Metode Kualitatif

Chapter
6

Common qualitative methods

Dean Whitehead
KEY TERMS LEARNING OUTCOMES

descriptive exploratory After reading this chapter, you should be
emancipatory able to:
ethnography • describe the common types of
qualitative research approaches in
grounded theory
relation to nursing and midwifery issues
interpretive • discuss the appropriateness of
Copyright © 2012. Elsevier. All rights reserved.
phenomenology qualitative frameworks, theories and

qualitative philosophies
qualitative meta-synthesis/analysis • describe the value of the knowledge
gained from qualitative research for
research methods practice
• identify the types of health-related
issues that are best explored by the
use of qualitative research.
Schneider, Z, Whitehead, D, LoBiondo-Wood, G, & Haber, J 2012, Nursing and Midwifery Research : Methods and Critical Appraisal for Evidence-Based
Practice, Elsevier, Marrickville. Available from: ProQuest Ebook Central. [18 April 2018].
Created from uts on 2018-04-18 18:58:53.
NURSING AND MIDWIFERY RESEARCH 4E
INTRODUCTION
Qualitative research refers to a series of both different and related methodologies that cluster
under a paradigmatic umbrella (see Chapter 2). No one approach governs qualitative research
and so permits multiple ways of exploring different phenomena. Qualitative researchers
therefore have a range of research approaches available to them. Which approach researchers
choose to adopt usually depends on the nature of the study and the type of knowledge the
researcher wishes to uncover. Today, the most common form of qualitative enquiry undertaken
in nursing and midwifery is that of a descriptive exploratory approach. This is in quite stark
contrast to the last edition of this book — when the three most common qualitative research
approaches were phenomenology, grounded theory and ethnography. They are still commonly
adopted and, proportionally, they still rank in this order. Each of these approaches holds a set of
related but differing ontological (being-related), epistemological (knowledge-related) and
methodological beliefs. It is these beliefs that inform and shape qualitative research studies.
One of the main qualities of qualitative research is that it involves a close relationship
between the researcher and participant. This is quite different from research conducted within
the quantitative paradigm, where there is frequently no direct contact with participants.
Research participants, in qualitative research, are therefore viewed as ‘knowers and participators’.
That is, they are viewed as having the knowledge that the researcher seeks to uncover. This is
because the participants will have been selected on the basis that they are part of the
phenomena, environment or culture that the researcher is examining — or that they have lived
through an experience from which relevant opinions, values or beliefs have emerged (see
sampling in Chapter 7).
Qualitative methods are governed by specific philosophical or theoretical positions and
frameworks. It is necessary to explore these in some detail if we are to understand how, why and
when such research is undertaken. Such exploration is necessary because studies may report that
they have occurred under the ‘umbrella’ of qualitative research, but do not specifically state
which type (see later in this chapter). Here there may be an assumption by the author/s that the
reader can accurately interpret the specific approach from the described study information.
An appreciation of the more common qualitative methods will help the reader to make a
more informed decision as to what method/s has been used, even if it is not stated. This
chapter, then, takes the reader through the more common qualitative approaches in health-
related research. It is important to note here that this chapter focuses mainly on the theoretical
and philosophical positions, frameworks and processes of the most common qualitative
methods. The following chapters, 7 and 8, deal with the specifics of qualitative research process
and design, such as sampling techniques, data collection and data analysis.
WHY IS QUALITATIVE non-human (i.e. a specific drug or clinical

interventions such as a wound dressing or
RESEARCH USEFUL? catheter product being tested). What quantitative
Quantitative research (see Chapters 9–13), research does not intend to do, however, is to
through the collection and analysis of numerical understand personal experiences, interpretations
data, generally informs us of how often, when or and opinions from the point of view of research
how effective particular nursing and midwifery participants. Instead, this is the place and
interventions or treatments are. This information intention of qualitative research.
relates directly to the research participants, Qualitative research, over the years, has proven
‘subjects’ or ‘elements’, which often may be very useful to the disciplines of nursing and
Practice,104
Elsevier, Marrickville. Available from: ProQuest Ebook Central. [18 April 2018].
6 • Common qualitative methods
midwifery. Both professions share similar beliefs THE MAIN APPROACHES TO

about individuals and their relationship to the
care environment. Qualitative research generally
QUALITATIVE RESEARCH
adopts an interpretive and naturalistic approach Descriptive exploratory
to viewing the world and its phenomena. This Since the last edition of this text there has been
means that qualitative research is designed to quite a dramatic turnaround in terms of what
help us understand naturally occurring social is now the most common form of qualitative
events through exploring the attitudes, beliefs, enquiry in nursing and midwifery studies. It was
meanings, values and experiences of research mentioned in the 2007 chapter (almost as a
participants. The intention is to produce ‘rich’ footnote) that:
narrative (spoken or observed) data that allow us
to interpret the ‘essence’ of what it is that has Annells (2007) argues that this form of
been said or observed. This is where qualitative ‘descriptive exploratory’ methodology is fast
research possesses the greatest potential to be emerging in nursing and midwifery research
useful. It has the potential, through such inquiry and could even take over as the most common
with its chosen participants, to raise awareness of qualitative approach in the future.
the need for change or intervention. It was a bold claim at the time, but that
Different qualitative methodologies broadly prediction has come about in a relatively short
share many similar properties. While sharing period of time. Whereas phenomenology,
properties, different qualitative approaches grounded theory and ethnographical approaches
explore experiences and phenomena in different (in that rank order) were the most common
ways; generally producing different types of approaches in the mid part of the last decade,
research outcomes. For this reason, much of this they have now been notably overtaken by
chapter is devoted to the most common research descriptive exploratory approaches.
traditions used in nursing and midwifery-related There are two sides to the debate about the
qualitative research — and the exploration of rapid development of the descriptive exploratory
how they are structured and influence nursing approach. For those who see it as a threat, they
and midwifery practice. view researchers as possibly either opting for the
simplest option, or that they simply do not
1 Tutorial Trigger
Choose a health topic that you think
would be best explored using a
qualitative approach and think of a
understand other more complex traditional
approaches to qualitative research. On the other
hand, some researchers view the situation as
liberating. Therefore, those who support
suitable research question (see Chapter 4) to descriptive exploratory approaches feel that they
investigate that issue. do not have to be ‘shackled’ by the conventions
of traditional approaches, allowing a greater
degree of freedom in expressing and reporting
Points to ponder their findings. Sometimes, however, authors
appear to compensate against the claim that

Qualitative methods offer researchers the descriptive exploratory approaches are a simpler
opportunity to gather rich information from and more manageable form of qualitative
the chosen participants (population) and, at
the same time, develop close and
enquiry by adding more complex philosophical/
meaningful relationships. theoretical frameworks to their studies. For
Qualitative research is best used where the instance, Dempsey (2008) adopts Parse’s
researcher wishes to gain insights into the humanbecoming philosophical position as the
way that nurses and midwives, their theoretical perspective for her qualitative
patients, their caregivers and their descriptive exploratory study exploring
colleagues engage and interact with each confinement with 13 volunteer adult men,
other. In other words, to gain insights into incarcerated in the same mental health unit of a
the way that they define, interpret and
US medium-security prison.
analyse different situations, events,
experiences and phenomena. Descriptive exploratory methodology is not so
much a specific approach, but more a ‘general’
105
approach that usually adopts common aspects of Evidence-based practice tip

all qualitative approaches. In effect, descriptive
exploratory researchers collect rich narrative data When adopting a descriptive exploratory
from small sample populations (see Chapter 7) approach to qualitative studies, it is best that
and analyse that data using broad ‘free-form’ the researcher offers a clear reason why the
method has been chosen and why the
thematic/content analysis methods (see Chapter
particular method best addresses the
8). Compared to the following sections, purposes of the study. This further validates
particularly with phenomenology for instance, the study and defends its position, where
there is not a great deal that can be discussed others may potentially challenge its
with regard to descriptive exploratory evidence-base.
approaches. They adopt ‘generic’ (general)
qualitative principles and, therefore, are not
usually governed by complex theoretical or
philosophical positions that require more careful RESEARCH IN BRIEF
detailing and exploration. It appears that authors
Huntington et al. (2011) explored nurses’
might be trying to convince research consumers
perceptions of the reality of practice based on
that the approach is more complicated than it data from the Nurses and Midwives e-cohort
actually is. For instance, Drey et al. (2012, in Study. It examined the workforce
press) describe their descriptive exploratory study characteristics, such as work–life balance and
on patients’ adherence to antiparkinsonian health of nurses. They performed a qualitative
medication as an ‘in-depth’ qualitative study. analysis of data from a cohort of Australian,
As referred to earlier, some authors do not New Zealand and UK-based nurses. Of the
describe their qualitative approaches as 7604 participants, 1909 provided qualitative
descriptive exploratory. Perhaps a reason for this comments related to nursing practice;
is that most research is, by nature, descriptive thematic analysis resulted in four ordered
(both qualitative and quantitative) and most themes (see Chapter 8): ‘embodied care’
which discussed the impact of work on the
qualitative approaches are of an exploratory
nurse’s physical and emotional health;
nature. For instance, McKenna et al. (2011 ‘quantity/quality care’ which addressed
p 682) conducted 11 focus groups with 46 key increasing pressures of work and ability to
academic midwives across Australia on the provide quality care; ‘organisational care’
subject of clinical simulation, and simply stated raising the seeming lack of support from
‘A qualitative design was employed …’. Their management; and ‘(un)collegial/self care’
title qualifies the approach as a ‘A qualitative where bullying and professional relationships
examination of perceptions of leaders’. Similarly, were uncovered.
Sweet and Glover (2012, in press), in their
exploration of the Flinders University (Adelaide)
midwifery continuity-of-care program, simply
stated ‘a qualitative study was conducted’. Crowe RESEARCH IN BRIEF
et al. (2010) also make the same claim about Qualitative descriptive research can be used
their New Zealand-based study on the impact of in culturally based studies. Ryan and Wilson
lower back pain, with the title ‘Self-management (2010) describe their New Zealand study that
and chronic low back pain: a qualitative study’. utilised a Kaupapa Māori methodology to
Another variation on descriptive exploratory investigate child-to-mother violence. They
approaches lies in the use of terms such as an found that Māori mothers, where abused by
‘interpretative approach’. For instance, Shih and their child, chose to protect their child. They
Honey (2011), in their qualitative study on the do report, however, that the mothers reached
impact of dialysis on rural-based Māori and their a point after which they undertook a new
families, use this term. Another variation occurs journey of telling their story to others,
reconnecting with indigenous roots and
in Wilkes et al.’s (2011) Australian study of the
engaging in ‘healing activities’. The study also
experiences and expectations of adolescent young highlighted the lack of support that these
expectant fathers where the researchers describe mothers were offered by health professionals.
their study as a ‘narrative inquiry’.
Practice,106
understand the possibilities embedded in the
2 Tutorial Trigger
What reasons do you think most
likely explain the rapid and recent
emergence and popularity of
experience of phenomena.
Phenomenology remains popular in nursing
and midwifery research because it reflects values
and beliefs that are common to both disciplines. It
qualitative descriptive exploratory approaches allows questions to be explored that are important
to research? to them both. Certain questions are most often
asked. These tend to focus on understanding
‘TRADITIONAL’ APPROACHES experiences of phenomena related to health and
illness, treatment and care — from the viewpoint
TO QUALITATIVE RESEARCH of both those cared for and those providing care.
As has already been hinted at in this chapter, For instance, McBride-Henry (2010) investigated
more established (traditional) approaches to New Zealand women’s interpretations of their
qualitative research are generally far more breastfeeding experiences providing insights into
complex than the recently popular descriptive how health professionals might support women to
exploratory approaches just discussed. They are prolong breastfeeding. Similarly, Bigwood and
usually governed by longstanding theoretical and Crowe’s (2008) New Zealand study on physical
philosophical positions that have evolved over restraint in acute inpatient mental health service
many years — alongside (often) longstanding settings examined mental health nurses’
critical debate and comparison. This is experiences of physical restraint and how it
particularly the case with phenomenology. With impacted on their clients. They found that,
these facts in mind, it is therefore necessary to despite it being an integral part of their role,
explore the more common traditional qualitative they were ‘very uncomfortable’ with the role.
methods in some detail, as follows. The goal of phenomenology is to develop an
understanding of a phenomenon through the
Phenomenology specific human experience of the phenomenon,
in order to better understand that experience of
Origins and philosophical underpinnings being in that ‘life-world’. It serves to understand a
Phenomenology, as a framework for research person’s experiences rather than to provide causal
inquiry, has been widely embraced by health explanation of those experiences. The process of
professional researchers. It is seen as a way of phenomenological research, therefore, does not
understanding phenomena that occur within ‘break down’ the experience that is being studied.
and outside where health professionals work. Instead, it provides descriptions that are rich and
It is still one of the most common qualitative full and interpretations that exactly describe what
methods adopted by nursing and midwifery it means to be a person in their particular world.
researchers and, therefore, a focus of this chapter. The phenomenological researcher is committed to
Phenomenology, however, is one of the most understanding the experience of the phenomena
philosophically ‘challenging’ of all the qualitative as a whole, rather than parts of that experience.
approaches. Because of the wide variations in Phenomenology, therefore, is mostly used to

what makes up and describes phenomenological develop ‘pathic’ understanding. This type of
research, Norlyk and Harder (2010) advise understanding is useful for understanding ‘care’
caution before choosing. and in guiding nursing and midwifery actions
Phenomenology is designed to discover concerned with feelings/emotions, interactions,
phenomena and unearth previously unnoticed or meanings of experiences and responses to
overlooked issues, as it explores the experience phenomena. Researchers find phenomenology
and meaning of phenomena. Phenomenology, particularly useful for the study of those
therefore, reveals meanings that appear ‘hidden’ phenomena that do not lend themselves easily
or identifies the impact of a phenomenon, rather to the processes of quantification, control or
than making inferences. At the same time, this comparison. Beck and Watson (2008), for
approach provides rich descriptions that aid example, use a phenomenological approach to
understanding. The result of uncovering this investigate the impact of birth trauma on
knowledge is that researchers may better mothers’ breastfeeding experiences. The approach
107
provides the description required to capture the in-depth knowledge of their adopted
traumatic experience of a difficult birth and a philosophical framework in order to produce
mother’s ‘duty’ to provide for their newborn. research that is true to the chosen framework.
Emerging themes, such as ‘proving oneself as a The two most common phenomenological
mother: sheer determination to succeed’, ‘making schools of philosophy, adopted by both nurses
up for an awful arrival: atonement to the baby’, and midwives, have emerged from the Husserlian
‘helping to heal mentally: time-out for the pain in and Heideggerian tradition and occasionally
one’s head’ and ‘just one more thing to be from the works of Gadamer (Paley 1998).
violated’ vividly highlights this point. Other popular, but less used, philosophical
interpretations have emerged — such as those of
RESEARCH IN BRIEF van Manen (1984), Merleau-Ponty (Dowling
2007) and Crotty (Barkway 2001). Reference to
Kelly and Ahern (2008) describe their Brisbane- the just-mentioned citations will assist in giving a
based phenomenological study of student useful overview of these other philosophical
nurses preparing for registered practice. The ‘schools’. In some cases, such as in the study by
main themes to emerge were: ‘This is nursing’
Lyneham et al. (2008), they conducted a ‘mixed’
(with sub-themes of ‘discovering nursing
culture’ and ‘language’); ‘Eating their young’
phenomenological method that used a van
(with sub-themes of ‘power games’, ‘hierarchy’ Manen-based approach, but also a Gadamerian-
and ‘bitchiness’); and ‘Not really prepared’ (with based analysis. The participants were 14
sub-themes of ‘role conflict’, ‘thrown in at the experienced emergency nurses interviewed across
deep-end’ and ‘double-reality shock’). These five Australian states about how ‘intuition’
‘self-explanatory’ themes and sub-themes, even influenced their practice. Due to its popularity,
without reading the whole study, serve to a number of articles offer a detailed and
identify that the undergraduate nursing insightful account of many of the different
experience was not always a comfortable one. phenomenological schools to aid understanding
(i.e. Dowling 2007; McConnell-Henry et al.
2009; Earle 2010). This section provides a basic
overview of some key concepts that need to be
Points to ponder considered when undertaking phenomenological
Phenomena can be understood through research. These key concepts have implications
the experiences that people have of them. for how research studies, using certain
Phenomenology provides an understanding phenomenological approaches, are conducted.
of people and their relationships with their
world.
The ‘trick’ to knowing
Language is accepted as a means for
understanding others’ experience of phenomenology
phenomena. To some extent, the reader of this chapter
may find the philosophical elements of
Phenomenology was first a ‘general’ phenomenological research confusing. They

philosophy but has subsequently been used as a can appear overly complex. Conducting and
structured approach to research inquiry (Earle critiquing phenomenological research is not an
2010). While phenomenology has provided easy task, but there are certain ways to make it
health professionals with many riches, in terms of easier. One way is to know and understand that
understanding human existence and experience, it requires a commitment to philosophical
it also provides challenges to the researcher. This understanding. Therefore, researchers and readers
is mainly due to the many different philosophical need to be able to:
schools of thought and subsequent interpretations • reflect on what it means to be a person in the
that have emerged since the end of the twentieth world
century. A phenomenologist, by necessity, • reflect on one’s own experience and explore
requires an overall understanding of several one’s own understandings of a phenomenon
different philosophical schools of thought. • think beyond the ‘proving of facts’ towards a
Alongside this, they must also possess an desire to explore the experiences of self and
Practice,108
others — of a phenomenon in a particular moved philosophical discussion from the

context question of whether or not objects in our
• have sufficient understanding of the ‘conscious awareness’ had a separate existence, to
phenomenological methodology and the systematic analysis of consciousness and its
framework in order to understand how it objects. He aimed to separate out (bracket)
informs the method of the study and the mood, thoughts, memories and emotions to
findings of the study. focus on conscious awareness of objects. He
In this chapter the presentation of the believed that understanding about intuition and
traditional philosophies can only be quite brief. judgment (therefore, logic and truth also)
However, to help simplify matters, some emerged as a result of reflecting upon experiences
phenomenological researchers have devised of life (Dahlberg et al. 2001). Husserl’s
step-by-step procedures to help interpret and phenomenology is epistemological in nature (see
analyse the collected language (data). The two Chapter 3). That is, it is concerned with asking
main authors are Giorgi (1997) (see the next questions of knowledge about objects gained
‘Research in brief ’) and Colaizzi (1978) (see through conscious awareness. Husserl concluded
Chapter 8). Reference to their seminal work and that ‘essences’, as the things that define
nursing studies that adopt their principles may experience, exist within the conscious experiences
provide further clarity. of people and that this consciousness (and its
intention) is presented by people to the world
(Sadala & Adorno 2002).
RESEARCH IN BRIEF
Kvigne et al. (2005) use a Giorgi-inspired
phenomenological method to research the RESEARCH IN BRIEF
nature of nursing care and rehabilitation of Doherty’s (2010) study describes the lived
female stroke survivors from the perspective of experience of midwifery clients throughout the
14 hospital-based nurses. The analysis of the life span. A phenomenological approach in the
data used the Giorgi-related steps of tradition of Husserl was employed. This is
1. gaining a sense of the whole described in the context that the clients’
2. distinguishing the text into meaningful units experiences reflected ‘essential structures
3. generating essential aspects and themes and embedded in human phenomena’ and that to
4. synthesising the essential aspect of understand their social reality, their knowledge
understandings and reflections into a (consciousness) formed the essence of the
consistent statement. data. In-depth interviews were conducted with
a purposive sample of 12 midwifery clients. The
research question was: What has been your
Husserlian phenomenology experience with midwifery care? Interviews
Phenomenology, as a philosophical movement, were audio-recorded and transcribed verbatim.
has its origins in Ancient Greek philosophy. It is, Data saturation was achieved and analysis
however, the German philosopher Husserl procedures from Colaizzi (see Chapter 7) were
(1859–1938) who is credited as the founder of used. Five themes emerged from the data: 1)
decision to seek midwifery care; 2) working
the twentieth century phenomenological
together in a therapeutic alliance; 3)
movement. Husserl’s desire was to seek an formulating a birth plan; 4) childbirth
alternative to positivism (see Chapter 2) that education; and 5) nurse-midwives as primary
would integrate the world of science alongside healthcare providers throughout the life span.
the real ‘life-world’ (lebenswelt) of people (Sadala They recommend that health professionals
& Adorno 2002). For Husserl, human beings listen to the voices of midwifery clients around
were subjects in a world of objects and it was the a midwifery model of care that includes
study of the consciousness of those objects that recognition of life-span issues.
he called phenomenology. From this focus, he
developed one of the two main schools of
phenomenology (descriptive phenomenology) and Heideggerian phenomenology
was primarily interested in the question, ‘What Heidegger (1889–1976), who was a pupil and
do we know …?’ (Koivisto et al. 2002). Husserl colleague of Husserl, questioned the relationship
109
between consciousness and objects and so moved questioning the collected data (text) and moving
significantly from Husserl’s interpretations. from parts to the whole of this text, in which
Heidegger’s views helped to form the other main each part gives the other parts meaning (see
school of phenomenological philosophy Chapter 8). It also defines how meaning and
(interpretive phenomenology). For Heidegger, the language are understood and, therefore, how
practical ‘situatedness’ of human experience was knowledge about humans and their world is
his most important claim. Heidegger focused his subjective, temporal (of time and worldly) and
efforts on the study of a person’s ‘position’ related historical. This ‘hermeneutic circle’ (Heidegger
to their human experience and towards the 1962 p 119) describes the historical, cultural and
understanding of the necessary conditions for personal interpretations from which human
people being or existing in their world. As such, understanding is developed.
Heideggerian phenomenology is ontological (see The hermeneutic circle is not a static thing; it
Chapter 3). This means that it hopes to is dynamic and fluid. Therefore, the assumptions
understand the conditions whereby human contained in understanding are challenged
beings can understand their existence and, by new understandings. Through making
therefore, the nature and the meaning of ‘being’. background assumptions visible, in language, the
The notion of being or ‘being-in-this-world’ testing of assumptions is possible. The process is
is central to Heidegger’s interpretations and is ‘kaleidoscopic’, as different patterns emerge from
referred to by Heidegger in the commonly used taken-for-granted understandings. People come
context of ‘dasein’ (Heidegger 1962 p 67). The to phenomenological research with a history of
German verb dasein means ‘to exist’, although culture and experience that is bound in language.
there are other variations in interpretation. It is a This process of understanding brings together
contraction of the correct form of das and sein perspectives influenced by past and current
(das meaning ‘the’ and sein meaning ‘being’). events and presented in a shared language. For
Therefore, Heidegger suggested that people are instance, Whitehead (2002a) refers to the
aware of their own existence and question what ‘phenomenological nod’ that he experienced
it means to be them in or outside their own when investigating the academic assignment
world. This is connected to the concept of ‘self ’ writing experiences of a group of student nurses.
which is, in turn, linked to the wider position of This nod confirmed that the students’
the person’s place in their community, world and experiences were very similar to his past
the cosmos. Therefore, people are capable of experiences and describes how they relate to the
questioning the meaning of their experiences of current and future experiences of both parties.
being. They can interpret their different worlds Also important to Heidegger (1962 p 386)
by comparing with others around them. People was the notion that ‘being in the world’ is always
can reflect on the meaning of their experience understood in terms of temporality. Temporality
and can look forward to other possibilities of refers to the fact that life, as it is lived now,
‘being’. James and Chapman (2009) describe the cannot be separated from the historical
experiences of undergraduate Australian nurses experience of living a life and the potential for
during their first clinical placement. Their that life in the future. Temporality is therefore
adopted Heideggerian ‘lens’ allowed them to see directly related to ‘the meaning of life’
that the experience, for most, was ‘overwhelming’ experience. In summary, Heideggerian
and, reflecting on those experiences, had some philosophy has at its core the relationships
students question their continuation in nursing. between self, being, meaning, existence and
Heidegger also described dasein as something temporality. For those who require a deeper
that exists in a world that is familiar and that is understanding of Heidegger’s interpretive
understood by people. This world has horizons phenomenology, Mackey (2005) provides a
that contain pre-understandings used to assist us comprehensive description and analysis.
make sense of our situations. This notion lends
itself to the commonly used term ‘hermeneutics’.
Hermeneutic phenomenology provides a Gadamerian phenomenology
framework that defines a view of persons and While Heidegger viewed phenomenology and
their being-in-the-world. It does so through hermeneutics as one and the same, Gadamer
Practice,110
challenged this. Gadamer (1976) wanted to

expand the ideas of Heidegger and his concept
of the hermeneutic circle. He did this through
suggesting that the realisation of ‘self ’ occurs in
a ‘circle of understanding’. Wood and Giddings
3 Tutorial Trigger
Referring back to tutorial trigger 1,
can you identify a specific
phenomenological approach that
(2005), in interviewing New Zealand-based would best suit you? Would you have to adjust
Research Fellow Brian Phillips, discuss the your initial research question?
nature and intention of his PhD study. In this
study, he used Gadamerian hermeneutics to
interpret men’s experiences of suicidality and
the relationship of masculinity in shaping their Points to ponder
beliefs and understanding of this phenomenon.
For this level of ‘self-realisation’ to occur, The process of phenomenological
interpretation involves both an awareness
the researcher does not simply examine the of the pre-understandings that the
language of the participant to discover researcher brings to the study and close
Heidegger’s ‘dasein’. Instead, they bring their reading of the gathered text.
own interpretation and understanding from Phenomenological writing is a creative
their own personal world. Therefore, self- process that reaches beyond narrative
understanding does not emerge from transparency description to reveal meaning and
of oneself, but through the tendencies and understanding.
motivations that are exposed in the language
spoken. Turner’s (2005) study of hope, seen
4
through the eyes of Australian youth, adopts this
philosophy of understanding. The participants Tutorial Trigger
described this process as including: ‘identification When critically reviewing a
of the researchers’ pre-understandings of the phenomenological study what would
explored phenomenon’, ‘adopting an attitude of you expect to see that would
suggest an effective phenomenological
Bildung (remaining open to meaning)’,
process had been applied?
‘identification of prejudices and expectations of
the whole’, ‘using prejudices to develop horizons’
and ‘fusion/blending of these horizons to identify
explored phenomenon’. GROUNDED THEORY
Origins and theoretical
underpinnings
RESEARCH IN BRIEF
Grounded theory refers to the method initially
McCloud et al. (2011) investigated 18 South developed and introduced by Glaser and Strauss
Australian patients’ experience of the surgical
(1967), and further discussed and developed by
procedure of vitreo-retinal day surgery. They

adopted a Gadamerian approach against the
them and other colleagues (Corbin & Strauss
context that ‘people experience the world 1990; Glaser 1999; Strauss & Corbin 1998).
through language, and language was the Glaser and Strauss, two non-health professional
conduit for understanding and knowledge sociologists working in a US-based department
development’. This process uncovered four of nursing doctoral studies in the 1960s, devised
‘constitutive’ themes: those of ‘the physical techniques for generating theory about social
Self’; ‘the psychological Self’; ‘the historically- processes so that the theory became ‘grounded’.
located Self’; and ‘the Self located in the The theories are grounded by the fact that
community’. These themes were located in the theory begins and emerges through analysing
context of human need. It should be noted collected data. The data are collected from
that ‘Self’ is inflected to stress the concept.
human action and interaction as they occur
The patient experiences included ‘pain’,
‘nausea’, ‘problematical self-care’ and
over time. This is through speaking with and
‘psychological angst’. listening to those who are engaged in the
action and interaction — and sometimes from
111
documents relating to the action and interaction. social processes, but has also evolved to explain
Essentially, grounded theory is designed to human action and interaction in clinically
develop theoretical explanation for socially related issues of social, psycho-social or
constructed events. It ideally generates spiritual dimensions of life. The classic
hypotheses for further research (see Chapter 4). grounded theory method, as formulated and
Theory grounded in this way is often thought published originally by Glaser and Strauss
to produce more useful outcomes than those (1967), has been modified so that there are now
emerging from ‘pure’ theorising alone. multiple versions (e.g. Corbin & Strauss 1996;
Therefore, knowledge may increase through Strauss & Corbin 1998; Charmaz 2000).
generating new theories, rather than analysing Different versions primarily reflect different ideas
data within existing theories (Heath & Cowley about how data are analysed to the point that a
2004). Grounded theory is a widely used theory results. This said, some other ideas
qualitative methodology in nursing and relating to the method differ. Most commonly,
midwifery research, especially as a means to in nursing and midwifery research, either classic
inductively separate clinical issues of importance grounded theory, or the more recent Strauss and
by creating meaning about those issues through Corbin (1990, 1998) version, is used. Reference
the analysis and modelling of theory (Mills to Heath and Cowley’s (2004) seminal paper, on
et al. 2006). comparing Glaser and Strauss’s versions of
Grounded theory is associated by many with grounded theory, will give the reader additional
the notion of symbolic interactionism — a term insight and understanding. A more recent article
coined by Blumer in 1937 (Neill 2006). This by Chen and Boore (2009) does similar, with the
process aligns an interactionist approach added benefit of including wider works by both
alongside naturalistic inquiry to develop theory. Corbin and Charmaz. Whole research texts are
This is where individuals are known to share devoted to just the works of single contemporary
culturally orientated understandings of their grounded theorists. Artinian et al.’s (2009) text
world, where understandings are shaped by titled Glaserian Grounded Theory in Nursing
similar beliefs, values and attitudes and Research is a good example.
determine how individuals behave according to In grounded theory development, according
how they interpret the world around them. to Strauss and Corbin (1998), there are three
People are seen as being both ‘self-aware’ and levels:
‘aware of others’ and, therefore, can adapt their 1) description — using language to convey ideas
social interactions and situational behaviour to that intend to describe aspects of the action
shape meaning and society (Heath & Cowley and interaction
2004). In this sense, the focus lies with the 2) conceptual ordering — organising ideas into
symbolic meanings that are uncovered by abstract concepts and grouping (classifying)
people’s interactions, actions and resulting these into like-groups (categories) and possibly
consequences. This is linked to the fact that sub-groups (subcategories) — in order to
many grounded theory research questions start make sense of action and interaction (see
with the intention of asking ‘How do people Chapter 8)

…?’. For instance, Whitehead (2002b p 199)
broadly asks the question, in his grounded 3) an explanatory scheme — identifies explanatory
theory study, ‘How do nursing students relationships between the categories (and
prepare for their current and ongoing health includes also the levels of description and
promotion role?’ conceptual ordering).
Grounded theory research, according to the
area of interest, tends to concentrate on either
The purpose and process of the patient, the nurse or midwife involved in
grounded theory patient action and interaction, or both. A good
Grounded theory, as a research methodology, is example is Dahlen et al.’s (2010) study of ‘novice
popular among nurse and midwifery researchers. birthing’ theorising first-time Australian mothers’
Perhaps this is because it is not just focused on experiences of birth. The focus here was on the
Practice,112
patients/clients. The 19 participants shared a core

common experience of seeing themselves as RESEARCH IN BRIEF
‘novices reacting to the unknown’. Bonner’s Carlsson et al. (2009) report their grounded
(2007) study, on the other hand, focuses on theory study on 18 women’s experiences of
nurses as participants, in their study of 17 seeking care and being admitted during the
Australian expert nephrology nurses’ latent phase of labour. Self-explanatory
understanding of the role of knowledge in their categories emerged from the analysis of the
collected interview data. The ‘core category’
practice. Hylton’s (2005) New Zealand-based
that emerged was ‘handing over
study sought to theorise the experiences of a responsibility’, and the five additional
sample of predominantly Māori enrolled nurses categories were: ‘longing to complete the
(ENs) as they made the transition from this role pregnancy’; ‘having difficulty managing the
towards full registration within a degree uncertainty’; ‘having difficulty enduring the
program. slow progress’; ‘suffering from pain to no
avail’; and ‘oscillating between powerfulness
and powerlessness’. The study highlighted
obvious dilemmas with the then current model
of care. It highlighted that midwives have an
RESEARCH IN BRIEF important role in assisting women with coping
during the latent phase of labour, and in
Mills et al. (2008) describe their Australia-wide giving the women opportunity to hand over
study of nine rural nurses’ experiences of responsibility. They recommended that the
mentoring nurses. The design was intended as care should include validation of experienced
a reflexive, constructivist grounded theory pain and confirmation of the normality of the
approach to investigate the dilemma of slow process, information and support.
initiating, settling and retaining new and
novice nurses to isolated rural areas. They
found that new or novice nurses were quick to
gain the support of experienced nurses,
especially in either wanting to demonstrate
their potential or when experiencing critical
It is generally agreed that the framework for a
incidents. The themes that emerged were grounded theory is that which is developed from
‘getting to know a stranger’, ‘looking after data analysed to form and support the grounded
each other’, ‘the importance of a name’ and theory. That is, the theoretical framework
‘building a foundation’. ‘evolves during the research itself ’ (Strauss &
Corbin 1990 p 49). Grounded theory research
can be conducted according to a variety of
perspectives, but with the primary ones being
objectivism and constructivism. Objectivism
Strauss and Corbin (1998 p 25) define considers that, as in the natural sciences, there
theorising as ‘the act of constructing, from data, are realities/truths/facts (an object) to be
an explanatory scheme that systematically revealed. Objectivist grounded theory aims to

integrates various concepts through statements find and uncover what is believed to be ‘there’
of relationship’. A grounded theory is most (to be real) about human action and interaction.
likely to be a middle-range theory. That is, it is In contrast, constructivism considers that, in
more than some working hypotheses used in human social science, there are multiple
everyday life, but not an all-inclusive ‘grand’ constructed realities that are determined
theory, beyond the context of human action according to the opinion of the person
and interaction (Glaser & Strauss 1967). experiencing the situation and the person
Grounded theory is also usually context- theorising. Constructivist grounded theorists
dependent and often substantive, where the view their research product (theory) as
resulting theory may be about seeking solutions representing one of multiple realities about what
to a problem (see Carlsson et al. in the ‘Research may be happening regarding human action and
in brief ’). interaction. The researchers’ theorising ‘lens’ is
113
shaped by factors such as culture, political explains that ethnography is not a particular data
ideology and moral stance. collection method, but a style of research with
While the variety of grounded theory versions the objective to understand the activities and
can be frustrating for someone planning a meanings of a social group.
grounded theory research project, this situation
does provide choice. To adapt methods is also
common (Glaser 1999). Lastly, it is also RESEARCH IN BRIEF
important to understand that, although grounded Bland (2007), using a critical ethnography,
theory research analyses mostly qualitative data, examined the concept of ‘comfort’ for New
quantitative ‘type’ data can also be collected and Zealand-based clients in residential aged care
analysed. Grounded theory is commonly viewed facilities. It required 90-days of fieldwork,
as the methodology that most closely bridges the interviews with 27 residents and 28 staff
‘paradigm gap/tension’ between quantitative and and extensive examination of facility
documentation. Bland found that residents
qualitative research (see Chapter 2).
could be ‘betwixt and between’ comfort
simultaneously, which contradicted the
5
constraints of an observed ‘one-size-fits-all’
Tutorial Trigger care delivery approach.
Referring back to tutorial trigger 1,
could you use a grounded theory
method to investigate your chosen Fundamental to ethnography is the concept of
clinical issue? Would you have to adjust your culture. It is known that different cultural groups
initial research question? (human societies) view relationships and
meanings differently. Culture then emerges from
knowledge learned and shared. Subsequently,
interactions and behaviours are interpreted and
understood by its members. Ethnography is
Points to ponder considered holistic in this sense, as it aims to
Some grounded theory research may not understand the behaviour of a group of people
fully construct a theory (as an explanatory within the context of their own culture. For
theme) but may offer conceptual ordering instance, Walsh’s (2006) study used ethnography
about human action and interaction
to study the intuitive ‘nesting’ and ‘matresence’
process.
behaviours of pregnant mothers, as the mothers
Grounded theory research may be
assessed the suitability of birth centres. They
conducted according to a variety of
philosophical perspectives about what can found that the environment invoked a nesting
be known concerning human action and response and a nurturing orientation of
interaction, and how it can be known. ‘becoming mother’ (matresence). This resulted in
Different approaches will provide different a common bond between mothers. This type of
outcomes for practice. understanding and outcome is achieved over
long periods of observation (see Chapter 7), the

gathering of many kinds of data and employing
ETHNOGRAPHY multiple methods and hypotheses to cover all
aspects of forming a picture of the social whole
Origins and theoretical (Fetterman 2000). This is to say that behaviours
underpinnings and events are studied in relation to other factors
The term ‘ethnography’ originates from the that may influence or generate the events and
Greek ‘ethnos’ (custom, culture, group) and the behaviours. One of the main strengths of
Latin ‘graphia’ (drawing, writing or description). ethnographic research is in the emic (insider
Therefore it is concerned with describing a reality/perspective) and etic (outsider reality/
custom, group or culture. Ethnography, as the perspective) interpretations of phenomena. An
descriptive study of cultures, has emerged as a ethnographic researcher may have access to both
sub-set of anthropological research (the study of perspectives, depending on their level of
humankind) over the years. Brewer (2000) involvement within the culture.
Practice,114
interactions during ward rounds occurred in a

RESEARCH IN BRIEF critical care unit because one of the researchers
Hunter et al.’s (2008) ethnographic study, was a staff member of the unit. While some
conducted in an Australian neonatal intensive studies require one site for research, there are
care unit, looked to observe how nurses studies that may require multiple sites. Liu
learned practices with and from each other et al.’s (2012, in press) study of medication
over a period of 12-months of observed communication between nurses and patients was
fieldwork. They found a variety of complex and
conducted in two separate medical wards of a
multi-layered forms of learning existed
between staff, with the main ones being
Melbourne metropolitan hospital. One ward
informal, incidental, interpersonal and contained longer-term patients with complex
interactive. In particular, they discovered that medical issues, while the other (a medical
the interactive and interpersonal modes of assessment ward) contained shorter-term patients
learning included codified and tacit due to be discharged within 48 hours. The
knowledge, as well as intuitive understanding intention was to compare different divergent
of ‘how we do things around here’. practices to maximise ‘transferability’ of the
findings.
Point to ponder Points to ponder

Ethnography allows in-depth inquiry of a In ethnography, substantial fieldwork is vital
phenomenon within its cultural context. for adequate sampling of people and
events over time.
The different types of data gathered in
ethnographic research help to provide the
Evidence-based practice tip richness in description and interpretation.
Nurses and midwives can conduct
ethnography to promote relationships,
understanding and collaboration with other
Evidence-based practice tip
healthcare professions to enhance teamwork
for the benefit of the patient. When conducting ethnographic research, the
researcher must be theoretically informed. This
is needed either to guide the study or to
recognise emerging theories for testing, as
The purpose and process well as to be able to build on existing theories
of ethnography related to the practice setting.
A central belief related to ethnographic process is
that individuals’ experiences are socially
6
organised. As such, the researcher examines these
experiences and then proceeds to explore how Tutorial Trigger
broader social relationships have shaped them. In Referring back again to tutorial
trigger 1, could you use an
order to do this, all ethnographers have to enter
ethnographic method to investigate
a research site to conduct their study, be it in a your chosen clinical issue? Would you have to
community setting or a hospital unit etc. The adjust your initial research question?
research setting is the ‘conceptual field’ and the
conduct of research in the field is known as
fieldwork. The selection of the field depends on
the research topic. In many nursing and OTHER ‘COMMON’
midwifery examples, the site is chosen on the
basis of convenience and/or familiarity. Manias QUALITATIVE METHODS
and Street’s (2001) study provides a typical The four most common methodologies described
example. Their research on nurse–doctor so far are all categorised in the interpretive
115
tradition of qualitative research (see Chapter 2). others who undertake nursing work. In
There are other less common research methods investigating more recent history, Biedermann
of note that are relevant to nursing and et al. (2001) used oral history interviews to
midwifery research. Two of these are categorised explore the wartime experiences of living
under the heading of ‘critical/emancipatory Australian Army nurses serving in the Vietnam
research’. The first, feminist research, is already War (1967–1971). While not directly impacting
covered in Chapter 2. The second, action on practice, the findings assist current knowledge
research, is covered in Chapter 14. One other, on what it is like for nurses working in war
also covered in Chapter 14, is the Delphi environments.
technique. In Chapter 14, however, the common With historical research, data are collected and
case is argued that ‘mixed method’ approaches, analysed from a variety of sources. With more
such as action research and Delphi, do not come recent history, this may be from interviews with
under the umbrella of just qualitative research, the living related to those who have died some
but are, in fact, part of a separate paradigm. time ago. This could be those directly involved
They are briefly mentioned here, however, in investigated events or from descendants/
because many nursing and midwifery researchers relatives of those passed on. More likely is that
do classify them ‘purely’ as qualitative. That the historical reference is from archived written
debate aside, this leaves one particular once- sources; that is, personal/official letters, diaries,
common qualitative methodology of note journals, reports, documents, meeting minutes,
(although others will argue that there are several and so forth. For instance, Meehan’s (2003)
more — but beyond the scope of this chapter): study of the Irish system of ‘careful nurses’ of the
that of historical research. nineteenth century included the study of letters,
biographies, diaries and British Crimean War
army correspondence. Other forms of historical
Historical research representations are from the visual arts and
Historical research has been used for many years might include paintings, drawings, cartoons and
by nursing and midwifery researchers. It has photographs. Mander and Marshall (2003) used
many uses and a number of different forms. historical analysis to study seven paintings (from
Historical research is most useful when 1550–1676) depicting dead babies, and compare
comparing social systems to see what is common them to recent photographs, noting similarities
across societies — and in the study of long-term in the way that they were viewed. They reported
societal change and connections between that, back at this time and perhaps through such
divergent social factors (Yuginovich 2000). For open representations, mothers and families
many, historical research simply provides the lens reacted better to such events.
by which the past can be viewed, both positive Most of the studies reported in this section
and negative, in relation to current and future are, ironically, some of the most up-to-date
events and cycles. It is known that nursing and examples. As with feminist research, historical
midwifery practice has long been influenced by research has recently fallen out of favour.
ongoing, repetitive trends, and that these trends However, it is still worth mentioning these
either change or repeat with each new generation approaches because, as with history itself,
(Kirby 2004). research ‘vogues’ often repeat themselves; out of
Most health professionals will appreciate why, favour one moment and in favour the next. For
at times, it is useful to look back at past events more current writing on historical research,
in our healthcare history. To do so provides a readers are more likely to find this in whole texts
form of reference where we can identify if we on the subject, such as Mason et al.’s (2011) text
have learnt and moved on from past mistakes, on the history of the nursing profession.
are in a position to re-learn or if it is appropriate
to repeat events of the past. In Madsen’s (2005) KEEPING UP WITH QUALITATIVE
historical analysis of twentieth century untrained
nursing staff in a district of Queensland, she DEVELOPMENTS
states that findings could influence current Different interpretations of using and combining
relationships between professional nurses and common and less common qualitative
Practice,116
approaches have emerged, as we look to integrate the findings from both quantitative and
investigate different clinical issues in different qualitative studies. There are many approaches to
ways. For instance, Schneider (2002) explored meta-synthesis and a review of meta-synthesis
models of care that women experienced during methods for qualitative research lists
their pregnancy. Two qualitative research approximately 10 methods (Barnett-Page &
approaches were incorporated in the same study; Thomas 2009), resulting in different terms
namely, grounded theory and a feminist associated with it, such as meta-summary.
phenomenological interviewing technique, Whatever the approach, researchers essentially
sometimes called phenomenological interviewing. follow a method where all qualitative studies that
This method refers to an interviewee-guided exist on a particular topic are searched and
investigation of a lived experience that asks reviewed and then matrices (tables) are used to
almost no prepared questions. In the study, compare studies and create a new interpretation
elements of three models of care were identified: of the collected data. Recent examples are those
a ‘medical/technocratic model’; ‘a midwifery of Duggleby et al.’s (2012) meta-synthesis of
model’; and a ‘feminist perspective model’. In hope in older adults with chronic illness and
some instances, there was blurring and Goethals et al.’s (2012) meta-synthesis of nurses’
overlapping of models. decision-making in cases of the physical restraint
Henderson (2005) set the scene for combining of patients.
the methodologies of dramaturgy,
ethnomethodology and ethnography. Bradbury-
Jones et al. (2009) explore the ‘congruence’ of SUMMARY
using focus groups in phenomenological studies,
and ask the question ‘is it “an oxymoron”?’ In turn, the common qualitative methodologies
Cutcliffe et al. (2006) presented a ‘modified’ of descriptive exploratory, phenomenology,
grounded theory study, while Perry et al. (2006) grounded theory and ethnography have been
apply a novel approach to feminist ethnography. explored in this chapter. Other less common,
However, it is worth bearing in mind that only but important, qualitative traditions are also
experienced researchers should take on discussed. Each is an important approach in its
developing novel approaches to studies, especially own right. Appreciation of them all will assist
when different methods and philosophies are the beginning researcher in deciding which
adopted. Novice researchers should also be method fits which research task best. Qualitative
warned about taking on novel approaches in research represents a historically important part
their studies that others have developed. It is of nursing and midwifery research. Its place in
generally safer to adopt established contemporary nursing research is assured and, if anything, is
approaches. stronger today than at any time previously. This
is especially so with the emergence of mixed-
methods research (see Chapter 14). Nursing
Qualitative meta-synthesis and midwifery have an interest in maintaining
Another relatively recent and still emerging this qualitative tradition, as the disciplines
phenomenon in qualitative research has been the look to gain the methodological advantage
often contentious development of qualitative that accompanies the building on and further
meta-synthesis. The term meta-synthesis is used to development of qualitative method, rigour,
distinguish this approach from quantitative scope and outcome. The following two
meta-analysis (see Chapter 3). Meta-synthesis chapters explore and describe method-specific
may be used just to integrate the findings of design processes as they apply to qualitative
qualitative studies alone or it may also be used to research.
117
KEY POINTS
• The four most common qualitative methods for nursing and midwifery research are
descriptive exploratory, phenomenology, grounded theory and ethnography.
• Qualitative research is by nature usually interpretive, emic, naturalistic and holistic.
• Qualitative methods aim to help us understand naturally occurring social phenomena
through exploring the attitudes, beliefs, meanings, values and experiences of the research
participants.
• Nurse and midwifery researchers and theorists are continually adapting and
recontextualising qualitative methods and techniques, as a means to explore new
phenomena in new ways.
Learning activities
1. Qualitative research’s main aim is to: 4. Husserlian phenomenology is associated
a) investigate issues that quantitative with:
research is unable to a) lebenswelt, epistemology, bracketing,
b) understand naturally occurring social descriptive phenomenology
phenomena b) lebenswelt, ontology, bracketing,
c) include participants in the research interpretive phenomenology
d) determine what patients think about c) dasein, epistemology, bracketing,
nurses. descriptive phenomenology
2. Qualitative research, by its nature, is d) dasein, ontology, bracketing, interpretive
usually: phenomenology.
a) deductive, emic, naturalistic and holistic 5. Heideggerian phenomenology is associated
with:
b) interpretive, etic, naturalistic and holistic
a) lebenswelt, epistemology, descriptive
c) interpretive, emic, naturalistic and
phenomenology
holistic
b) lebenswelt, ontology, interpretive
d) deductive, etic, naturalistic and holistic.
phenomenology
3. According to many, the main advantage of
c) dasein, epistemology, descriptive
qualitative descriptive exploratory
phenomenology
approaches to research is:
d) dasein, ontology, interpretive
a) they are easier to manage
phenomenology.
b) they don’t use complicated terminology

c) they do not limit the researcher to a
particular philosophical worldview
d) they can incorporate a variety of different
perspectives.
Practice,118
6. The hermeneutic circle describes: 8. Grounded theory originates from and has
a) the fact that life experiences go around been further developed by:
and around a) Strauss and Corbin
b) the fact that life cycles go around and b) Strauss and Chopin
around c) Glaser and Corbin
c) the historical, cultural and personal d) Glaser and Strauss.
preconceptions from which
9. Ethnography has its origins in:
understanding is developed
a) quantitative research
d) the process by which all life is
understood. b) feminist research
7. Grounded theory aims to: c) historical research
a) develop a well-rounded theory for use in d) anthropology.
later research 10. Ethnography typically includes:
b) develop theoretical explanation for a) the study of cultures, fieldwork, surveys,
socially constructed events and ideally insider/outsider reality
generate hypothesis for further research b) the study of cultures, fieldwork,
c) develop a rationale for linking qualitative observation, insider/outsider reality
findings to quantitative findings c) the study of individuals, fieldwork,
d) develop theoretical explanation for observation, insider/outsider reality
experimentally constructed events and d) the study of individuals, laboratory work,
ideally generate hypothesis for further observation, insider/outsider reality.
research.
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For further content associated with this chapter visit

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Practice,122
Chapter
7

Sampling data and data collection

in qualitative research
Violeta Lopez and Dean Whitehead
KEY TERMS LEARNING OUTCOMES

focus groups After reading this chapter, you should be
interviews able to:
observation • describe the rationale and processes
for conducting qualitative sampling
qualitative data collection
techniques
qualitative sampling • describe the main types of sampling in
questionnaires qualitative research and give examples

sampling criteria of research for each type
• explain the selection criteria in
qualitative sampling
• describe the different qualitative data
collection approaches and note
examples of research for each
approach
• discuss the benefits and limitations of
each of the qualitative data collection
approaches.
INTRODUCTION
A major part of the qualitative research process lies in determining and choosing an appropriate
population (sample) for the study so that data can then be collected from that population. With
qualitative research the population being studied is nearly always human, although there are
some exceptions that will be discussed in this chapter. A human individual is most commonly
referred to as a participant (sometimes ‘subject’) in qualitative research. A population sample is a
chosen subset usually representative of a wider population. In this chapter, both sampling and
data collection techniques used in qualitative research are the focus.
SAMPLING TECHNIQUES 1) convenience sampling

AND PROCEDURES IN 2) purposive sampling
QUALITATIVE RESEARCH 3) snowball sampling
The primary purpose of sampling is the selection 4) theoretical sampling.
of suitable populations (or ‘elements’) so that Convenience sampling
the focus of the study can be appropriately
researched. In qualitative research, effective This is the most common form of qualitative
sample selection process is very important sampling and occurs when people are invited
because inappropriate procedures may seriously to participate in the study because they are
affect the findings and outcomes of a study. conveniently (opportunistically) available with
There are a number of types of sampling regard to access, location, time and willingness.
procedures that can be adopted and the choice Convenience sampling is a relatively fast and
of qualitative research design will often guide easy way to achieve the sample size needed for
that process. the study. For example, Cubit and Lopez (2011)
used a convenience sample of 44 newly
graduated nurses who had previously practised
1
as Enrolled Nurses to explore their transition
Tutorial Trigger experiences. These nurses were invited to
You want to explore the experiences participate as the researchers were able to
of carers who care for relatives with produce a list of all newly graduated nurses from
cancer. What initial considerations the hospital where they had to complete their
might you need to identify for choosing an
one-year clinical rotation. However, the main
appropriate participant sample?

limitation of using convenience sampling is that
it could suffer from either under-representation
or over-representation of particular groups within
Types of sampling the population. It could also potentially be that
Sampling in qualitative research is non-probability the sample is unlikely to be representative of the
sampling. It is unlike probability sampling used population being studied and, therefore, limiting
in quantitative research where researchers recruit researchers’ ability to make generalisations of the
the population with characteristics that represent findings to a wider population (Creswell 2007).
a wider community. With non-probability Some would argue, however, that this is not
sampling in qualitative research the researchers always important in qualitative studies.
recruit only specific populations to investigate a
specific topic or when the total population is Purposive (purposeful) sampling
unknown or unavailable. There are four main This is also a commonly used sampling strategy,
types of non-probability sampling: in that participants are recruited according to
Practice,124
7 • Sampling data and data collection in qualitative research
pre-selected criteria relevant to a particular generation migrants), time periods (e.g. 3, 6,

research question. Sometimes referred to as 12 months) or context (e.g. hospital and/or
‘judgment sampling’, purposive sampling is community settings). For example, Holroyd
designed to provide information-rich cases for et al. (2011) conducted audio-taped interviews
in-depth study. This is because participants are (see later) to examine the postnatal practices of
those who have the required status or experience, two generations of Chinese women in Australia.
or are known to possess special knowledge to This provided different data related to the fact
provide the information researchers seek. For that the participants were first-time mothers
example, Elmir et al. (2010) used a purposive and their mothers. The study aimed to uncover
sample of four Australian women to investigate whether the Chinese cultural practice of ‘doing
their lived experience of recovering from breast the month’ was influenced by or had changed
cancer. The selection criteria included those from one generation to the next.
diagnosed with breast cancer that resulted in
breast surgery, under 50 years of age and able to Snowball sampling
converse in English. Although the sample size Also known as ‘chain referral’ or ‘networking’
of four participants might be regarded as small, sampling, snowball sampling occurs when the
in keeping with the aim of encouraging the researcher starts gathering information from one
detailed richness of women’s emotional or a few people and then relies on these people to
experience, the sample size was deliberately put the researcher in touch with others who may
kept small. be friends, relatives, colleagues or other significant
There are two other types of sampling that contacts. This type of sampling is especially useful
come under the umbrella of purposive sampling. where the sample is representative of marginalised
These are quota sampling and maximum variation or stigmatised individuals and to find and recruit
sampling. In quota sampling, the researcher ‘hidden populations’, where individuals are not
decides the number of participants and which easily accessible to researchers through other
characteristics they need to possess. The sampling strategies (Green & Thorogood 2009),
characteristics may be according to age, gender, such as drug-users, prostitutes, AIDS/HIV
profession, diagnosis, ethnicity and so forth. The sufferers, etc. As such, the potential participants
inclusion criteria (see later) allow the recruitment may normally be reluctant to come forward
of participants who would most likely experience without the reassurance of knowing someone
or have experience related to the research topic. who has already participated in the study.
It is different from purposive sampling because Sometimes though, research ethics committees
quota sampling is more specific with respect to may not grant permission for snowball sampling
sizes and proportions of the sub-samples for because of either privacy concerns, issues of
each prescribed quota. For example, Chan et al. consent or the potential for coercion. This is not
(2010) conducted a study to explore the always the case though, as with Hood et al.’s
perceptions of coronary heart disease (CHD) (2010) descriptive exploratory study of Western
among Hong Kong Chinese people. The study Australian midwives’ experiences of an external
targeted three sample groups according to their review (Douglas Inquiry) of obstetric services.
level of CHD risk factors: ‘low-risk public’, Snowball sampling was used to invite 16
‘multiple risk public’ and those with ‘confirmed Australian midwives to participate in tape-
diagnosis of myocardial infarction’ (MI). In this recorded interviews. Some limitations of snowball
study, the CHD risk factor is the focus of sampling are that the researcher needs to rely
interest in determining how people understand on referrals from initial contacts to generate
CHD, which is why a quota sample was used to additional participants. The participants,
seek an equal balance of people with low risk, therefore, are often not considered to be
multiple risk and those who had an MI. representative of the overall population being
Maximum phenomena variation sampling is studied.
sometimes used to ensure that the full range and
extent of the phenomena are represented. When Theoretical sampling
choosing this type of sampling, the focus could This form of sampling is mostly used in
be either on people (e.g. first, second and third grounded theory studies (see Chapter 6) but is
125
increasingly being used to gather data from sampling criteria. Sampling criteria identify the
participants for theory generation (see Chapter characteristics of the sample population and
2). In order to identify the similarities and their eligibility to be part of the study based on
differences amongst the selected cases, the pre-selected inclusion and exclusion
research starts from a homogeneous (small) requirements.
sample and moves to a heterogeneous (larger)
sample (Creswell 2007). It is sampling that Inclusion criteria
occurs sequentially and alongside data analysis. Inclusion criteria are specific characteristics that
This is when previously analysed data guides the person or population or elements must
what data needs to be collected next (see possess, such as a certain age range or gender.
Chapter 8). The first selected participants, For example, Jones et al. (2007) explored the
from whom initial data are collected, are usually training requirements of residential aged-care
purposively chosen or conveniently available. For personal carers needed in order to understand
example, Utriainen et al. (2009) used theoretical and respond to residents with dementia and
sampling in their grounded theory approach to mental illness. In the study, personal carers were
create a substantive theory of wellbeing at work those who carry out all front-line nursing care
among ageing hospital nurses in Northern tasks such as bathing, feeding, dressing, simple
Finland. The aim was to discover core processes wound management and organising residential
of the phenomenon based on nurses’ authentic aged-care plans. The inclusion criteria included
experiences. The 21 subjects of this study were all personal carers enrolled in Certificate III and
nurses working at a university hospital, aged Certificate IV in Aged-Care and all those who
45–55 years with at least 10 years of hospital worked primarily in aged-care facilities in
work experience and performing three shifts per Canberra, Australia.
week. The material consisted of first-phase open The chosen qualitative methodology will
interviews and diary entries and of second-phase ‘automatically’ determine inclusion criteria. For
interviews and open-data collection forms (see instance, participants in phenomenological
later). studies are mostly chosen because of their
experience of the phenomenon being studied
and because of their ability to express that
experience. In grounded theory, because samples
Point to ponder of events and incidents involving action or
The type of sampling chosen often depends interaction relevant to the research focus are
on its ability to maximise the opportunity for sought, participants must have been or are
producing enough ‘rich’ data to answer the currently involved in those events. With
chosen research question. ethnographic research, the researcher is in the
‘field’, observing and recording the events and
behaviours of participants, so the participants
2
have to already be in the observable location.
Tutorial Trigger
If you wanted to explore the Exclusion criteria
phenomenon of client-centred care,
which sampling technique would/
Exclusion criteria identify characteristics that
could you choose? deem a participant inappropriate for inclusion in
a study, such as any person who is cognitively-
impaired or where the conducted language of
the study is the participant’s second-language.
Sampling criteria These criteria may be stated in a study or they
In qualitative research, participants are viewed are implied as a ‘given’. For instance, studies
as capable individuals able to reflect upon and related to maternal care would not normally
clearly express their experiences, values, beliefs include males, unless the studies wanted to
and opinions. Different qualitative approaches explore expectant fathers’ roles or roles of
have varying sampling intentions regarding male health professionals involved in maternal
participants. The selection depends on the services.
Practice,126
range from as few as 4 to as many as 12. The

overall number could be higher, especially where
Point to ponder more than one group is needed for comparison
Whatever inclusion and exclusion criteria you between groups or in the case of program
use, you must always provide a rationale for evaluation research. Cheek et al.’s (2005) South
both the sample and the inclusion/exclusion Australian study, for instance, used 14 different
criteria.
stakeholder focus groups to investigate factors
that influenced the decisions of older people
3
living in independent units. Within the literature,
Tutorial Trigger
You intend to research the
decision on the number of focus groups is often
perceptions of patients in a compared to the method of analysis to be used. As
residential aged-care facility with such, sample size should refer to the number of
in-dwelling urinary catheters. What might you groups and not to the total of participants in the
decide in terms of inclusion/exclusion criteria? study (Carlsen & Glenton 2011). Small samples,
however, are far more manageable because of the
amount of potentially rich and detailed data that
Sample size in qualitative research can be generated from each single participant.
Unlike quantitative approaches which aim to
establish statistical significance by sampling a
predetermined number of subjects or elements, Point to ponder
qualitative researchers do not usually begin a Sample size in qualitative research should be
project with a predetermined sample size. In adequate to achieve data saturation, richness
qualitative research, there are no overall formal of data and not too large that it is difficult to
criteria for determining sample size and, undertake in-depth, meaningful analysis.
therefore, no rules to suggest when a sample size
is small or large enough for the study. Essentially, DATA COLLECTION IN
the ‘richness’ of data collected is far more
important than the number of participants QUALITATIVE RESEARCH
(Tuckett 2004). This said, the researcher still The process of data collection is directly related
requires insight to the size most likely to achieve to sampling and is best viewed as complementary
the purpose, context and the richness of the data to it. Data, therefore, are collected directly from
collected (Patton 2002). the identified and selected sample population.
Regarding the number of participants in Data collected from the sample can be either
qualitative studies, a common range is usually ‘direct data’ or ‘indirect data’. Direct data include
somewhere from 8 to 15 participants, but will recordable spoken or written words and also
vary widely both inside and outside this range. A observable body-language, actions and
number of qualitative methodologists, however, interactions. Here, the interactions may be
provide sample size guidelines for qualitative human-to-human or human responses to
research designs. Creswell (2007) recommends inanimate objects, such as a haemodialysis

3–5 participants for a case study, 10 for a machine. Whatever can be observed or
phenomenological study and 15–20 for grounded communicated are considered to be potential
theory study, whereas Morse (1995) suggests a or actual data. This will occur when considering
sample size ranging from six participants for a the thoughts, feelings, experiences, meaning of
phenomenological study and 30–50 for an experience, responses, actions, interactions,
ethnographic study. Rarely, quite a large number language and processes of individuals and groups
of participants may be involved. For example, within their social and/or cultural setting. It
Crowe et al.’s (2001) New Zealand-based is this type of data that sets the ‘context’ of
qualitative study accessed 131 community-based qualitative studies. Indirect data are generated,
client participants in order to evaluate consumer in the first instance, by someone or something
mental health service provision. With focus groups else, such as with documents or photographs
(group interviews — see later), Krueger and Casey reporting an event or an artistic rendition of an
(2009) suggest 5–10 participants but this can also event or experience (e.g. novels, songs, paintings,
127
poems, photographs). Turner (2005) used structured. With unstructured interviews, neither
photographs taken by Australian youth study the specific questions to be asked nor the range
participants to depict their interpretations and or type of possible answers are pre-determined.
experiences of hope. Direct data, though, are the The interviews are designed to be informal and
most common form in qualitative research. conversational with the aim of encouraging
Depending on the types of data required for a participants to express themselves in a naturally
qualitative study, various methods of collecting unfolding manner. Unstructured interviews tend
data can be used singularly or in combination to to start with single broad questions, such as
obtain direct data. For direct data, these methods ‘what is your experience of …’. The researcher,
may include interview, observation, open-ended however, has an idea in mind of the general
questionnaire, journalling (diary accounts) issues to be covered and may use a topic list as
or ‘think aloud’ sessions. Direct data can be a reminder. Turner (2005 p 510) described his
collected by the participant involved in a study unstructured interviews with Australian youths as
at the request of the researcher (e.g. through ‘a free-flowing conversation with a definite focal
writing a personal journal or diary) and then point’.
provided to the researcher. Most commonly, Semi-structured interviews have an interview
however, qualitative approaches acquire data guide providing a set of questions for discussion.
primarily through interpersonal contact with The questions are set to ensure the research
participants (usually an interview) or, secondly, questions or objectives are covered. However,
through the presence of the researcher in there is freedom to ask any questions in any
proximity to pertinent events (usually order, following tangents or seeking clarification
observation). This is unlike quantitative research of previous answers or elaboration of responses.
where, frequently, there is no interpersonal In other words, semi-structured interviews steer
contact with participants or events. Manias et al. the interview yet allow for flexibility. For
(2005) used both interview and observational example, Gagnon (2011) used semi-structured
techniques to gather qualitative data concerning interviews with 11 immigrant midwives in their
Australian nurses’ communication with health ethnographic study to learn the adaptations and
professionals when managing patients’ transformations that midwives, coming from
medications. Where indirect data need to be abroad into the Quebec healthcare system,
collected these are sought through a variety of needed to go through in order to integrate into
methods. These may include systematically practice. Using both unstructured and semi-
searching archives or browsing through the structured interviews, questions were non-
internet — with data collected being either in directed and mainly open-ended and were
hard copy or electronic form (see Chapter 3). designed to trigger and stimulate the participant
to talk about their adaptations.
Structured interviews in qualitative research
Interviews are not very common and follow a list of set
Interviews are regarded as the prime method for questions usually asked in a certain order, but
qualitative data collection; also representing the these questions are still open-ended; that is,
most common method for gathering qualitative usually commencing with words like ‘how’,
data in nursing-related research (Borbasi et al. ‘why’, ‘where’, ‘when’ etc. This distinguishes
2005). Spoken ‘narrative’ is the basis of most them from structured quantitative interviews
qualitative data, where that narrative is most which usually only ask closed-ended questions.
often gained through a direct encounter between
the researcher and participant (or several
4
participants) using in-depth interviews or focus
group interviews. Interviews can be conducted Tutorial Trigger
Prepare an interview schedule for
by telephone, email and, more recently, through investigating the experiences of
social media conversations (e.g. Twitter, clients who have an in-dwelling
Facebook). urinary catheter. What sort of questions might
Interviews in qualitative research may be you want to ask of your participants?
unstructured, semi-structured or occasionally
Practice,128
Conducting interviews however, the participant wishes to stop the
The structure and conduct of interviews are interview or the researcher senses that the
very important. A poor interview will produce participant is becoming too tired or distressed,
poor quality narrative data and poor outcomes then the interview can be stopped or paused
overall. Conducting interviews can be a at any time. This may mean setting up a new
complex and demanding skill that requires appointment for another occasion. It is, however,
attention to process. It is unwise to conduct preferable to resume as soon as possible so that
qualitative research interviews in terms of flow and recall of previous discussion is not lost.
‘learn as you go’. If unsure, many researchers It is recommended that no single interview last
perform ‘dry or dummy runs’ with peers and/or more than 1–2 hours as ‘interview fatigue’ is
colleagues as a form of piloting the interview likely to occur.
schedule.
Where novice or experienced researchers are
5
appropriately equipped to conduct interviews in
the clinical setting, certain prerequisites need to Tutorial Trigger
be in place. The ‘rules of engagement’ need to What might be the features of a
‘desirable’ environment for the
be established early on, such as establishing and
conduct of qualitative interviews?
maintaining a warm and non-judgmental
manner towards the participant/s, asking
questions in a balanced, unbiased, non-
threatening, sensitive and clear way, and During an interview, the interviewer’s presence
choosing a setting for the interview where it is and engagement (including how they listen and
most appropriate to ask personal questions. The attend to and end responses) is vital to the
majority of interviews conducted in qualitative process. It should be remembered that the
research are audio-recorded or, less commonly, purpose is to gain information from the
video-recorded. In Fenwick et al.’s (2005) study, participant — and not an opportunity for the
they completely tape-recorded telephone researcher to express their own thoughts and
interviews of a self-selected cohort of Western feelings. In a structured or semi-structured
Australian women who had experienced interview, an appropriate range of questions
childbirth. Annells (2006), however, chose are asked as listed on interview schedules. The
to video-record interviews for her Australian purpose of these question lists is to provide
hermeneutic phenomenology study on the clarity and assist the participant if hesitant or
experience of flatus incontinence by people with confused. Questions may also be used to prompt
bowel ostomies. Both of these formats have an expansion and elaboration if further detail is
advantage over handwritten notes because it required. An active listening position is adopted
is often impossible to record everything the by the researcher, concentrating on what is
interviewer hears or to observe everything that being said as well as being alert to other cues,
occurs in an interview situation. particularly non-verbal cues. During the
In the interview process, the participant needs interview, some researchers find it useful to
to be made to feel as comfortable as possible. It record (memoing) non-verbal aspects of the
is necessary to ensure privacy and comfort and interview. Another researcher may be invited to
ensure that all items required for the encounter take detailed notes (memos) during the course of
are available. This will likely include recording the interview. The notes are later used to guide
equipment, tapes, consent forms, participant the data collected from the audio/video-taped
information sheets, drinks and tissues. interviews. Alongside this, the interviewer may
Researchers should take active steps, such as well note and review their own thoughts and
posting ‘do not disturb’ signs and disabling feelings about the interview and any
telephone or pager devices. This will help to ‘extraordinary’ situations or events that arise. The
ensure that interruptions are avoided. memos may then assist later data analysis (see
Appropriate time should be allowed for each Chapter 8).
interview. Interviews should not be hurried or Qualitative interviews should allow the
stopped before they have naturally completed. If, interviewee to speak freely and offer in-depth
129
and lengthy responses through techniques used When conducting interviews it is also
singularly or in combination. Possible techniques important to consider the use of language,
include those in the following list. especially in cross-cultural settings. In qualitative
• Funnelling — beginning the interview with research where participants are not fluent in oral
general and broad (non-threatening) opening or written English language, it is important that
questions and then narrowing down to topic the interviewer is fluent not only in the language
specifics as the interview progresses. but is culturally understanding or representative
• Probing — eliciting further details or seeking of the participants and their environment. In
clarification. Price (2002) details an innovative multicultural societies, such as New Zealand and
probing technique called ‘laddered questions’. Australia, research is often conducted involving
This is where appropriate questions are asked participants from culturally and linguistically
in a series leading from the least intrusive diverse (CALD) backgrounds for the purpose of
questions to the most intrusive. This technique describing, understanding and clarifying their
identifies classifications of questions; questions cultural ‘worldview’. As such, research in a
about ‘actions’ are deemed to be the least multilingual environment poses methodological
invasive, through to questions about challenges (Liamputtong 2008). Appropriate
‘philosophy’ (feelings/values/beliefs) as the strategy for data collection, when another
most invasive. Story-telling, as another language is used during interviews, is to include
technique, involves asking questions in a language assistants (such as bilingual researchers
manner which encourages story-telling and or professional interpreters). In the Fernandez
more elaborate answers; for example, ‘Tell me and Wilson (2008) ‘research in brief ’ (see
about when you last experienced …’ earlier), one of the researchers is of Ngati Tahinga
• Paraphrasing — repeating what the participant descent and is also a Fellow of ‘Te Mata o te Tau’
has said, without changing the meaning of (Academy of Māori Research & Scholarship).
what has been said, assists understanding and Benefits of interviews
clarity and acts as a further prompt.
Interviews provide the researcher with a valuable
opportunity to enter the world of the participant
and reflect on a particular event. Rapport and
trust can be developed and are desirable to collect
RESEARCH IN BRIEF the extensive and detailed data that are needed.
Fernandez and Wilson (2008) examined the Interviews should develop as conversational
effectiveness of smoking cessation initiatives encounters that offer opportunities to clarify
for Māori in New Zealand. They conducted a issues, as well as probe for ever-deeper insight.
focus group interview, consisting of five Māori Interviews also offer unique data, where interview
women who had stopped smoking, to ask outcomes will never be the same between
what was more likely to influence Māori participants. When emotional and emotive issues
women to quit and the data were thematically
arise during the course of the interview session,
analysed (see Chapter 8). Two themes were

identified: (1) ‘transmission of Whanau’
the interviewer is able to offer appropriate
(immediate and extended family) with values support and referral to counselling if the need
that included the sub-categories ‘Whanau exists or arises. Overall, qualitative interviews
experiences’, ‘being mothers’ and ‘role potentially offer a productive, meaningful and
models’; and (2) ‘factors crucial in influencing supportive engagement that benefits both
change’ that included the sub-categories of researchers and participants.
‘choices and exercising own will’, ‘a positive
perception of self’ and ‘a Māori approach’. Limitations of interviews
The findings provide insight for nurses into Price (2002) identifies a range of challenges
Māori women’s insights that highlight the when it comes to interviewing, such as securing
importance of ‘Whanau’ and supportive
access, making sensitive records, managing power
relationships, and can be used to inform
strategies to assist Māori women in smoking
relationships, managing ‘space’, managing
cessation. communication and managing the sequence of
interviews. Interviews are not so much limited
Practice,130
by the techniques and methods used, but mostly interpreted in context. Sometimes group
by how these are applied by the researcher. ‘synergy’ or consensus (agreement) on issues
Ethically, interview schedules should be occurs, but this is not always the case.
challenged if there are questions which are If a series of focus groups are scheduled, initial
seemingly biased, leading, unbalanced, emotive, interviews usually identify broad issues and
imposing, coercive, manipulative or threatening. perspectives related to the focus of the study,
Therefore, the potential for an increased while subsequent interviews seek to prioritise
imbalance in the power relationship between and narrow down generated issues. In Fragar and
interviewer and interviewee should be avoided. Depczynski’s (2011) study of the challenges at
Even in research designs that are well executed, work for older nurses and allied health workers
some degree of power differential will always beyond 50 years of age in rural Australia,
exist in an interview situation. In order to communities were selected for focus group
minimise the imbalance in the power discussions based on size and geographical spread
relationship, it is important for the interviewer across the region of rural New South Wales. A
to explain why it is in the interest of the convenience sample of 80 older health workers
participants to answer the questions and remain attended six focus groups. One or two items
in control of the interview. A good interview is from each group were selected for further
a discussion rather than a question and answer discussion by the larger group to assist other
session. It is important to always treat the group members to contribute and/or debate on
participants with respect and politeness. the ideas that arose from each small focus group.
Interviews can be time-consuming and Such focus groups work because they include
resource-intensive to establish. Although in participants who are similar to each other.
qualitative research, estimation can be made Homogeny (consistency) was determined by
about how many interviews may be necessary to the purpose of the study and by the general
gather a complete set of data, this is not always inclusion criteria; that all were beyond 50 years
an exact science. Also, limiting data collection to of age, all were rurally located and all were
‘one-off ’ interviews with participants may lead health workers. From the methodological
to insufficient in-depth information. Another approach used, the results of this study provided
consideration is the interviewer, despite any ways to address concerns and avoid demands
effort to ‘bracket’ out their own experiences, being placed on older healthcare workers across
ideas, prejudices and opinions prior to the the rural health service.
interview, is always partly generating their
own internalised data. The resulting data will Benefits of focus group interviews
inevitably be partly influenced by the interviewer One of the main benefits of this method of data
whether this is through subtle body language or collection is that they are often less intimidating
the nature of questions asked. than individual interviews. The focus group
method allows access to participants who may
find individual interviews intimidating or
Focus group interviews inappropriate (Krueger & Casey 2009;

Focus groups are useful as they help to explore, Liamputtong 2010). They potentially offer
develop and refine initial research questions and supportive group interactions as each member
interview schedules. They can also be useful as is encouraged to identify, describe, analyse and
part of a developing evaluative framework to resolve issues (Morgan 1997; Krueger & Casey
assess client needs and the outcomes of such 2009). They are particularly useful in discovering
investigation (Banning 2005). Focus groups use new information or obtaining different
interview schedules but these differ in scope, perspectives on the same topic. Focus group
nature and intention from other research interviews are also useful in gaining participants’
interviews. This is because of the unique nature views, beliefs, values and perceptions on why
of group dynamics and insights gained from they think and feel the way they do (Litosseliti
interaction between participants. Focus groups 2007). Focus group interviews are usually more
offer a collective set of values, experiences and economical to conduct than individual
observations of participants that are later interviews.
131
Limitations of focus group interviews the daily life and behaviours of participants in
Focus groups may not explore issues as deeply as their natural setting to record aspects such as
one-on-one interviews. At the same time, as they social position and function, or actions and
are not as intimate and private as individual interactions. Qualitative observation is
interviews, they tend not to uncover sensitive or traditionally adopted by ethnographers (Borbasi
potentially embarrassing information. et al. 2005), but can be used in other qualitative
Researchers generally need quite high levels of approaches. This is especially so with studies
interviewing expertise to conduct focus group using an interpretive/constructivist approach (see
interviews. For instance, they require ‘gate- Chapter 2) where exploring observed events are
keeping’ skills to help avoid ‘group think’ often used to interpret and understand behaviour
outcomes, prevent any individuals from (Mulhall 2003).
dominating conversations as well as teasing In qualitative research, observation methods
contributions from quieter members. That said, are mostly unstructured. Sometimes, however,
where the focus group does not present any of qualitative observation may have some structure.
these dilemmas, the researchers should be mostly With unstructured observation, the researcher
anonymous — often only needing to contribute enters the ‘field’ with no predetermined schedule
to commence, prompt occasionally and finalise as to what they may or may not see or hear.
the session. Using this approach requires an ‘observation
protocol’ to record the same information
collected during observations by the data
collectors. For instance, observers in a ward
Point to ponder or clinic may focus observation on a certain
phenomenon of interest. Munyisia et al. (2011)
Focus groups are small, structured groups with
selected participants led by a moderator. undertook an observational study to see how
Focus groups are specialised groups in terms nursing staff spent their time performing clinical
of purpose, size, composition and procedures. activities in a 110-bed nursing home in
Interaction in focus groups is important with Australia. Their study required a team of trained
an element of flexibility and adaptability observers to use a predetermined classification of
designed to obtain the best results (Litosseliti activities in recording the specific activity being
2007).
undertaken at a particular time by nurses.
Some examples of the predetermined nursing
activities observed included ‘time spent in
RESEARCH IN BRIEF communication’, ‘medication management’,
‘direct care’, ‘indirect care’ and ‘documentation’.
Paulin (2010) investigated the understanding
A total of 6538 observations were recorded over
and experience of supervision by dietitians
in New Zealand. Twenty senior dietitians
5 days among 74 nursing staff.
participated in the study. Focus group
Process of observation
audio-taped interviews (four in each group)

were conducted in a conversational style using Methods of observation range across a
an interview guide to ensure all topics were continuum from participation to observation
covered. A research assistant was also present where four distinct roles of participation and
during the interview to take notes. The study observation can be identified. These being:
provided in-depth insight into the professional complete participant; participant-as-observer;
supervision practice of New Zealand dietitians observer-as-participant; and complete observer.
which was regarded as important to ensure These roles can also be adopted in quantitative
safe practice.
research and are further discussed in Chapter 11.
Differences in observer roles depend on the
degree of researcher involvement (intervention)
Observation or detachment (concealment) with participants
Observational methods are commonly used in (see Figure 7.1).
qualitative research designs and vary between With complete participation, the researcher
methods. Observation is the process of watching is an accepted and established member of the
Practice,132
Complete Participant Participant as Observer

• Researcher is immersed in group/community • Researcher steps into and out of groups/
(complete intervention) community (intervention)
• Research is usually concealed (covert) • Research is known (open)
Observer as Participant Complete Observer

• Researcher mainly observes but occasionally • Researcher does not participate
enters field (brief intervention) • Research is either known (open) or
• Research is known (open) concealed (covert)
Figure 7.1 Different roles of the observer in observational research
community (or group or sub-group) under These are classified as single, multiple and mobile.
observation. Complete participation gives the In single positioning the observer occupies one
researcher the best opportunity to observe location only. They are less likely to distract
behaviours as the researcher is part of the participants or be distracted. Multiple positioning
community. Most anthropological studies use allows the observer to move to different locations
this technique as the researcher is already a and view events from different angles/
member of the community or attempts to be perspectives. Mobile positioning is needed in
invited into and ultimately be accepted by the situations where the observer must follow
community. Often it is not known by the participants as they go about daily activities.
community that the participant observer is a Another method of conducting observational
researcher (a form of concealment) to avoid study is by the use of video-recording. Decisions
disruption of normal activity. In a participant- on how to record observational data depend on
as-observer role, the researcher is acting as both the focus of the research question and the
participant and observer with this openness analytical approached proposed. A main
allowing productive relationships to develop with advantage of this approach is that the researcher
other participants, and allows the researcher to has the ability to play the video over and over,
step in and out of the research environment aiding the data analysis process and reducing
when they think it is best. With observer-as- personal observational bias. This method can also
participant, the researcher’s role is made public be effectively used for intervention studies to
and the researcher is first an observer, with compare pre- and post-change in practice. For
participation a secondary role. The close relations example, Mjaaland et al. (2011) video-taped
of a complete participation role, however, are (using a still camera and extended microphones)
more difficult to establish in this role. As a 72 doctors’ encounters with their patients before
complete observer, a researcher is confined to and after a communication-skills training

observations only and offers no interaction with intervention. The focus of the study was to
participants. The research study itself may or observe if doctors responded to patients’ cues
may not be revealed. There are major ethical and concerns when they expressed negative
implications for not revealing to people that they emotions. The results showed that doctors
are being observed for research purposes and so tended to avoid supporting or exploring patients’
examples, not just in nursing and midwifery, are emotions. A further related method is the use
rare. Sometimes, it may be planned that of photographic observation which serves to
participants are informed instead after the illustrate aspects of activities that are not easily
research has finished. However, this is still described. Researchers could, for example, take a
usually not a compelling case for ethical approval series of 10 to 15 photographs of an activity and
to be given. then describe what they see so that an account
A further aspect of observation is in the of what is happening in the activity unfolds
‘positioning approach’ that the observer adopts. (Kawulich 2005).
133
Benefits of observation deceived (Kawulich 2005). Table 7.1 highlights

Mulhall (2003) suggests that observation has some of the overall benefits and limitations of
several advantages for qualitative research. the main qualitative data collection methods.
These being: ‘capturing data in more natural
circumstances’, ‘capturing the whole social
setting’ and ‘context of the environment in
which people function’, and ‘informing about RESEARCH IN BRIEF
influences of the immediate physical Walsh (2006) used a mixture of both observer-
environment’. Depending on the observation as-participant and complete observer
method used, there is opportunity to interact (depending on whether he was dealing with
with participants while gaining rich data and colleagues or clients), in his ethnographic
perspectives related to participants’ values and study of a free-standing birth centre. In the
experiences. Where the researcher is also a first instance, he would find himself informally
chatting to the women and families and
participant, observation allows them to reflect
making field tape-recordings. In the other
on and evaluate their own feelings about their instance (complete observer), as he was not
experiences in the field. In this case, researchers employed by the birth centre, he simply ‘hung
can choose to either ‘step back from’ or ‘be out there, shadowing the staff as they went
immersed in’ situations. about their daily work’ (pp 229–30).
Limitations of observation
If researching from an ‘objective’ stance, it is
6
necessary to be aware of Mulhall’s (2003) caution
that observation is more prone to ‘subjective’ Tutorial Trigger
Devise an observation schedule for
interpretation by the researcher than is usually
observing chronically ill children on a
the case with interview data. Field notes are paediatric ward. What type of
likely often written up following the observation observer/participant role/s would you employ?
event potentially adding to the subjectivity of What might you expect to observe?
data. However, neither of these issues would
be a primary concern if working within a
constructivist paradigm of research (see Chapter
2). For example, Manias and Street (2001) state Other types of data collection
in their study that researcher/participant Although most qualitative studies use interviews
subjectivity was an important and positive aspect or observations for the collection of data, other
of observation. Mulhall (2003) also points to the data collection methods are also applied —
incidence of the Hawthorne effect (reactivity) in either singularly or in relation to each other. For
observational research methods. This effect is a instance, qualitative research questionnaires can
well-known phenomenon whereby people who be used where a list of open-ended questions
know that they are being researched (particularly capture qualitative data. Journals can be written
when observed) tend to behave in different ways by participants about their experiences, decision-
than they would normally — either to please the making or whatever is the focus of the study,
researcher or to present themselves in a different with the journalling usually occurring soon after
and possibly more positive way (see Chapters 5 the event or the experience. A novel form of data
and 10 for a more detailed account of this collection is the ‘think-aloud’ technique. This is
phenomenon). To avoid participant ‘reactivity’ where participants record reflective thoughts,
altogether, a practical solution is concealment decision-making processes or impressions about
of the researcher’s role from start to finish (Li events and incidents into, for example, a hand-
2008). The disadvantages of this approach, held audio-recorder. This occurs in a study of
however, are that the researcher may lack patients where they are making self-management
objectivity, the group members may feel distrust decisions about their diabetes (Thorne &
when the identity of the researcher is revealed Paterson 2001).
and the ethics of the situation are questionable A long-established method of data collection
since the group members are essentially being is using a form of ‘systematic searching’ for
Practice,134
TABLE 7.1
Summary of benefits and limitations of main qualitative data collection methods
DATA COLLECTION
METHODS BENEFITS LIMITATIONS
Individual interview • Allows participants to express their own • Minimal control over the order
ideas in which the topics are covered
• Allows interviewer to be responsive to • Usually small sample size
individual differences and situational limited due to cost and time
circumstances
Focus group • Allows organised discussion structured in a • Researcher has less control
interview flexible way over the flow of discussion
• Provides opportunity for all to participate • Facilitating focus group
and give their opinions interviews requires
• Dominant and submissive participants can considerable skill
be directed and controlled • Difficult to distinguish between
• Discussion generated between participants individual view and group view
• Large quantity of information collected in • More difficult to organise and
a short amount of time order data for analysis
Involved observation • Allows researcher immersion and • Altered behaviours of
prolonged involvement with participants observed groups by the
• Encourages free and open conversation presence of the researcher
with the participants • Takes time to build trust with
participants
Detached • Reveals descriptions of behaviours by • Potential researcher bias in the
observation stepping outside the group design of a study
• Allows identification of recurring patterns • Sources or participants may
of behaviours that participants may be not be equally credible
unable to recognise or reveal themselves • Analysis of observation can be
biased
stored or displayed items of relevance (indirect of a national curriculum evaluation

data) that can later be analysed. The search may framework.
be for items of historical information (e.g. The systematic search process may also be
archival material, minutes of meetings, used for indirect data that present as a range of
biographies, personal and organisational diaries, literary and artistic media, including paintings,
letters and personal documents). For instance, literature and photography. In this case, some
Kirby (2004) used government reports and qualitative researchers also ask participants to
professional journals to investigate nursing create collages, take photographs or perform

recruitment crises in the 1930s and 1940s — to other artistic processes related to the research
compare how this impacted on the foundations focus of a study. For example, Turner (2005)
of nursing research from 1950 to the 1970s. investigated hope, from the perspective of 10
Such sources provide historical and contextual young Australian people, asking them to take
accounts either to back up observations and photographs that reflected their experiences and
interviews, or to provide data in its own right. interpretations of hope. Ureda et al. (2011) used
In the Chaboyer et al. (2004) benchmarking ‘story-mapping’ with their focus group
project, for embedding evidence-based practice participants to illustrate their decision-making
into a nursing curriculum, data were drawn processes for dealing with prostate cancer. The
directly from official university documents. story maps were illustrated visually by a local
Similarly, Leibbrandt et al. (2005) examined artist in colour and were found to increase
the curriculum documents of 26 Australian participants’ identification of the issues
universities to produce data for the formation surrounding prostate cancer. In addition,
135
a discussion guide was used to assist the focus used (Marshall 1996). However, this can be
group process of how and where, in their overcome when researchers ‘feel’ that they have
community, participants might learn about enough information at hand or, alternatively, the
screening for prostate cancer. emerging data becomes repetitive or uncovers
nothing new. If this is the case, then researchers
Using multiple data continue collecting data until data saturation,
redundancy of data or ‘theoretical saturation’ is
collection methods achieved (see Chapter 8). Saturation, therefore, is
More and more nurse and midwifery researchers not dependent on the amount of data collected
are conducting research using mixed-method/ but based on the richness of the emerging data
triangulation research (see Chapter 14). One set (Tuckett 2004; Guest et al. 2006). There is
form of methodological triangulation is where some controversy, though, as to whether it is
the researcher uses different methods for really possible to achieve true data ‘redundancy’
collecting data in the same study. For instance, or saturation, because further interviews always
Henderson (2003) details a grounded theory have the potential to uncover something new or
study where she uses interviews and participant unexpected (Wray et al. 2007). Therefore, the
observation to investigate power imbalances point at which this situation seems to occur will
between nurses and patients in Western vary with each study and cannot be predicted.
Australia. Ray and Street (2005) use interviews However, once the researcher is reasonably
and an original technique, called ‘ecomapping’, satisfied that this point has potentially been
to explore the dynamic nature of social networks achieved, data collection can then cease and the
of Australian motor-neurone disease sufferers. researcher can move on to the next stage in the
Ecomapping is a form of observational technique research process — data analysis.
that maps and tracks relationships, social
networks and support over time and offers a
visual schematic of identified connections.
Point to ponder
Close attention is needed when selecting data
RESEARCH IN BRIEF collection methods for a research study.
Williams and Irurita (2004) report their Without effective data collection strategies,
grounded theory study to investigate Western the collected data will be flawed — as will the
Australian patients’ perspectives of therapeutic findings and conclusions of the whole study.
and non-therapeutic interpersonal interactions.
Three types of data collection methods were
used. Forty patients were interviewed
individually; 78 hours of participant SUMMARY
observation field notes accompanied this and With qualitative research, sampling methods and
patient-related documentation was also methods of collecting data are a vital and closely
reviewed for data retrieval. ‘Emotional comfort’

related part of the study design (see Chapter 2).
and ‘emotional control’ emerged in the
findings as the main factors that either
A number of different options are available
prevented or promoted therapeutic which, in turn, will determine the nature and
relationships. Emotional comfort was found to approach of the research to be conducted. So, for
be related to ‘level of security’, ‘level of instance, different types of fields of observation
knowing’ and ‘level of personal value’. are linked with different types of ethnographical
studies. Careful attention to detail is required
with both sampling and data collection
WHEN HAVE ENOUGH DATA processes. Errors in either are likely to severely
affect overall study outcomes. The effectiveness
BEEN COLLECTED? of these processes greatly impacts on the next
Qualitative researchers often experience stage of qualitative design process, that of data
uncertainty when not being able to generalise analysis. Qualitative data analysis is the focus of
their findings due to the small sample sizes often the following chapter.
Practice,136
KEY POINTS
• Qualitative research uses a wide range of methods and techniques for both sampling from
the appropriate population and for collecting required data from the sample.
• The four main types of sampling used in qualitative research are convenience sampling,
purposive sampling, snowball sampling and theoretical sampling.
• Choosing a sample size and sampling scheme and collecting data from the chosen sample
should be an active process of reflection which is central to qualitative research.
• Qualitative research usually employs either/both interviews or observation to collect data
from sample populations. Each has both its strengths and limitations.
Learning activities
1. In sampling, the inclusion criteria indicate: 4. What is the most common method used
a) characteristics or properties of the chosen for collecting qualitative data:
sample that the researcher would not a) questionnaire
want them to possess b) interview
b) characteristics or properties of the chosen c) observation
sample that the researcher would most
d) survey.
want them to possess
5. When interviewing, starting off with simple
c) characteristics or properties of the sample
and broad questions to help ease the
that the researcher would find most
participant into the process is referred to as:
attractive
a) nurturing
d) characteristics or properties of the chosen
sample that the researcher would find b) channelling
least attractive. c) funnelling
2. Which group of participants below would d) easing.
represent a judgment sample: 6. Observational methods can employ which
a) all the people working in a hospital of the following approaches:
b) specialist nurses recommending other a) in-place participant; participant-as-
specialist nurses observer; observer-as-participant; and
c) specialist nurses working in intensive absolute observer
care b) complete participant; participant-as-
d) all inpatients in a hospital. observer; observer-as-participant; and
complete observer
3. When sampling methods are applied to
data already collected, this is called: c) absolute participant; participant-as-
observer; observer-as-participant; and
a) data sampling
in-place observer
b) information sampling
d) complete participant; in-place observer;
c) theoretical sampling in-place participant; and complete
d) non-theoretical sampling. observer.
137
7. Observation techniques are most commonly 9. A form of methodological triangulation

used in: applies when:
a) phenomenology a) participants are mixed up
b) grounded theory b) different methods for collecting data are
c) historical research employed in the same study
d) ethnography. c) different methods for collecting data are
employed in different studies
8. A qualitative researcher knows that it is not
useful to collect any further data: d) the data collection methods are mixed up.
a) when they sense that this is the case 10. The Hawthorne effect, in observational
research, is when:
b) when the participants say that they have
nothing more to say a) participants behave in different ways
than they would normally
c) when data saturation/redundancy of data
is reached b) participants are observed when the
research is concealed from them
d) when data overload is reached.
c) the researcher becomes totally integrated
into the community being researched
d) there is more than one observer and
observations are integrated for objectivity.
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Chapter

Common qualitative methods

KEY TERMS LEARNING OUTCOMES

phenomenology qualitative frameworks, theories and

WHY IS QUALITATIVE non-human (i.e. a specific drug or clinical

midwifery. Both professions share similar beliefs THE MAIN APPROACHES TO

appear to compensate against the claim that

approach that usually adopts common aspects of Evidence-based practice tip

understand the possibilities embedded in the

approaches. Because of the wide variations in Phenomenology, therefore, is mostly used to

Phenomenology was first a ‘general’ phenomenological research confusing. They

others — of a phenomenon in a particular moved philosophical discussion from the

challenged this. Gadamer (1976) wanted to

procedure of vitreo-retinal day surgery. They

with the intention of asking ‘How do people Chapter 8)

patients/clients. The 19 participants shared a core

an explanatory scheme that systematically revealed. Objectivist grounded theory aims to

long periods of observation (see Chapter 7), the

interactions during ward rounds occurred in a

Point to ponder Points to ponder

b) they don’t use complicated terminology

Additional resources References

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Sampling data and data collection

KEY TERMS LEARNING OUTCOMES

questionnaires qualitative research and give examples

SAMPLING TECHNIQUES 1) convenience sampling

appropriate participant sample?

pre-selected criteria relevant to a particular generation migrants), time periods (e.g. 3, 6,

range from as few as 4 to as many as 12. The

research designs. Creswell (2007) recommends inanimate objects, such as a haemodialysis

analysed (see Chapter 8). Two themes were

Focus group interviews inappropriate (Krueger & Casey 2009;

audio-taped interviews (four in each group)

Complete Participant Participant as Observer

Observer as Participant Complete Observer

Figure 7.1 Different roles of the observer in observational research

complete observer, a researcher is confined to and after a communication-skills training

Benefits of observation deceived (Kawulich 2005). Table 7.1 highlights

stored or displayed items of relevance (indirect of a national curriculum evaluation

professional journals to investigate nursing create collages, take photographs or perform

reviewed for data retrieval. ‘Emotional comfort’

7. Observation techniques are most commonly 9. A form of methodological triangulation

Additional resources Borbasi S, Jackson D, Wilkes L 2005 Fieldwork in

with litigation and the impact on clinical practice.

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