Qualitative Research in the Health Sciences

Methodologies, Methods and Processes

Bev Taylor, Karen Francis

• Publisher: Routledge
• Year: 2013
• ISBN:
  9781135039660
• Edition: 1
• Topic: Medicine
• Subtopic: Nursing

There is a growing interest in, and acceptance of, qualitative research approaches in the health science disciplines, both as standalone methodologies and integrated with quantitative designs in mixed methods approaches. This comprehensive text provides deeper knowledge and application of a wide range of methodologies, methods and processes, enabling readers to develop their qualitative research skills.

Divided into two parts, focusing first on methodologies and then on methods and processes, the text also includes revision of essential aspects of quantitative research as they apply to mixed methods research and a discussion of the uptake of qualitative research in the health sciences.

The methodologies covered include: Grounded Theory; Historical Research; Ethnography; Phenomenology; Narrative Inquiry; Case Study Research; Critical Ethnography; Action Research and Mixed Methods.

The methods and processes covered include: Interviewing and Analysis; Group Work and Analysis; Narrative Analysis; Discourse Analysis.

Using accessible language to help extend readers' practical research skills, this is a thorough and reliable text to guide advanced students and researchers from all health-related disciplines – including nursing, midwifery, public health and physiotherapy – to the best use of qualitative research.

Part I Methodologies

DOI: 10.4324/9780203777176-1

In the first chapter of Part I of this book, our initial task as authors is to refresh your memory of some fundamental ideas relating to qualitative research, by clarifying what we mean by methodologies, methods and processes. We imagine you are most probably reading this book to assist you in undertaking research in the health sciences after basic research and practice preparation, so you already know about research in general, and you will have an interest in generating research evidence for your practice. By way of introduction, this book begins with some statements about each of the aforementioned foundational areas, before discussing world views guiding approaches to research, including quantitative and qualitative approaches, and the integration of both in mixed methods research. Lastly, we review some ideas about postmodern influences on paradigmatic shifts in research, before flagging the methodologies from Chapter 2 onwards.

1 Introduction

Bev Taylor

DOI: 10.4324/9780203777176-2

Differentiating methodologies, methods and processes

Qualitative research invites you to inquire about the human condition, because it explores the meaning of human experiences and creates the possibilities of change through raised awareness and purposeful action. People communicate their meanings through language, so words and language are fundamental tools for creating and validating knowledge in qualitative research. As it is with any other focus of human interest, specific words denote the fundamental ideas, and in qualitative research you must be conversant with these words and what they mean, in order to communicate meaningfully with other researchers and the research participants. In order to discuss qualitative research and ‘do’ it well, it is important to be clear about the definitions of key terms, and at the outset of reading this book, it is very important for you to differentiate between qualitative methodologies, methods and processes and understand their interrelationships.

In qualitative research, methodologies are particular sets of theoretical assumptions, which underlie the choice of data collection and analysis methods and processes (Taylor, Kermode and Roberts, 2006). This means that qualitative interpretive methodologies, such as grounded theory, historical research, ethnography and phenomenology, and qualitative critical methodologies, such as action research, critical ethnography, discourse analysis and feminism, all have deep, broad theoretical bases on which they base their search for new or amended, valid knowledge.

The methods and processes you use in collecting and analysing data depend on your choice of methodology. Methods are what you do to collect and analyse data, and processes are how you go about doing them. For example, in the methodology of grounded theory there are some well validated step-by-step methods for collecting and analysing data (Glaser and Strauss, 1967; Strauss and Corbin, 1998). The processes of how you undertake grounded theory will fit with the methodological assumptions of grounded theory and the nature of your researcher/participant relationship, so your inductive approach may include inviting participants to share their experiences of an area in which little is known, through an exploratory data collection method, such as an interview, and of being aware constantly of how to undertake the grounded theory project authentically from the start to the finish.

The research methods and processes merge into a meshwork of what you are doing and how you are doing it, for example, in the grounded theory method of analysis of the first transcribed interview you will search for codes and when you are clear about the contributions of the first participant’s account of the research area, you may need to extend the questions in the subsequent interview, and so on, to increase theoretical sampling until data are saturated, the codes fit into categories, and the integrated constructs lead to a grounded theory of the research area of inquiry. Therefore, the integrated grounded theory methods and processes involve having a sense of being on a mission of discovery, continually enacting the agreed ethical safeguards for and with participants, while following a systematic inductive approach, being open to what emerges, using memoing, conceptual diagrams and literature to extend your thinking, recognizing when no further codes are emerging in the data, and integrating the categories into meaningful theoretical statements. The methods and processes for other methodologies will vary according to the methodological assumptions of the specific approach and be in accord with your research aims, objectives and questions.

Differentiating the meaning of words is important, because basic problems arise by being unclear about terminology, which grow into major epistemological misunderstandings and debates, simply because words are used without due care, resulting in a lack of shared meaning. For example, the claims for the balanced, integrated innovation and benefits of mixed methods research are based to some extent on the complementarity of quantitative and qualitative methodologies (Tashakkori and Teddlie, 2010), when what is actually done is an adoption of an implicit postpositivistic orientation about mixed methods (Giddings and Williams, 2006; Hesse-Biber and Leavy, 2010).

Research after basic preparation

Increasingly, health sciences professionals are embracing qualitative research methodologies, methods and processes (Bhavnani and Fisher, 2010; Bower and Scambler, 2007; Égalité, Özdemir, and Godard, 2007; McKeown, Clarke, Ingleton, and Repper, 2010; Miller et al., 2008; Shaw, 2003; Skeat and Perry, 2008; Stein and Mankowski, 2004; Swift and Tischler, 2010). This book is geared towards people engaged in the health sciences and healthcare professionals, who have moved beyond their undergraduate research training, to postgraduate levels, although this book can be of help to anyone who takes the time and makes the effort to grapple with its ideas. As the book’s authors, our intention is to engage you in epistemological conversations, which will help you to review your ideas about the ‘big stories’ that make up the pedagogy of qualitative methodologies, methods and processes. Our conversations will be facilitated through the tone and content of our writing and your willingness to engage in critical thinking about the ideas we put forward in exercises as ‘food for thought’.

Qualitative research has moved into and beyond postmodernism, so as this book’s authors we acknowledge that our writing puts us firmly into the role of agents of authority, but in the role of a reader, you have the freedom to mediate on our writing and decide for yourself the extent to which you take on the ideas. We are aware that multiple interpretations can be made about each and every methodology, method and process, so our intention as authors is to provide a practical way through the conceptual maze of qualitative research, so you can build your own ideas and make adaptations as you see fit. Therefore, two principles with which we align and apply throughout this book to qualitative research, are the need for epistemological congruency, and the need for some relatively stable conceptual structures.

The need for epistemological congruency

Congruency connotes links, connections, continuities, consistencies, coherence, cohesiveness and comprehensibility. In relation to qualitative research, congruency means linking and connecting ideas, so that there is a discernible flow and fit between the ideas arising from the entire research inquiry, from the questions, aims and objectives, right through to the data collection and analysis methods and processes, and the eventual research insights and implications, that show the application and progression of ideas ‘faithful’ to the foundational ideas of a respective methodology.

The faithfulness in congruency is akin to ‘being true to the spirit or nature’ of a particular methodology’s basic ideas. For example, congruency is discernible in an ethnographic research project when the chosen methods and processes of data collection and analysis reflect knowledge about the habits, rituals, patterns, symbols and shared understandings of a particular culture or subculture, so you would expect to see the people who comprise the culture being described in their context. An ethnographic researcher looks closely as an interested and focused observer, at a group of people in their context, to generate, validate and report rich descriptions of their ways of being, which tell us more than we knew or understood previously about that group of people. The ethnographic research report becomes more comprehensible and ‘believable’ when it is found to be in tune with the basic assumptions of the anchoring ethnographic ideas.

In this postmodern era of extremely relative representations of knowledge, it may seem strange for us as authors to appeal to readers to be mindful of the need for congruency in qualitative research, but we recognize, and hold to the need to fulfil, some criteria for a project’s trustworthiness. If there is no sign of congruency in a qualitative project, how can a reader discern if a study can be ‘trusted’? If there is no flow, fit or match between a qualitative project’s aims, objectives, methodological assumptions, methods and processes, and the new or amended insights it generates, what is it but a jumble of incoherent ideas with no purpose, direction or useful end point? Without congruency, a qualitative project’s transitions and multiple end points may be interesting and poetic reading, but how can we know that the research is worthwhile for advancing the human-focused interests of the health sciences, and indeed, that it is not a hoax or ‘fashionable nonsense’ (Sokal, Bricmont, and Dawkins, 1998)?

Postmodern theorists have been criticized for creating an absurd philosophy through ‘a pistache of Left-wing cant, fawning references, grandiose quotations, and outright nonsense’ (Sokal, 1996, p. 217). In a well-publicized publication hoax, a New York University physics professor tricked the editors of Social Text, an influential academic journal of cultural studies, into publishing an article pretending to compare the similarities between quantum gravitational theory and postmodern philosophy. Sokal (1996) used the most fashionable postmodern terms and the ‘silliest quotations’ by postmodern academics that he could locate about mathematics and physics, to invent a position on ‘Transgressing the boundaries: Towards a transformative hermeneutics of quantum gravity’. Based on Sokal’s reputation in physics and his ability to write obscure pseudo-postmodern arguments with academic authority, the journal’s editor published the article without peer review. The exposure of the hoax by Sokal soon after, resulted in highly publicized academic and public quarrels internationally, about the scholarly merit of the journal, the right of authors to publish cross-disciplinary critiques, and the academic ethics of the matter.

To further advance his concerns about postmodern theorists’ tendencies to misrepresent t...