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== Introduction ==
== Introduction ==
Interpreting a [https://physio-pedia.com/Qualitative_Research?utm_source=physiopedia&utm_medium=search&utm_campaign=ongoing_internal 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<ref>Algeo N. Interpreting a Qualitative Research Paper. Physioplus Course 2020</ref>.  
Qualitative research aims to study things in their natural setting to make sense of a phenomenon in terms of meanings people bring to them. <ref>Denkin NK & Lincoln YS (Eds.) ''Handbook of qualitative research.'' London: Sage. 1994. </ref><ref>Yates J, Leggett T. Qualitative research: An introduction. Radiologic technology. 2016 Nov 1;88(2):225-31.</ref> This type of research "seeks to understand and explore rather than to explain and manipulate variables". <ref>Nassaji H. [https://journals.sagepub.com/doi/epub/10.1177/1362168820941288 Good qualitative research.] Language Teaching Research. 2020 Jul;24(4):427-31.</ref>Qualitative research involves the studied use of a variety of methods – case study, personal experience, introspective, life story, interview, observational, historical, interactional, and visual texts. <ref>Aspers P, Corte U. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6494783/pdf/11133_2019_Article_9413.pdf What is qualitative in qualitative research]. Qualitative Sociology. 2019 Jun 1;42(2):139-60.</ref>   


'''Characteristics of qualitative research'''<ref name=":0" />''':'''   
Interpreting a [https://physio-pedia.com/Qualitative_Research?utm_source=physiopedia&utm_medium=search&utm_campaign=ongoing_internal qualitative research] paper is an analysis of the quality of the material. It allows you to understand the reliability of the research and the construction of the paper. <ref name=":1">Algeo N. Interpreting a Qualitative Research Paper. Plus Course 2020</ref> 
* Explores the meaning  
 
* Achkowleges the researcher’s point of view (reflexivity)   
'''Characteristics of qualitative research'''<ref name=":0">Samsi K. Critical appraisal of qualitative research. Lecture, from King’s College London. 2012.</ref>''':'''   
* Interpretative methods of analysis   
* Explores meanings  
* Acknowledges the researcher’s point of view (reflexivity)   
* Uses interpretative methods of analysis   
* Iterative process   
* Iterative process   
* Contextual: concerned with the individual's perspective   
* Contextual: concerned with the individual's perspective   
* Inductive method of inquiry   
* Inductive    


== Critically Appraise Qualitative Research ==
== Critical Appraisal of Qualitative Research ==
'''Techniques for imposing rigor'''<ref name=":0" />''':'''
'''The qualitative researcher must'''<ref name=":0" />''':'''
* 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'''<ref name=":0" />''':'''  
* Eliminate subjectivity  
* Eliminate subjectivity  
* Acknowledge their relationship with the study/participants/data and question implications on study findings
* Acknowledge their relationship with the study/participants/data and question implications on study findings
* Discuss varied viewpoints to gain a greater range of perspectives
* Discuss varied viewpoints to gain a greater range of perspectives
* Examine deviant participants and multiple coding exercises that challenge assumptions
* Examine deviant participants and multiple coding that challenge assumptions
Edwards et al (2002)
Trustworthiness or rigour of a study refers to the degree of confidence in data, interpretation, and methods used to ensure the quality of a study. Researchers should discuss the methods and procedures necessary for a study to be considered credible <ref>Connelly LM. Trustworthiness in qualitative research. Medsurg Nursing. 2016 Nov 1;25(6):435-7.</ref>


describes the use of a “signal to noise” approach, where a balance is sought between the
Credibility is how confident we are in the truth of a particulars studies findings. Lincoln and Guba<ref>Lincoln, YS. & Guba, EG. Naturalistic Inquiry. Newbury Park, CA: Sage Publications. (1985).</ref> suggested that the trustworthiness of a study depends on 4 factors: credibility, transferability, dependability, and confirmability. These four criteria are used to appraise the accuracy of qualitative research.<ref name=":2">Stenfors T, Kajamaa A, Bennett D. [https://onlinelibrary.wiley.com/doi/epdf/10.1111/tct.13242 How to… assess the quality of qualitative research]. The clinical teacher. 2020 Dec;17(6):596-9.</ref>


methodological flaws of a study and the relevance of insights and findings it adds to the
This table was adopted from [https://methods.cochrane.org/qi/supplemental-handbook-guidance Cochrane library supplemental handbook guidance]<ref>Hannes K. Chapter 4: Critical appraisal of qualitative research. In: Noyes J, Booth A, Hannes K, Harden A, Harris J, Lewin S, Lockwood C (editors), Supplementary Guidance for Inclusion of Qualitative Research in Cochrane Systematic Reviews of Interventions. Version 1 (updated August 2011). Cochrane Collaboration Qualitative Methods Group, 2011. Available from URL <nowiki>http://cqrmg.cochrane.org/supplemental-handbook-guidance</nowiki></ref>
 
overall synthesis. Other researchers do not acknowledge the value of critical appraisal of
 
qualitative research, stating that it stifles creativity (Dixon-Woods, 2004).
 
While
 
recognising that all these views have some basis for consideration certain approaches
 
succeed in positioning the qualitative research enterprise as one that can produce a valid,
 
reliable and objective contribution to evidence synthesis.
 
== CASP checklist ==
[https://www.physio-pedia.com/images/e/ec/CASP-Qualitative-Checklist.pdf CASP]  stands for the critical appraisal skills programme. The CASP offers free downloadable checklists that help in critiquing research papers. 
 
Critical Appraisal Skills Programme (CASP) checklists 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:
# Are the findings of the study valid?
# What are the findings?
# Will the results help locally? (i.e. in my setting)
It is formed of ten questions.
 
'''Section A,''' and it looks at the validity of the study 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 participan'''ts who the interesting s'''ubject 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 <ref>Hibbert P, Coupland C, MacIntosh R. Reflexivity: Recursion and relationality in organizational research processes. Qualitative Research in Organizations and Management: An International Journal. 2010 May 11.</ref> 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<ref>Lincoln, YS. & Guba, EG. Naturalistic Inquiry. Newbury Park, CA: Sage Publications. (1985).</ref> 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 [https://methods.cochrane.org/qi/supplemental-handbook-guidance Cochrane library supplemental handbook guidance]<ref>Hannes K. Chapter 4: Critical appraisal of qualitative research. In: Noyes J, Booth A, Hannes K, Harden A, Harris J, Lewin S, Lockwood C (editors), Supplementary Guidance for Inclusion of Qualitative Research in Cochrane Systematic Reviews of Interventions. Version 1 (updated August 2011). Cochrane Collaboration Qualitative Methods Group, 2011. Available from URL <nowiki>http://cqrmg.cochrane.org/supplemental-handbook-guidance</nowiki></ref>  
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{| border="1" cellpadding="1" cellspacing="1"
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! scope="col" | Applicability  
! scope="col" | Applicability  
! scope="col" | Transferability
! scope="col" | Transferability
! scope="col" |  External Validity or generalisibility
! scope="col" |  External Validity or generalisability
|-
|-
! scope="col" | Consistency
! scope="col" | Consistency
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! scope="col" |  Objectivity
! scope="col" |  Objectivity


|}
|}                                                                      
                                                                     
Assessing Credibility: Credibility evaluates whether or not the representation of


data fits the views of the participants studied, whether the findings hold true.
'''Techniques for imposing rigour'''<ref name=":0" />
* Triangulation: is defined as the use of varied methods, data sources, and multiple researchers
* Reflexivity: refers to the position of the researchers in relation to the research and their interaction with the participants  
* Multiple coding: refers to 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: exploring participants who might seem to be deviant from the norm and involve them in the study


Evaluation techniques include: having outside auditors or participants validate
== Step by Step Guide to Interpreting A Qualitative Research Paper ==
The [https://www.physio-pedia.com/images/e/ec/CASP-Qualitative-Checklist.pdf CASP]  is the Critical Appraisal Skills Programme checklists which are often used in health research. They 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<ref name=":1" />:
# The validity of the results
# The findings of the study
# The transferability


findings (member checks), peer debriefing, attention to negative cases,
=== Analyzing the Introduction ===
The introduction to a research paper 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 as well as the angle of focus.


independent analysis of data by more than one researcher, verbatim quotes,
Previous research should also be discussed and highlight similarities and limitations to explain why this research should take place and it's significance to find answers. <ref name=":1" />


persistent observation etc.
When interpreting the introduction, a good question to ask is whether the use of qualitative research was appropriate for this type of study or not? Qualitative methods are typically used for illuminating the actions, or subjective experiences, of participants or when looking to gain an in-depth understanding of a phenomenon.


 Assessing Transferability: Transferability evaluates whether research findings
'''Questions to ask when interpreting the research question:'''
 
* Is there a clear statement of the aims of the study?
are transferable to other specific settings.
* What are the goals of the study?
 
* What was the rationale for this research?  
Evaluation techniques include: providing details of the study participants to
* How relevant is this?  
 
* Is the research question clearly formulated? Is it important?                                    
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: <nowiki>http://www.joannabriggs.edu.au/services/sumari.php</nowiki>
 
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: <nowiki>http://eppi.ioe.ac.uk/eppireviewer/login.aspx</nowiki>
 
Used by: Bradley P, Nordheim L, De La Harpa D, Innvaer S &amp;amp; Thompson
 
C. A systematic review of qualitative literature on educational
 
interventions for evidence-based practice. Learning in Health &amp;amp; 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):
 
<nowiki>http://www.phru.nhs.uk/Doc_Links/Qualitative%20Appraisal%20Tool.pdf</nowiki>
 
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&amp;quot; or &amp;quot;Moral career&amp;quot;? The two sides of managing
 
antidepressants: A meta-ethnography of patients&amp;#39; experience of
 
antidepressants. Soc Sci Med. 2009; 68(1):154-68.
 
Quality Framework UK Cabinet Office
 
<nowiki>http://www.gsr.gov.uk/downloads/evaluating_policy/a_quality_framework.pdf</nowiki>
 
Used by: MacEachen E et al. Systematic review of the qualitative
 
literature on return to work after injury. Scandinavian Journal of Work
 
Environment &amp;amp; Health 2006; 32(4): 257-269.
 
Evaluation Tool for Qualitative Studies
 
<nowiki>http://www.fhsc.salford.ac.uk/hcprdu/tools/qualitative.htm</nowiki>
 
Used by: McInnes RJ &amp;amp; Chambers JA. Supporting breastfeeding mothers:
 
qualitative synthesis. Journal of Advanced Nursing 2008; 62(4): 407-427.
 
Qualitative research<ref name=":0">Samsi K. Critical appraisal of qualitative research. Lecture, from King’s College London. 2012.</ref>:
 
Concerned with nuances of meaning and in-depth
 
understanding
 
 Predominantly inductive method of enquiry, i.e. bottom-up
 
data-driven approach (Bryman, 2004, p.9)
 
 Contextual: Importance of understanding human experience
 
at an individual perspective (Denzin and Lincoln, 2008)
 
 Flexible research strategy: Commitment to iterative process
 
 Rich data: Depth versus breadth
 
 Small sample but high detail
 
 Analysis is descriptive and interpretative
 
 Researcher’s standpoint acknowledged and
 
questioned (reflexivity)
 
Principles of rigour
 
Credibility and authenticity
 
 Critical appraisal and integrity
 
How can the researcher remained faithful
 
to participants’ experience? (Hammersley, 1992)
 
Has the researcher explore alternative explanations,
 
discrepant data, examine bias & etc.?
 
(Graneheim and Lundman, 2004)
 
Techniques for imposing rigour
 
Triangulation Reflexivity
 
Multiple coding Respondent validation
 
Deviant case analysis
 
Techniques for imposing rigour
 
Triangulation
 
“The use of more than one method or source of
 
data in the study of a social phenomenon”
 
Types:
 
•Multiple methods
 
•Focus groups/ interviews/ journals/ observations
 
•Multiple data sources
 
•GPs/ patients/ carers/ social care staff
 
•Multiple researchers
 
•To get different observations on same situation
 
Techniques for imposing rigour
 
Reflexivity
 
•Position of researcher in research
 
•Interaction with participants
 
•Characteristics of researcher:
 
•e.g. age, gender, profession, relationship,
 
personal experience
 
•Consider what this might imply and try to
 
limit the effects
 
Multiple coding
 
•2 or 3 independent researchers
 
•Different disciplinary backgrounds
 
•Calculate inter-rater reliability
 
•Process rather than value
 
•Discuss and resolve discrepancies
 
•Generates ideas
 
Respondent validation
 
•Taking findings back to participants
 
•Getting their opinions on interpretations and
 
implications drawn from their interviews
 
•Incorporate this into analysis
 
•Must be aware of the limitations
 
•Researcher aiming to provide overview
 
•Generates further data to be interpreted
 
Deviant case analysis
 
•Process of exploring experiences of those
 
participants who appear to be ‘deviant’ from
 
responses of the norm
 
•Encourages the researcher to examine, question,
 
develop and refine the emergent theory further
 
•Most prevalent in grounded theory
 
Questions to ask (from Kuper et al, 2008a)
 
1. Was the sample used in the study
 
appropriate to its research question?
 
2. Were the data collected appropriately?
 
3. Were the data analysed appropriately?
 
4. Can I transfer the results of this study to my
 
own setting?
 
5. Does the study adequately address potential
 
ethical issues, including reflexivity?
 
6. Overall: is what the researchers did clear?
 
Was the sample used appropriate to its
 
research questions?
 
How were participants selected and
 
recruited?
 
 Were they relevant to the research question?
 
 Was sampling strategy justified?
 
 Was the sampling purposive/ theoretical?
 
 Was it a convenience sample?
 
Were the data collected appropriately?
 
 Were the data collection
 
methods appropriate for
 
research objectives and
 
settings?
 
 Field observation
 
(participant/ non- participant)
 
 Interviews (in-depth; focus
 
groups)
 
 Document analysis (diaries;
 
letters; newspaper articles)
 
 Was there explicit
 
consideration of how this
 
might have influenced
 
findings?
 
Sample size dilemma?
 
 Not an issue of sample size
 
in statistical sense
 
 Data collection needs to be
 
comprehensive enough in
 
breadth and depth to
 
generate and support
 
interpretation
 
 Adequacy depends on
 
emerging findings
 
 Need for iterative process
 
 Can the data be audited?
 
 Paper trail
 
Were the data analysed appropriately?


 Transparency of analytical methods – especially for
=== Sample size and participants ===
The norm for the sample size should not only be judged by data saturation or a rule-of-thumb, but rather their extensiveness and appropriateness for a specific qualitative research goals. <ref>Sarfo JO, Debraha TP, Gbordzoea NI, Affula WT, Obenga P. [https://d1wqtxts1xzle7.cloudfront.net/89079430/jare.2021.3-with-cover-page-v2.pdf?Expires=1666993357&Signature=ADbvhvVN0E~RxMEksbwaoZ9w9thuHm4xL51uO4U6gqx2lRjczoI~B-YmSI8Vt8IOwmGrVWZFgD89HINpm6RloeSWFA4jdO2pfUgAz99eXJX0pC0RvtVm38zs8upjKvrM1DSs4ZtddvkHzWX2wsZmabvv6gfh7p1Axl8SUyzbBoqhQhpQX~za4CE7gKdypHYomx-eXHlbGlTWYICsDJiYFmVz7wBk10jkZeWzb9g7BEnvGTnBfO7dKfmEYHojQCOMQcbIcWfvt99C3Kxb6iCSHWXF3-sJwKS2ALaJAsMhSEn98wRpr4i72vPglcPXMN5dHxq~kfgZa8tRF7g7o~5tyw__&Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA Qualitative Research Designs, Sample Size and Saturation: Is Enough Always Enough?]. Journal of Advocacy, Research and Education. 2021;8(3):60-5.</ref> When assessing the quality of research, it is important to check for the following<ref name=":0" />:
* Was the sample used appropriately for its research questions?
* What were the 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?
* What were the inclusion and exclusion criteria of the study?


interpretation
=== Data Collection ===
It is important to analyse whether the data collection methods were appropriate for the research objectives and settings? This involves an in-depth analysis of the methods and how did the methods influence the findings?


 Systematic approach should have been used
The study should justify the data collection method used to meet the criteria of the research question. <ref name=":1" />


Data-driven or theory-driven (e.g. thematic analysis;
Data saturation is the point at which new information or themes stop to emerge. This is often under-reported by researchers in qualitative research. <ref name=":1" />     


grounded theory)
=== 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
* Credibility of results
* Justified conclusion


 Efforts made to describe contradictory data and
=== Reflexivity ===
Reflexivity is an additional marker of quality. <ref name=":2" /> It is a self-awareness of one’s role in the research process  when a researcher reflects on their own position within the research and they consider their own biases. The Consolidate Criteria for Reporting Qualitative Research( [http://cdn.elsevier.com/promis_misc/ISSM_COREQ_Checklist.pdf COREQ]) is a checklist of the criteria for authors which contains a whole section dedicated to reflexivity. <ref name=":1" /> <ref>Williams V, Boylan AM, Nunan D. [https://ebm.bmj.com/content/ebmed/25/1/9.full.pdf Critical appraisal of qualitative research: necessity, partialities and the issue of bias.] BMJ Evid Based Med. 2020 Feb;25(1):9-11. </ref>


divergent findings
It is unlikely that a researcher would remain completely neutral towards a topic with no opinion or viewpoint towards it at all. Reflexivity is sometimes confused with reflection. Hibbert et al <ref>Hibbert P, Coupland C, MacIntosh R. Reflexivity: Recursion and relationality in organizational research processes. Qualitative Research in Organizations and Management: An International Journal. 2010 May 11.</ref> offer a useful distinction between the two terms, suggesting that reflection is like a mirror image that gives 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.                               


 Multiple coding – so findings are corroborated by
=== Transferability ===
Can the results of the study be transferred or applied to the practice?


more than one researcher
Transferability refers to the extent that the findings of a particular qualitative study can be applied to other situations. This should be reflected in the large and variant sample size, depending on the research question.<ref>Probyn J, Howarth M, Maz J. The ‘middle bit’: how to appraise qualitative research. British Journal of Cardiac Nursing. 2016 May 2;11(5):248-54.</ref>Researchers should include sufficient information about the study setting and participant characteristics. They ought to compare findings to other studies conducted in different populations. This approach allows other researchers to judge whether the findings can be applicable to their own setting.<ref>Baumgart A, Craig JC, Tong A. [https://www.ajkd.org/action/showPdf?pii=S0272-6386%2821%2900008-1 Qualitative research in CKD: how to appraise and interpret the evidence.] American journal of kidney diseases. 2021 Apr 1;77(4):538-41.</ref>


 Do results look credible and justify conclusions?
=== Clarity and transparency of data analysis ===
Taking the following steps will ensure the study is clear of bias:
* The in-depth description and the type of analysis
* How the data were selected from the original sample?                                
* Is there enough data to support the findings? In qualitative research that might be in the form of quotes<ref name=":1" />                               
The main findings should be discussed clearly in the discussion section with evidence both for and against their argument agreeing or contradicting previous literature .<ref name=":1" /> 


Can I transfer results of this study to my
=== Ethics ===
Components of the ethical research relationship<ref name=":0" />
* Acknowledgement of bias
* Rigour
* Rapport and managing distress
* Respect for autonomy
* Confidentiality
* Avoidance of exploitation (being aware of power relationships 


own setting?
{{#ev:youtube|H8Y-yfi3vp4|300}}<ref>Introduction to critical appraisal. Available from:https://www.youtube.com/watch?v=H8Y-yfi3vp4[last accessed 01/11/2020]</ref>


 Qualitative research is contextual – i.e. not seeking to be
=== Other Checklists: ===
[https://ppw.kuleuven.be/mesrg/seminars-and-events/three-day-systematic-review-workshop-quantitative-and-qualitative-approaches-1/sr-2012-course-materials/sr-2012-day-3/meta-aggregation.pptx QARI software developed by the Joanna Briggs Institute],


generalisable
[https://www.gov.uk/government/publications/government-social-research-framework-for-assessing-research-evidence Quality Framework UK Cabinet Office]


 “Transferability” more important principle (Kuper et al.
[http://usir.salford.ac.uk/id/eprint/12970/1/Evaluation_Tool_for_Qualitative_Studies.pdf Evaluation Tool for Qualitative Studies by Salford University]
 
2008a)
 
 How do these apply in other contexts/ situations/
 
real world?
 
 Onus for assessing transferability rests with reader
 
 Author has to describe setting and context
 
transparently and honestly
 
 Real-world implications for practice should be clearly
 
described, if not obvious
 
Does the study adequately address potential
 
ethical issues, including reflexivity?
 
Essentially, balancing moral actions of the researcher and virtues of
 
research aims and outcomes
 
Principles to follow:
 
1. Autonomy
 
2. Beneficence/non-maleficence
 
3. Justice
 
4. Misrepresentation
 
 In qualitative research, components of 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)
 
The importance of relevance
 
A form of transferability, ‘relevance’ refers to
 
emphasizing the value of the study and the wider
 
implications of it (Mays & Pope, 2000)
 
 “So what?”
 
 What contribution does the study make to existing
 
knowledge?
 
 Are the limitations thoughtfully discussed?
 
 How do the findings fit with existing theory?
 
 Does it contribute by developing new theory?
 
 What are the implications for practice/service?
 
 Has the study been disseminated responsibly?
 
Assessing qualitative research in mixed-
 
method studies
 
 Integrating qualitative and quantitative methods should be
 
done from conception, design to conclusion
 
 Often ensures triangulation
 
 Has study been adequately justified?
 
 Does it explain descriptive, reductionist quantitative
 
study
 
 Rationale presented for chosen methodology
 
 Sampling conducted appropriately?
 
 Ethical balance – power relationships considered?
 
 Recruiting participants from control group
 
 Have findings from both studies been presented jointly?
 
 Is it necessary?
 
CASP Quality checklist
 
Screening questions
 
1. Was there a clear statement of the aims of the research?
 
2. Is a qualitative methodology appropriate?
 
Detailed questions
 
3. Was the research design appropriate to address the aims of the
 
research?
 
4. Was the recruitment strategy appropriate to the aims of the research?
 
5. Were the data collected in a way that addressed the research issue?
 
6. Has the relationship between researcher and participants been
 
adequately considered?
 
7. Have ethical issues been taken into consideration?
 
8. Was the data analysis sufficiently rigorous?
 
9. Is there a clear statement of findings?
 
10. How valuable is the research?
 
== Resources ==
== References  ==
== References  ==


<references />
<references />
[[Category:EBP]]
[[Category:Research]]
[[Category:Course Pages]]
[[Category:Plus Content]]

Latest revision as of 06:59, 29 October 2022

Original Editor - Mariam Hashem

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

Introduction[edit | edit source]

Qualitative research aims to study things in their natural setting to make sense of a phenomenon in terms of meanings people bring to them. [1][2] This type of research "seeks to understand and explore rather than to explain and manipulate variables". [3]Qualitative research involves the studied use of a variety of methods – case study, personal experience, introspective, life story, interview, observational, historical, interactional, and visual texts. [4]

Interpreting a qualitative research paper is an analysis of the quality of the material. It allows you to understand the reliability of the research and the construction of the paper. [5]

Characteristics of qualitative research[6]:

  • Explores meanings
  • Acknowledges the researcher’s point of view (reflexivity)
  • Uses interpretative methods of analysis
  • Iterative process
  • Contextual: concerned with the individual's perspective
  • Inductive

Critical Appraisal of Qualitative Research[edit | edit source]

The qualitative researcher must[6]:

  • 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 that challenge assumptions

Trustworthiness or rigour of a study refers to the degree of confidence in data, interpretation, and methods used to ensure the quality of a study. Researchers should discuss the methods and procedures necessary for a study to be considered credible [7]

Credibility is how confident we are in the truth of a particulars studies findings. Lincoln and Guba[8] suggested that the trustworthiness of a study depends on 4 factors: credibility, transferability, dependability, and confirmability. These four criteria are used to appraise the accuracy of qualitative research.[9]

This table was adopted from Cochrane library supplemental handbook guidance[10]

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

Techniques for imposing rigour[6]

  • Triangulation: is defined as the use of varied methods, data sources, and multiple researchers
  • Reflexivity: refers to the position of the researchers in relation to the research and their interaction with the participants
  • Multiple coding: refers to 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: exploring participants who might seem to be deviant from the norm and involve them in the study

Step by Step Guide to Interpreting A Qualitative Research Paper[edit | edit source]

The CASP is the Critical Appraisal Skills Programme checklists which are often used in health research. They 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[5]:

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

Analyzing the Introduction[edit | edit source]

The introduction to a research paper 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 as well as the angle of focus.

Previous research should also be discussed and highlight similarities and limitations to explain why this research should take place and it's significance to find answers. [5]

When interpreting the introduction, a good question to ask is whether the use of qualitative research was appropriate for this type of study or not? Qualitative methods are typically used for illuminating the actions, or subjective experiences, of participants or when looking to gain an in-depth understanding of a phenomenon.

Questions to ask when interpreting the research question:

  • 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?

Sample size and participants[edit | edit source]

The norm for the sample size should not only be judged by data saturation or a rule-of-thumb, but rather their extensiveness and appropriateness for a specific qualitative research goals. [11] When assessing the quality of research, it is important to check for the following[6]:

  • Was the sample used appropriately for its research questions?
  • What were the 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?
  • What were the inclusion and exclusion criteria of the study?

Data Collection[edit | edit source]

It is important to analyse whether the data collection methods were appropriate for the research objectives and settings? This involves an in-depth analysis of the methods and how did the methods influence the findings?

The study should justify the data collection method used to meet the criteria of the research question. [5]

Data saturation is the point at which new information or themes stop to emerge. This is often under-reported by researchers in qualitative research. [5]

Data Analysis[edit | edit source]

Characteristics of proper data analysis:

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

Reflexivity[edit | edit source]

Reflexivity is an additional marker of quality. [9] It is a self-awareness of one’s role in the research process when a researcher reflects on their own position within the research and they consider their own biases. The Consolidate Criteria for Reporting Qualitative Research( COREQ) is a checklist of the criteria for authors which contains a whole section dedicated to reflexivity. [5] [12]

It is unlikely that a researcher would remain completely neutral towards a topic with no opinion or viewpoint towards it at all. Reflexivity is sometimes confused with reflection. Hibbert et al [13] offer a useful distinction between the two terms, suggesting that reflection is like a mirror image that gives 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.

Transferability[edit | edit source]

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

Transferability refers to the extent that the findings of a particular qualitative study can be applied to other situations. This should be reflected in the large and variant sample size, depending on the research question.[14]Researchers should include sufficient information about the study setting and participant characteristics. They ought to compare findings to other studies conducted in different populations. This approach allows other researchers to judge whether the findings can be applicable to their own setting.[15]

Clarity and transparency of data analysis[edit | edit source]

Taking the following steps will ensure the study is clear of bias:

  • The in-depth description and the type of analysis
  • How the data were selected from the original sample?
  • Is there enough data to support the findings? In qualitative research that might be in the form of quotes[5]

The main findings should be discussed clearly in the discussion section with evidence both for and against their argument agreeing or contradicting previous literature .[5]

Ethics[edit | edit source]

Components of the ethical research relationship[6]

  • Acknowledgement of bias
  • Rigour
  • Rapport and managing distress
  • Respect for autonomy
  • Confidentiality
  • Avoidance of exploitation (being aware of power relationships

[16]

Other Checklists:[edit | edit source]

QARI software developed by the Joanna Briggs Institute,

Quality Framework UK Cabinet Office

Evaluation Tool for Qualitative Studies by Salford University

References[edit | edit source]

  1. ↑ Denkin NK & Lincoln YS (Eds.) Handbook of qualitative research. London: Sage. 1994. 
  2. ↑ Yates J, Leggett T. Qualitative research: An introduction. Radiologic technology. 2016 Nov 1;88(2):225-31.
  3. ↑ Nassaji H. Good qualitative research. Language Teaching Research. 2020 Jul;24(4):427-31.
  4. ↑ Aspers P, Corte U. What is qualitative in qualitative research. Qualitative Sociology. 2019 Jun 1;42(2):139-60.
  5. ↑ 5.0 5.1 5.2 5.3 5.4 5.5 5.6 5.7 Algeo N. Interpreting a Qualitative Research Paper. Plus Course 2020
  6. ↑ 6.0 6.1 6.2 6.3 6.4 Samsi K. Critical appraisal of qualitative research. Lecture, from King’s College London. 2012.
  7. ↑ Connelly LM. Trustworthiness in qualitative research. Medsurg Nursing. 2016 Nov 1;25(6):435-7.
  8. ↑ Lincoln, YS. & Guba, EG. Naturalistic Inquiry. Newbury Park, CA: Sage Publications. (1985).
  9. ↑ 9.0 9.1 Stenfors T, Kajamaa A, Bennett D. How to… assess the quality of qualitative research. The clinical teacher. 2020 Dec;17(6):596-9.
  10. ↑ Hannes K. Chapter 4: Critical appraisal of qualitative research. In: Noyes J, Booth A, Hannes K, Harden A, Harris J, Lewin S, Lockwood C (editors), Supplementary Guidance for Inclusion of Qualitative Research in Cochrane Systematic Reviews of Interventions. Version 1 (updated August 2011). Cochrane Collaboration Qualitative Methods Group, 2011. Available from URL http://cqrmg.cochrane.org/supplemental-handbook-guidance
  11. ↑ Sarfo JO, Debraha TP, Gbordzoea NI, Affula WT, Obenga P. Qualitative Research Designs, Sample Size and Saturation: Is Enough Always Enough?. Journal of Advocacy, Research and Education. 2021;8(3):60-5.
  12. ↑ Williams V, Boylan AM, Nunan D. Critical appraisal of qualitative research: necessity, partialities and the issue of bias. BMJ Evid Based Med. 2020 Feb;25(1):9-11.
  13. ↑ Hibbert P, Coupland C, MacIntosh R. Reflexivity: Recursion and relationality in organizational research processes. Qualitative Research in Organizations and Management: An International Journal. 2010 May 11.
  14. ↑ Probyn J, Howarth M, Maz J. The ‘middle bit’: how to appraise qualitative research. British Journal of Cardiac Nursing. 2016 May 2;11(5):248-54.
  15. ↑ Baumgart A, Craig JC, Tong A. Qualitative research in CKD: how to appraise and interpret the evidence. American journal of kidney diseases. 2021 Apr 1;77(4):538-41.
  16. ↑ Introduction to critical appraisal. Available from:https://www.youtube.com/watch?v=H8Y-yfi3vp4[last accessed 01/11/2020]
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