Interpreting a Qualitative Research Paper

Original Editor - Mariam Hashem

Top Contributors - Mariam Hashem, Kim Jackson, Ewa Jaraczewska, Mandy Roscher and Tarina van der Stockt  

Introduction

Interpreting a qualitative research paper is an analysis of the quality of the material between your hands. It allows you to understand the reliability of the research and the construction of the paper.

Characteristics of qualitative research:

• Explores the meaning
• Achkowleges the researcher’s point of view (reflexivity)
• Interpretative methods of analysis
• Iterative process
• Contextual: concerned with the individual's perspective
• Inductive method of inquiry

Critical Appraisal of Qualitative Research

Techniques for imposing rigor:

• Triangulation: is defined as the use of varied methods, data sources, and multiple researchers
• Reflexivity: refers to the position of the researcher/s in relation to the research, their interaction with participants
• Multiple coding: the use of independent researchers, calculate inter-rater reliability and idea generation
• Respondent validation: involving participants to give their opinion and interpretations to provide an overview and generate further data
• Deviant case analysis: most relevant in the ground theory. Exploring participants who might seem to be deviant from the norm

A qualitative researcher must:

• Eliminate subjectivity
• Acknowledge their relationship with the study/participants/data and question implications on study findings
• Discuss varied viewpoints to gain a greater range of perspectives
• Examine deviant participants and multiple coding exercises that challenge assumptions

Step by Step Guide

Sample size and participants

Check the following:

• Was the sample used appropriate to its research questions?
• Methods of the participants' selection and recruitment
• Was the recruitment strategy relevant to the research question?
• Was the sampling strategy justified?
• Was the sampling purposive/ theoretical?
• Was it a convenience sample?

Data Collection

Were the data collection methods appropriate for research objectives and settings? this involves an in-depth analysis of the methods and how did this influence the findings?

Data Analysis

Characteristics of proper data analysis:

• Transparency in the analysis and interpretations
• Uses a systematic approach
• Discusses contradicted data and divergent findings
• Multiple coding
• Creditibility of results
• Justified conclusion

Transferability

Could the results of the study be transferred or applied to the practice?

Ethics

The study should reflect a balance of moral actions

Components of the ethical research relationship

• Acknowledgement of bias
• Rigour
• Rapport and managing distress:
• Respect for autonomy
• Confidentiality, especially in research reports
• Avoidance of exploitation (being aware of power relationships)

Checklists:

CASP is the Critical Appraisal Skills Programme (CASP) checklists which are often used in health research and cover many research methods, including qualitative research. They are designed to prompt the reader to reflect on different aspects of a research paper and are typically structured around three core domains asking:

1. The validity of the results
2. The findings of the study
3. The transferability

The Validity of the results: This can be subjective as these studies don't have statistical significance instead there is a heavy reliance on the essence of the qualitative research by critically appraise and reflect on the methods and the design of the research.

Section B looks at the findings or the results of the study.

Section C is concerned with the applicability of the results.

Analysing the qualitative research, think about these questions:

• Is there a clear statement of the aims of the study?
• What are the goals of the study?
• What was the rationale for this research?
• How relevant is this?
• Is the research question clearly formulated? Is it important?

A-The research introduction should give the context and reflect the importance of the research question leading up to the rationale of the research. It should also discuss the gap in the area that's been researched with the angle of focus. Previous research should also be discussed and a highlight on similarities and limitations to explain why this research should take place and it's significant to find answers,

B- Analysis of the qualitative research methods and the used approach. Is it appropriate for the questions? is a qualitative approach appropriate? Qualitative methods are used when illuminating some actions or subjective experiences of participants or looking to gain an in-depth understanding of a phenomenon.

C- Reflecting on the study design and whether it's appropriate for the research question or not. For example, using ethnography would be an appropriate design when studying a particular cultural group.

D- Analysing the recruitment strategy. For example, exploring the experience of rural dwelling, older adults in communicating with family members during the COVID pandemic. Recruiting participants through social media and using the snowballing technique is a good way to encourage a large sector of participants but using it a the sole recruitment strategy could dismiss or potentially exclude people who aren't good with using technology or those who haven't used technology to communicate with their families.

E- The sampling strategy. Are the inclusion and exclusion criteria clear and purposeful to recruit specific participants who the interesting subject of the research? Also, think if the sampling was probably quite inclusive and left any cohorts out?

F-The data collection method. Looking into the methods used in the research whether they were justified to meet the criteria of the research question and does it match the subject of research? are the methods varied enough to give participants choice? Also, analysing the way the authors used and documented the methods. For example, if interviews were used to collect data, we should be looking into was the interview structured? Was it semi-structured? Or was it unstructured? And why was that? so the details of the method and the rationale that justifies the use and the application of the method.

G-Data saturation. In qualitative research, particularly if it's interviews or focus groups, data saturation is the point at which new information or themes stop to emerge when the data set is saturated.

Data saturation and sample sizes in qualitative research are under-reported sometimes. Sample sizes, can often not be justified very well in qualitative research. So, for example, if it's an interpretive phenomenological analysis looking into in-depth analysis usually involves a smaller sample size.

If data saturation isn't mentioned in the qualitative paper, it could prompt to ask or query the validity of the results because I don't know for certain that there wouldn't have been any other themes that emerged or any contradicting viewpoints or sub-themes that could have emerged.

This could be challenging for researchers when writing the research protocol and determining the sample size at the stage when data saturation is still unknown at which number of participants and it needs to be monitored and reported.

H- Looking at the validity of the findings and any conflict of interest and the relationship between the researcher and the participants as this might influence the results. Looking at factors that might reflect bias in the viewpoints of the researcher, the data collection method that is known as reflexivity. Reflexivity is essentially self-awareness when a researcher reflects on their own position within the research and they consider their own biases. And importantly, when they make it fairly clear and explicit in the research paper of potential biases that they may have. COREQ is a checklist of the criteria for reporting qualitative research. It is for authors to check and tick off when writing qualitative research where there is a whole section dedicated to reflexivity and the research team and their relationships and their own self-awareness.

Reflexivity is self-awareness of one’s role in the research process, and how a researcher’s viewpoint may influence the process. It is unlikely that a researcher would remain completely neutral towards a topic with no opinion or viewpoint towards it at all. As a result, awareness and reflection of this thinking and an examination of our ways of doing is important to note in qualitative research. reflexivity is sometimes confused with reflection. Hibbert et al offer a useful distinction between the two terms, suggesting that reflection is like a mirror image in which gives us the opportunity to observe and examine our ways of doing. Reflexivity, on the other hand, involves thinking about our experiences and questioning our ways of doing.

Section B is around the results. What are they? There are questions in the checklist to think about:

1-Ethical considerations. Mainly looking into the details of recruitment and involving participants and whether ethical standards were maintained and kept. For example, does it talk about informed consent? Do the authors talk about a participant information leaflet? Do they talk about an opportunity for participants to pose any questions? Also looking into whether the authors discussed any particular issues raised by the study, for example, the effects of the study and how they were handled particularly when a sensitive topic is explored. How did they handle participants becoming distressed or experienced discomfort?

2- Clarity and transparency of data analysis. The steps that were taken into the process and making sure they weren't biased. Looking into the in-depth description of the analysis process? Types of analysis,

The data that is presented, how was it selected from the original sample? To demonstrate the analysis process. Is there enough data to support the findings? So, for example, if we have a theme and I say that most men with prostate cancer reported fear of recurrence around their condition. But I only give one quote to support that. Is that enough? You usually need to have sufficient data, within reason. You also need to consider as the reader that qualitative papers can be quite lengthy, where the results section is quite vast often because you are really going in-depth and there's a lot of quotes and things. So, sometimes, it's possible that the authors mightn't have had enough space to put in lots and lots of quotes. So while we aren't looking for, you know, a quote from every single participant or most participants to support that theme, we do want, you know, two or three quotes, maybe that support our findings that we're claiming.

3- Contradicting data. There will often be some contradictory data that arises from the research and that needs to be recorded for clarity and transparency with the balance to discuss both sides.

4- Did the researchers consider other opinions without bias. a third party could be involved to eliminate the bias of research and reflect reflexivity

5-Clear statement about the results of the findings. The main findings should be discussed clearly in the discussion section with evidence both for and against their argument agreeing or contradicting previous literature. Do they critically analyse their findings in the context of different populations, different settings, in the context of research, practice, policy in the context of the evidence base that's out there?

6- The credibility of the findings. Credibility is one of four domains of Lincoln and Guba's evaluative criteria. The four criteria are credibility, transferability, dependability, and confirmability.

Lincoln and Guba suggested that in order to evaluate the worth of a study, its trustworthiness needs to be established. Trustworthiness, they suggest, involves establishing credibility, transferability, dependability, and confirmability.

Credibility is how confident we are in the truth of the findings? One thing to think about is triangulation, for example, looking at different cohorts who have their own experiences of a phenomenon, but from a different viewpoint. An example, looking at facilitators and barriers to return to work after Breast Cancer diagnosis. Including different cohorts such as women who've had breast cancer, employers, healthcare professionals. partners or colleagues, etc.To get different viewpoints and that triangulation is what supports the findings and helps to come into a conclusion.

Triangulation can be also achieved by using a number of different methods.

Respondent validation. also known as member checking. Checking the analysis to ensure the conclusion is not just an analysis of your interview and ensures a fair representation of the findings.

7-How valuable is this research? Is it applicable or practical to apply on practice, research, policy, to a different population? Looking into the authors' discussion of the contribution of the study to the existing body of knowledge or how does the study contribute to our understanding? Are there new areas of research identified? And also did the author discuss whether findings can be transferred to other contexts or populations or settings. in other words, checking the transferability of the research.

the table is adapted from Cochrane library supplemental handbook guidance

Aspect	Qualitative Term	Quantitative Term
Truth value	Credibility Internal	Validity
Applicability	Transferability	External Validity or generalisibility
Consistency	Dependability	Reliability
Neutrality	Confirmability	Objectivity

Assessing Credibility: Credibility evaluates whether or not the representation of

data fits the views of the participants studied, whether the findings hold true.

Evaluation techniques include: having outside auditors or participants validate

findings (member checks), peer debriefing, attention to negative cases,

independent analysis of data by more than one researcher, verbatim quotes,

persistent observation etc.

 Assessing Transferability: Transferability evaluates whether research findings

are transferable to other specific settings.

Evaluation techniques include: providing details of the study participants to

enable readers to evaluate for which target groups the study provides valuable

information, providing contextual background information, demographics, the

provision of thick description about both the sending and the receiving context

etc.

 Assessing Dependability: Dependability evaluates whether the process of

research is logical, traceable and clearly documented, particularly on the methods

chosen and the decisions made by the researchers.

Evaluation techniques include: peer review, debriefing, audit trails, triangulation

in the context of the use of different methodological approaches to look at the

topic of research, reflexivity to keep a self-critical account of the research process,

calculation of inter-rater agreements etc.

 Assessing Confirmability: Confirmability evaluates the extent to which findings

are qualitatively confirmable through the analysis being grounded in the data and

through examination of the audit trail.

Evaluation techniques include: assessing the effects of the researcher during all

steps of the research process, reflexivity, providing background information on

the researcher’s background, education, perspective, school of thought etc.

QARI software developed by the Joanna Briggs Institute, Australia

URL: http://www.joannabriggs.edu.au/services/sumari.php

Used by: Pearson A, Porritt KA, Doran D, Vincent L, Craig D, Tucker D,

Long L, Henstridge V. A comprehensive systematic review of evidence on

the structure, process, characteristics and composition of a nursing team

that fosters a healthy environment. International Journal of Evidence-

Based Healthcare 2006; 4(2): 118-59.

EPPI-reviewer developed by the EPPI Centre, United Kingdom

URL: http://eppi.ioe.ac.uk/eppireviewer/login.aspx

Used by: Bradley P, Nordheim L, De La Harpa D, Innvaer S & Thompson

C. A systematic review of qualitative literature on educational

interventions for evidence-based practice. Learning in Health & Social

Care 2005: 4(2):89-109.

Harden A, Brunton G, Fletcher A, Oakley A. Teenage pregnancy and

social disadvantage: a systematic review integrating trials and qualitative

studies. British Medical Journal Oct 2009.

Critical Appraisal Skills Programme (CASP):

http://www.phru.nhs.uk/Doc_Links/Qualitative%20Appraisal%20Tool.pdf

Used by: Kane GA et al. Parenting programmes: a systematic review and

synthesis of qualitative research. Child Care Health and Development

2007; 33(6): 784-793.

Modified versions of CASP, used by:

Campbell R, Pound P, Pope C, Britten N, Pill R, Morgan M, Donovan J.

Evaluating meta-ethnography: a synthesis of qualitative research on lay

experiences of diabetes and diabetes care. Social Science and Medicine

2003; 56: 671-84.

Malpass A, Shaw A, Sharp D, Walter F, Feder G, Ridd M, Kessler D.

‘Medication career" or "Moral career"? The two sides of managing

antidepressants: A meta-ethnography of patients' experience of

antidepressants. Soc Sci Med. 2009; 68(1):154-68.

Quality Framework UK Cabinet Office

http://www.gsr.gov.uk/downloads/evaluating_policy/a_quality_framework.pdf

Used by: MacEachen E et al. Systematic review of the qualitative

literature on return to work after injury. Scandinavian Journal of Work

Environment & Health 2006; 32(4): 257-269.

Evaluation Tool for Qualitative Studies

http://www.fhsc.salford.ac.uk/hcprdu/tools/qualitative.htm

Used by: McInnes RJ & Chambers JA. Supporting breastfeeding mothers:

qualitative synthesis. Journal of Advanced Nursing 2008; 62(4): 407-427.