508 Unit TWO The Research Process
The researcher as a whole person is
totally involved perceiving, reacting,
interacting, reflecting, attaching meaning,
and recording. Such is the case whether
the study involves observing and
participating in social situations, as would
occur in phenomenological, grounded
theory, ethnographical, or critical social
theory research, or whether the study
deals with written communications, as
might occur in phenomenological,
historical, philosophical, or critical social
theory studies. For a particular study, the
researcher may need to address data
collection issues related to relationships
between the researcher and the
participants, reflections of the researcher
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
spontaneously observing and recording
what one sees with a minimum of
planning. Although unstructured
observations give the observer freedom,
there is a risk that the observer may lose
objectivity or may not remember all fcf
the details of the event. If possible, the
researcher should take notes during the
observation periods. If this is not possible,
the researcher needs to record the
observations soon afterward. You may
even find it useful to photograph or
videotape the observation period so that
you can examine it extensively at a later
time (Harrison, 2002; Mullhall, 2002).
Unstructured observations are not
unsystematic or sloppy as the term might
suggest. Rather, unstructured means that
the researcher has few predetermined
notions as to what he or she might
observe. What notions the researcher
does have may change over time as data
are collected. As Mulhall (2003) pointed
out:
The way people move, dress, interact and use space
is veiy much a part of how particular social settings
re constructed. Observation is the key method for
collecting data about such matter.... Observers have
a great degree of freedom and autonomy regarding
what they choose to observe, how the)' filter that
information, and how it is analysed.... Observation
also captures the whole social setting in which
people function, by recording the context in which
they work.... Finally, observation is valuable
because it informs about the influence of the
physical environment. This aspect of observation is
quite
lacking in nursing research. Observati made of
peoples behaviour, but data a' physical
environment seldom are cod (pp. 307, 308)
Hamilton and Manias (2007) studied
the o methods of psychiatric nurses
and their ity in an acute inpatient
setting. This excel not only gives you
as reader a clear underst the careful
observation conducted during : but
it also enables you to understand
ho observation must be in a
qualitative study you a chance to
think about how you might your
own observations. Hamilton and
Marias described their study as
follows.
The postmodern approach used in the study was
by Foucault (1973. 1980, 1995, 1994) and by
after him (Fox, 1993; Rhodes, 1991; Silvermzz.
A postmodern epistemology informed both
tioning of the first author during fieldwort
emphasis on discourses, power relations and
concepts in data analysis. A postmodern
ogy informed both the positioning of the first
during fieldwork and the emphasis on
power relations and particular concepts in
sis. In postmodern ethnography, the ethneg
power in the portrayal of the field is made
(Alvesson, 2002). Accordingly the first author, a
enced psychiatric nurse, was cast as an objective:
but as an active participant, recognizing and exr
own subjectivity in shaping the research, (p. 35->
The study was based in a 44-bed acute ps
inpatient unit, on the site of metropolitan a ing
hospital in Victoria, Australia. Ethics gained from
the hospital, in accordance win: guidelines in
Australia.
Ethnography has been widely used to study as
subcultures (Silverman, 2005). This study the work
of 11 participating psychiatric nurses first author,
who worked part time as a psych: alongside the
participants for 18 months. Fief:
were generated through: participant observant
13 individual interview's and two focus group
participating psychiatric nurses: transcript file
notes and other documents related to asses the first
authors journal that detailed 170h of
as a registered nurse in the unit. (p. 334) The
ethnography focused on nurses activities
nurse-nurse and nurse-patient interaction:, xl
chiatric nursing experience of the 11 nurse: rs
ranged from 2 to 30 years and ages ranged frm 67
years. Six nurses were women, a gender rar: ing
w'ith the current psychiatric nursing woe Australia
(Clinton, 2001), which includes a r:
Chapter 23 Qualitative Research Methodology
of men than in other specialties of nursing,
'cipants were positioned as key informants I
insight into the social life of the unit (Riley *.
2006). Participant observations extended
xreipants rostered working shifts, through all
: week and all three shifts (morning, afternoon
. in order to attend to a variety of contexts,
experiences and practices, (p. 334)
~ESS OF ANALYSIS
our analysis of how inpatient psychiatric df
served patients were the Foucauldian con- ' the
gaze and of discipline, both given form in recursive
practices (Roberts, 2005). Analy- focused on
discursive practices of assessment, end to be the
micro-politics of nurses language sc (Fox, 1993, p.
161). Everyday nursing prac- xned in the fieldwork
texts were highlighted :ve practices when we could
show how these were imbued with power through
social, histor- roiitical conditions, and in the wider
context of ' ~ discourse (Irving, 2002). (pp. 334-
335)
LTS
Jn: three identified modes of nurses obser-
zurses scanning of patients, nurses obvious
probing of patients, and nurses discreet and
observations of patients.
--sing Scan
:;an is used here to encompass nurses frequent 5 of
eyes across rooms, surfaces and spaces of taking in
features and contents of the space as impressions of
the people occupying it. Nurses K their sight,
supplemented by other senses to the scan. Through
scanning, nurses monitored cal spaces and their
objects, commenting on zells and temperature, and
noticing and mov- ds. Nurses also scanned for
emotional tone in for potential areas of distress and
conflict that ercompass patients, staff and visitors.
The nurses
' in the demeanour and behaviour of individual
and groups of patients. Nurses scanned in pass-
-nts bodies, expressions, movements, gestures i
of voice...
ses visual observations were supplemented by Jng
into sounds of movement, or listening in to - talk.
Whether in the office or circulating in the s were
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
509
to frequently interrupt their own planned work. They were often
drawn away from planned work to go and see the event or
person at the source of an interruption. Nurses scanned the unit
on arrival, when entering a different area of the unit, or when
returning after an absence, such as a tea break. Their scan was
brief, capturing the physical and social condition of the unit at
that moment. From such activity, details were reported to
colleagues, in snatches of conversation and handovers. Nurses
exercised the scan both as a baseline form of monitoring and as
a prelude to more focused work with individuals and groups of
patients, assisting them to determine work priorities and issues
for the working shift, (p. 336)
Nurses Probing Observations of Patients Nurses focused on
patients who were assigned to their care. As they scanned the
ward space and occupants, their attention was drawn also to
patients who were assigned to other nurses. The probing
observation of a patient was a distinctive activity in that nurses
stopped circulating, and looked in a more considered way at a
patients body7, social interactions and behaviour. From this
probing, nurses gleaned clues about the patients feelings,
thoughts and motivations, the patients ways of interacting, the
patients coping abilities or strengths, as well as evidence of
symptoms. On occasions, nurses withdrew7 after a pe^od of
sharp observation, W'ithout interrupting the patients activity or
speaking at all.. .-(p. 337) Through observations, nurses
elicited evidence of symptoms and also absence of symptoms.
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
activity. Nurses counterbalancing of psychiatric symptoms
w'ith a lack of such symptoms, coping and prow'ess, in the
context of unstructured activity, was an element of nurses
assessment. Nurses accounts of symptoms, based in the
behaviour they observed in the unit, were potentially important
accounts in the ongoing construction of illness by the treating
team. (p. 337) Nurses Discreet Observation: Clinical and Civil
Surveillance Nurses observations of patients in the acute
psychiatry unit were shaped substantially by the legal status and
admission circumstances of patients, most of whom were
detained and treated under the Mental Health Act (1986). The
loss of fundamental rights to freedom and choice in psychiatric
treatment could cause great offence to patients, many of w7nom
flatly disagreed with the medical diagnosis and bitterly resented
being detained and given psychotropic medications. The w7ard
environment w7as a place where direct contact w'ith clinicians
frequently provoked patients ire. Since nurses were the group
of clinicians in most frequent and close contact with patients,
they w'ere attuned
 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}'
with interviewing
encounter some challenges during an inter-
mon problems include interruptions such as
calls, stage fright that often arises when the
nt realizes he or she is being recorded,
failure fish a rapport with your subject,
verbose par and those who tend to wander
off the subject, need to tactfully guide the
interview back to . If the participant is
emotionally distressed as :: die interview,
remain with the individual until ::pant is able
to restore his or her composure, and
interviewers tend to underestimate the time
required for an interview. If the partici-
aarried, the quality of data is affected. the
study focuses on families, issues arise J which
members are interviewed. In some cases,
member is selected to represent the family.
This biases the results because other family
members different perspectives of the
situation. Select y members and interview'
each separately. The igy. of course, is to
interview each member sep- faut this
requires an inordinate amount of time arid,
Paavilainen, & Lenti. 2001). velar concerns
arise when a researcher is inter- colleagues.
The interviewer (an insider) lacks distance
that facilitates a balanced, objective e.
Common experiences tend to be taken for
spects of the social world that should be
ques- ic overlooked. You may find it difficult
to ask about sensitive issues of someone in
your own oup. However, there are
advantages. Because of position, insiders are
familiar with the social thus can interpret
and attach meaning that may outsider. As an
insider, you may find that you een the lines
of participants comments rather sg them at
face value. This capability may be ;y
important if the group under stud}' is a
minor- or otherwise marginalized (McEvoy,
2001). an ethical perspective, interview's tend
to be as noninvasive and thus as posing no
threat xerv iewee. However, interview's are
an inva- liie psyche. For some, this may be
therapeutic, c. an interview is capable of
producing risks alth of the participant.
Therefore, the internist always avoid inflicting
unnecessary harm participant (Munhall, 1991:
Sullivan. 1998). data you obtain are affected
by characteristics person being interview'ed.
These may include Itnicity, gender,
professional background. :ral level, and
relative status of interviewer riewee, as w'ell
as impairments in vision \g. speech
impediments, fatigue, pain, poor
disorientation, emotional state, or lansuasre
511
difficulties. Interview's with children may
require special considerations (Deatrick &
Ledlie, 2000). In some studies,
interview'ers may be profoundly affected
by participants stories and may need
debriefing. This need may extend to
those transcribing the interview's and to
researchers analyzing the data. Because
of privacy issues, study participants are
not able to share their feelings with those
who usually provide support and
comfort. In these cases, a person or
persons should be designated to address
these needs (Moyle, 2002; Price, 2002;
Sullivan. 1998; Wilmpenny & Gass. 2000).
Berg (1998) has identified the
followung ten commandments of
interviewing:
1. Never begin an interview cold. Remember to
spend several minutes chatting and making
small talk with the subject. If you are in the
subjects home, use whats there for this
chatting. Look around the room and ask about
such things as photographs, banners, books, and
so forth. The idea here is to set the subject at
ease and establish a warm and comfortable
rapport.
2. Remember your purpose. You are conducting an
interview in order to obtain information. Try to
keep lift, subject on track, and if you are
working with an interview schedule, always
have a copy of it in front of you even though
you should have your questions memorized.
3. Present a natural front. Because your questions
are memorized, you should be able to ask each
one as if it had just popped into your head. Be
relaxed, affirmative, and as natural as you can.
4. Demonstrate aware hearing. Be sure to offer the
subjects appropriate nonverbal responses. If
they describe something funny, smile. If they tell
you something sad, look sad. If they say that
something upset them, try 10 console them. Do
not present yourself as uninterested or unaware.
5. Think about appearance. Be sure you have
dressed appropriately for both the setting and
the kind of subject you are working with.
Generally, business attire is most appropriate. If
you are interviewing children, a more casual
appearance may be more effective. Remember to
think about how you look to other people.
6. Interview in a comfortable place. Be sure that
the location of the interview is somewhere the
subject feels comfortable. If the
512 Unit TWO The Research Process
subject is fearful about being overheard or being
seen, your interview may be over- before it ever
starts. Don't be satisfied with monosyllabic
answers. Be aware when subjects begin giving yes-
and-no answers. Answers like these will not offer
much information during analysis. When this does
occur, be sure to probe with questions such as,
Can you tell me a little bit more about that?" or
What else happened?" Even a simple pause and
an uncomfortable silence might yield additional
information. Be respectful. Be sure the subject feels
that he or she is an integral part of your research
and that any answer he or she offers is absolutely
wonderful. Often subjects will say things like, You
dont really want to know how I feel about that."
Assure them that you really do! Practice, practice,
and practice some more. The only way to actually
become proficient at interviewing is to interview.
Although this book [Berg, 1998] and other manuals
can offer guidelines, it is up to you as a researcher
to develop your own repertoire of actions. The best
way to accomplish this task is to go out and do
interviews. Be cordial and appreciative. Remember
to thank the subject when you finish, and answer
any questions he or she might have about the
research. Remember, you are always a research
emissary. Other researchers may someday want to
interview this subject or gain access to the setting
you were in. If you mess things up through
inappropriate actions, you may close the door for
future researchers. (Berg, 1998, pp. 87-88)
The following is an abstract of a study on Ph.D.-
prepared nurses in the clinical setting (McNett,
2006).
Background: The emergence of new doctoral programs
within the nursing discipline has stimulated dialogue
regarding the role of the doctorally prepared nurse in the
clinical setting. National nursing organizations have
cited the need for additional research that would provide
information regarding the current practice of doctorally
prepared nurses. A review of the literature reveals little
published information about the role of PhD nurses in
the clinical setting.
A survey from one university in the year 2000
revealed that only 40% of that universitys doctoral
nursing students planned to seek employment in the
academic setting.
The remaining 60% were entering the clinical ss
(Munro, 2001) (p. 135) Purpose: The purpose of this
descriptive qnai tive study was to investigate how
PhD-prepared or describe and define their role
within the clinical: Methods: Interviews were
conducted with 5 PhD who were all employed full
time in the clinical: Interview notes were recorded,
transcribed, and arm using qualitative data analysis.
Recurrent themes emerged from the interviews were
identified, (p. 13- Redundancy with participants
responses i- after interviews with 5 nurses. Given
the explcm nature of this study, the redundancy
from pare;:? and the nature of the findings, it was
determined 5 nurses were sufficient to form a base
for the prr nary results reported here. (pp. 135-136)
Interviews were conducted by the principal im gator
either in person or via telephone with the pm ipants.
The interview began with a series of q_rs regarding
the current title and position of the . prepared nurse,
as well as their area of specialty, na of years the}'
have been in their position, and number years since
having earned a PhD. Lastly, the parti, were asked
to describe their masters degree and i what
discipline they had earned their doctoral degre:
Using an interview schedule of 5 questions, the
were then asked to respond to the following state or
questionst(l) Describe your role and respor.sirf as a
PhD-prepared nurse working in the hospital sec (2)
Compare these roles and responsibilities as a .
prepared nurse with a CNS or NP working in this 1
tion who does not have a PhD. (3) What are some i
advantages of having a PhD in your current posa (4)
What are some of the obstacles you have eaa tered
in the clinical setting because of your PhD? (5 " me
a story that best highlights what you consider :: one
of your successes as a PhD nurse, (p. 135) Results:
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
setting. This information can ix to guide additional
research that might influence the d opment of future
doctoral programs in nursing, (p. 13 All participants
in this study choose to make i a priority within their
various hospital roles and : sibilities. All
participants are striving to advance i ing science
through practice-based research, and 1. the
importance of nurses being the principal investor in
these study. This finding is especially sigmre
because 4 of the 5 participants did not hold reseats:
 Chapter 23 Qualitative Research Methodology 513
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
found that research did not have r profound influence on the
roles of all of the doctor- fr prepared nurses that they
interviewed, (pp. 137-138)
Groups groups were designed to obtain the
partici- perceptions in a focused area in a setting
that _ ' -we and nonthreatening. One of the assump-
ate deri ving the use of focus groups is that group
ecus can help people to express and clarify' their
~ ways that are less likely to occur in a one-to-
iew. The group may give a sense of safety pers" to
those wary of researchers or those who groups are a
relatively recent strategy that si initially in nursing
studies in the late 1980s. they have been used in
other fields for a ie. The idea of focus groups
emerged in the an approach for examining the
effective- marketing strategies. The concept
reemerged pkorld War II with efforts to determine
ways e the morale of the troops. The technique s
variety of purposes in nursing research. It med to
perform qualitative studies (Twinn, take policy
analyses (Straw & Smith, 1995), rtfimer satisfaction,
evaluate the quality of din & Pelletier, 1996),
examine the effec- :: public health programs, assist
in profes- sci-ion making (Bulmer. 1998; Southern :!l .
develop instruments, explore patient care and
strategies for developing effective inter- develop
education programs (Halloran & >95), and study
various patient popula- cmey & May. 1998; Goss,
1998: Quine & 1995: Reed & Payton, 1997). It has
also ^jyed as a data collection strategy in partici-
Kcarch. A focus group study might include 5>1
groups.
towing assumptions underlie focus groups
Peoples, 1999): jcciegeneous group provides the
participants freedom to express thoughts, feelings,
and i ors candidly. cals are important resources of -
an on. are able to report and verbalize their and
feelings. p's dynamics can generate authentic -uon.
Group interviews are superior to
individual interviews. The facilitator can
help people recover forgotten
information by focusing the interview. The
effective use of focus groups requires
careful planning. Questions that must be
addressed include the following: Tiat are
the aims of the focus groups? How many
focus groups should be assembled? How
many individuals should be in each focus
group? How will you recruit for the focus
groups? Can you locate sufficient people
for the focus groups? Are you selecting
the right people for the focus groups?
Where should the focus groups meet?
What skills should the groups moderators
have? How will moderators interact with
participants? What questions will the
moderators ask? How should the data be
analyzed? Many different communication
forms are used in focus groups, including
teasing, arguing, joking, anecdotes, and
nonverbal approaches such as gesturing,
facial expressions, and other body
language. Kitzinger (1995. pp. 299-300)
has sugge^ed that peoples knowledge
and attitudes are not entirely
encapsulated in reasoned responses to
direct questions. Everyday forms of
communication may tell us as much, if not
more, about what people know or
experience. In this sense focus groups
reach the parts that other methods
cannot reach, revealing dimensions of
understanding that often remain
untapped by more conventional data
collection techniques. (full text available in
Health Source Nursing/ Academic
edition)Recruiting appropriate
participants for each of the focus groups
is critical, because recruitment is the most
common source of failure. Each focus
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
candidates by mail. Inform them at the time of
consent that you will be calling to remind them
of the group and to verify that the phone
number they gave you is the best number to
call. You may need to offer incentives. Cash
payments are, of course, the most effective if
the resources are available through funding.
Other incentives include refreshments at the
focus group meeting, T-shirts, coffee mugs, gift
certificates, or coupons. Overrecruiting may be
necessary; a good rule is to invite two more
potential participants than you need for the
group (Morgan, 1995).
Segmentation is the process of sorting
participants into focus groups with common
characteristics. Selecting participants who are
similar to each other in lifestyle or experiences,
views, and characteristics facilitates more open
discussion. And you can increase the groups
validity by conducting multiple focus groups
and placing participants with differing
characteristics into separate groups. These
characteristics might be age, gender, social
class, ethnicity, culture, lifestyle, or health
status. Strickland (1999) pointed out the
problems that could occur if differing cultural
groups are included in the same focus group.
Communication patterns, roles, relationships,
and traditions might interfere with the
interactions within the focus group. In some
cases, groups may occur naturally such as
those who work together. Be cautious about
bringing together participants with
considerable variation in social standing,
education, or authority because some group
members may hesitate to participate fully,
whereas others may discount the input of
those with perceived lower standing (Kitzinger,
1995; Morgan, 1995).
Establish a setting for your focus group that
is relaxed. There should be space for
participants to sit comfortably in a circle or U-
shape and maintain eye contact with all
participants. Ensure that the acoustics of the
room will allow you to obtain a quality tape
recording of the sessions. As with the one-on-
one interview discussed earlier, place your tape
or video recorders unobtrusively, and use
batteries rather than plugging your equipment
into a power source as this is less invasive. Use
a highly sensitive microphone. However, it may
be necessary for the moderator or assistant
moderator to take notes when the speakers
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.
although some may extend to an entire a.
continue as part of a series of meetings It
is important for the researcher : : aims of
the focus groups and commu-f aims to
the moderators and the part::.p the
group session. Instruct participants tbs of
view are valid and helpful and thjB should
not have to defend their positions to the
group that the facilitators role is ate the
discussion, not to contribute. O the
questions that are to be asked d_r:ri
group, and, if time permits, pilot-test
them! number of questions to those most
sufficient time is left for discussion. Yoa to
give participants some of the quest::ns
group meeting to enable them to give
eu_ to their responses. Questions should
be pi a way that group members can
build Ai
on
of others in the group, raise their : --r and
question each other. Probes car. Be richer
details using questions such as
that make a difference? or What mai
that? Why questions are not good r. tend
to push a participant toward talur.g i
defending it. Then it is difficult to ira ;
the stand if th^; group begins moving
consensus. The act of questioning ::
ideas offers a stimulating learning exi
group members. Their thinking may be
tested, and participants may be prsentai
ways of thinking about a problem ( HoH
& Goble, 2002).
A common problem in focus group; is
into the topic of interest to the researct
emphasis on the interests of the partieip
the session, provide opportunities for .
express their view's on the topic of :
proceed with the questions. Use probes r]
sion wanders too far. A good facilitator
questions into the discussion naturally
tators role is to clarify, paraphrase, ami
what group members have said. Tf.es
tend to express group norms, and mif
dissent may be stifled. However, wher
is on sensitive topics, the group may sca-
the discussion because less inhibitec is
the ice for those who are more retieenu
may also provide group support for e
ings, opinions, or experiences. Late is
the moderator may encourage group
beyond the current discussion or define
inconsistencies among participants an
own thinkina. The moderator can use
Chapter 23 Qualitative Research Methodology
[group members to encourage
participants to
points of view more clearly and
provide a :*:r their position
(Kitzinger, 1995).
* Role
SII effective moderators is as critical
as select- priate participants. The
moderator must K participants to talk
about the topic. Sim Hunted out that
the focus group moderator Cuer.ee
powerfully the process of interaction
place, and the way in which the
moderator ind the verbal and non-
verbal cues that he es to the group,
are crucial in this respect _ Because
expertise in the topic may make par-
leluctant to speak, the moderator
should make "tit he or she is there to
learn from the group in some cases,
you will want to include moderator
as well as a moderator. Par- should
be encouraged to talk to one
another r addressing all comments to
the rnodera- icessful moderator
encourages participants to wrh one
another, formulates ideas, and draws
:: e structures not previously
articulated, rs should remain neutral
and nonjudgmen- ; topic is sensitive,
moderators need to be able
rticipants at ease. To accomplish this
goal, rifenttor with characteristics
similar to those of participants.
Extreme dominance
to: participants sayor extreme ss on
thempart participants interact will
of the moderator leadone
with to
Kitzinger,
another 1995; Morgan.
curate attribution 1995; of
Morrison
quotations& to individual faarp
members
Section should not interfere with
c-ction
"the coordi- [thatthe
; recommended the group. Thebemethod
following data
of data collection IRK have reactive
effects on the participants. 1998), citing
the work of Reinharz (1992) 1983),
suggested using a computer group
strategy, combining focus group
interviewing esive observation to
gather information. Partir: given a
web site where each indiv idual can
or her thoughts. All participants have
access r__ .cipants comments and
can enter their own espond to
comments of others. Thus, these
hguided focus groups in which the
discourse synergistically created
convergence of sriences (Berg, 1998,
p. 108).
515
Kelly and Patterson (2006) conducted a
study titled Childhood Nutrition:
Perceptions of Caretakers in a Low-
Income Urban Setting in which they used
focus groups. The following abstract
describes their research.
The incidence of overweight and obese children,
especially those from low-income and minority
backgrounds, continues to rise. Multiple factors
contribute to the rising rates. In order to gain an
understanding of factors contributing to obesity in low-
income families, a qualitative study was conducted with
the purpose of gaining knowledge of low-income urban
caretakers understanding and attitudes regarding
childrens nutrition. A focused ethnography was used as
a means of understanding behavior within the context of
a persons cultural environment. The sample was 17
caretakers of children in the ls'-3rd grades. Four focus
groups were conducted. Two themes emerged from
caretakers perceptions: knowing the right things
children should eat and balancing healthy nutrition with
unhealthy' choices. Four categories emerged regarding
influences on food choices: tradition, finances, time
constraints, and role models. Lastly, five barriers and
three facilitating factors emerged. Implications of the
study findings for school nurses include the need, when
implementing healthy eating programs for school
children, to gain information from caretakers about t sir
perceptions of childhood nutrition, (p. 345)
Procedure: A semistructured interview guide, based
on the health care literature and input from pediatric nurse
experts, was used to guide the focus groups. Four focus
groups were conducted at an elementary school in a
classroom at the end of school hours. The interviews were
audiotape-recorded and lasted from 1.5-2 hours. Although
there were some challenges to conducting focus groups in
this setting (Patterson & Kelly, 2005), participants
enthusiastically shared their views and thoughts about the
nutrition. Healthy refreshments were served. The same
researcher conducted all focus groups. Field notes about
observations in classrooms, the cafeteria, and surrounding
community were recorded regularly. Data collection
continued until saturation was reached, (p. 247)
Collecting Stories
During observation and interviewing, the
researcher may record stories shared by
participants. Banks-Wallace (1998)
described a story as an event or series of
events, encompassed by temporal or
spatial boundaries, that are shared with
others using an oral medium or sign
language. Storytelling is the process or
interaction used to share stories. People
sharing a story (storytellers) and those
listening to a story (storytafcers) are the
main elements of storytelling (p. 17).
Stories can help researchers to
understand a phenomenon of
516 Unit TWO The Research Process
interest. In some qualitative studies, the
focus of the research may be the
gathering of stories. Gathering of stories
can enable health care providers to
develop storytelling as a powerful means
to increase insight and promote health
behavior in clients. For example, Nwoga
(1997, 2000) studied how African-
American mothers use storytelling to
guide their adolescent daughters
regarding sexuality. The stories could
assist other mothers who are struggling
to help their daughters deal with sexuality
issues.
The story is an obvious way for social actors, in talking
to Coffey
strangers and
(e.g.,Atkinson (1996)to discussed
the researcher), retell key
the
experiences and events. Stories serve astories
importance of capturing variety ofin
qualitative studies.
functions. Social actors often remember and order their
careers or memories as a series of narrative chronicles,
that is, as series of stories marked by lce\f happenings.
Similarly, stories and legends are told and retold by
members of particular social groups or organizations as a
way of passing on a cultural heritage or an organizational
culture. Tales of success or tales of key
leaders/personalities are familiar genres with which to
maintain a collective sense of the culture of an
organization. The use of atrocity stories and morality
fables is also well documented within organizational and
occupational settings. Stories of medical settings are
especially well documented (Atkinson, 1992; Dingwall,
1977). Here tales of professional incompetence are used
to give warning of what not to do and what will happen
if you commit mistakes.... Narratives are also a common
genre from which to retell or come to terms with
particularly sensitive or traumatic times and events.
(Coffey & Atkinson, 1996, p. 56)
Mattingly and Lawlor (2000) described
their research in which they solicit illness
stories. These authors skillfully guide you
in interpreting the process of the story,
identifying key turning points as the story
progresses.
During the first interview with Barbara, she told a
harrowing story of how she struggled time and time again
to get health professionals to find out what was wrong
with her little girl. The following extensive excerpt of this
first interview gives a powerful picture of this struggle.
Since it includes the interviewers (Cheryls) questions, it
also illustrates the kind of questioning process often
required to prompt someone to move from broad
descriptions of situations to vivid and fine-grained stories
of particular events, (p. 9)
Three people are present in this interview, which takes
place in a hospital waiting room. Barbara, the mother,
Cheryd, the interviewer, and Rhonda, the ill child.
Rhonda,
who is just 3 years old at the time, becomes
the way that.ehildren do and interrupts, forcing l
to pay some attention. Barbara is adept at shifdng
responding to Rhonda and picking up her r.arra.
Cheryl lacks Barbaras easy facility, but tries
to keep Rhonda entertained while listening to
story'. She also tries to keep the tape recorder ox
das hands who gets curious about how it wccsa
has supplied Rhonda with some colored per..'
since Rhonda loves to draw', (p. 9)
At the stage of the interview' excerpted beles
has been remembering the period of several
which Rhonda has often been violently sic!:::
ach, but no doctor has discovered anything :
She then remarks:
So on Labor Day (pause) Labor Day, her C
... and he was keeping her till the next mcmd
next morning, at 5 o clock, he called and said,
really vomiting bad." And I said, Bring her
can take her," I said, I'm taking her to C.r
So I said, Bring her here."
The very way that Barbara has phrased
nals Cheryl that a significant moment is
described. A key marker of a story is the :.
event in a specific time. Barbara begins this p
conversation with specific temporal indiea::".
Labor Day (a 24-h time period) but even 5
the morning. Here is the verbal SLjuivaiez
lens, which moves from a hazy distance ::
ingly sharp focus on one particular moz;
Barbara is setting the stage and we know s
important is about to happen. A second -
significant story is about to unfold is Ba-
five strategy of recalling dialogue. She
said, she said mode in which she not oah
the remembered phone conversation, >-r~
conversation, but she even shifts her va
the various characters, namely herself and re-
husband.
While, upon reading the transcript, it =
Barbara is heading in an important direct:
Cheryl seems a bit oblivious to these cine*
series of distracting questions, which 5a
answers.
C: Had you been to City Hospital ye: sc
B: No. Cause Icouldn t...
C: Its a long trip.
B: And plus the job. I figured the ped:ar
taking her to, that shes had ever since she
that you know, they would handle it. and
the kind of job that I couldnt, like, take
or, you know, I was always stressed tha: f
know, that I would lose my job, you kno* '
C: Yeah.
B: And, especially since I had got ser-x~
I really couldnt afford to take no time.;
C: Yeah
Chapter 23 Qualitative Research Methodology 517
But then, tenacious storyteller that she is, when Bar-
rara sees an opening she returns to her story as though
see had never been interrupted.
B: So, I was taking her, you know, to a lot of the emer-
gencies and to, you know, X Hospital and Y Hospital,
mid I was taking her there, but then I started just say-
aig. forget it. [Barbara means here that she finds she is
mo: getting any helpful treatment for Rhonda and gives
MC or. the idea of continually taking her to the doctors]
started taking her to my ex-husbands place. And so, he
fri t bring her home that morning when he called me at
f t slock. He brought her home, like, later in the after-
. But by then, she stopped vomiting, okay? But later
mm that evening, it started back up. She just, like when
MLi was drinking something, it would, like, just shoot
m out across the room. Just like how the Exorcist
C: Yeah, yeah.
: You know? And I wap like, really getting, um, crazy,
p ? had brought her down ... I called Z Hospital, and I
them that my daughter's like, vomiting and having
itches, you know, and um, they said, well um, Bring
You know, and then so I brought her to the emer-
fctoy there. And then, um, I had a little confrontation
ptbt the lady in there, okay?
|5i tins passage Barbara begins the shift from general
[2-: -:ion of her life to specific, vivid storytelling. She
cs with an overview of her situation during this time
m tc Rhondas diagnosis in which she speaks about
~rriculties in getting time off work and her continual
Ec various clinics in the area. But then she switches
B specific highly dramatic incident, which she locates
specific time, that morning. Though her account is
r infusing in detail, it is clear that something much
frightening is going on with Rhonda than has hap-
refore. Barbara uses a graphic image, vomiting
rise Exorcist to get her message across of what this
ce was like for her.
cs ooint, Cheryl had caught on that this is a piv-
SELiide in Barbaras illness story. She suspects that
phrase little confrontation is the tip of an
C: Tell me about this. Just describe that. Wlmt happened?
B: Yeah. That evening, when I brought her um ... the
doctor down there in the emergency, she um, came and
checked her, and I was telling her, shes really ... shes
constantly vomiting and having headaches really bad. And
she did her little checking, and she said, Well, I dont see
anything. And we did her urine, and, 7 don't see
anything. I said, But Im not leaving here unless you guys
tell me to do something because ... and then she started,
like, getting a little smart on me.
C: Yeah, like what did she say? Just go... just go through
this.
B: Okay. She was, like, saying, well, if you don't think that
Im doing my job, then you could just take her to the, um ...
Im gonna make you an appointment and you can take her
to the day hospital. I said, Oh, its not that I dont think you
re doing your job; I just want my daughter to get help. You
know, as you understand, Ive been taking her eveiywhere
and she still be doing the same thing constantly, over and
over. And so then, she got a little upset, so she left...
C: What did she say?
B: And she went across the hall and ... where her little
office was ... when all that time, the door was open, you
know, all the time she was seeing patients. But when she left
therefrom talking to me, she went over there and she closed
her door, and I guess she was telling the social worker ...
because the social worker came down and came in there and
talked to me and was asking me, Whats going on? Is there
something wrong?" I said, Yes, theres something wrong."
She said, Well, the doctor feels that you dont think shes
doing her job. I said, So, but why does she have to call the
social worker on me?" You know? And then I started feeling
like they was, um ... I felt like she thought that / was, like,
kind of crazy or did something to my daughter myself. Thats
the kind of feeling I got. I felt very uncomfortable. I said, Do
you guys call the social worker on all people?" you know?
And she ... and I was letting the social worker explain. No,
its not on all people. Its just when the parents feel that you
re not happy with your doctor, and the doctor will call.
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
see my baby ... I said, Nobody wants to
see my baby and shes really sick, and I
keep getting the run-around. She
remembers that they tell her, Well,
Rhondas appointment is not until the
21st, you know, of October, so you
have to wait. Finally, she gets one
administrative lady to listen to her and
this woman locates Dr. Romburg. And
so he was doing a little history on
Rhonda...I said, My baby keeps
complaining of her headaches.
Just then, the doctor has Rhonda walk. Barbara recalls
her horror at what happens next. But she started walking
like she couldnt walk by herself anymore you know?
And started walking, like, into the wall, you know, to the
right. And I said, Oh Lord! Something is really going
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
same thing for him. So then they went and talked and they
came back. They said to me, It seems like its some form
of a mass or something, pressing down on her head to
give her headaches. So then I was saying, Oh Lord. As
terrified as Barbara is, there is one phrase this doctor told
her, one she repeated several times and in later interviews
again, that deeply reassured her. While others had only
paid attention to Rhondas stomach because of her violent
vomiting, Dr Romburg, he said, Were gonna start from
her head and work our way down.
Again, note the contrast of Barbaras wrenching story to
the pristine note in the medical chart in which the doctor
reports, Physical examination: looks well but wobbly ...
has me concerned about mass in head, will schedule CT.
No one would know what Barbara endured to get this
essential CT scan, which led to Rhondas diagnosis of a
brain tumor just 3 days later.
Rhonda is now 5 years old, still very sick, still receiving
treatment, but still alive, (p. 12)
Constructing Life Stories
A life story is designed to reconstruct and
interpret the life of an ordinary person.
The methodology, which emerged from
history, from anthropology, and more
recently from phenomenology, has been
described by a number of scholars
(Bateson, 1989; Bertaux, 1981; Frank, 1979;
Gergen Gergen. 1983; Josselson &
Lieblich, 995; Linde, 1993; Mattingly &
Garro, 1994; Polkinghorne. 1988; Sarbin,
1986; Tanner et a l 1 9 9 3 ; Ventres, 1994).
The life story can be used to clarify the
meanings of various states of health,
chronic illness, and disability in the lives
of patients, their families, and other
caregivers. These stories can help us
understand the meaning to patients of
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
from observations may be important,
and peer documents such as diaries or
historical records be used. Analysis
involves more than just strita^ events
together; events should be linked in
an pretation through w'hich the
researcher car . theoretical sense.
Materials are organized an; lyzed
according to theoretical interests.
Cor.rt ing a life story often requires a
long-term :: and extensive
collaboration w'ith the par;;; (Frank,
1996; Larson & Fanchiang, 1996; Male
Kielhofner, & Mattingly, 1996).
Roesler (2006) provided a life story'
of Herr 2 in an article describing a
archetypal story patterns :r.
biographical narratives. The article
The following transcript is taken from an au::
is
translate:
Herr BittnerGerman.
graphical interview with a person called Herr B.
has been severely physically disable
birth by spastic cerebral palsy. He has always beer.t
dependent on external help. In his life story he ce>;
himself as a political person. He was an active ra
of the political movement of disabled persons fis
for an independent life and for equal rights. Ac
he was the first disabled person in Germany who
live outside of any institution through help from ;
people doing their civil sendee. In his narrative self
sentation, he lives a life exemplary for all disables j
pie, always before the eyes of the public. His life
political fight for equal rights for al! disabled re.
and the changes in his own life, his growing aut,
and self-respect, mirror the changing attitude in r
towards disabled people and their rights, (p. 577;
In his introduction to the actual narrative he
that physically disabled persons are often mistake*
the public as being also mentally retarded and are
criminated against just because they have physical
lems with speaking, with precise pronunciation,
because they look strange. He now wants to take on
task of showing and proving to the public, again in a
that will be exemplary for all disabled people, ir.ai
are at least as intelligent as normal people, and his
possibility of doing so is by showing that he car.
cleariy and precisely. With the actual narrative he
an example of that: (p. 577)
Herr Bittner: ... and still today l love to surps
experts. I want to give an example; years ago I have
to a university clinic and then the professor and his i
staff came to my bed and he says, Now how do yamj
how do we feel today?, that is, in we-fonn. And
said, Professor. I cannot judge how you feel today
know how I feel." T cha. Then I said, You actuals:,
me how we feel" (Laughs) and one hour later ar. ,
tan! doctor came in and she said Arc you mad.
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
computer literate than those with more
artistic, humanistic interests, in which case
affinity with computing may have
something to do with personal traits....
Some of the ... arguments [by qualitative
researchers against using computers]
could simply be rationalisation by
computer-phobic researchers. However,
Taft expressed concern about the dark
side of computer technology for
qualitative researchers. The researcher
may be tempted to study larger samples
and sacrifice depth for breadth.
Meaningful understanding of the data
may also be sacrificed. Sandelowski
(1995a) expressed concern that the use of
computers will alter the aesthetics of
qualitative research and suggested that
the key motivation for using computer
technology in qualitative research is to
legitimize the claim that qualitative
researchers are doing science. She stated,
computer technology permits qualitative
researchers to have computer printouts of
data (with the veneer of objectivity they
confer) comparable to their quantitative
counterparts whose claims to doing
science are often not questioned. Even
so-called soft data can become hard when
produced by hardware. Qualitative work can
now have the look and feel, or aesthetic
features, of science (p. 205).
The computer can assist researchers in
activities such as processing, storage,
retrieval, cataloging, and sorting and
leaves the analysis activities up to the
researcher. Anderson (1987) pointed out
that the computer does not perform the
thinking, reviewing, interpretative, and
analytic functions that the researcher
must do for himself or herself. Rather, the
computer makes the researcher more
efficient and effective in those high-level
functions, and eases some of the tedious
mindless tasks that otherwise consume
so much time and energy (pp. 629-630).
However, Sandelowski (1995a) has argued
that replacing and streamlining the
cutting and pasting activities may be seen
as desirable by some because they are
uncomfortably reminiscent of childhood
play. She argued against the claim that
machine technology saves human labor
and suggested that it may actually
increase labor because more data are
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
within several categories, if desired. At
the : interviews or descriptions of
observations car re intact for reference
as needed. In addition, m. :~r
processing programs can perform sort
opera can search throughout a text
file for a selectee or a string of words.
Many of these activities performed
with a traditional word processing c
(Burnard. 1998). Files in a word
processing g- can be transferred to a
database spreadsheet Excel, dBase, or
Lotus 1-2-3 to organize the ' matrices.
A number of computer programs
have developed specifically to
perform qualitatr- e se's. Podolefsky
and McCarty (1983) descrtrec of the
earliest attempts. This program. C:
Assisted Topical Sorting (CATS),
allowed to insert codes, designated as
numbers, lt.t: i file. A mainframe text
editor gave users the ity to search for
strings of characters such or phrases.
St John and Johnson (2000) exp A
pros and cons of various data analysis
sofiv qualitative research.
Transcribing Interviews
Tape-recorded interviews are
generally tr- word for word. Field and
Morse
Pauses are(1985) prow
denoted in the J
transcript following
with * while
instructions
series of dots for transcribing a tape-n"
indicate gaps or prolonged p All
interview.
exclamations, including laughter and explelrsi
included. Instruct the typist to type interview s
spaced with a blank line between speakers. A g-
rnargin on both sides of the page permits the leh to
be used for coding and the researchers ow n . of the
interview' style, and the right margin to re for
comments regarding the content. ... Star, i paragraph
each time a topic is changed. ... Ensure all pages are
numbered sequentially and that ea, is coded with the
interview number and the info number. (Field &
Morse, 1985, pp. 97-99)
Sandelowski (1994) indicated that the
researcher choose which features
about the interview serve in print.
These choices directly influe nature
and direction of the analysis. Once the
view has been transcribed, the
transcript takes independent reality
and becomes the resea raw data.
Sandelowski suggested that the r:
transcription alters reality. The text is
max- formations removed from the
so-called un.'< ated reality it was
intended to represent
Chapter 23 Qualitative Research Methodology
mended asking the following
questions transcription:
c Transcript necessary to achieve the arch goals?
m transcription is required, what features f the
interview event should be preserved a: all possible)
and what features can be r/v ignored?
inf notation system should be used?
or purposes besides investigator analyser se
will the transcript serve? (Sand- * ski, 1994,
pp. 312-313)
ski pointed out that transcriptions
require hours for each 1 hour of
interview time. The work may be
$20/hour for an experienced
r.son (2005) has developed an
innovative : f data analysis that uses
audio-editing soft- eve selected
audio bytes from digital audio The
data are never transcribed but
remain term. A database is used to
code and manage ed audio files
and generate detailed and sum-
ports. Although the system is time
consum- up, it negates the need
for expensive and isive transcription
of recorded data, to the tape
recordings as soon after the
interpossible. Listen carefully to
voice tone, infiec- pauses of the
researcher and the participant, ts
the content. These features may
indicate that is very emotional or
very important. While evening, read
the written transcript of the tape,
cations of your observations on
the transcript.
and Poirier (1996) pointed out that
quali- Isalysis results from the
recontextualization of : d a t a , always
with the caveat that the new must in
some way be faithful to its origins. -
e data are meaningless without
context Using the reader response
theory' emerging work of Iser (1980)
and Kermode (1983), Poirier
indicated that the meaning of a text
m the interaction of the mind
(including the ' history) of the reader
with the content of the jeh in turn
arose from the mind and personal of
the interview respondent) (p. 164).
Reading results in an interaction
between the mind and history of the
respondent and the mind oral
history' of the researcher. This
interaction the emergence of a
virtual text, which is the ng
interpreted. Thus, there is no real
objec- ,ntic information from which
only one correct ion can be made.
The text does not explain
521
everything. Motives, histories,
antecedents, and causal links, sometimes
entire subplots are left to the reader, to
the researcher, to infer (Ayers & Poirier,
1996, p. 165). The process of interpretation
occurs in the mind of the reader. The
virtual text grows in size and complexity'
as the researcher reads and rereads.
Throughout the process of analysis, the
virtual text develops and evolves.
Although multiple valid interpretations
may occur if different researchers examine
the text, all findings must remain
trustworthy to the data. This
trustworthiness applies to the unspoken
meanings emerging from the totality of
the data, not just the written words of the
text.
Immersion in the Data
Data collected during a qualitative study
may be narrative descriptions of
observations, transcripts from tape
recordings of interviews, entries in the
researchers diary reflecting on the
dynamics of the setting, or notes taken
while reading written documents. In the
initial phases of data analysis, you need to
become familiar with the data as you
gather them. This process may involve
reading and rereading notes and
transcripts, recalling observations and
experiences, listening to tapes, and
viewing videotapes .until you have
become immersed in the data. Tapes
contain more than words; they contain
feeling, empllasis, and nonverbal
communications. These aspects are at
least as important to the communication
as the words are. In phenomenology, this
immersion in the data is referred to as
dwelling with the data.
Data Reduction
Because of the volumes of data acquired
in a qualitative study, initial efforts at
analysis focus on reducing the volume of
data so that the researcher can more
effectively examine them, a process
referred to as data reduction. During data
reduction, you begin attaching meaning
to elements in your data. You will discover
classes of things, persons, and events and
detect properties that characterize things,
persons, and events. You will also note
regularities in the setting or the people.
These discoveries will lead to classifying
elements in your data. In some cases, you
may apply the classification scheme used
by participants or authors. In other cases,
you may wish to construct your own
classification scheme. According to
Sandelowski (1995b),
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
researcher gets a sense of the interview as a whole;
it is, occasionally, the first time investigators will
hear something said, even though they conducted the
interview. During the proofing process, researchers
will often underline key phrases, simply because they
make some as yet inchoate impression on them. They
may jot down ideas in the margins next to the text
that triggered them, just because they do not want to
lose some line of thinking, (p. 373)
Data Analysis
The following is a description of some of
the techniques qualitative researchers use
during the process of data analysis and
inteipretation. These techniques include
coding, reflective remarks, marginal
remarks, memoing, and developing
propositions.
Codes artd Coding
Coding is a means of categorizing. A
code is a symbol or abbreviation used to
classify words or phrases in the data.
Codes may be placed in the data at the
time of data collection, when entering
data into the computer, or during later
examination. Through the selection of
categories, or codes, the researcher
defines the domain of the study.
Therefore, it is important that the codes
be consistent with tire philosophical base
of the study. Organization of data,
selection of specific elements of the data
for categories, and naming of these
categories all reflect the philosophical
base used for the study. Later in the
study, coding may progress to the
development of a taxonomy. For
example, you might develop a taxonomy
of types of pain, types of patients, or
types of patient education. Initial
categories should be as broad as
possible, but categories should not
overlap. As you collect more data in
Data consisted of joint and individual tape-recorded
relation
interviewed thea White
to particular
families, category, you can
interviews that were professionally transcribed. I
and a masters-prepared
section
Black nurse interviewed the Black families. smaller
the major category into During
categories.
third- trimester interviews, teens and grandparents
SmithBattle
privately described (2007) described
the pregnancy and theirher
coding process
expectations, hopes, as
andfollows.
fears about the future. At 1, 3,
6, and 9 months, participants were asked in separate
interviews to recall recent stressful and meaningful
episodes in being a parent or a grandparent, and what
they thought, felt, and
did in each situation. Teens were also provided \* is :u
posable cameras and a baby book journal in which rta|
wrote about their experiences. Following each p: turn
interview, the teen described her photos an; ;;_r* her
journal entries with the interviewer. A family bean !
interview was conducted with grandparents at 6 - term.
At 9 months, mother and baby were videotaped ir.
activities. After viewing the videotape with the inter*-
* the mother described her reactions to taped segment
1 joint interviews at 3 and 10 months, teens and
grandpa* described their daily schedules and the care
of the rail Individual and joint interviews were
scheduled a: faafl members convenience and typically
lasted less v an ij hours. Teens received US$10 for each
interview or LSlfl for completing tire study. Parents
were not reimbursed Data were analyzed using
interpretive strategies 7 _ emerged directly from the
data and were used to up .ml view excerpts that were
then moved as a block :: ca summaries for each family.
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
my analyses and ima* excerpts could be easily retrieved
for subsequent sai sis. As cases were analyzed, I
searched for pana* teens and grandparents concerns,
meanings, preena and interactions. Cases .were then
compared to ira similarities and differences in personal
and famih cents, meanings, practical, and interactions.
The s interviewer and two additional researchers read
cases to validate or refine my interpretation, (p. 2;I
The types of codes that can be used
are desc. interpretative, and
explanatory. Descriptive c>;: sify
elements of the data by using terms
that i how the researcher is
organizing the data. It is n plest
method of classification and is
common! in the initial stages of data
analysis. Descriptr c remain close to
the terms that the participant ua ing
the interview. For example, if you
were re transcribed interview in
which a participant di experiences in
the first days after surgery; ya use
descriptive codes such as PAIN,
MOVING and REST.
Interpretative codes are usually
develop in the data-collecting
process as the researcaa some
insight into the processes occurring
_r; to move beyond simply sorting
statements. 1 ticipants terms are
used to attach meanings a
statements. For example, in a study
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
the listener. All of these factors make the likelihood
of a researcher, using textual data and a method of
textual analysis, uncovering the precise meaning of
pieces of communication an unlikely scenario. ...
Transcripts are always post hocthey always occur
after and, sometimes, at some distance from the
original interviews. This means that the reader of the
transcriptsthe researcheralways comes to the
transcripts too late. What really happened in the
interview has been lost. (Barnard, 1995; full text
available in Nursing Collection)
One way to address this problem is to
use multiple data collection methods.
Interviews might be videotaped as well as
audiotaped. The researcher might
strengthen his or her analysis by
simultaneously reviewing video and audio
transmissions while reviewing the
transcript. Parse (1990) referred to this
process as immersion in the data.
Multimedia computers are now available
in which text, video, graphical media, and
sound can be used for such immersion.
Burnard (1995) foresees a time when CD-
ROM disks might be used to store these
multimedia data sets. This type of
integrated and triangulated approach to
analysis would provide a richer
understanding of meaning.
Analysis of Focus Group Data
Historically, content analysis has been
used to analyze focus group data.
However, data from focus groups are
complex in that analysis is required at
both the individual level and at the group
level, considering interactions among
individuals and the group, and making
comparisons across groups. It is
important to attend to the amount of
consensus and interest in topics
generated in the discussion. Analysis of
deviance and minority opinions is
important. Attending to the context
within which
If the unit statements
of analysis is limited to were made
the group, then the is
critical
evolvingtointeraction
the analysis (Morgan,
of members and the1995).
impact on
Carey (1995) made the following
opinions will be unobserved. Because the interaction
suggestions regarding analyzing focus
within the group will affect the data elicited, an
appropriate description
group data.
of the nature of the group
dynamics is necessary to incorporate in analysisfor
example, heated discussion, a dominant member, little
agreement, (p. 488)
It is important in analyzing the data to
determine M said what. If only tape-
recording is available, ::.sn be a
problem. Video recording can help
you ta ;i this information; if this is not
feasible, the cofacjH can take notes
that may provide some inforn.mmcl
will help you to make this
determination. One i* analysis strategy
is to examine all the inpu: : i g ticular
individual and the extent to which th:s
nd uals comments influenced the
position of other J members.
Nonverbal interaction should also be :
Dominant members of the group
may suppress
Certain members of thesonant
group may views that
be more -isesl or
increase theothers,
articulate than richness of the
and their views may c :nJM
According
dominate theto Sim (1998):
proceedings: such individuals have ag
described as thought leaders. In the process, ami
of the group who are less articulate may be i-.nag
from expressing alternative viewpoints. This refisEM
tendency of those who find themselves in a rrirani
acquiesce to the majority view. The effect of this fl
that these alternative views are simply not voiced.*
those who remain relatively silent are falsely J to
agree with the prevailing view. Hence, whilst -TiJ
may at times indicate agreement, it may so rerra an
unwillingness to dissent. Skillful questioning 1
moderator may assist in distinguishing these ro: - J
bilities, and asking participants to write their v:es; i in
advance may encourage disclosure from less coni*
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.
fairly safe to assume that this reflects a correspand
underlying difference of view. However, tiie c not
necessarily the case; the absence of diversity eg data
does not reliably indicate an underlying cecsaJ A
feeling of consensus or conformity in the caa. J
merelv reflect the group dynamics, and say little the
various views held by individual particiraici. 348)
Generalization from Focus Group Ana: :sa
The common v iew of focus groups
was tAa# were representative of a
target population aaa* generalization
to the target group W'as ac:er:a
However, participants are not
obtained using ri bility sampling, and
one is on shaky ground ;u=dS
generalization using this argument.
The r person likely to agree to
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