B. Dierckx de Casterlé Academic Center of Nursing and Midwifery Department of Public Health & Primary Care 1
“Qualitative research involves any research that uses data that do not indicate ordinal values” (Nkwi, Nyamongo & Ryan, 2001) Functional & outcome based Type of data as determining factor 2
“Qualitative researchers are interested in understanding the meaning people have constructed, that is, how people make sense of their world and the experiences they have in the world.” (Merriam, 2009) Research purpose & focus ‘Finding & understanding of meaning and sense’ 3
“ Investigation of phenomena, typically in an indepth and holistic fashion, through collection of rich narrative materials using a flexible research design” (Polit & Beck, 2004) “ Covers complex (social) phenomena, studied in their natural setting, and useful for understanding the processes that are at play in a situation.” (Morse, 1997) Subject, aim, design, data collection, … 4
Qualitative research as umbrella concept Description in comparison with quantitative research ◦ Empirical nature and specific characteristics subject, aims or research questions paradigm design data collection method & sampling data analysis outcome In line with quantitative approach Risk of polarisation of qualitative-quantitative debate 5
When do we need a qualitative design? Subjects explored in qualitative studies? Specific aims & research questions? What is the role of nurses in the care for patients requesting euthanasia? 6
What is the role of nurses in the care for patients requesting euthanasia? How many involved? How often they perform euthanasia? What exactly doing? .... “measure & count” 7
What is the role of nurses in the care for patients requesting euthanasia? Understanding the caring process How nurses experience being involved? How nurse manage the process and deal with ethical challenges? How nurses experience their responsability? Which dynamics impede/facilitate the process? … 8
Aim to gather an in-depth understanding of human behavior / social phenomena behavior, experiences, interactions, social processes, practices, … How and why questions ◦ Rich, narrative data (words, images, experiences, stories) subjective richness to understand complex issues ◦ Focus on daily reality / social environment of respondents (where they live, experience, interact, give meaning to …) to understand social phenomena as the occur spontaneously in their own natural environment 9
Lived experience of older people living with early- stage dementia? How do care providers experience lack of time and its impact on care? How do nurses reason and behave in cases of physical restraint in acute elderly care? How do employers experience their role and responsibility regarding the employee’s return to work after breast cancer treatment? “Subjective reality” Use of the experienced reality to understand complex phenomena how to develop knowledge based on ‘subjective reality’? 10
Well established framework a specific group of researchers use in their research Views, assumptions, concepts, values, and practices about the nature of reality and knowledge development o What reality is, what & how to investigate, how knowledge can be developed, what is the value of evidence, … Shared by a scientific community and guiding the community in the way they do research Different ideas bout reality & knowledge development in qualitative & quantitative approaches different paradigms http://www.thefreedictionary.com/paradigm; http://www.qualres.org/HomePhil-3514.html 11
Aims at mapping the objective, mathematic reality o by focusing on events, causal relations o testing hypotheses, controlling and predicting Aims at a large, horizontal perspective on the research phenomenon o by questioning a lot of persons in a uniform manner o using a clear and structured questionnair or measure o ethic perspective (imposed structure/frame based on literature & previous research) “Positivist paradigm” (www.qualres.org, www.celt.mmu.ac.uk, www.academia.edu) 12
Reality exists (world/phenomena = objective reality) ◦ basically ordered & regular ◦ have causes and effects ◦ exist outside the knowledge of an individual (reality out there ) > creation of the human mind (e.g. cerebrovascular accident) ◦ can be learned, tested & verified through scientific means Focus on objectivity; understanding of the underlying causes of phenomena ◦ researcher independent from those/what being researched ◦ use of orderly, disciplined procedures (control research situation) ◦ test & verify information & experiences to gain confidence (Polit & Beck, 2017; www.qualres.org, www.celt.mmu.ac.uk, www.academia.edu) 13
Understanding & interpreting the subjective reality (meaning giving process) ◦ Discovering the meaning persons give to their experiences & situation ◦ Discovering the underlying social processes and interactions explaining behavior/phenomena Focusses on an indepth, vertical view in order to understand the phenomenon in its complexity Emic perspective: focus on respondents, looking for structure in the respondents’ experiences “Interpretivist/constructivist paradigm” 14
Reality is not a fixed entity but a construction of the participants ◦ Reality depends on the meaning given by the persons to their experiences or situation (context-bounded) ◦ Reality is constructed through experiences and relationships ◦ No ultimate truth Persons studied as human beings who to a large extent construct their world through meaning giving and meaning experiences Basic idea: the way persons react and behave mainly can be explained in terms of the meaning persons give at their daily life, their situations, … 15
Try to understand/interpret this subjective reality ◦ Listening to or observing this subjective reality Subjective interactions = primary way to access them Voices & interpretations of research participants crucial to obtain a more informed and sophisticated understanding ◦ Looking for patterns, structure & commonalities Interpretative process Findings = product of interactions researcher – participants 16
Bottom up approach http://research-methodology.net/ 17
Top down approach http://research-methodology.net/ 18
1. Focus on the natural environment ◦ Social processes explored from the respondents’ living world ◦ Taking into account the rich context of respondents’ life 2. Focus on a ‘holistic’ understanding of the phenomenon ◦ Allowing to approach the research phenomenon in a systematic, comprehensive and integrated way 19
3. Open & flexible design (emergent) ◦ Requiring ‘open’ mind of researcher ◦ Allowing to adapt the research process to specific context Continuous interaction between research and context Not everything can be planned/ anticipated in advance 4. Continuous interaction between data collection and data analysis Data collection and data analysis occurs ◦ simultaneously and in interaction 20
1. Focus on the natural environment 2. Focus on a ‘holistic’ understanding of the context 3. Open & flexible design (emergent) 4. Continuous interaction between data collection and data analysis High explorative power 21
In general: data collected using interviews/observations o Focus on the respondents’ perspectives, the way they give meaning to their life, their experiences o Respondents are invited and stimulated to tell in detail about their experiences or will be observed in their natural setting Open and flexible ◦ Room for unexpected events ◦ Guided by the data analysis Often mix of methods (individual/focus interviews, observation, analysis of document) data from multiple perspectives Often requires intense/sustained contact with respon- dents in their environment (rich & nuanced information) 22
To discover and understand meanings in the specific context (indepth vertical view) Purposively selected sample large, random sampling (generalisability) ◦ Looking for a mix of cases/participants/ perspectives to obtain rich and nuanced information ◦ Variation allowing to get an overall insight in the complex process ◦ Sample size determined by principle of saturation Point where a sense of closure is attaint because new data/interviews do not result in new information (redundant information) Quality > quantity of the participants 23
How would you describe this statue? 24
• The descriptions will vary (according to the persons’ perspectives) but they all refer to the same object • Every description • is unique & ‘true’ • interesting peace of puzzle to get an understanding of the whole 25
Nurses’ involvement in euthanasia Understanding through exploration of nurses’ experiences Requires a variety of perspectives 26
Man, neutral hospital, pro euthanasia, 10 years experiences palliative care, Involved in 8 euthansia cases… Nurses’ involvement ‘Respecting patient’s request’ as main focus Absolutely certainty about request Ensure all procedural steps are taken Protocol as checklist 27
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