4.3 Qualitative Research Methodologies
Phenomenology is a research approach that seeks to understand the essence of a particular phenomenon through a detailed exploration of individual experiences. It is especially beneficial for exploring personal experiences such as emotions, perceptions, and awareness. As a budding qualitative researcher, it is imperative that you understand the different qualitative methods to enable you to choose the appropriate methods for your research question. In this chapter, we aim to discuss the most common qualitative methodologies which include descriptive, phenomenology, narrative inquiry, case study, ethnography, action research and grounded theory (Figure 4.2).
Descriptive: A descriptive qualitative study attempts to systematically describe a situation, problem, phenomenon, service or programme. It focuses on discovering the who, what, and where of events or experiences and gaining insights from informants regarding a poorly understood phenomenon.12 It is also used when more information is required to aid the development and refinement of questionnaires in research projects aiming to gain firsthand knowledge of patients’, relatives’ or professionals’ experiences with a particular topic.13 This is a good choice for beginner qualitative researchers doing exploratory studies. It uses purposive or convenience sampling, with in-depth interviews as the most common data collection method.14 Data analysis for this type of qualitative research focuses on a rich descriptive summary of the characteristics (themes) of the phenomena with some interpretation.14 An example is the study by Cao et al. 2022 that explored the state of education regarding end-of-life care from the perspectives of undergraduate nurses. The findings showed that the undergraduate curriculum related to end-of-life care was disjointed and cultural attitudes toward disease and death impede the undergraduate nurses’ learning and knowledge translation of end-of-life care.15
Phenomenology is also commonly used in qualitative research, and it is a research approach that seeks to understand the essence of a particular phenomenon through a detailed exploration of individual experiences. It is especially beneficial for exploring personal experiences such as emotions, perceptions, and awareness.that is especially beneficial for exploring personal experiences such as emotions, perceptions, and awareness.16 It involves in-depth conversations on a specific topic, captures the relationships between people, things, events and situations and describes and explains phenomena from the perspective of those who have experienced it.17 It explores the dimensions of participants’ experiences.18 It seeks to understand problems, ideas, and situations in terms of shared understandings and experiences rather than differences.19 Phenomenological research often employs in-depth, unstructured or semi-structured interviews as a means of data collection.20 Data analysis typically involves identifying the essential structure or meaning of the experience being studied and then describing it in a way that is understandable to others. The researcher uses a process called the transcendental-phenomenological reduction to bracket off or set aside any preconceived notions of the phenomenon being studied.21 In this method, researchers use theme analysis to focus on the attributed meaning of participants’ lived experiences rather than influencing findings with their own beliefs.21 This process allows the researcher to gain a deeper understanding of the phenomenon’s essence as it is lived and experienced by participants.21 For example, Liao et al. 2021 conducted a study exploring what medical learners experience through narrative medicine and the meanings they ascribe to narrative-based learning. The study identified six themes: feeling hesitation, seeking guidance, shifting roles in narratives, questioning relationships, experiencing transformation, and requesting a safe learning environment.22
Narrative inquiry: Narrative inquiry is qualitative research that seeks to understand how individuals make meaning of their lives and the world around them through studying their stories and experiences.23 This qualitative research focuses on marginalised populations, usually individuals or small groups and aims to give voice to their perspective.24 This approach helps people learn more about the participants’ culture, historical experiences, identity, and lifestyle and is often recorded as a biography, life history, artifacts or traditional story.25 It captures a wealth of story data, including emotions, beliefs, images, and insights about time. It also considers the relationship between personal experience and the wider social and cultural context.24 Importantly, it also involves joint investigation and joint meaning-building between participants and researchers.26 A major benefit of narrative inquiry is that it involves storytelling, and because humans are natural storytellers, the approach makes it easy to elicit stories.24 Additionally, it facilitates the creation and construction of data through narratives of lived experience and fosters meaning formation, thus providing valuable insight into the complexities of human life, culture, and behavior.11 This makes it possible to gather in-depth meaning as participants usually reveal themselves in their stories.27 Narrative inquiry entails collecting data in the form of stories or narratives through interviews, written or visual materials, or other kinds of self-expression.24 Data analysis in narrative inquiry involves identifying the themes, patterns, and meaning of the stories under consideration and understanding how the stories are formed and related to the individual’s experiences and perspective.24 An example is the study by Gordon et al. 2015 which explored medical trainees’ experiences of leadership and followership in the interprofessional healthcare workplace.28 The findings showed that participants most often narrated experiences from the position of follower.28 Their narratives illustrated many factors that facilitate or inhibit the development of leadership identities.28 Traditional medical and interprofessional hierarchies persist within the healthcare workplace, and wider healthcare systems can act as barriers to distributed leadership practices.28
Case Study aids holistic exploration of a phenomenon. It provides powerful stories within social contexts through various data sources. It undertakes the exploration through various lenses to capture continuity and change and reveal multiple facets of the phenomenon.29 It is an explanatory, descriptive or exploratory analysis of a single case example of a phenomenon. Case study aids researchers in giving a holistic, detailed account of a single case (or more) as it occurs in its real-life context.30 The purpose of a case study is to understand complex phenomena and to explore new research questions in a real-world setting.29 There are three main types of qualitative case study design: intrinsic case study, instrumental case study and collective case study.31 An intrinsic case study is often conducted to learn about a one-of-a-kind phenomenon.31 This type of case study focuses on a single case or a small number of cases and explores a specific phenomenon or issue in depth.30,31 The researcher needs to define the phenomenon’s distinctiveness, which separates it from all others. In contrast, the instrumental case study employs a specific instance (some of which may be superior to others) to acquire a more extensive understanding of an issue or phenomenon.30,31 An instrumental case study uses a single case or a small number of cases to explore a broader research question or problem.31 The collective case study researches numerous instances concurrently or sequentially to obtain a more comprehensive understanding of a specific subject.30,31 This type of case study analyses multiple cases to understand a phenomenon or issue from different perspectives.31 The data collection techniques used in a case study include interviews, observations, or written or visual materials. Data can be collected from various sources, including the case, documents or records, and other relevant individuals. In a case study, data analysis is often inductive, which means that the researcher begins with the data and generates themes, patterns, or insights from it. To examine the data, the researcher may employ a range of approaches, such as coding, memoing, or content analysis. An example of a case study is the study by Lemmen et al. 2021, which aimed to provide insight into how adopting positive health (PH) in a general practice affects primary care professionals’ (PCP) job satisfaction.32 The findings of the study identified three themes regarding PCPs’ adoption of PH and job satisfaction, namely adopting and adapting Positive Health, giving substance to Positive Health in practice, and changing financial and organisational structures.32 Thus, the PCPs adopted PH, which supported PCPs to express, legitimise, and promote their distinctive approach to care work and its value.32 PH also enabled PCPs to change their financial and organisational structures, freeing time to spend on patients and their own well-being. The changes made by the practice increased the job satisfaction of the PCPs.32
Ethnography is the study of culture and entails the observation of details of everyday life as they naturally unfold in the real world. It is commonly used in anthropological research focusing on the community 33. It generally involves researchers directly observing a participant’s natural environment over time.33 A key feature of ethnography is the fact that natural settings, unadapted for the researchers’ interests, are used. In ethnography, the natural setting or environment is as important as the participants, and such methods have the advantage of explicitly acknowledging that, in the real world, environmental constraints and context influence behaviours and outcomes.34 Ethnography focuses on the lived culture of a group of people, that is, the knowledge they use to generate and interpret social behaviour.35 Ethnography often involves a small number of cases or a community, ethnic or social groups. The researcher enters the lived experience of participants in the field and spends considerable time with them to understand their way of life. This research approach increases the strength of the data.35 An example of ethnographic research is the study by Hinder and Greenhalgh, 2012. The study sought to produce a richer understanding of how people live with diabetes and why self-management is challenging for some. The study revealed that self-management involved both practical and cognitive tasks (e.g. self-monitoring, menu planning, medication adjustment) and socio-emotional ones (e.g. coping with illness, managing relatives’ input, negotiating access to services or resources).36 Self-management was hard work and was enabled or constrained by economic, material and socio-cultural conditions within the family, workplace and community.36 Although this study is old, it provides insight into some of the challenges associated with diabetes.36 While more devices have helped with diabetes in recent years, some of these challenges may still exist.
Action Research involves a cyclical process of planning, action, observation, and reflection to improve practice or address a problem. It attempts to understand and improve the world via change.37 The goal of action research is to generate new knowledge and understanding about a specific issue while at the same time taking action to improve the situation.37 Action research is guided by the desire to take action, so it is not a design. A type of action research is participatory action research.38 At its core, this is a collaborative, self-reflective enquiry undertaken by researchers and participants to understand and improve upon the practices in which they participate and the situations in which they find themselves.38 The goal is for the participant to be an equal partner with the researcher.39 The reflective process is inextricably tied to action, impacted by knowledge of history, culture, and the local context, and is rooted in social connections.38 It is an inquiry process used to understand and improve complex social systems, such as organisations, communities, or classrooms.40 Participatory action research draws on qualitative methods such as interviews and observation to inquire about ways to improve the quality of practice.41 The study by Doherty and O’Brien, 2021 explored midwives’ understandings of burnout, professionally and personally, in the context of contemporary maternity care in Ireland.42 Multiple factors influenced midwives’ views and understandings of burnout. PAR provided a platform for midwives to examine their ideas and views on burnout with the collaborative support of their midwifery colleagues, via cycles of action and reflection, which is necessary to develop and maintain change. Midwives characterised burnout as continuous stress and tiredness, with an accompanying decline in their coping capacities, motivation, empathy, and/or efficacy. Burnout is unique to the person and is primarily induced and irrevocably tied to excessive workload in midwifery.42
Grounded theory first described by Glaser and Strauss in 1967, is a framework for qualitative research that suggests that theory must derive from data, unlike other forms of research, which suggest that data should be used to test theory.43 It is a qualitative research process that entails developing theories based on evidence that has been collected from the participants.43 Grounded theory may be particularly valuable when little or nothing is known or understood about a problem, situation, or context.44 The main purpose is to develop a theory that explains patterns and correlations in data and may be utilised to understand and predict the phenomenon under investigation. This method often entails gathering data through interviews, focus groups, questionnaires, surveys, transcripts, letters, government reports, papers, grey literature, music, artefacts, videos, blogs and memos, then analysing it to identify patterns and relationships.45 Data is analysed via inductive analysis; the researcher starts with observations and data and then builds hypotheses and insights based on the data. In addition, a continual comparison technique is employed, which entails comparing data repeatedly to identify patterns and themes.46 Furthermore, open, axial and selective coding is used. Open coding divides data into smaller chunks and classifies them based on their qualities and relationships.47 In axial coding, links between categories and their subcategories are examined with respect to data.47 Through “selective coding,” all categories are brought together around a “core” category, and categories requiring further explanation include descriptive information. This type of coding is more likely to occur in the final stages of study.47 An example is the study by Malau-Aduli et al., 2020; the study had two main aims – (1) to identify the factors that influence an International Medical Graduate’s (IMG) decision to remain working in regional, rural, and remote areas; (2) to develop a theory, grounded in the data, to explain how these factors are prioritised, evaluated and used to inform a decision to remain working in RRR areas.48 The findings revealed that the IMG decision-making process involved a complex, dynamic, and iterative process of balancing life goals based on life stage. Many factors were considered when assessing the balance of three primary life goals: satisfaction with work, family, and lifestyle. Another example is the study by Akosah-Twumasi et al. 2020 which explored the perceived role of sub-Saharan African migrant parents living in Australia in the career decision-making processes of their adolescent children.49 The study showed that the majority of SSA immigrant parents continued to parent in the same manner as they did back home.49 Interestingly, some parents modified their parenting approaches due to their perceptions of the host nation.49 However, due to their apparent lack of educational capacity to educate their children, other parents who would otherwise be authoritative turned into trustworthy figures.49
