external help. In his life story he ce>;
her, one she repeated several times and in later interviews himself as a political person. He was an active ra
again, that deeply reassured her. While others had only of the political movement of disabled persons fis
paid attention to Rhondas stomach because of her violent for an independent life and for equal rights. Ac
vomiting, Dr Romburg, he said, Were gonna start from he was the first disabled person in Germany who
her head and work our way down. live outside of any institution through help from ;
Again, note the contrast of Barbaras wrenching story to people doing their civil sendee. In his narrative self
the pristine note in the medical chart in which the doctor sentation, he lives a life exemplary for all disables j
reports, Physical examination: looks well but wobbly ... pie, always before the eyes of the public. His life
has me concerned about mass in head, will schedule CT. political fight for equal rights for al! disabled re.
No one would know what Barbara endured to get this and the changes in his own life, his growing aut,
essential CT scan, which led to Rhondas diagnosis of a and self-respect, mirror the changing attitude in r
brain tumor just 3 days later. towards disabled people and their rights, (p. 577;
Rhonda is now 5 years old, still very sick, still receiving In his introduction to the actual narrative he
treatment, but still alive, (p. 12) that physically disabled persons are often mistake*
Constructing Life Stories
A life story is designed to reconstruct and
the public as being also mentally retarded and are
criminated against just because they have physical
interpret the life of an ordinary person. lems with speaking, with precise pronunciation,
The methodology, which emerged from because they look strange. He now wants to take on
history, from anthropology, and more task of showing and proving to the public, again in a
recently from phenomenology, has been that will be exemplary for all disabled people, ir.ai
described by a number of scholars are at least as intelligent as normal people, and his
(Bateson, 1989; Bertaux, 1981; Frank, 1979; possibility of doing so is by showing that he car.
Gergen Gergen. 1983; Josselson & cleariy and precisely. With the actual narrative he
Lieblich, 995; Linde, 1993; Mattingly & an example of that: (p. 577)
Herr Bittner: ... and still today l love to surps
Garro, 1994; Polkinghorne. 1988; Sarbin, experts. I want to give an example; years ago I have
1986; Tanner et a l 1 9 9 3 ; Ventres, 1994). to a university clinic and then the professor and his i
The life story can be used to clarify the staff came to my bed and he says, Now how do yamj
meanings of various states of health, how do we feel today?, that is, in we-fonn. And
chronic illness, and disability in the lives said, Professor. I cannot judge how you feel today
of patients, their families, and other know how I feel." T cha. Then I said, You actuals:,
caregivers. These stories can help us me how we feel" (Laughs) and one hour later ar. ,
understand the meaning to patients of tan! doctor came in and she said Arc you mad.

their health behavior, lifestyles, illnesses,


or impairments; the meaning of
symptoms; their experiences of
treatment; how they adapt; and their
hopes and possibilities of reconstructing
their lives. Interview's are tape-recorded
and transcribed. Notes
Chapter 23 Qualitative Research Methodology 519

Benderix and Sivberg (2007) provided an


example
wgh in his presence, and he went out into the
' said what did the guy really mean to say?
of a case study.
rly the transcript cannot show how strongly is The aim of this study was to describe the present and
distorted by his spasticity and how he still IETC past experiences of 14 siblings from five families in
to speak clearly and exactly, (p. 577) tenns of having a brother or sister with autism and mental
retardation. Personal interviews were conducted with the
siblings before their brothers or sisters were moved to a
newly opened group home. Qualitative content analysis
xamines a single unit within was used for the analysis of the transcribed texts. The
the context analysis resulted in seven content categories: precocious
e environment. The unit may be responsibility, feeling sorry, exposed to frightening
a person,
behavior, empathetic feelings, hoping that a group home
will be a relief, physical violence made siblings feel
ng unit, or an organization. In unsafe and anxious, and relations with friends were
the early affected negatively. The conclusion is that these siblings
rury. the most common nursing experiences revealed stressful life conditions. Counseling
study was for the family and for siblings is recommended to help
Medical case studies were also them deal with their feelings and problems. For the
common, siblings in these five families, a group home was a
rose studies were published in the relevant alternative as a temporary' or permanent
placement for the child with autism and mental
American retardation, (p. 410)
mursing and initiated a variety of
nursing
T;i:;ent care. As nursing research DATA MANAGEMENT AND REDUCTION
began to
xx>us methods, the case study t
fell into dis- Using the Computer for Qualitative Analysis
r - er. the importance of Traditionally, qualitative data collection
information from and analysis were performed manually'.
is again being recognized. Case The researcher recorded the data on
studies can small bits of paper or note cards, which
r. e. qualitative, or mixed were then carefully coded, organized, and
methods of data filed at the end of a day. Manual analysis
is important for the researcher requires cross-checking each bit of data
to consider with all the other bits of data on little
aspects that affect a particular pieces of paper. It is easy to lose data in
case and to the mass of paper. Keeping track of
essential
rubies to information in the plan
be examined is a connections between various bits of data
for data
critical compo- requires meticulous record keeping. This
mr.g malysis.
the study. Multiple sources method was developed because it was
of infor- uestions, as well as the important for the qualitative researcher to
qualitative
ir.any of the variables as maintain a close link withor become
for the study, give
possible guide the data the immersed inthe data being analyzed.
collection.
a i iity. This is referred to at Some qualitative researchers believe
ith most
B Slata trian- qualitative studies, as that using the computer can make
anfunder-
Jpk eii diary is also useful because analysis of qualitative data quicker and
r.e situation begins to emerge,
insights easier without the researcher .losing
otherd ques- as they occur. The touch with the data (Anderson, 1987;
new data may be gathered
researcher mightto Miles & Huberman, 1994; Pateman, 1998;
address
new variables that need to the be St John & Johnson, 2000; Taft. 1993). Taft
A researcher might want to
examined, has suggested that because of the ease
understand
nse to events should also be of coding and recoding, the researcher
recorded,
of factors that affect patient feels more free to play with the data and
cp care, a rerson,all of multiple interviews experiment with alternative ways of
mayrat needaffect
to the emotional state coding. This freedom fosters analytical
of
requiring a a person
strong insight and thus facilitates data analysis.
ar illness,
commitment or the factors
from that
the Researchers can also search for codes
affect
ocumentary learn-
evidence is also a that tend to occur together. Also, easy
rricular approach to patient
valuable access to the data facilitates team
education,
related to the case. Analysis research. Pateman 1998; full text available
include the social and political
focuses in Nursing Collection) suggested that
environ-
rich, in-depth description of "some would argue that scientific,
rure
the is being provided. Thus, case,
identifying
as with many qualitative
studies,.is not
(^e'-er. comparisons with similar
situations
- ossible.
520 Unit TWO The Research Process
mathematically-minded people are more within several categories, if desired. At
computer literate than those with more the : interviews or descriptions of
artistic, humanistic interests, in which case observations car re intact for reference
affinity with computing may have as needed. In addition, m. :~r
something to do with personal traits.... processing programs can perform sort
Some of the ... arguments [by qualitative opera can search throughout a text
researchers against using computers] file for a selectee or a string of words.
could simply be rationalisation by Many of these activities performed
computer-phobic researchers. However, with a traditional word processing c
Taft expressed concern about the dark (Burnard. 1998). Files in a word
side of computer technology for processing g- can be transferred to a
qualitative researchers. The researcher database spreadsheet Excel, dBase, or
may be tempted to study larger samples Lotus 1-2-3 to organize the ' matrices.
and sacrifice depth for breadth. A number of computer programs
Meaningful understanding of the data have developed specifically to
may also be sacrificed. Sandelowski perform qualitatr- e se's. Podolefsky
(1995a) expressed concern that the use of and McCarty (1983) descrtrec of the
computers will alter the aesthetics of earliest attempts. This program. C:
qualitative research and suggested that Assisted Topical Sorting (CATS),
the key motivation for using computer allowed to insert codes, designated as
technology in qualitative research is to numbers, lt.t: i file. A mainframe text
legitimize the claim that qualitative editor gave users the ity to search for
researchers are doing science. She stated, strings of characters such or phrases.
computer technology permits qualitative St John and Johnson (2000) exp A
researchers to have computer printouts of pros and cons of various data analysis
data (with the veneer of objectivity they sofiv qualitative research.
confer) comparable to their quantitative
counterparts whose claims to doing Transcribing Interviews
science are often not questioned. Even Tape-recorded interviews are
so-called soft data can become hard when generally tr- word for word. Field and
produced by hardware. Qualitative work can Morse
Pauses are(1985) prow
denoted in the J
transcript following
with * while
now have the look and feel, or aesthetic instructions
series of dots for transcribing a tape-n"
indicate gaps or prolonged p All

features, of science (p. 205). interview.


exclamations, including laughter and explelrsi
included. Instruct the typist to type interview s
The computer can assist researchers in spaced with a blank line between speakers. A g-
activities such as processing, storage, rnargin on both sides of the page permits the leh to
retrieval, cataloging, and sorting and be used for coding and the researchers ow n . of the
leaves the analysis activities up to the interview' style, and the right margin to re for
researcher. Anderson (1987) pointed out comments regarding the content. ... Star, i paragraph
that the computer does not perform the each time a topic is changed. ... Ensure all pages are
numbered sequentially and that ea, is coded with the
thinking, reviewing, interpretative, and interview number and the info number. (Field &
analytic functions that the researcher Morse, 1985, pp. 97-99)
must do for himself or herself. Rather, the
computer makes the researcher more
efficient and effective in those high-level Sandelowski (1994) indicated that the
functions, and eases some of the tedious researcher choose which features
mindless tasks that otherwise consume about the interview serve in print.
so much time and energy (pp. 629-630). These choices directly influe nature
However, Sandelowski (1995a) has argued and direction of the analysis. Once the
that replacing and streamlining the view has been transcribed, the
cutting and pasting activities may be seen transcript takes independent reality
as desirable by some because they are and becomes the resea raw data.
uncomfortably reminiscent of childhood Sandelowski suggested that the r:
play. She argued against the claim that transcription alters reality. The text is
machine technology saves human labor max- formations removed from the
and suggested that it may actually so-called un.'< ated reality it was
increase labor because more data are intended to represent
stored and retrieved and once the data
are stored, one has more of a sense that
it must all be accounted for in the report
of results.
Computer use has several advantages
over the more traditional methods of
recording and storing data. Multiple
copies can be made with ease, and files
can be copied onto backup disks and
stored at another site without the need
for a large amount of storage space.
Blocks of data can also be moved around
in the file or copied to another file when
Chapter 23 Qualitative Research Methodology 521

mended asking the following everything. Motives, histories,


questions transcription: antecedents, and causal links, sometimes
entire subplots are left to the reader, to
c Transcript necessary to achieve the arch goals? the researcher, to infer (Ayers & Poirier,
m transcription is required, what features f the 1996, p. 165). The process of interpretation
interview event should be preserved a: all possible) occurs in the mind of the reader. The
and what features can be r/v ignored? virtual text grows in size and complexity'
inf notation system should be used? as the researcher reads and rereads.
or purposes besides investigator analyser se Throughout the process of analysis, the
will the transcript serve? (Sand- * ski, 1994, virtual text develops and evolves.
pp. 312-313) Although multiple valid interpretations
may occur if different researchers examine
ski pointed out that transcriptions the text, all findings must remain
require hours for each 1 hour of trustworthy to the data. This
interview time. The work may be trustworthiness applies to the unspoken
$20/hour for an experienced meanings emerging from the totality of
r.son (2005) has developed an the data, not just the written words of the
innovative : f data analysis that uses text.
audio-editing soft- eve selected Immersion in the Data
audio bytes from digital audio The Data collected during a qualitative study
data are never transcribed but may be narrative descriptions of
remain term. A database is used to observations, transcripts from tape
code and manage ed audio files recordings of interviews, entries in the
and generate detailed and sum- researchers diary reflecting on the
ports. Although the system is time dynamics of the setting, or notes taken
consum- up, it negates the need while reading written documents. In the
for expensive and isive transcription initial phases of data analysis, you need to
of recorded data, to the tape become familiar with the data as you
recordings as soon after the gather them. This process may involve
interpossible. Listen carefully to reading and rereading notes and
voice tone, infiec- pauses of the transcripts, recalling observations and
researcher and the participant, ts experiences, listening to tapes, and
the content. These features may viewing videotapes .until you have
indicate that is very emotional or become immersed in the data. Tapes
very important. While evening, read contain more than words; they contain
the written transcript of the tape, feeling, empllasis, and nonverbal
cations of your observations on communications. These aspects are at
the transcript. least as important to the communication
and Poirier (1996) pointed out that as the words are. In phenomenology, this
quali- Isalysis results from the immersion in the data is referred to as
recontextualization of : d a t a , always dwelling with the data.
with the caveat that the new must in
some way be faithful to its origins. - Data Reduction
e data are meaningless without Because of the volumes of data acquired
context Using the reader response in a qualitative study, initial efforts at
theory' emerging work of Iser (1980) analysis focus on reducing the volume of
and Kermode (1983), Poirier data so that the researcher can more
indicated that the meaning of a text effectively examine them, a process
m the interaction of the mind referred to as data reduction. During data
(including the ' history) of the reader reduction, you begin attaching meaning
with the content of the jeh in turn to elements in your data. You will discover
arose from the mind and personal of classes of things, persons, and events and
the interview respondent) (p. 164). detect properties that characterize things,
Reading results in an interaction persons, and events. You will also note
between the mind and history of the regularities in the setting or the people.
respondent and the mind oral These discoveries will lead to classifying
history' of the researcher. This elements in your data. In some cases, you
interaction the emergence of a may apply the classification scheme used
virtual text, which is the ng by participants or authors. In other cases,
interpreted. Thus, there is no real you may wish to construct your own
objec- ,ntic information from which classification scheme. According to
only one correct ion can be made. Sandelowski (1995b),
The text does not explain
Although data preparation is a distinctive stage in
qualitative work where data are put into a form that
will permit analysis, a rudimentary kind of analysis
often begins when the researcher proofs transcripts
against the audio- taped interviews from which they
were prepared.
522 Unit TWO The Research Process

Indeed, the proofing process is often the first time a did in each situation. Teens were also provided \* is :u
researcher gets a sense of the interview as a whole; posable cameras and a baby book journal in which rta|
it is, occasionally, the first time investigators will wrote about their experiences. Following each p: turn
hear something said, even though they conducted the interview, the teen described her photos an; ;;_r* her
interview. During the proofing process, researchers journal entries with the interviewer. A family bean !
will often underline key phrases, simply because they interview was conducted with grandparents at 6 - term.
make some as yet inchoate impression on them. They At 9 months, mother and baby were videotaped ir.
may jot down ideas in the margins next to the text activities. After viewing the videotape with the inter*-
* the mother described her reactions to taped segment
that triggered them, just because they do not want to 1 joint interviews at 3 and 10 months, teens and
lose some line of thinking, (p. 373) grandpa* described their daily schedules and the care
of the rail Individual and joint interviews were
Data Analysis scheduled a: faafl members convenience and typically
The following is a description of some of lasted less v an ij hours. Teens received US$10 for each
the techniques qualitative researchers use interview or LSlfl for completing tire study. Parents
during the process of data analysis and were not reimbursed Data were analyzed using
inteipretation. These techniques include interpretive strategies 7 _ emerged directly from the
coding, reflective remarks, marginal data and were used to up .ml view excerpts that were
remarks, memoing, and developing then moved as a block :: ca summaries for each family.
propositions. Summaries were am;- jsi additional interviews were
coded. This approach ratar possible to condense each
familys set of lengthy rae views into one file so that
Codes artd Coding my analyses and ima* excerpts could be easily retrieved
Coding is a means of categorizing. A for subsequent sai sis. As cases were analyzed, I
code is a symbol or abbreviation used to searched for pana* teens and grandparents concerns,
classify words or phrases in the data. meanings, preena and interactions. Cases .were then
Codes may be placed in the data at the compared to ira similarities and differences in personal
time of data collection, when entering and famih cents, meanings, practical, and interactions.
data into the computer, or during later The s interviewer and two additional researchers read
examination. Through the selection of cases to validate or refine my interpretation, (p. 2;I
categories, or codes, the researcher
defines the domain of the study. The types of codes that can be used
Therefore, it is important that the codes are desc. interpretative, and
be consistent with tire philosophical base explanatory. Descriptive c>;: sify
of the study. Organization of data, elements of the data by using terms
selection of specific elements of the data that i how the researcher is
for categories, and naming of these organizing the data. It is n plest
categories all reflect the philosophical method of classification and is
base used for the study. Later in the common! in the initial stages of data
study, coding may progress to the analysis. Descriptr c remain close to
development of a taxonomy. For the terms that the participant ua ing
example, you might develop a taxonomy the interview. For example, if you
of types of pain, types of patients, or were re transcribed interview in
types of patient education. Initial which a participant di experiences in
categories should be as broad as the first days after surgery; ya use
possible, but categories should not descriptive codes such as PAIN,
overlap. As you collect more data in
Data consisted of joint and individual tape-recorded
MOVING and REST.
relation
interviewed thea White
to particular
families, category, you can
interviews that were professionally transcribed. I
and a masters-prepared Interpretative codes are usually
section
Black nurse interviewed the Black families. smaller
the major category into During develop in the data-collecting
categories.
third- trimester interviews, teens and grandparents process as the researcaa some
SmithBattle
privately described (2007) described
the pregnancy and theirher insight into the processes occurring
coding process
expectations, hopes, as
andfollows.
fears about the future. At 1, 3, _r; to move beyond simply sorting
6, and 9 months, participants were asked in separate statements. 1 ticipants terms are
interviews to recall recent stressful and meaningful used to attach meanings a
episodes in being a parent or a grandparent, and what statements. For example, in a study
they thought, felt, and
of posta experiences, you might
begin to recognize i participant was
investing much energy in ses relieve
symptoms and seeking information
the health care providers believed
that he or [ doing. These might be
classified by using in codes of
RELIEF and INFO.
Chapter 23 Qualitative Research Methodology
523
Explanatory codes are developed late in
the data- lecting process after titled with the key concept discussed, and
theoretical ideas front the iy have connected by codes with the field notes
begun to emerge. The explanatory or forms that generated the thoughts
codes part of the researchers attempt (Miles & Huberman, 1994).
to unravel the :ngs inherent in the
situation. These codes con- rhe data to Developing Propositions
the emerging theory, and the codes : As the study progresses, relationships
nay be specific to the theory' or be among categories, participants, actions,
more general, fc as PATT (pattern), TH and events will begin to emerge. You will
(theme), or CL (causal ' . Typically, develop hunches about relationships that
codes will not stay the same through- you can then use to formulate tentative
tne study. Some codes will have to be propositions. If the study is being
divided into 'Ossifications. Other codes conducted by a team of researchers,
may be discontinued se the}' do not everyone involved in the study can
work. participate in the development of
propositions. Statements or propositions
ctive Remarks can be written on index cards and sorted
!e she or he is recording notes, into categories or entered into the
thoughts or bits often emerge into the computer. A working list can then be
researchers conscious- These thoughts printed and shared among the
are generally included within the as researchers to generate further
reflective remarks and are separated discussion (Miles & Huberman, 1994).
from res: of the notes by double
parentheses (()). Later, may need to be Multimedia Analysis
extracted and used for memoing is The purpose of any sort of analysis of
Huberman, 1994). transcripts is to ascertain meaning. The
type of meaning sought may vary.
"al Remarks However, meaning in an interaction is not
are reviewing your notes, conveyed totally' through the words that
immediately write any observations are used. The way in which the words
you may have about them, remarks were expressed may be critical to the
are usually placed in the right-hand : meaning being conveyed. In addition,
of the notes. The remarks often approximately 70% of communication is
reconnect
her develops
the ntha other
memoparts to record
of the nonverbal. As Burnard (1995) wisely
insights
data or rr.ated to notes,
suggest newtranscripts, or
inter- ons. pointed out, often the words used are
codes. Memos
Reviewing unecan
notes researcher toward
become boring, not particularly relevant or are not
theorizing
which r.a! and
thatare concep-
thinking hashe: than
ceased. registered by the parties involved in a
factual.
MakingTheymarginal
may link pieces of datathe
rks assists or conversation. We do not, after all, usually
use a specific in
researcher piece of data aasthought-
"retaining an exam- pick our words very carefully when we
-onceptual idea. The 1994,
(Miles & Huberman, memo may be
p. 65). speak, nor do we continually check each
written to 3C else in the study or may be other to ascertain that understanding
just a note you > aurself. The important has occurred. And yet we do understand
thing is to value your get them written one another, most of the time (full text
down quickly. Whenever an ges, even if available in Nursing Collection). In some
it is vague and not well thought clop cases, the words used have little or no
the habit of writing it down meaning. They are used to convey
immediately. unstated meanings. The meanings are
ou might feel that tire idea is so clear behind the words. It may be impossible to
in your : you can write it down later. capture this meaning by analyzing
However, you KO forget the thought transcripts. The participant, asked for an
and be unable to retrieve Hi exact interpretation of what was meant,
becomes immersed in the data, these may not be able to explain the meaning.
ideas cr: at odd times, such as 2 AM, Sometimes,
when you are t cr when you are
preparing a meal. There- fcsp paper words do no! convey any meaning at all but instead
and pencil handy. If an idea wakes Ip. v create a mood.... Sometimes words can be used as
' e it down immediately; it may be fillers between pieces of information.... in
gone" ct Make sure that your memos summary, then, it seems possible that we
are dated. communicate, using words, in many different ways.
First, we may use words precisely and to convey
very definite concepts. Second, we may use words to
convey or to create moods. In this case, we are not
conveying particular or precise meanings. Third, it
may be that we communicate in chunks of words
and phrases. Finally, in this summation, we may
note that not everything ur

524 Unit TWO The Research Process

say is of equal importanceeither to ourselves or to It is important in analyzing the data to


the listener. All of these factors make the likelihood determine M said what. If only tape-
of a researcher, using textual data and a method of recording is available, ::.sn be a
textual analysis, uncovering the precise meaning of problem. Video recording can help
pieces of communication an unlikely scenario. ... you ta ;i this information; if this is not
Transcripts are always post hocthey always occur feasible, the cofacjH can take notes
after and, sometimes, at some distance from the that may provide some inforn.mmcl
original interviews. This means that the reader of the will help you to make this
transcriptsthe researcheralways comes to the determination. One i* analysis strategy
transcripts too late. What really happened in the is to examine all the inpu: : i g ticular
interview has been lost. (Barnard, 1995; full text individual and the extent to which th:s
available in Nursing Collection) nd uals comments influenced the
position of other J members.
One way to address this problem is to Nonverbal interaction should also be :
use multiple data collection methods. Dominant members of the group
Interviews might be videotaped as well as may suppress
Certain members of thesonant
group may views that
be more -isesl or
audiotaped. The researcher might increase theothers,
articulate than richness of the
and their views may c :nJM
strengthen his or her analysis by According
dominate theto Sim (1998):
proceedings: such individuals have ag
simultaneously reviewing video and audio described as thought leaders. In the process, ami
transmissions while reviewing the of the group who are less articulate may be i-.nag
transcript. Parse (1990) referred to this from expressing alternative viewpoints. This refisEM
process as immersion in the data. tendency of those who find themselves in a rrirani
Multimedia computers are now available acquiesce to the majority view. The effect of this fl
in which text, video, graphical media, and
that these alternative views are simply not voiced.*
those who remain relatively silent are falsely J to
sound can be used for such immersion. agree with the prevailing view. Hence, whilst -TiJ
Burnard (1995) foresees a time when CD- may at times indicate agreement, it may so rerra an
ROM disks might be used to store these unwillingness to dissent. Skillful questioning 1
multimedia data sets. This type of moderator may assist in distinguishing these ro: - J
integrated and triangulated approach to bilities, and asking participants to write their v:es; i in
analysis would provide a richer advance may encourage disclosure from less coni*
understanding of meaning. members. This underlies the danger of trying tc iar<
focus group as a measure of consensus.... If a dr.. of
opinions or perspectives emerges from the dan.
Analysis of Focus Group Data
Historically, content analysis has been
fairly safe to assume that this reflects a correspand
underlying difference of view. However, tiie c not
used to analyze focus group data. necessarily the case; the absence of diversity eg data
However, data from focus groups are does not reliably indicate an underlying cecsaJ A
complex in that analysis is required at feeling of consensus or conformity in the caa. J
both the individual level and at the group merelv reflect the group dynamics, and say little the
level, considering interactions among various views held by individual particiraici. 348)
individuals and the group, and making
comparisons across groups. It is
important to attend to the amount of
consensus and interest in topics Generalization from Focus Group Ana: :sa
generated in the discussion. Analysis of The common v iew of focus groups
deviance and minority opinions is was tAa# were representative of a
important. Attending to the context target population aaa* generalization
within which
If the unit statements
of analysis is limited to were made
the group, then the is
to the target group W'as ac:er:a
critical
evolvingtointeraction
the analysis (Morgan,
of members and the1995).
impact on
However, participants are not
Carey (1995) made the following
opinions will be unobserved. Because the interaction
obtained using ri bility sampling, and
suggestions regarding analyzing focus
within the group will affect the data elicited, an
appropriate description
group data.
of the nature of the group one is on shaky ground ;u=dS
dynamics is necessary to incorporate in analysisfor generalization using this argument.
example, heated discussion, a dominant member, little The r person likely to agree to
agreement, (p. 488)
participate in a focus probably
different from those who decline. The
group is a carefully constructed
environmerrJ the setting designed to
facilitate the group dysB