Đại cương về thiết kế nghiên cứu định tính. Gs,ts,bs Lê Hoàng Ninh

Đề cương nghiên cứu định tínhCâu hỏi và mục tiêu nghiên cứu Hồi cứu y văn và các ghi nhận có tính lý thuyết Người tham gia - Bạn quyết định bạn muốn thế nào?... Thí dụ câu hỏi nghiên cứu

Đại cương về thiết kế nghiên cứu định tínhGs,ts,bs lê hoàng ninh

Nghiên cứu định tính là gì?

Tập trung trên chất chứ không phải lượng

Phát triển / hình thành giả thuyết chứ không kiểm định giả thuyết

Điều tra : TẠI SAO và THẾ NÀO ?

Thu thập dữ liệu gồm : phỏng vấn,nhóm chủ đích, tư liệu, quan sát

Dữ liệu: bài văn, hình nghệ thuật, ảnh

Tại sao dùng cách tiếp cận định tính?

Câu hỏi nghiên cứu liên can tới sự tìm hiểu, mô

tả một hiện tượng / biến cố đặc biệt nào đó mà

sự am hiểu còn rất hạn chế

Để có được những đặc điểm khía cạnh không thể định lượng được vế cuộc sống của con

người

Hiện tượng quan tâm có liên can tới dự hiểu biết

về sự trải nghiệm, ý nghĩa sâu xa, tình cảnh, sự cảm kích và những khía cạnh xảy ra hằng ngày

Đề cương nghiên cứu định tính

Câu hỏi và mục tiêu nghiên cứu

Hồi cứu y văn và các ghi nhận có tính lý thuyết

Người tham gia

- Bạn quyết định bạn muốn thế nào?

Câu hỏi và mục tiêu nghiên cứu

• Câu hỏi nghiên cứu phải là một câu hỏi: thường là Tại Sao hay Thế Nào ?

• Mục tiêu nên nêu rõ, chuyên biệt về cái

mà bạn đang muốn làm

• Không có trước giả thuyết nghiên cứu

Thí dụ câu hỏi nghiên

cứu định tính

Thí dụ câu hỏi nghiên cứu định tính

Văn hoá nghề nghiệp thể hiện như thấ nào ở

các học viên chuyên khoa 2 của 3 tỉnh tay ninh, bình dương, b.r vũng tàu?

Bệnh nhân thể hiện sự cảm xúc thế nào khi chờ đợi 3 gio82 để được bác sĩ thăm khám bệnh

trong 3 phút

Học viện chuyên khoa cấp 2 có suy nghỉ gì khi

đề cương bị bác và làm lại đề cương khác.?

Hồi cứu y văn (Literature Review)

What has already been done?

What do we already know?

Where are the gaps in the literature?

Why is your study necessary?

Why is a qualitative approach the best

option?

“sensitizing concepts”

Researcher studies the meaning, behaviour ,

language, and interactions of a culture-sharing group

Data collection usually involves multiple sources and often includes observation; can take many

Based in philosophy, psychology and sociologyFocus is to uncover the meaning of how humans experience phenomena through description of those experiences as they are lived by

Phenomenology Example

Ribau C and JP Marc-Vergnes “ Towards a phenomenology of persistant pain” Pesse Medicale 2004; 33(7): 449-52

Each piece of info is reviewed, compared and

contrasted with earlier collected info (constant

comparison)

used; usually includes interviews

Grounded Theory Examples

Chaar B and Kwong K “Direct-to-consumer

advertising: Australian pharmacists’ experiences with non-prescription medicines.” International Journal of Pharmacy Practice 2010;18(1):43-50.Pottie K, et al “Pharmacist’s identity

development within multidisciplinary primary

health care teams in Ontario: qualitative results from the IMPACT project” Research in Social

Administrative Pharmacy 2009; 5(4):319-26

Benson A et al “Understanding pharmacists’

values: a qualitative study of ideals and

Case Study

In-depth analysis of single cases or comparison across multiple cases

Comes from Political Science, Sociology

Data collection normally includes a variety of

sources including documents, interviews and

observation

Data from different sources are triangulated

When multiple cases are available,

case-by-case analysis is completed first, followed by

cross-case comparisons

Case Study Example

Knapp DA et al “Growth of a pharmacy school through planning, cooperation, and

establishment of a satellite campus” American Journal of Pharmaceutical Education 2009;

73(6):102

Nanji KC et al “Overcoming barriers to the

implementation of a pharmacy bar code

scanning system for medication dispensing: a case study” Journal of the American Medical Informatics Association 2009; 16(5):645-50

Objectives/Questions strongly influence methodology choice

If one is interested in focusing on social groups, then one may reject phenomenology

OR

if one is interested in individuals’ experiences, then ethnographic or case study approaches

might be rejected

Data Collection

Match to your methodological approach

What kind of data do you need:

Forms of Data

Generally anything that can be reduced to text:

- interview and focus group transcripts

- documents

- field notes

- observational notes

- reflective journaling

Interviews in….

Ethnography: hold equal weight with

observation; multiple interviews over extended period of time

Phenomenology: very in-depth, unstructured,

small number (<10)

Grounded Theory: continue until reaching

saturation of key emerging themes in the

developing theory

Case Studies: only one of multiple sources; often

Individual Interviews

General Rules of Thumb

“A good interview is like a good conversation”Good interviewer may not say much, but

works hard at listening

Unstructured or semi-structured

Vary in length: average in literature 60-90

minutes

Questions should be open-ended

of knowledge: “Tell me about that” instead of

“what do you know about that?”

Sample

Interview

Guide

Audio Recording

Allows you to interact with the participant instead

of writing notes constantly

Provides higher quality data (better record of

what was actually said)

Place recording device closer to the participantCheck recording immediately after interview

Supplement with field notes

Can be costly (and time consuming) to

transcribe

Takes 2-4 times the length of the interviewConventions vary depending on the type of analysis planned

ID Code; date; interviewer

Number lines and pages

Leave space in right margin

Codes for emotion (e.g., laughter), pausesChecking transcripts

Example transcript

Sample

Transcript

How many people do you need to

interview?

research question and the diversity of your

participants

data in the key themes is being collected

Guest et al “How many interviews are enough:

An experiment with data saturation and

variability” Field Methods 2006; 18:59-82

Focus Groups

Group discussion with a facilitator

Groups of 4-10

Lasts for 1-2 hours

Purpose: to facilitate description and

understanding of perceptions, interpretations, and beliefs of a selected population

When to Use Focus Groups

Together with individual interviews and participant

observation in ethnographic research

triangulation

Focus Group Participants

Homogeneous groups

Allows for more “free-flowing” conversations

Can group by age, gender, religion, occupation, ethnicity etc

Heterogeneous groups

Sometimes helps to stimulate discussion

(greater likelihood of range of opinions

behaviours, clothing, expressions, interactions in

a particular setting

Simple unobtrusive observation

Participant observation

Definition: accounts describing experiences and observations the researcher has made

Way to document experience in the “field”

Vital component of observation

Encouraged as additional contextual information for interviews and focus groups

Putting into words the “experience” of the

researcher

Also includes the researcher’s perception and interpretation of the events

Observation: Pros and Cons

Advantages

May more accurately

reflect behaviour than

perspective (rather than a participant perspective as with interviews)

Sources can include: literature; print media, diaries, graffiti, letters, government policies etcCan be used as a supplement to other data collection or as a stand-alone method

Documents: Pros and Cons

Advantages

Cheaper and less

time consuming than

collecting data from

people

Ethical consent not

necessary for public

documents

DisadvantagesLimited to what is written (i.e., can’t probe for additional information)

May be shaped for an intended audience

(need to factor in to analysis)

Key Informants

Key informants: those with unique/special

knowledge about the research topic who are willing/able to discuss it

Can help give you “entry into the field”

Start with personal contacts

May need permission/endorsement from “official” bodies

Formal letter of introduction

Multiple follow-ups often necessary

General Analysis Strategies

No consensus on how to analyze qualitative

data

General strategies in common: basic

content/thematic analysis = a process of coding, sorting and organizing

Start analysis during data collection

General Strategy 1

General review of all information

Jotting down notes in the margin of the text

Writing memos and reflective notes (and/or

reviewing those that are part of the field notes)Purpose: to get an overall “sense” of the data

General Strategy 2

Begin to reduce the data

Look closely at words, phrases and metaphors used by participants

Develop key codes or categories

Create visual displays of the information (e.g., coding trees), graphs, diagrams

General Strategy 3

Start with 5-6 key categories and

expand/contract these as needed while

reviewing and re-reviewing the data

Normally don’t have more than 25-30 categories

at any time

Use sub-categories to refine coding

Work to identify the 5-6 key ones that will form the basis for a paper

Categories consist of:

occurs

Category

Definitions

emotional, aspects, etc.) –Looking at patient’s environment (family life, stress, etc.)

–Understanding the whole patient

Patient control/

Decision Making Issues related to patient control of their health (can be the patient not wanting to take control of their health

Anything about pts making decisions Patient education/

–Any discussion between provider/team and patient –Patient asking questions, being ‘informed’

–‘informed’ consent –Anything related to patients being empowered to take control of their healthcare

providing ‘patient centred care’

–They can include things like: frustration, feeling a lack

of control to tell patients what to do, personal

‘individual’ barriers –Not having enough time

Category Names

The best category names are:

language)

Unit of coding

The most basic segment or element of the raw data that can be assessed in a meaningful way regarding the phenomenon being studied

Examples:

Coding Exercise

Read the transcript excerpt

Underline the “key content”:

Create a “category” name for each thing you have underlined

content in several different places (constant

comparison method)

Computer Analysis Programs

Examples: NVIVO, Ethnograph

Most helpful for larger data sets (e.g., over 500 pages of text)

Not useful for small data sets – too time

consuming to enter all the data

Advantages of Computer Analysis

Provides organized file storage system

Allows storage of all data in one place

Allows you to quickly and easily locate material

of all sources

Facilitates line-by-line analysis of the data

Coded segments can be placed back in context

Disadvantages of Computer

Analysis

Learning curve to use the program

Computer coding can be tedious if already

completed manually

Computer coding should not take the place of types of coding required for each tradition

May make the researcher perceive coding

categories to be less flexible

Computers DO NOT do the analysis –

researchers do

How do we know a qualitative study is believable, accurate, or

“right”?

General Standards for all Research

Does the research question drive the methods

and analysis (i.e., do they match?)

Were the data collection and analysis techniques competently applied ?

Were the researchers’ assumptions made

explicit?

Validity of Qualitative Research

Enhanced by asking questions in “real” settings

as opposed to “experimental” settings

questions/themes often dictated by the

participants

“truth” = participants’ perspectives

Techniques for Enhancing Validity

Actively seek “negative” cases

Prolonged engagement in the field

Use of “thick description”

Audit trails and/or external audits

triangulation (i.e., using different data collection techniques)

Participant feedback (member checking)

Peer review or debriefing

External Reliability

Researcher status position - clearly identify in

report

informant choices - clearly describe who was

chosen as informants and how they were chosen social situations and conditions: identify

identify how analytic constructs and premises

evolved

clearly identify all techniques used for data

collection and analysis

Recommended Qualitative Texts

Creswell, John W Qualitative Inquiry and

Research Design Choosing Among Five

Sage, 2007

Morse, Janice M Qualitative Health

Research Creating a New Discipline Walnut Creek , CA: Left Coast Press Inc, 2012

Munhall PL Nursing Research: A Qualitative

available)

Pope C and N Mays “Researching the parts

other methods cannot reach: an introduction to qualitative methods in health and health services research” British Medical Journal 1995;311:42-5.Britten N “Qualitative interviews in medical

research” British Medical Journal 1995;311:251Pope C et al “Analysing qualitative data” British