Qualitative Research Methods

Qualitative Research Overview

• Qualitative research has been used in behavioral sciences and applied more recently in health sciences.
• Qualitative research methods do not seek quantified answers like prevalence rates or odds ratios, but to understand social phenomena.
• Qualitative research aims to understand social phenomena in their natural settings without intervention.
• Qualitative research can help answer behavioral questions and characteristics of behaviors.
• Qualitative research seeks to explain social phenomenon, sample size, and type of sampling are not unduly concerned.
• Instead, purposive sampling is used.
• Patient expression is more important than age, gender, socioeconomic status or frequencies.

Types of Qualitative Research Methods

• Types include: case studies, interviews, observational techniques (surveys), focus group discussions and consensus methods or Delphi technique.
• A combined qualitative and quantitative approach is increasingly used in health.

Case Studies

• Case studies are used in behavioural and medical sciences.
• Case studies do in depth intensive study of one or a few cases as typical examples.
• Investigation may include characteristic individuals, families, communities, or institutions.
• Clinic based case studies also fall into this category.
• Case studies require comprehensive workups.
• Detailed investigation may be impossible in survey techniques.
• The biggest drawback is an inability to generalize findings.
• The method can be used to pinpoint data or hypotheses that can be tested with more encompassing methods.

Surveys

• Surveys are a basic research tool in communities.
• Surveys include: social, Gallup polls, utilization, health, and morbidity surveys.
• Surveys focus on groups or populations rather than individuals.
• Outcome analysis in a survey yields a sum total and does not reflect each individual's interest.
• A main benefit of surveys is that they provide a denominator allowing for comparisons - a factor not possible in case studies.
• The denominator is total units in a survey, and can be a population, # of males, # drug addicts, # students etc.
• Survey scope can vary, encompassing a few individuals to an entire population.

Basic Types of Health Sector Surveys

• Health Surveys: used to study and assess a population's health problems or detect health conditions.
• Morbidity Surveys: a specific survey dealing with only one element in the full range of possible components of a health survey. Focuses on disease states and their distribution in population groups.
• Utilization Surveys: Illustrate how many people are using services provided by specific facilities.

Uses of Surveys

• Surveys assess the magnitude of disease conditions or health related events within a specified area.
• Surveys guide in planning national, regional, or local health programs.
• Surveys evaluate control activities or national health programs.
• Surveys study community perceptions and attitudes regarding health and disease.
• Surveys evaluate utilization of healthcare facilities.
• Surveys provide data for planning/evaluation of community intervention and health educational activities.
• Surveys suggest/test hypotheses on health related events and disease conditions.

Survey Instruments

• Instruments can be grouped into two categories: data collection and diagnostic tools.
• Data collection instruments include: observation, focus group discussions (group interviews), interviews, questionnaires, schedules and projective techniques (used in psychiatry).
• Supplementary diagnostic instruments include: hemoglobinometer, microscope, ECG, and X-ray machines, etc.

Focus Group Discussions

• Focus groups capitalize on group interactions when responding to questions.
• The moderator asks people to comment on their experiences such as interpersonal relationships after becoming blind.
• A focus group is useful for exploring people’s knowledge and experiences, not only considering what they think, but also how and why they think that way.
• Focus groups can investigate the interactions of the members of the group to a question.
• A number of focus group discussions may be conducted for a problem.
• Each focus group should have 6-8 people who don't know each other, and it should last 1-1.5 hours.
• Group members should share similar characteristics like gender, age and social status.
• Analysis of focus groups is cumbersome and involves recording entire statements, including nonverbal communication.
• Focus group sessions are usually audio taped, then transcripts are analyzed for content

Delphi Technique

• This method is a consensus method.
• It determines how much experts/lay people agree/disagree on a topic.
• Is widely used in health research (technology assessment, education and training, priority setting and information).
• Enables a large, cheap way to contact experts using a self-administered questionnaire through mail.
• This process typically occurs over a number of "rounds".
• A knowledgable group expresses opinions and selects experts to participate in subsequent rounds during the first round.
• Comments are put into a questionnaire and experts rank comments from the first round during the second round.
• This information is then summarized and sent back to the experts to rethink their stance on the subject during the third round.
• Re-rankings are then analyzed; if there is no consensus, repeat rounds are done until consensus emerges.

Nominal Group Technique

• This is a consensus method, but unlike the Delphi technique, this method plans a highly structured meeting with 9-12 relevant experts, making decisions upon a specific topic of concern.
• Necessitates a great deal of groundwork, unlike the Delphi technique; this initial round may have little structuring.

Nominal Group Technique Steps

• Participants write down views about the topic.
• Each participant contributes one idea to the facilitator, who records it on a flip board.
• Similar suggestions are grouped.
• Group discussion clarifies and evaluates each idea.
• Each participant ranks each idea privately.
• The ranking is tabulated and presented.
• The overall ranking is discussed and reranked.
• The final rankings are tabulated and the results fed back to participants.