Learning objectives our lives are full of

Afer reading this chapter reader

striving all the time toqualities
find out
and we are
shouldknow: substitutes them. This happensquantitative
for
of qualitative
because of overemphasis in our probably
The importance system about education
research
admission to aobjectivity. Let it be geting
Differences between qualitative and an institution. medical
Amedicalcollege
or job in
quantitative research surely have knowledge but student should
Steps in planning qualitative research more than that she shouldaccording to me
have qualities
Methods of qualitative research of empathy and
our entrance kindness. Unfortunately
Data collection and analysis in examinations are all based
qualitative research
on
objective type questions with multiple
choices and we are seeing the outcome.
Softwares for analyzing qualitative state of affairs of medical practice and The
research the
malpractices are all shouting against such
Uses of qualitative research methods for getting admission to a medical
Limitations of qualitative research college. It is likely that we continue with a
system as there is no valid alternative or we
Ibert Einstein's famous quote- Not have become complacent and not searching
for other methods.
Aeverything that can be counted
counts and not everything that counts can be No doubt, we are comfortable with
counted" is a fitting response to those who quantities. But consider this example. Awife
question the utility of qualitative research asks her husband, "How much do you love
in medical field! It is paradoxical that all me?" The husband answers, "75% One can

HOMWUCH

o y oLuO v E
 and how they say
they feel.
imagine what will happen in that house! I It This kind
of information subjective. t
is
am sure the 75% would be considered as 0% involves
feclings and impressions, rather than
and the husband will have to repent for his numbers' (Bellenger, Bernhardt and
quantitative answer. Goldstucker).
Same problem happens now a days in Qualitative research often studies
phenomena in the environments
schools too. They have replaced marks by
grades. Now students getting marks from which they naturally 0ccur and uses
grade.
90 to 100°% are all classificd as 'Athe day social actors' meanings to understand
parentson the phenomena. (Denzin
Tou can see the faces of &
of them to
of result. It is ditticult for many good as Lincoln)
as
digest thefact that their child is Oualitative research 1s an approach
23 others! which seeks to understand, by means
often and
Measurements cantell us how of exploration, human experience,
particular way
how many people behave in ato the question perceptions, motivations, intentions and
but we cannot get answer behavior.
attempts to
"Whv?" The research which
thingsare Qualitative Researchers study "things"
increase our understanding of why C
worldand why (people and their thoughts) in their
the way they are in our social
called as
the people act in a way they do is natural settings, attempting to make
"Qualitative" research. sense of, or interpret, phenomena in
What is qualitative research? terms of the meanings people bring to
them.
Qualitative research is an

interdisciplinary, trans-disciplinary, and Qualitative research involves the

sometimes counter-disciplinary field. It studied use and collection of a variety
crosses the humanities and the social and of empirical materials case study,
physical sciences. Qualitative research is personal experience, introspective,
many things at the same time. It is multi life story, interview, observational,
paradigmatic in focus. Its practitioners historical, interactional, and visual fexts
are sensitive to the value of the multi that describe routine and problematic
method approach. They are committed moments and meanings in individuals'
to the naturalistic perspective, and to the lives.
interpretative understanding of human
experience. At the same time, the field It deploys a wide range ofinterconnected
is inherently political and shaped by methods, hoping always to get a better
multiple ethical and political positions fix on the subject matter at hand.
(Nelsonet al. 1992). What are the differences between
"Oualitative Research...involves finding qualitative and quantitative rescarch?
out what people think, and how they feel The table below gives salient differences
- or at any rate, what they say
they think between these two types of research.
 Quantitative rescarch
Generalfcatures " Experimental Qualitative research
" Ficld research
" Laboratory-like control
Logical Positivism Ethnography or phenomenology
Arpnch Sccks facts and causes apart from Constructivist
Secks to
Ratwtionist vs, individual states understanda
from within an phenomenon
Constretivist How is expericnce shapcd by the of being individual's state
world?
How is the world
experienced?
Role of Creates variables that are amenable
measurement to statistical analysis
Uses discourse as data, long
External, easily verifiable descriptive text using
own wordsand dialogues. people's
Seeks techniques to explore a
phenomenon from "under the
skin" of another
Deductive Vs. Variables are conceived a priori No preconceived assumptions/
Inductive Research question/Hypothesis comes suspend your beliefs
first
Patterns emerged from the
collected data after the fact
Role of researcherResearcher's judgment essential Researcher becomes the
before and after instrument"
Researcher should be "absent"
during experiment Triestosuspendanypredispositions
and assume it is being experienced
for the first time"
Reduction Vs. Truth is to be found incrementally, Humanistic perspective urges a
Holist one small "tweak' after another holist approach
Science has always found out about When we reduce people to
phenomena little at a time variables, we lose the larger
Science Vs. Art
understandings possible
Quantitative Approach Qualitative Approach
Once youunderstand the basic rules, Takes a lot of practice to do it
anyone can do it. well.
Data Numerical Textual
Sampling
Study design
Random/Probability Non random/convenience
Stable from beginning tillend Some aspects are flexible
Hypothesis Confirms hypothesis Explore hypothesis
Tools for gathering Highly structured Semistructured or un structured
information
Gaining " Bit by bit...as if looking in the light Suddenly everything becomes
knowledge of a torch while we search an item in
a dark place.
visible.. as if lightening in a dark
place.
 a)Main c)
(on issues:
Qualitative
assessment
involves
It dimensions
features (of be
více-verSa.
There groups, b) a)
is oneuniqueviewed other with have onlyone
explorative measurement
variables studied. Maharashtra
wil Phenomenon by
individual
Instance whatandEvery nurses,operation
have happy wil "Are necessarv, patient
inparameter. beHuman 0y Usually
parameters used.are
are and facets not step. To the judgcdasking
of communities treated not you
by other stayto
be phenomenon and with be hospital teels
qualitative of (or We many henceothers. of interview of may is behavior multiple
villagers enough. other etc )
sufficient.
the satistied If
in researchvariables may in seen him on a
nature. & nced the areknowwhy can
not but about Hence
we single
analysis) aspects observations the committing staf)! treatment then the
not Each same be be or (behavior not wi th the want questions
or village
Investigator heard has onl y many cannot
interest).
research understood the Because basis
qucstion
studied), to societies,easilyindividual incident to victim's the treatment
the to
understand
and of several (medicine know
understand farmers in real in of wa y one questions
of be and
values data apply made and suicides the treatment?" he
are units as truth. levels
doctors,people may questionoffered assesscd
a or multiple
|02 ---- and wife step first what singlecannot
to to on is is talk will many
and be are
a
ThereConcepts.
who a
Iiterally able to researcher
other data, studied,
being
develop or maypersonreality
hopePhenomenological towardsemphasizes real
may partexperience
way Qualitative
1.research
designs b) a)Uses c) ) c) )
ofthe
identify wil be a Phenomenology
is is be participateto people's such social for be life An Theyareofgenerated
research. It
quantitative
from methods. Itnumbers. holistic.
flexible. It
is isI It t
at of
means waiting
his - of Mcaning
the is has
a events,
describing the life) foactive
r dat
hel
aps hel ps
qualitative
henomenon.
ying- the Here world of asmay or experienceapproach interactive
worker example, inductive
the sample a interpretation
research. orher
for and in in
centrecomes in the novels, draw what involvement five explaining is
situations, phenomenon only
"Two which study because the aresearch, seeks developing
questions
for more
something in kidney main research and
approach.
the of films on it what to
of 1 The remaining
the sourceis of of important
men the we of thpeople
ey phenomenological other like research,
which types reflexive.
role phenomena.
live. of
1990s. transplant it in then, an to quantitative
researchingor
researcher means one explore such
saw theof Pthat under have who sources the beto individual.
is
s than
CxperiencesPhenomena existS directed
from persona
rstudy. It situation To a (which person' to as:
person has help nurse be the
the or 1 a
 onesawthe mud other the stars!" 3. Grounded theory
prison bars;
the individuals bring meaning to It is an
That'show approach to research in which
phenonenon. Aphenonenological study the aim is to collect and analyze
a explorethe cflect of a discase
may try to
data in order to develop a theoryqualitative
which is
schizophrenia of parents
likecpilepsy oron the children as regards
'grounded' in the data. Grounded theory
is rather different to the other
and its eflect
their personality development
and social
us that discussed so far, because it approaches
uses both
relationships. Clinical trials can tell inductive and deductive reasoning. The
epilepsy but
anedicine is effective against unanswered. researcher formulates tentative theories
the abovementioned issues are about what is observed (using inductive
definitive
Such research may not provide reasoning) and then follows up these ideas
insight
answers but it surely increases our by further inquiry (deductive reasoning).
and raises awareness.
Grounded theory falls into the category of
2. Ethnography the generation of knowledge through theory
An approach to research influenced
development rather than theory testing. The
approach to analysis in grounded theory is
by the anthropological tradition, in which more structured than in other methods. Data
the researcher seeks to understand human
behavior from the perspective of the is analyzed concurrently as it is collected.
individual in a given culture. There are Any emerging theories that arise out of the
many strong arguments in favor of using research are called as grounded in the data.
this approach in health and social care. After This methodology has originated from the
all, if we have a clearer understanding of work on interactions between health care
the culture of the client groups that we are providers and dying patients by Glaser and
working with it should help us to direct our Strauss. Its main feature is the development
care tomeet their needs more of new theory through the collection and
Ethnography means "portrait appropriately.
of people" analysis of data about a phenomenon. The
and it is a methodology for explanations that emerge are truly new
studies of cultures and peoples. descriptive knowledge which is used to develop new
O a common
parameter in such
Examples theories about a phenomenon.
include geographical (a region or studies 4. Case study
religion, tribe, some shared country),
Researchers may choose an
experience etc. Case study research is one of those
pproach because the cultural ethnographic approaches which can take a qualitative or
described above is suspected ofparamneter
affecting
as quantitative stance. While understanding
people's response to care or treatment. the
descriptive studies we have learnt about
exampl e people from onc
refusing to take polio communityIf were
For
case report or case study. In the qualitative
COnduct s ethnographic studyvaccination. one research in depth analysis of asingle or small
have some then we Can number of units is carried out. Such study is
which if not understanding
polio eradicationaddressed
programme.
of such
to can damagebehavior
our
used to describe an entity that forms a single
unit such as aperson, an organization or an
institution.

-- 103 --
 interviews one should not ask
5. Surveys questions. Follow-up interview
needed to verify some lemayadingbe
This is a design in which we go to a
group of people once (Cross sectional) or ii. Key Informant Interviews: information.
more than once (longitudinal) to obtain some
information. This method is routinely used
are "Qualitative, in-depth, flexible
interviews with
These
by practitioners of public health to estimate
or or experts who
knowledgeable
know what is persons
SOme parameters such as mean Hb%
serum cholesterol etc. Similarly survey can
on in the community,
which we want to get
about atopicgoingon
be used to know the patterns of behaviors in informat
objectives1sinclude collecting:ion." The
people.
Steps in planning a qualitative research
from a wide range of people-
community leaders, professionals:
infionrclmuatdiinogn
getting general information
lt is not very different from the
steps
local community and the about
of research as we have seen in
research. These steps include:
quantitative
obtaining insight
on the nature of problems and thei.
recommendations for solution.
a) Selection of the problem
iii. Focus group discussions: FGD is a
b) Formulation of hypothesis (Optional)
group discussion of
c) Selection of research strategy (Study
persons guided by a approximately
6-12
design and sample size) facilitator,
which the members of the groupduringtalk
d) Development of study instrument (Set
freely and spontaneously about a certain
of questions, pictures, posters etc)
e) Collection of data
topic.
f) Analysis of data Focus group discussion Can help
researchers to:
g) Report writing
Some commonly used methods in Focus research and develop relevant
qualitative research research hypotheses.
A. Rapid appraisal procedures Formulate appropriate questions for
more structure and large-scale surveys.
i.
Individual in-depth interviews: Its Help understand and solve unexpected
purpose is to identify and provide problems in interventions.
preliminary exploration of relevant
topics with selected Develop appropriate messages for health
informants. It is
conversational, one-on-one interviews
using open-ended questions. The education programs.
aim is to get EXplore perceptions on controversial or
and express informants in "open up"
to
themselves their own sensitive topics.
terms. Some operational issues Steps in the process of focus group
include
preparation of in-depth Interviews, discussion
interviewing process, and recording theof Identify and train
interviews. While conducting in-depth recorder.
the moderator and

104 --
Reeruit
purposefully selected Limitations of focus group:
participants. You identify
may It requires skilled moderator and
participants during social bemapping recorder. The group is often difficult to
exercisc.Participantsshould willing assemble and considerable care must
the topic. be taken to provide a setting
to talk freely on conducive
for sitting, to discussion. As the
Make arrangenments
drinks and child
respondents are
guipment, snacksand purposefully selected, the researcher
care ifneceSsary. cannot generalize from the results.
breakers or warm-up One really needs to have a good practice
Begin with ice
twin pairs. Give
questions. (1. Make introduction. of asking leading and probing questions.
Ask FGDsession can go maximum up-to 90
little time for mutual
Ask minutes.
them to introduce each other, 2.
them about their well-being or general iv. Case studies: This is in-depth
health conditions in the village). interview, but focused on individual's
who is
Be aware of who is talking and own actions&explanations. Individual
not-Do not allow one or two individuals illness episode" can be very useful
to dominate. type of case study, wherein researcher
asks about entire illness episode and
Usebroad, open-ended questions. Fore.g.
use a checklist of items to fill in entire
What is your opinion about government
health care services? *Avoid* yes or sequence of treatment seeking as well as
no or short answer questions. For e.g. explanations on causeof illness, reasons
Do you like government health care for worsening/improvements etc.
services? V.
Participant Observation: In this
Always probe and don't imply judgment. method, investigator becomes active
Express your interest and curiosity. functioning member of culture under
study. He participates in activities,
Record body language, nonverbal observes what others do, gets involved
communication and record in writing in unstructured interviews and
any nonverbal data. (Add researcher's observations to seek a holistic view of
comments in parentheses.) people and behaviors being observed.
If a tape recorder is used, complement B. Free listing:
taped transcripts with field notes in
preparing final transcripts. Free lists help to isolate & define
relevant domains. Researcher simply asks
Prepare descriptive text
analyze it. See section on report and respondents to list as many items as they can
Analysis mater in this manualQualitative
for
think of in a particular domain. E.g. "Please
information about data analysis. more tellabout all the illnesses that old people get
in your village."
Write report. C. Pile sorting:
It aims to study relations among items
-- 105 --
 useful for discovering
(a Quality Assurance tool)
within a domain. It is and
perceptions on similarities && differences b. Method triangulation:

among items. Ithelps to look

variations in how informants
at intra-cultural
define domains.
cards with
qualitative & quantitative
Scheme of data Combining
analysis includesmethods
Informants are asked to sort

according to their own criteria and to

groups
names of items written into piles or make
steps
a) Free Listing
fol owing
they wish. Once Domain Evolution
as many ot as few piles as asked to
b)
pile sort is completed, informant is c) Coding
explain the difterent piles.
d) Comparative Tables
D.Triangulation: Stakeholders Across
quality of data
it is method to enhance Here is the summary table of
and is through some key
featuressoftechniques used for
Data triangulation: Results from
cross
in qualitative research: data collection
validation of data from various sources

Participatory research In-depth techniques Systematic

(PR) techniques techniques
Tools Social mapping, Pair-wise Focus Group Discussion Free listing
ranking, Seasonal calendar, (FGD), Key Informant combined with
Cobweb diagram, Trend Interviews (KII) and In Pile sorting,
analysis, Venn diagranm etc. depth Interview (IDI) Delphi panel
|Approach Community-based research Phenomenological and Pre-survey
and as teaching-learning grounded theory research or used
tool for students from approach in combination
social, medical and public with PR or in
health background depth techniques
Participants are seen as partners in the-are
seen as study are seen as study
research process subjects subjects
Analysis Diagrams and content
analysis of group Content analysis can be Analysis is done
discussion done using Atlas-ti, using Anthropac
Nvivo
SAMPLING IN QUALITATIVE
RESEARCH differenttperspectives on the research topic by
Sampling is a generating rich textual data, Non-probablty
agroup of
researchscientific way of selecting Sampling is recommended. (As opposed t
where each individual
purpose of participants.
qualitative Since the probability sampling
outthe answer to the research is to find has an equal chance of participationinthe
question why, explore study) The examples of non-probability
sampling are as follows.
 sampling, no new information is added after additional
Purposic(orl
Purposctul)
) sclected bccausc interviews or focus group discussions. Since
units are there is no sample size estimation and there
rich information about the
otler is the use of
theycan
of intercst, c.g. Women who non-probabilitysampling in
phenomenon contraception, qualitative research, the findings do not test
diflerent methods of any hypothesis but direct the future course of
events.
ims ofsome research on relatively new or rare topics by
sampling, where the generating rescarch hypothesis.
) Convenicncc
amenientl available respondents are

Women working in the field, Researcher uses following ways to analyze

his data
common meeting place.
emievisitors save time and
that while this can a) Categorisation
the richness of
Spures, itmay sacrifice
intomation obtained from a more purposeful b) Unitising data
sciaction ofparticipants.
c) Recognising relationships and
3) Quota sampling is a restricted type developing the categories useful to
of convenience or purposive sampling facilitate this
deining the quota of sample to be drawn
from different strata and then drawing the d) Developing and testing hypotheses to
reach conclusion
required sample. E.g. For each village, we
mav decide to undertake one FGD.
Softwares and programmes for data
4) In Snow-ball sampling, the sample analysis in qualitative research
is driven by the respondents. It involves a) Anthropac
zsking your respondents to identify other
potential participants with a specific set of b) Ethnograph
characteristics and then continuing to ask
the same of subsequent c) ATLAS/ti
respondents. It is
used when the target population is
or difficult to approach, e.g. unknown d) NUD*IST
workers, dowry victims etc. Such as SexX e) NVivo
Sample size in qualitative research: f) Weft QDA (freeware)
Itis difficult to
there is no determine sample size and Ethical Issues In Qualitative Research
Sample sizemathematical
in qualitative
formula to calculate There is an increase in publications on
On the purpose of the rescarch. depends qualitative research methods. Qualitative
It
Tesources, The validity, study and available research is vulnerable to bias through the
Ihsights generated from meaningfulness
the
and attitude and qualities of the researcher, social
have more to do with qualitativeof data desirability
the richness
factors, and conditions of worth.
dbtained. The process of data collection data Except
Continued tillthe saturation point, i.e. is sociological
with few exceptions of nursing,
and anthropological literature,
Where no published articles on qualitative methods
107 --
 a) c) b) a)
Limitations Qualitative c)
experts
without researcher.
Thepopulation these Can, b) a)Whystudies. in Some
beneficiaries.
ItQualitative based
Campaign philosophical
ethicalethics healthto ethical In in
the biomedicalresearchonhumansubjccts Specificwi(1CMR) th out
may quantitative
research. motivations research There
quantitative
research.
Usually health India,medical
multitude
in differences on
qualitative
formal efficiency committees
issues
professionals researchers
the not of is guidelines has
small sciences, reference Indian
field! that qualitative to no research
be research successes and better it arising provided
differences research understand research
training, of is but is aspects Council
(A representative and feelings have Unlike for have
ofquantitative much in to addressed
real
individuals doesn't way have
interest research
and effectiveness relation
dificulty qualitative qualitative
argucd ethical of
profess
danger!) can is ofsocial
in
failures in-depth
of than popular?
cheaper poor Medical
distinguish the patients. research. guidelines
research qualitative to thc ethical
towho, to of mix improve qualitative
assessing scientists,
orientation nced
rescarchrescarch.
be the the than
Rescarchissucs.
of are of the Also,
for tor
8. 7. 5. 4 3.
6. 2 1.Some
journals.
medicalpapers thisbeingbehaving. more 1 his about can rescarch theybutare and
Expectations services
Case doctor Satisfaction Photo-elicitation
Interpreting Workers
Teaching Discussions
Eliminating
explorationFarmers' of healthUsing component dissertation
examples starts feelings, be One
research
sent patient qualitative
studies Maharashtra quantitative
teaching happerning wi l
of the to This are must
suicides findjournalsperceptions of
rescarch
a health and with of transect papers satisfaction
qualitative not
of tertiary
of ofLearning Malnutrition: of wil1 complimentary.I understand
research
Childhood their their
terminally people patients qualitative
and antagonistic
as
Mothers surely but the
educational India: in amn I for with
care causes learning
the it
regarding a walk' legitimate qualitative sure compliance, research.
orhis or main methods
from Tool publication. result a has that
hospital Public
andAnganwadi Vidarbha
il a research these peculiar to part to
tool as in quantitative
feel
patiens practie"s a qualitative research
have of each in
posters a researchresearch r
place more It
hospital Health region public way may Some inmedical
Once other
and any
in of be
 qualitativeresearch
Reportingof
Consolidatedcriteriafor reporting qualitative rescarch (COREQ): a32-item checklist for
groups
interviewSandfocus
nutshell various domains and items covered in this checklist.
Following table gives in
Consolidated criteria for reporting qualitative studies
dies (COREQ): 32-item
Table:
checklist

No Item
team and reflexivity
Domain1: Research
luTo8)
Personal Characteristics Interviewer/facilitator, Credentials, Occupation,
Gender, Experience and training
Relationship with participants Relationship established, Participant knowledge
of the interviewer, Interviewer characteristics
23)
Domain 2: study design (9 to
Theoretical framework Methodologicalorientation and Theory
Participant selection Sampling , Method of approach , Sample size,
Non-participation
Setting of data collection, Presence of non
Seting
participants, Description of sample,
Data collection Interview guide, Repeat interviews, Audio/
visual recording, Field notes, Duration, Data
saturation, Transcripts returned
Domain 3:analysis and findings
(24 to 32)
Data analysis Number of data coders , Participant checking ,
Description of the coding tree, Derivation of
themes, Software
Reporting Quotations presented, Data and findings
consistent, Clarity of major themes, Clarity of
minor themes
research
[ Source:
Tong A, Sainsbury P,,Craig J. Consolidated criteria for reporting qualitative
(COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care.

2007;19(6):349-357.]