—with Heather Fritz and Cathy Lysack
The types of research discussed thus far have included explanatory, exploratory and descriptive approaches, with one commonality—they have all been based on quantitative methods, using empirical data to answer questions about cause and effect or establishing linkages among variables based on statistical applications. An important limitation of the quantitative paradigm, however, is its inability to capture human experience in more nuanced contextual ways, including understanding the experience of patients, families, and healthcare providers who encounter illness and disability in clinical practice and daily life.
Qualitative research is based on the belief that all interactions are inherently social phenomena. It is used to provide evidence when the goal is to identify, describe, and ultimately understand human or organizational behaviors, attitudes, and experiences, and how they influence health. The purpose of this chapter is to provide an overview of qualitative research methods that will provide sufficient background to appreciate published qualitative studies.
Because the true complexity of qualitative research is beyond the scope of this text, readers who want to pursue qualitative study are encouraged to seek out expert consultants and to refer to many excellent references that provide more in-depth coverage of qualitative methods.1-8
Human Experience and Evidence
Concepts of research typically involve quantitative assumptions within which human experience is assumed to be limited to logical and predictable relationships. Linked to the philosophy of logical positivism, this approach to inquiry is deductive and hypothesis-based, requiring that the researcher operationally define the variables of interest in advance.
However, when we think about all the reasons that an intervention does or does not work, or why some patients adhere to therapeutic regimens while others do not, we realize that “counting” responses for groups is unlikely to bring us the full understanding that is needed to appreciate how personal differences impact outcomes. And while healthcare providers try to give patients the best care possible, they may be missing essential underlying elements that can influence outcomes.
In contrast, qualitative research favors a gestalt way of seeing the world that strives to represent social reality as it is found naturally. It goes beyond learning about individual beliefs and behaviors to more deeply discover and describe socioculturally constructed worldviews, values, and norms and how these are instilled, enacted, reinforced, or resisted and changed in everyday life. To obtain these insights, qualitative researchers must conduct inquiry in the natural settings where people interact and then find ways to systematically capture, mostly in narrative form, qualities that are often complex and difficult to measure. Where quantitative research is based on numbers and statistics, qualitative data are text-based, involving open-ended discussions and observation.
Whereas quantitative researchers try to control the influence of “extraneous variables” through standardized design and measurement, qualitative researchers work ...