Qualitative Research In Health Care Research Articles

Thematic analysis informed by grounded theory (TAG) in healthcare research: foundations and applications

ABSTRACT Grounded theory (GT) and thematic analysis (TA) are commonly used in qualitative healthcare research. Published by Glaser and Strauss in 1967, GT was the first set of qualitative research strategies described. TA has since been compared with selected GT strategies. This narrative review aims to examine and illustrate how TA can be informed by GT and elucidate a TA informed by GT (TAG) methodology. Utlizing models of researching practice wisdom and reflexive inquiry, fifty author-published TAG studies (1996–2024) were examined. Analysis delineated a TAG methodology and clarifies Glaser and Strauss’s foundational roles in its development. TAG adheres to constructivism. Main GT strategies informing TAG include: comparative, predominantly inductive, and iterative analysis; and coding (data segment labels), category (code group), and thematic (category group) development. TAG can also encompass four-level thematic abstraction, and qualitative inter-rater reliability procedures enhance trustworthiness. TAG is a practical and effective methodological approach for qualitative healthcare research.

Opportunities and Challenges of Qualitative Research in Academic Health Sciences in Ethiopia

Background. The goal of qualitative research is to learn more about the opinions and experiences of the subjects being studied in relation to a particular question. There is a paucity of information on opportunities and challenges encountered to conduct qualitative research among the academic staffs in the health sciences. The purpose of this study was to examine the opportunities and challenges of conducting qualitative research among academic staff of health sciences in Ethiopia. Methods. A descriptive qualitative study design was conducted among health sciences academic staffs of selected public universities in Ethiopia. The study was conducted at three universities’ health sciences colleges, namely, Addis Ababa University, Dilla University, and Wolaita Sodo University. Data were collected using focus group discussions, in-depth interviews, and key informant interviews. MAXQDA 2020 software was used for coding and data management. A thematic analysis approach was followed to present the results. Both inductive and deductive coding approaches were used. Results. Three main themes have been identified as follows: general research practice, opportunities for qualitative research, and challenges to conduct qualitative research. Participants indicated that the availability of research opportunities will have a good impact on qualitative research engagement. Availability of grants, funding, and other incentives and demand for qualitative research in healthcare were described as opportunities for qualitative research practice. Despite the available opportunities, study participants uncovered different challenges that encountered by health academic staffs in conducting qualitative research. Resource limitations, lack of knowledge, negative attitudes or beliefs, publication, and language issues were raised as main challenges. Conclusion. Qualitative research practices were found to be low among health sciences academics. Lack of resources, training, and expertise, problems associated with publication, a lack of funding, and a shortage of experts were the main challenges in conducting qualitative research in health sciences academic settings in Ethiopia.

Desire to learn qualitative methods among researchers in healthcare fields.

July 2023 saw the high point to date of my 25+ years in academe. I had the pleasure of presenting a workshop—“ Strategies for Writing Effective Qualitative Research in Healthcare”—at the 18th annual conference of the International Society for the Study of Self-Injury (NSSI). Hosted by the Medical University of Vienna, the conference featured dozens of presentations, of which a sizeable minority were qualitative in nature. Qualitative research at the conference addressed such topics as stigma pertaining to NSSI, young adults’ experiences with NSSI in India, healthcare staff views of NSSI behaviors, and reasoning/beliefs among patients who self-injure [...]

Qualitative Research in Healthcare: Data Analysis.

Qualitative research methodology has been applied with increasing frequency in various fields, including in healthcare research, where quantitative research methodology has traditionally dominated, with an empirically driven approach involving statistical analysis. Drawing upon artifacts and verbal data collected from in-depth interviews or participatory observations, qualitative research examines the comprehensive experiences of research participants who have experienced salient yet unappreciated phenomena. In this study, we review 6 representative qualitative research methodologies in terms of their characteristics and analysis methods: consensual qualitative research, phenomenological research, qualitative case study, grounded theory, photovoice, and content analysis. We mainly focus on specific aspects of data analysis and the description of results, while also providing a brief overview of each methodology's philosophical background. Furthermore, since quantitative researchers have criticized qualitative research methodology for its perceived lack of validity, we examine various validation methods of qualitative research. This review article intends to assist researchers in employing an ideal qualitative research methodology and in reviewing and evaluating qualitative research with proper standards and criteria.

Qualitative Research in Healthcare: Necessity and Characteristics.

Quantitative and qualitative research explore various social phenomena using different methods. However, there has been a tendency to treat quantitative studies using complicated statistical techniques as more scientific and superior, whereas relatively few qualitative studies have been conducted in the medical and healthcare fields. This review aimed to provide a proper understanding of qualitative research. This review examined the characteristics of quantitative and qualitative research to help researchers select the appropriate qualitative research methodology. Qualitative research is applicable in following cases: (1) when an exploratory approach is required on a topic that is not well known, (2) when something cannot be explained fully with quantitative research, (3) when it is necessary to newly present a specific view on a research topic that is difficult to explain with existing views, (4) when it is inappropriate to present the rationale or theoretical proposition for designing hypotheses, as in quantitative research, and (5) when conducting research that requires detailed descriptive writing with literary expressions. Qualitative research is conducted in the following order: (1) selection of a research topic and question, (2) selection of a theoretical framework and methods, (3) literature analysis, (4) selection of the research participants and data collection methods, (5) data analysis and description of findings, and (6) research validation. This review can contribute to the more active use of qualitative research in healthcare, and the findings are expected to instill a proper understanding of qualitative research in researchers who review qualitative research reports and papers.

Methodological Insights, Advantages and Innovations Manuscript Title: Lessons Learned in Conducting Qualitative Healthcare Research Interviews in Malawi: A Qualitative Evaluation

With the growth of qualitative health research in low- and middle-income countries, local health professionals are increasingly involved in facilitating interviews with their fellow health workers. Understanding the methodological implications of such situations is required to ensure high-quality study findings and to build capacity and skills for interviewers with clinical backgrounds working with limited resources. This article reports a qualitative process evaluation of a study that assessed barriers and enablers of implementing bubble continuous positive airway pressure in Malawi. Findings were summarized through an iterative process of reflection on what worked, what did not work, areas for improvement, structural challenges, negotiating dual roles as nurses and researchers and the professional hierarchy within the health care system. Comprehensive practical training was critical to conducting qualitative research in a health setting. Interviewers were health workers themselves and required skills in reflexivity to effectively probe and navigate interviewing other health professionals, including senior staff. The main challenge in conducting interviews in a resource-limited healthcare setting was time constraints, which were compounded by staffing shortages. Lessons from this qualitative evaluation highlight the importance of training in reflexivity, engaging interviewers as collaborators and reserving adequate time to accommodate healthcare workers’ multiple roles and responsibilities.

Of Newcomers and Supervisors: Ethical Issues in Supervising Newcomers in Qualitative Health Research

This contribution focuses on our experiences as lecturers and supervisors in qualitative healthcare research in medicine, public health research and sociology, and the role of research ethics in guiding students in their qualitative studies. We argue that students themselves are vulnerable during the transition of becoming a qualitative researcher and that reflection on research is essential. Therefore, the selection of a topic, potential role conflicts and questions of field contingencies management become crucial elements in both teaching and researching. We use qualitative case vignettes, as suggested by Langer, to offer a reflective account of our experience. Protecting students from harm and preventing them from inadvertently causing harm to others are of utmost importance to us. Through these vignettes, we aim to provide a nuanced and reflective view of our experiences in supervising qualitative research.

Five Qualitative Research Concepts Grounded in Anthropological Methods for Teaching Design in Healthcare.

Biomedical engineering, engineering, and design in health programs around the world have involved human-centered design as part of their undergraduate curriculum. The disparities evidenced during the COVID-19 pandemic and the rapid developments of biotech startups have highlighted the importance of preparing professionals in the health areas for undertaking rigorous, empathetic, and ethical research. In addition to working with human-driven information, students in the health areas are challenged to deal with technical developments that involve legal and ethical concerns deeply rooted in sociopolitical issues and human rights. Concerned with how to achieve a better understanding of behavior in designing for healthcare, this article describes the rationale behind teaching qualitative research in healthcare for biomedical engineering and engineering design education. Through portraying different healthcare designs resulting from an engineering design course, it describes the instruction of qualitative-driven concepts taught to biomedical engineering, design, and premed undergraduate students. Using a design-based research approach, we look to increase the chances of adoption of the presented qualitative research concepts in educational design in health programs. We deliver five tested research tools that better prepare students to carry out more rigorous, respectful, and aware qualitative research in health areas for the development of novel solutions.

A commitment and call to strengthen and expand qualitative research efforts to improve the impact of antimicrobial stewardship.

Inadequate recognition of the value of qualitative research in healthcare, notably in antimicrobial stewardship (AMS), in addition to a lack of publishing space in medical journals has prompted JAC-Antimicrobial Resistance to focus on a qualitative series of AMS papers to incite interest in and support for pivotal qualitative approaches that make an indispensable contribution to our understanding of antibiotic use and how to address antimicrobial resistance. In this series, invited authors with diverse backgrounds and considerable expertise address and review intricate and varying qualitative research methods, behaviour change determinants, interventions and qualitative perspectives, with the aim of strengthening commitment and expanding qualitative initiatives to further the impact of AMS globally.

Qualitative Research in CKD: How to Appraise and Interpret the Evidence

Qualitative Research in CKD: How to Appraise and Interpret the Evidence

Content Analysis of Hospital Reviews From Differing Sources: Does Review Source Matter?

Social media has had an impact on how patients find and evaluate medical professionals and their experiences of modern healthcare. Qualitative research in healthcare has increased its focus on social media. The present study examined 497 reviews of hospitals in the Pittsburgh area across three websites: Google, Yelp, and Healthgrades. Using computerized content analysis tools (CATA), we analyzed positive and negative comments to identify key themes. Key themes and words included “doctor,” “hospital,” “staff,” and “time.” These findings highlight the importance of medical staff to patient experience. Results indicated that Yelp had the lowest average rating. CATA also revealed that the central term for Google reviews was “hospital,” for Healthgrades reviews it was “doctor,” and the central term for Yelp reviews was “patient.” These central terms reflect the focus of each website. The present study highlights the importance of healthcare professionals understanding the source of reviews and being cautious about how social media comments are used in decision-making about the practice. Future research should try to expand this approach to other cities and countries to evaluate cross-cultural effects on social media comments.

Interviews in qualitative health care research

INTRODUCTION: Interview is a conversation to procure information where an interviewer performs the action of questioning and an interviewee responds to the asked questions. The widely used modes are ‘Face-to-Face Interview’, ‘Telephonic Interview’, and ‘Interview via Electronic/Multimedia’ approach. Information acquisitions via interviews have proved their practicality under a wide range of considerations and aspects in domains of healthcare, social sciences, management, etc. Proper selection of the method right from planning, and establishment deliver the required information to the interviewer in the best expressible, and documented form to deliver results bringing the best after a whole planned workout of an interview. OBJECTIVE: In the present article, the author would be focused on the interview categorization in qualitative health care research. MATERIALS AND METHODS: Only PubMed and SCOPUS Databases were searched from inception to September 2020 for this narrative review. Only English language articles were searched with keywords, “Interview”, “Face-to-Face”, “Qualitative research” and “Category of Interview” and linked with Boolean words such as, “AND”, “OR” and “NOT”. Conference abstracts and proceedings articles were excluded. This narrative review did not followed PRISMA statement. RESULTS: The selection of interviews to be used in qualitative health care research should be based on time allocation, gender, prioritization of privacy, and requirement of the content of information. The interviewer should ask one question at a time, present with normalcy in facial and body expression following response even after noting the answers to be unpredictable and encourage the response rate to the highest for optimizing the results obtained. CONCLUSION: Various important aspects of interview in qualitative health care research has been discussed in this narrative review.

Processual Validity in Qualitative Research in Healthcare.

Knowledge development has been continuously challenging. Qualitative research seems to be promising; however, there are difficulties and complexities involved, one of which is validity. Qualitative research is based on different paradigms, ontologies, theories, and methods, and validity assessment may vary. We argue that processual validity can positively influence qualitative health care research. Processual validity is a methodological construction that involves all research steps, including those before and after data collection and analysis. We selected a processual validity model and two cases to illustrate its use and demonstrate processual validity’s importance and applicability. One case explores the gap between medical education and patients’ needs in primary health care. Other studies focus on health care improvements in hospitals. Our results highlight the benefits of processual validity to ensure the transparency and reliability of the research process and provide evidence of the findings to positively influence thinking and the execution of qualitative research in health care.

Conducting Qualitative Research to Respond to COVID-19 Challenges: Reflections for the Present and Beyond

The global response to mitigate the spread of the COVID-19 pandemic brought about massive health, social and economic impacts. Based on the pressing need to respond to the crisis, clinical trials and epidemiological studies have been undertaken, however less attention has been paid to the contextualized experiences and meanings attributed to COVID-19 and strategies to mitigate its spread on healthcare workers, patients, and other various groups. This commentary examines the relevance of qualitative approaches in capturing deeper understandings of current lived realities of those affected by the pandemic. Two main challenges associated with the development of qualitative research in the COVID-19 context, namely “time constraints” and “physical distancing” are addressed. Reflections on how to undertake qualitative healthcare research given the evolving restrictions are provided. These considerations are important for the integration of qualitative findings into policies and practices that will shape the current response to the pandemic and beyond.

Engaging Māori with qualitative healthcare research using an animated comic

This article reports an effective strategy for recruiting patients with asthma to a qualitative study using an animated comic advertised on social media. An ad spend of NZ$432 on Facebook resulted in 101 study enquiries, and 27 participants taking part in the focus groups, of which 16 (56%) were Māori, the Indigenous Peoples of New Zealand. Representation of Māori amongst participants was over five times higher than their proportion in the local population (9.7%), resulting in data fulfilling the principle of equal explanatory power, an approach to research which can help advance Māori health development and address inequity. The success of this campaign is of particular interest for health researchers in New Zealand where Māori continue to be disproportionately affected by poorer health outcomes compared with non-Māori, particularly those with asthma. Approaches that better engage and support participation of under-represented communities in clinical research are of wider global interest. We reflect on the recruitment strategy and outcomes within a Kaupapa Māori framework, explore how this can be applied more widely in healthcare, and suggest direction for future study and implementation. Lay summary We designed an animated comic to advertise a study for patients with asthma. This was shared locally with a Facebook ad. The approach was highly engaging with the public, and resulted in rapid recruitment. Interestingly, participation of Māori (the Indigenous People of New Zealand) was over five times higher than their proportion in the local population. Māori have poorer health outcomes and increased barriers to healthcare access compared with non-Māori, particularly those with asthma. Approaches which can engage and support under-represented communities to participate in clinical research are of wider global interest. In this article, we reflect on the recruitment strategy and outcomes, and suggest direction for future study and implementation.

Organizational Ethnographic Case Studies: Toward a New Generative In-Depth Qualitative Methodology for Health Care Research?

A growing body of literature suggests combining organizational ethnography and case study design as a new methodology for investigating complex organizational phenomena in health care contexts. However, the arguments supporting the potential of organizational ethnographic case studies to improve the process and increase the impact of qualitative research in health care is currently underdeveloped. In this article, we aim to explore the methodological potentialities and limitations of combining organizational ethnography and case study to conduct in-depth empirical health care research. We conducted a scoping review, systematically investigating seven bibliographic databases to search, screen, and select empirical articles that employed organizational ethnographic case study to explore organizational phenomena in health care contexts. We screened 573 papers, then completed full-text review of 74 papers identified as relevant based on title and abstract. A total of 18 papers were retained for analysis. Data were extracted and synthesized using a two-phase descriptive and inductive thematic analysis. We then developed a methodological matrix that positions how the impact, contextualization, credibility, and depth of this combined methodology interact to increase the generative power of in-depth qualitative empirical research in health care. Our review reveals that organizational ethnographic case studies have their own distinct methodological identity in the wider domain of qualitative health care research. We argue that by accelerating the research process, enabling various sources of reflexivity, and spreading the depth and contextualization possibilities of empirical investigation of complex organizational phenomena, this combined methodology may stimulate greater academic dynamism and increase the impact of research. Organizational ethnographic case studies appear as a new in-depth qualitative methodology that both challenges and improves the conventional ways we study the lives of organizations and the experiences of actors within the interconnected realms of health care.

Opportunities, challenges and learnings from qualitative research with stakeholders in frailty in three European countries

ABSTRACT The aims of this paper are to reflect upon the experiences of researchers involved in a cross-national qualitative study with stakeholders in three European countries (Italy, Poland and UK), within the context of the FOCUS project on frailty management and optimisation (see http://focus-aha.eu/en/home). Six researchers’ reflections were gathered using open-ended questions. Responses were thematically analysed. We report on our team diversity including cultural differences in epistemological stances and describe how working remotely challenged clear communication. We comment on linguistic issues, our data collection approaches and methods of analysis. However, we also reflect upon the ability of such projects to build knowledge, generate capacity and promote the value of qualitative research in healthcare across Europe. Finally, we advocate an approach to cross-national research that is as much about building a cohesive knowledge exchange network as it is about understanding the lives, perspectives and experiences of our stakeholders.

PD48-02 CARING FOR ADULTS WITH CONGENITAL GENITOURINARY ANOMALIES: ADULT UROLOGY DEPARTMENT LEADERS' PERSPECTIVES ON PROGRAMMATIC CHANGE

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Transitional Urology & GU Congenitalism1 Apr 2018PD48-02 CARING FOR ADULTS WITH CONGENITAL GENITOURINARY ANOMALIES: ADULT UROLOGY DEPARTMENT LEADERS' PERSPECTIVES ON PROGRAMMATIC CHANGE Briony Varda, Carlos Estrada, Caleb Nelson, and Erin McNamara Briony VardaBriony Varda More articles by this author , Carlos EstradaCarlos Estrada More articles by this author , Caleb NelsonCaleb Nelson More articles by this author , and Erin McNamaraErin McNamara More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2306AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Transitional and longitudinal multidisciplinary care models for adults with congenital genitourinary anomalies (CGA) are lacking. Prior research has studied various causes, but no studies have focused on the concerns of department leaders, who are central to supporting and promoting new programs. This study sought their perspectives to better understand a) the perceived role of adult programs in caring for CGA patients, and b) the barriers and facilitators to developing comprehensive care for this population. METHODS We conducted semi-structured interviews with adult urology chairs/division chiefs. Criterion-type sampling was used to create a heterogeneous sample reflecting programs of varying sizes and pediatric affiliations. An interview guide was created and iteratively revised via 5 pilot interviews. We used a framework approach (a systematic methodology often used in qualitative healthcare research) for analysis. This approach includes: 1) immersion with the data (reading of transcripts, explicit coding, and group discussions of emerging themes), 2) independent closed-coding using a code book based on emerging themes and research aims, and 3) a final interpretation of the data by evaluating coding reports to identify convergence, divergence and variation in themes, as well as contextual meaning and connotation. RESULTS Of 45 contacted, 20 leaders participated. There was wide variation regarding the perceived role of caring for CGA patients, ranging from episodic care by individual providers to comprehensive multidisciplinary care led by a urology team. Barriers related to cost prevailed, in particular the financial risk of taking on a population perceived to have high resource utilization with low compensation. This was often compounded by a lack of provider capacity and/or difficulty obtaining support from academic/hospital entities. Although the risk of unfavorable quality metrics was noted, this was ascribed nominal importance. Only 3 participants had established care models for patients with CGA, but intentions to develop programs were common. Motivated pediatric and adult providers were clear facilitators. There was a general sense of duty to care for the CGA population, and an educational value was widely noted. CONCLUSIONS Among adult urology program leaders, opinions vary regarding their programs' role in managing CGA patients with considerable concerns related to the cost of comprehensive care models. Our results highlight the need for strategic program development to overcome these barriers. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e961 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Briony Varda More articles by this author Carlos Estrada More articles by this author Caleb Nelson More articles by this author Erin McNamara More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Understanding the psychosocial, behavioural and environmental factors behind frequent hospital admissions

Introduction: Increasing numbers of hospital admissions is a complex issue of significant concern to health systems around the world, as a significant cost driver of healthcare is inpatient cost[i]. In Singapore, patients who are frequently admitted to hospitals, although comprising a small number, account for a disproportionately high use of scarce healthcare resources. While national efforts are currently underway to provide care planning and coordination to such patients, evidence shows that there is a need for case-finding of at-risk patients before they deteriorate[ii]. To date, most predictive models for frequent admissions are derived using administrative and clinical data, and little is known about the psychosocial, behavioural and environmental factors which contribute to frequent admissions in the local context[iii]. Aims: This study aims to Understand how psychosocial, behavioural and environmental factors contribute to frequent admissions, and identify the gaps in current services to address these factors; and Understand how frequent admitters and their caregivers cope with physical, mental and financial stress. Methods: A qualitative approach was used, where in-depth, semi-structured interviews (n=42) and focus group discussions (n=2) were conducted with 41 health and community care providers, and 13 frequent admitters (defined as patients with three or more admissions in a year) and/or caregivers recruited from both the National University Hospital and community care sectors through purposive sampling. Data analysis was done using a deductive approach[iv]. Results and Key Findings: Key psychosocial factors contributing to frequent admissions included social isolation, the lack of caregiver support or capability, anxious caregivers, caregiver stress and perceptionsthat hospital care was superior to community care. Behavioural factors included lack of motivation for self-care while environmental factors included poor communication during care transition between healthcare settings, and financial subsidy schemes which favour hospital rather than community care. Neighbours and friends were found to be an importance source of social support in preventing readmissions, while religion was found to have mixed impact on how patients or caregivers coped with illness. Discussion and Lessons Learnt: This study highlights the importance ofaddressing social isolation, and that informal networks such as neighbours and friends are an often overlooked source of psychosocial support for patients and their caregivers. Secondly, caregiver training, education and provision of respite services should also be in place to support caregivers in the community. Thirdly, a concerted effort is needed to address patients’ socio-cultural beliefs and perceptions about healthcare, while concurrently improving care integration between healthcare settings. Limitations: Comparatively more healthcare professionals than patients and caregivers were interviewed in this study, as many patients were too ill to be interviewed. Suggestions for Future Research: The findings of this study could be used to develop asurvey to understand the prevalence of factors identified in this study among frequent admitters. A screening tool could then be developed to screen individuals at-risk for frequent admissions so that pre-emptive interventions could be instituted.

Developing and Using Vignettes to Explore the Relationship Between Risk Management Practice and Recovery-Oriented Care in Mental Health Services.

There is a lack of literature evaluating the development and use of vignettes to explore contested constructs in qualitative health care research where a conventional interview schedule might impose assumptions on the data collected. We describe the development and validation of vignettes in a study exploring mental health worker and service user understandings of risk and recovery in U.K. mental health services. Focus groups with mental health workers and service users explored study questions from experiential perspectives. Themes identified in the groups were combined with existing empirical literature to develop a set of vignettes. Feedback focus groups were conducted to validate and amend the vignettes. Following use in research interviews, results suggested that the vignettes had successfully elicited data on issues of risk and recovery in mental health services. Further research using creative, comparative methods is needed to fully understand how vignettes can best be used in qualitative health care research.