A Primer of Qualitative Research

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A Primer of Qualitative Research

• Ellen Olshansky, D.N.Sc., WHNP-BC, FAAN Professor
  and Director
• Program in Nursing Science
• University of California, Irvine

2
What is Qualitative Research?

• Narrative data (may include some statistics)
• Field work (in naturalistic settings)
• Initial inductive mode of inquiry -
  hypothesis-generating
• Concerned with understanding phenomena from
  perspective of research informants
• Oriented toward understanding how the social
  world is interpreted and experienced
• Case-oriented (idiographic)

3
What is the Process of Doing Qualitative Research?

• Data collection and analysis are concurrent and
  ongoing
• Data collection begins in a broad, open-ended
  manner and becomes more focused as data analysis
  directs inquiry
• Further data collection then leads to
  modifications in data analysis

4
When is Qualitative Research Appropriately Used?

• When one is interested in learning how persons
  experience or give meaning to a particular
  phenomenon
• When little research has been conducted on the
  phenomenon of interest
• When one is interested in looking at a much
  studied phenomenon from a new or fresh
  perspective

5
Misnomers Regarding Qualitative Research

• The researcher is a tabula rasa
• It is atheoretical
• It is unsystematic
• It cannot be replicated
• Anything goes

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What Kinds of Qualitative Methods Exist?

• Qualitative Description
• Grounded Theory
• Ethnography
• Phenomenology
• Life Histories/Historical
• Narrative Analysis
• Discourse Analysis
• Critical Theory Analysis

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Qualitative Description

• Generic form of qualitative inquiry
• Topical, thematic summary
• Summarizes, provides informational content
• The least interpreted of the qualitative methods
  - Use of everyday terms rather than raising to a
  higher level of abstraction (description)

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Grounded Theory Method

• Based on the work of Glaser and Strauss
• Rooted in sociology - socio-psychological
  framework of Symbolic Interaction
• Process of discovery
• Goal is to develop a theory that is grounded
  in the data
• Some G.T. research emphasizes constructing a
  basic social process (Glaser)
• Some G.T. research emphasizes constructing a
  trajectory around a core category (Strauss)

9
What is Symbolic Interaction?

• Social-psychologic framework developed by Herbert
  Blumer, based on the work of George Herbert Mead
• Basic tenets
• persons construct their own reality through
  interactions with self and others
• persons construct meanings based on their
  interpretations of these interactions
• persons interact within a social context

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Pragmatism

• Truth or reality does not exist out there but
  is created or constructed when persons act and
  interpret what is occurring
• People base their knowledge of the world on what
  has proven useful to them (pragmatic) and alter
  that which no longer works
• People define social and physical objects based
  on their personal use or meaning

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Pragmatism as Influencing S.I.

• Emphasis on the interaction between the actor
  and the world
• The actor and the world are dynamic processes -
  not static structures
• Importance of actors ability to interpret the
  social world (focus on persons thinking process
  rather than simply responding as in a
  stimulus-response process)

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Variants of Grounded Theory

• Schatzmans Dimensional Analysis (based on a view
  that all of us as humans engage in natural
  analysis)
• Strauss and Glasers Differing Views of Grounded
  Theory

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Process of Grounded Theory

• Data Collection concurrent and ongoing with data
  analysis
• Data Analysis
• Open Coding
• Axial Coding
• Selective Coding
• Development of Core Category
• Theoretical Integration

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Ethnography

• Rooted in Anthropology
• Also has roots in Symbolic Interaction
• A hallmark of ethnography is doing research in
  the field
• Participant-observation
• Focus on lifeways and patterns of cultures
  (culture can be broadly defined)

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Phenomenology

• Rooted in philosophy (Husserl, Heidegger, Giorgi)
• Concerned with the lived experience (concrete,
  feeling level versus abstract theoretical
  understanding)
• Concerned with rendering a feeling versus
  thinking (existential understanding emotive,
  embodied)
• Uses technique of bracketing

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Life History/Historical Analysis

• Rooted in history, anthropology
• Focus on past events or someones life chronology
• Historical perspective as way of understanding
  phenomena
• Oral history

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Narrative Analysis

• Roots in literature, history, anthropology
• Life as told
• Humans are viewed as narrators
• Emphasis is on the linguistics rather than the
  actual informational content (e.g. how something
  is told)
• Retrospective and revisionist aspects of
  narrative (the teller tells something in
  retrospect, revises it)
• (Sandelowski, 2003 Qualitative Institute)

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Discourse Analysis

• Roots in history and literature
• Group of ideas or patterned ways of thinking
  found in texts, talk, others
• Sometimes reveals unequal power relations
• Looks for assumptions underlying an object of
  inquiry
• Interpretation and deconstruction of texts
• Sandelowski, 2003 Qualitative Institute

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Critical Theory Analysis

• Overt purpose of seeking social change
• Recognition of power differentials focus on
  concept of oppression
• Related to community-based participatory
  research (CBPR)
• Critical, deconstructionist view

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Process of Doing Qualitative Analysis

• Iterative process that occurs in a simulaneous
  and ongoing fashion with data collection
• Data collection and data analysis influence each
  other
• There are specific steps in doing analysis,
  though they are not completely linear

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Open Coding

• Looking for phrases, words that reflect the
  meaning in the data
• Develop provisional codes that reflect this
  meaning
• Continue to construct codes, discarding some and
  keeping others that demonstrate saturation

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Axial Coding

• Breaking down codes into components
• Conditions
• Consequences
• Strategies
• Putting components together as axes in a wheel

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Selective Coding

• Selectively focusing on those codes that have
  support in the data (i.e. that demonstrate
  saturation of data)
• Data collection becomes more focused as certain
  codes are selectively searched for and
  verification for the codes are sought.

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Development of Core Category

• Usually one or a few categories are seen as
  core to the analysis
• Data collection and analysis become even more
  focused at this point
• The core category serves as the anchor for the
  continuing, more focused analysis

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Theoretical Integration

• Synthesize the components of the core categories
  to reflect how these components are interrelated
• Reflect the complexity of the data, which further
  reflects the complexity of the context that is
  being studied
• Include variations and similarities (look for
  common patterns, but include the variations and
  explanations for the variations in the patterns)

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Summary of Major Points

• Qualitative research is concerned with
  interpretation and with meaning and perspective
• An iterative process of data collection and
  analysis/interpretation
• Initially inductive, becoming more deductive as
  the process continues
• Various qualitative methods, rooted in different
  disciplines
• Data analysis is composed of several steps that
  allow for more focused data collection and
  analysis

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Acknowledgment of Funding Sources

• National Institutes of Health/NINR
• Center for Womens Health Research, University of
  Washington School of Nursing
• Biomedical Research Support Grant, University of
  Washington School of Nursing
• Sigma Theta Tau, Alpha Eta Chapter
• American Nurses Foundation
• Duquesne University Faculty Development Award

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Overview of Program of Research

• Series of eight studies
• 7 qualitative studies using grounded theory
  methodology) generated substantive theory of
  identity as infertile
• Concurrent clinical practice

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Study One Womens and Mens Experiences of
Infertility

• Interviewed 17 couples
• Each spouse interviewed separately
• Each dyad interviewed together
• Open-ended questions to elicit their perceptions
  and experiences
• Olshansky, E.F. (1987). Identity of self as
  infertile an example of theory-generating
  research. Advances in Nursing Science, 9(2),
  54-63.
• Olshansky, E. (1996). Theoretical issues in
  building a grounded theory Application of an
  example of a program of research on infertility.
  Qualitative Health Research, 6(3), 394-405.

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Infertility as a Central Identity

• Core process/concept identity as infertile
• This identity becomes central in ones concept of
  self
• Other identities are pushed to the periphery

career
infertility
relationships
athlete
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Data to Support

• Yes, I used to be athletic but none of that
  matters now that Im infertile
• Its always there, it sort of is constantly
  something to deal with. Im trying to make it
  not be the central issue in my life and Ive
  realized how much it was really getting in the
  way.
• When I found out that my sperm count was zero I
  felt like I had just hit a brick wall I felt
  like a failure in a line of successful breeders.

32
Study Two Infertility and the Marital
Relationship

• Interviewed 20 couples
• Individual interviews
• Interviews with the dyads
• Open-ended interview questions that focused on
  their perceptions of their marriage
• Olshansky, E.F. (1988). Married couples'
  experiences of infertility. In Communicating
  Nursing Research (Ed.), Western Society for
  Research in Nursing (p. 47).

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Identity of Marriage/Partnership as Infertile

• Infertility defines relationship
• Infertility is part of relationship

relationship
infertility
infertility
relationship
34
Data to Support

• He felt like a failure and I felt like a
  failure, and we felt our relationship was a
  failure.
• Our sexual life hasnt recovered yet. When I
  finally failed the last time with Pergonal, I was
  so depressed that I didnt want to have anything
  to do with sex at all, and he was so depressed
  that he had been through all of this for nothing
  that he didnt want to have anything to do with
  sex.
• We are still able to enjoy one another
• We go out on dates

35
Study Three Infertility and Womens Careers

• Secondary analysis of the two previous studies
• Focused only on those women who had jobs/careers
  outside the home (N17)
• Analyzed the data related to their descriptions
  of their jobs/careers
• Olshansky, E.F. (1987). Infertility and its
  influence on women's career identities. Health
  Care for Women International, 8(2,3), 185-196.

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Infertility and Womens Career Identities

• Infertility as central
• Increasing attention to career during infertility
• Career subsumes and integrates infertility

career
infertility
infertility
career
infertility
career
37
Data to Support

• Infertility has taken a focus away from what I
  presume I would be doing if I just had kids
  through the natural course of events. When I was
  28 I thought that, well, I either have to get
  pregnant or get a Ph.D. and I havent done
  either.
• Infertility was a part of every decision.
  Should I take a job? Well, if Im going to be
  off for a year with a new baby I shouldnt take a
  new job.

38
Study Four Experience of Using Technological
Interventions for Infertility

• Secondary analysis of previous studies
• Focus on those individuals and couples who used
  technology (N7)
• Artificial insemination with donor sperm
• In vitro fertilization
• Olshansky, E.F. (1988). Responses to high
  technology infertility treatment. IMAGE The
  Journal of Nursing Scholarship, 20(3), 128-131.

39
Identity and Technological Intervention for
Infertility

• Increased attention/vigilance in scheduling
  procedures, focusing on complexities of
  technology
• Cycling up or exacerbation of ones identity as
  infertile
• Increased centrality of identity as infertile

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Data to Support

• Now that Im spending such an inordinate amount
  of time noticing my temperature and all that
  other stuff, I feel like everything is under a
  microscope.
• People get really caught up in having to follow
  this protocol because theyve made a decision to
  do so. They just cant live their lives.
• The horrible business of Pergonal. I had to
  give her the shots, we had to survive this. I
  was going M.D. rather than Ph.D. for a change.
• All these procedures are taking over my life.

41
Studies Five and Six Womens Experiences of
Pregnancy and Parenting after Infertility

• Interviewed 24 women who were pregnant after
  infertility, and followed up with 4 of these
  women after they delivered their babies (study 6
  included these 4 women after delivery as a
  feasibility/pilot study)
• Olshansky, E.F. (1990). Psychosocial implications
  of pregnancy after infertility. NAACOG's Clinical
  Issues in Perinatal and Women's Health Nursing,
  1(3), 342-347.
• Olshansky, E.F. (1992). Redefining the concepts
  of success and failure in infertility treatment.
  NAACOG's Clinical Issues in Perinatal and Women's
  Health Nursing, 3(2), 343-346.

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Shifting Identities

• Concept of identity shift
• Straddling two identities
• Process of attempting to normalize ones identity
  as pregnant (and not infertile)

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Attempt at Identity Shift
Pregnant
Infertile
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Straddling Two Identities
Infertile
Pregnant
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Data to Support

• I feel like an infertile pregnant woman.
• Im not like the other pregnant women.
• I know Im pregnant, but I still feel
  infertile.
• I dont feel like this pregnancy belongs to me.

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Parenting Experiences

• Vulnerability
• Lack of permission to complain
• Expectations of others may be incongruent with
  womans authentic feelings

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Data to Support

• Ive had so many losses, I cant believe this
  baby is OK.
• Im always so afraid that something is going to
  happen to him.
• After all Ive gone through I feel like I have
  no right to complain about anything. Everyone
  expects me to be happy now that I finally have
  what I want.

48
Study Seven Experiences of Menopause in Women
with a History of Infertility

• Nine menopausal or post-menopausal women with a
  history of infertility (3 had biological
  children, 3 adopted, and 3 did not become
  parents)
• Individual interviews
• finally feeling normal
• Olshansky, E. (2005). Feeling normal Womens
  experiences of menopause after infertility. MCN
  The American Journal of Maternal Child Nursing,
  30 (3), 195-200.

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Conceptual Representation
Identifying with women Their age
Reconciling Infertility
Finally feeling normal
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Description of Concepts

• Reconciling infertility menopause as an
  opportunity to look back on infertility from a
  new and different perspective
• Identifying with women their age finally able
  to see themselves as part of rather than other
  than or different from women as a group
• Finally feeling normal perceived themselves as
  experiencing something that is normal to
  experience at their stage in womens lifecycle

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Data to Support

• Menopause meant that you couldnt have kids and
  so, in that sense, it happened for me years
  before. I can now look back and feel better
  about things.
• During the whole period of my life when
  reproduction would have been a possibility, I
  always felt really abnormal and so now I look at
  menopause as I can get back to normal.
• It makes me feel normal it that realm.
• You know what? Everybody goes through it.