DOI QR코드

DOI QR Code

Qualitative Research in Healthcare: Data Analysis

  • Dasom Im (Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine ) ;
  • Jeehee Pyo (Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine ) ;
  • Haneul Lee (Ulsan Metropolitan City Public Health Policy's Institute) ;
  • Hyeran Jung (Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine ) ;
  • Minsu Ock (Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine )
  • Received : 2022.11.15
  • Accepted : 2023.01.31
  • Published : 2023.03.31

Abstract

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.

Keywords

References

  1. Chung J, Cho JJ. Use of qualitative research in the field of health. J Korean Acad Fam Med 2008;29(8):553-562 (Korean). 
  2. Pyo J, Lee W, Choi EY, Jang SG, Ock M. Qualitative research in healthcare: necessity and characteristics. J Prev Med Public Health 2023;56(1):12-20.  https://doi.org/10.3961/jpmph.22.451
  3. Hill CE, Thompson BJ, Williams EN. A guide to conducting consensual qualitative research. Couns Psychol 1997;25(4):517-572.  https://doi.org/10.1177/0011000097254001
  4. Hill CE. Consensual qualitative research: a practical resource for investigating social science phenomena. 1st ed. Washington, D.C.: American Psychological Association; 2012. 
  5. Hill CE, Knox S, Thompson BJ, Williams EN, Hess SA, Ladany N. Consensual qualitative research: an update. J Couns Psychol 2005;52(2):196-205.  https://doi.org/10.1037/0022-0167.52.2.196
  6. Ock M, Han YJ, Choi EY, Pyo J, Lee W. Perceptions of medical students regarding career counseling in Korea: a qualitative study. Int J Environ Res Public Health 2020;17(10):3486. 
  7. Lee K, Lee SH, Park T, Lee JY. Stressors of Korean disaster relief team members during the Nepal Earthquake dispatch: a consensual qualitative research analysis. J Korean Med Sci 2017;32(3):507-513.  https://doi.org/10.3346/jkms.2017.32.3.507
  8. Van Manen M. Researching lived experience: human science for an action sensitive pedagogy. 2nd ed. New York: Routledge; 1997. 
  9. Husserl E. Ideas: general introduction to pure phenomenology. 1st ed. London: Routledge; 2012. 
  10. Lee N. Phenomenology and qualitative research method. Seoul: Hangilsa; 2014 (Korean). 
  11. Giorgi A. The descriptive phenomenological method in psychology: a modified Husserlian approach. Ann Arbor: Duquesne University Press; 2009. 
  12. Edward KL, Welch T. The extension of Colaizzi's method of phenomenological enquiry. Contemp Nurse 2011;39(2):163-171.  https://doi.org/10.5172/conu.2011.163
  13. Colaizzi PF. Psychological research as the phenomenologist views it. In: Valle RS, King M, editors. Existential-phenomenological alternatives for psychology. New York: Oxford University Press; 1978. 
  14. Benner P. From novice to expert: excellence and power in clinical nursing practice. Am J Nurs Sci 1984;84(12):1480. 
  15. Diekelmann N. Narrative pedagogy: Heideggerian hermeneutical analyses of lived experiences of students, teachers, and clinicians. ANS Adv Nurs Sci 2001;23(3):53-71.  https://doi.org/10.1097/00012272-200103000-00006
  16. Diekelmann N, Allen D. A hermeneutic analysis of the NLN criteria for the appraisal of baccalaureate programs. In: Diekelmann N, Allen D, Tanner CA, editors. The NLN criteria for appraisal of baccalaureate programs: a critical hermeneutic analysis. New York: National League for Nursing; 1989, p. 11-34. 
  17. Van Kaam A. Existential foundations of psychology. Philos Phenomenol Res 1967;28(1):140-141.  https://doi.org/10.2307/2105343
  18. Kim Y, Jung S. Qualitative research methods V: data analysis. Seoul: Academy Press; 2017 (Korean). 
  19. De Castro A. Introduction to Giorgi' s existential phenomenological research method. Psicol Caribe 2003;(11):45-56. 
  20. Larraya FP. Drinking as a cultural pattern of the Chaco aborigins. Acta Psiquiatr Psicol Am Lat 1976;22(1):21-45 (Spanish). 
  21. Dhillon AZ, Doran T, Aggarwal VR. Perceptions of waterpipe smoking among young adults: a phenomenological study. Dent J (Basel) 2020;8(4):134. 
  22. Bayked EM, Workneh BD, Kahissay MH. Thirst for information and needs reflections of type 2 diabetes patients receiving insulin treatment in north-east Ethiopia: a qualitative exploration. J Prev Med Public Health 2021;54(2):119-128.  https://doi.org/10.3961/jpmph.20.510
  23. Erol O, Unsar S, Yacan L, Pelin M, Kurt S, Erdogan B. Pain experiences of patients with advanced cancer: a qualitative descriptive study. Eur J Oncol Nurs 2018;33:28-34.  https://doi.org/10.1016/j.ejon.2018.01.005
  24. Lane AS, Roberts C. Phenomenological study of medical interns reflecting on their experiences, of open disclosure communication after medication error: linking rationalisation to the conscious competency matrix. BMJ Open 2020;10(5):e035647. 
  25. Kim Y, Lee H. Nurses' experiences with disclosure of patient safety incidents: a qualitative study. Risk Manag Healthc Policy 2020;13:453-464.  https://doi.org/10.2147/RMHP.S253399
  26. Merriam SB. Qualitative research: a guide to design and implementation. 3rd ed. San Francisco: Jossey-Bass; 2009. 
  27. Merriam SB. Qualitative research and case study applications in education. 2nd ed. San Francisco: Jossy-Bass; 1998. 
  28. Stake RE. The art of case study research. Thousand Oaks: Sage; 1995. 
  29. Yin RK. Discovering the future of the case study: method in evaluation research. Eval Pract 1994;15(3):283-290.  https://doi.org/10.1016/0886-1633(94)90023-X
  30. Hays PA. Case study research. In: deMarrais KB, Lapan SD, editors. Foundations for research: methods of inquiry in education and the social sciences. Mahwah: Lawrence Erlbaum; 2004, p. 217-234. 
  31. Creswell JW. Qualitative inquiry and research design: choosing among five approaches. Thousand Oaks: Sage Publications; 2007. 
  32. Punch KF. Introduction to social research: quantitative and qualitative approaches. 2nd ed. Thousand Oaks: Sage; 2005. 
  33. Yin RK. Case study research: design and methods. 4th ed. Thousand Oaks: Sage; 2009. 
  34. Marshall DC, Rossman GB. Designing qualitative research. 5th ed. Newbury: Sage; 2011. 
  35. Lincoln YS, Guba EG. Naturalistic inquiry. Thousand Oaks: Sage; 1985, p.120. 
  36. Woolston W, Connelly LM. Felty's syndrome: a qualitative case study. Medsurg Nurs 2017;26(2):105-109, 118. 
  37. Pyo J, Ock M, Han YJ. Medical litigation experience of the victim of medical accident: a qualitative case study. Int J Qual Stud Health Well-being 2019;14(1):1595958. 
  38. Meyer Y, Pehlke-Milde J, Muntwyler FS, Fleming V. Integrative power in Swiss home-like childbirths: a qualitative multiple case study. Midwifery 2019;78:97-103.  https://doi.org/10.1016/j.midw.2019.08.005
  39. Beal CC, Millenbruch J. A qualitative case study of poststroke sexuality in a woman of childbearing age. J Obstet Gynecol Neonatal Nurs 2015;44(2):228-235.  https://doi.org/10.1111/1552-6909.12553
  40. Yoo K, Jung J, Kim Y, Kim H. Qualitative research methods. 2nd ed. Seoul: Park Young Story; 2018 (Korean). 
  41. Creswell JW. Educational research: planning, conducting, and evaluating quantitative and qualitative research. Upper Saddle River: Pearson Education; 2002. 
  42. Morse JM. Situating grounded theory within qualitative inquiry. In: Schreiber RS, Stern PN, editors. Using grounded theory in nursing. New York: Springer; 2001. 
  43. Charmaz K. Constructing grounded theory: a practical guide through qualitative analysis. Thousands Oaks: Sage; 2006. 
  44. Strauss AL, Corbin JM. Basics of qualitative research: grounded theory procedures and techniques. Newbury Park: Sage; 1990. 
  45. Kim JE. Changes in Strauss & Corbin's grounded theory. J Korean Acad Nurs 2019;49(5):505-514 (Korean).  https://doi.org/10.4040/jkan.2019.49.5.505
  46. Kim IS. Divergence of grounded theory: focused on the differences of Glaser and Strauss. Korean J Soc Welf Stud 2011;42(2):351-379 (Korean).  https://doi.org/10.16999/kasws.2011.42.2.351
  47. Choe KS. Grounded theory methodology - Strauss' version vs Glaserian version-. J Korean Acad Psychiatr Ment Health Nurs 2005;14(1):82-90 (Korean). 
  48. Kim B, Kim O. The disease management experience of patients with asthma: grounded theory approach. J Korean Acad Nurs 2020;50(5):714-726 (Korean).  https://doi.org/10.4040/jkan.20139
  49. Choi HG, Yeom HA. Experiences of ego integrity recovery in elderly cancer patients: grounded theory approach. J Korean Acad Nurs 2019;49(3):349-360 (Korean).  https://doi.org/10.4040/jkan.2019.49.3.349
  50. Waldboth V, Patch C, Mahrer-Imhof R, Metcalfe A. The family transition experience when living with childhood neuromuscular disease: a grounded theory study. J Adv Nurs 2021;77(4):1921-1933.  https://doi.org/10.1111/jan.14754
  51. Herron DL, Priest HM, Read S. Supporting people with an intellectual disability and dementia: a constructivist grounded theory study exploring care providers' views and experiences in the UK. J Appl Res Intellect Disabil 2020;33(6):1405-1417.  https://doi.org/10.1111/jar.12768
  52. Wang C, Burris MA. Empowerment through photo novella: portraits of participation. Health Educ Q 1994;21(2):171-186.  https://doi.org/10.1177/109019819402100204
  53. Latz AO, Mulvihill TM. Photovoice research in education and beyond: a practical guide from theory to exhibition. New York: Routledge; 2017. 
  54. Wang CC. Youth participation in photovoice as a strategy for community change. J Community Pract 2006;14(1-2):147-161.  https://doi.org/10.1300/J125v14n01_09
  55. Wang C, Burris MA. Photovoice: concept, methodology, and use for participatory needs assessment. Health Educ Behav 1997;24(3):369-387.  https://doi.org/10.1177/109019819702400309
  56. Wang CC. Photovoice: a participatory action research strategy applied to women's health. J Womens Health 1999;8(2):185-192.  https://doi.org/10.1089/jwh.1999.8.185
  57. Graziano KJ. Oppression and resiliency in a post-apartheid South Africa: unheard voices of Black gay men and lesbians. Cultur Divers Ethnic Minor Psychol 2004;10(3):302-316.  https://doi.org/10.1037/1099-9809.10.3.302
  58. Teti M, Murray C, Johnson L, Binson D. Photovoice as a community-based participatory research method among women living with HIV/AIDS: ethical opportunities and challenges. J Empir Res Hum Res Ethics 2012;7(4):34-43.  https://doi.org/10.1525/jer.2012.7.4.34
  59. Moffitt P, Vollman AR. Photovoice: picturing the health of Aboriginal women in a remote northern community. Can J Nurs Res 2004;36(4):189-201. 
  60. Lopez ED, Eng E, Randall-David E, Robinson N. Quality-of-life concerns of African American breast cancer survivors within rural North Carolina: blending the techniques of photovoice and grounded theory. Qual Health Res 2005;15(1):99-115.  https://doi.org/10.1177/1049732304270766
  61. Martin Romero MY, Jeitner EC, Francis LA. Visualizing perceived enablers of and barriers to healthy eating by youth in rural El Salvador. J Nutr Educ Behav 2019;51(3):348-356.  https://doi.org/10.1016/j.jneb.2018.09.012
  62. Weber RP. Basic content analysis. Beverly Hills: Sage; 1985. 
  63. Choi S, Jeong J, Jung SW. Concept and procedure of qualitative content analysis. J Qual Inq 2016;2(1):127-155 (Korean). 
  64. Lee Y, Kim Y. Qualitative research in education. Seoul, Korea: Gyoyukgwahaksa; 1998 (Korean). 
  65. Riffe D, Lacy S, Fico FG. Analyzing media message: using quantitative content analysis in research. New York: Routledge; 1998. 
  66. Krippendorff K. Content analysis: an introduction to its methodology. Beverly Hills: Sage; 2004. 
  67. Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res 2005;15(9):1277-1288.  https://doi.org/10.1177/1049732305276687
  68. Elo S, Kyngas H. The qualitative content analysis process. J Adv Nurs 2008;62(1):107-115.  https://doi.org/10.1111/j.1365-2648.2007.04569.x
  69. White MD, Marsh EE. Content analysis: a flexible methodology. Libr Trends 2006;55(1):22-45.  https://doi.org/10.1353/lib.2006.0053
  70. Lester P, Smith R. African-American photo coverage in life, Newsweek and Time, 1937-1988. Journal Mass Commun Q 1990;67(1):128-136.  https://doi.org/10.1177/107769909006700119
  71. Benedikt T, Marlies B, Susanne G, Nikolaus R, Ewald S, Thomas N. Content analysis of suicide-related online portrayals: changes in contents retrieved with search engines in the United States and Austria from 2013 to 2018. J Affect Disord 2020;271:300-309.  https://doi.org/10.1016/j.jad.2020.03.063
  72. Huang X, Lee S, Hu Y, Gao H, O'Connor M. Talking about maternal breast cancer with young children: a content analysis of text in children's books. J Pediatr Psychol 2015;40(6):609-621.  https://doi.org/10.1093/jpepsy/jsu110
  73. Rakic M, Escher M, Elger BS, Eckstein S, Pacurari N, Zwahlen S, et al. Feelings of burden in palliative care: a qualitative analysis of medical records. J Palliat Care 2018;33(1):32-38.  https://doi.org/10.1177/0825859717750522
  74. Golafshani N. Understanding reliability and validity in qualitative research. Qual Rep 2003;8(4):597-607. 
  75. Guba EG, Lincoln YS. Fourth generation evaluation as an alternative. Educ Horiz 1985;63(4):139-141. 
  76. Lincoln YS, Guba EG. But is it rigorous? Trustworthiness and authenticity in naturalistic evaluation. New Dir Program Eval 1986;(30):73-84. 
  77. Creswell JW, Miller DL. Determining validity in qualitative inquiry. Theory Pract 2000;39(3):124-130.  https://doi.org/10.1207/s15430421tip3903_2
  78. Korstjens I, Moser A. Series: practical guidance to qualitative research. Part 4: trustworthiness and publishing. Eur J Gen Pract 2018;24(1):120-124. https://doi.org/10.1080/13814788.2017.1375092