focus groups as a research method: a critique of some aspects of their use in nursing research

METHODOLOGICAL ISSUES IN NURSING RESEARCH2

Focus groups as a research method: a critique of some

aspects of their use in nursing research

Christine Webb PhD RN

Professor of Health Studies, Institute of Health Studies, University of Plymouth, Plymouth, UK

and Jennifer Kevern BSc MSc RN RNT

Senior Lecturer (Research), Institute of Health Studies, University of Plymouth, Plymouth, UK

Submitted for publication 18 May 2000

Accepted for publication 27 October 20003

Introduction

Focus groups as a method of data collection seem to have

grown in popularity in nursing in recent years, as evidenced

by the number of publications reporting their use. In the

process of reviewing the method as part of the planning

process for several empirical research projects, it emerged

that focus groups were being used in nursing not solely for

qualitative research but for a number of other purposes

perhaps more closely related to their earlier uses in political

and marketing programmes. Furthermore, many articles were

`theoretical discussion' papers not based on actual experience

798 Ó 2001 Blackwell Science Ltd

Correspondence:

Christine Webb,

44 Chandlers Walk,

Exeter EX2 8BA,

UK.

E-mail: [email protected]

W E B BW E B B CC. && K E V E R NK E V E R N JJ . ( 20 01 )( 20 01 ) Journal of Advanced Nursing 33(6), 798±805

Focus groups as a research method: a critique of some aspects of their use in nursing

research

Objective. To evaluate and critique reports in the nursing literature in the period

1990±1999 of the use of focus groups as a research method.

Methods. The articles were identi®ed by a computerized search of the CINAHL

database and subjected to critical review.

Findings. The result of the search was that very few articles were found that

reported on a speci®c piece of research using the method. Methodological

discussions were more common and these were sometimes at a somewhat super®cial

level without analysis or critique. The largest category of articles was concerned

with service development projects. The research-based articles were found to be

relatively unsophisticated in their use of the method, in particular in relation to data

analysis and social interaction within focus groups. Terms such as `content analysis'

and `grounded theory' were used in nonrigorous ways and incompatibility between

the underlying research approach and implementation of the method was identi®ed

in the cases of phenomenology and grounded theory. Whilst selection of the focus

group method was often justi®ed in terms of the bene®ts that participant interaction

could yield, this interaction was rarely reported or discussed in the articles. One

author proposed a scheme for analysing this type of interaction, and this is

recommended to future researchers as a possible framework for interaction analysis.

Conclusions. The article concludes by calling for more in-depth consideration at the

research planning stages of the underlying assumptions of methodological approa-

ches that may be used to underpin focus group research and methods to be used to

analyse and report the data generated.

Keywords: data analysis, focus groups, grounded theory, phenomenology, nursing

research database

with the method and relying on secondary sources in nursing

literature rather than citing the original developers of the

method or social science writings on the methodology. The

most notable issue was the variety of data analysis methods in

use, some of which did not seem strictly appropriate to the

method. Therefore it was decided to conduct a more system-

atic analysis of the published material in relation to nursing

research.

Search strategy

Because the interest was speci®cally in nursing research, a

search was conducted using the CINAHL database and the

keywords `focus groups' limited by the term `research' and to

the period 1990±1999 and articles written in English. This

yielded 124 articles, of which 22 were published in or since

1995. Thus it appears that enthusiasm in nursing for the

method in the early 1990s diminished somewhat in the

second half of the decade.

Abstracts of the articles were scrutinized and those

appearing to be research-based and concerned with nursing

were obtained for detailed reading. This reduced the total to

33 articles obviously reporting nonresearch-based work

(descriptions/discussion of method n� 32, service develop-

ment n� 28, health promotion, n� 10, curriculum develop-

ment n� 10, teaching n� 4, miscellaneous n� 7) being

omitted. Nevertheless, when the 33 retained articles were

examined it emerged that only 16 were actually based on

experience of conducting a piece of empirical research. The

remaining 17 were discussions of the method based on

references to the literature and were very much in the `how

to' genre. Hand searching of the articles did not identify any

further relevant papers. Thus, despite the earlier attempt to

screen out nonresearch articles, the majority of the 33 articles

were not research-based or -related. Many were very short

and simplistic and clearly not based on any systematic

consideration either of the available literature or of the

method as a research tool (See for example Fox 1993a,

Clarke 1999); articles of this type were usually published in

`professional' rather than `academic' journals. This high-

lights the importance of a systematic consideration of a

research method when planning a study and is a reminder of

the fact that computerized databases must be used critically

when attempting to identify relevant articles for such a

review.

Conclusions from the search

From the search and preliminary scrutiny it emerged that the

apparent surge in nursing interest in focus groups as a

qualitative research method was not con®rmed. There was

indeed an increase in use of the method, but this had occurred

more in relation to nursing education and management

projects than to research studies. The next stage in the

attempt to understand how the method should be used in

research, and in particular at the data analysis stage, involved

detailed reading of the remaining 16 articles and following up

relevant references in the articles themselves. The rest of this

article is devoted to a consideration of the ®ndings from this

extended process.

De®nitions and processes of focus groups

Much has been written about what focus groups are and how

to conduct them. The more in-depth theoretical discussions

appear in the social science literature, the most-cited experts

being the North Americans, Merton (Merton et al. 1956),

who has been credited with initiating the use of focus groups

in social science, and more recently, Morgan (1988, 1993),

who has been a leading exponent of the method. In the

United Kingdom (UK), a recent edited collection of papers on

focus group research by social scientists is concerned with

`Developing Focus Group Research' (Barbour & Kitzinger

19994 ).

As the uses, advantages and disadvantages of focus groups

have been explored in these readily available sources, as well

as the nursing articles mentioned earlier, they will not be

rehearsed again here. Rather the discussion will explore

methodological issues emerging from the review, and speci®-

cally compatibility between methodological approaches and

focus groups as a method, interaction among participants as a

key feature of the method, and data analysis. A consideration

of de®nitions of focus groups will pave the way for this

discussion.

De®nitions

A straightforward de®nition of focus groups is given by

Krueger (19945 , pp. 10±11):

The focus group interview¼ taps into human tendencies. Attitudes

and perceptions relating to concepts, products, services or programs

are developed in part by interaction with other people. We are a

product of our environment and are in¯uenced by people around us.

This de®nition links to the principal justi®cation for using

focus groups, which is that they `capitalize(s) on the inter-

action within a group to elicit rich experiential data' (Asbury

1995, p. 414).

Developing this emphasis on interaction, Kitzinger (1995,

p. 299) writes that:

Methodological issues in nursing research2 Focus groups: a critique of nursing research1

Ó 2001 Blackwell Science Ltd, Journal of Advanced Nursing, 33(6), 798±805 799

The idea behind the focus group method is that group processes can

help people to explore and clarify their views in ways that would be

less easily accessible in a one to one interview¼ When group

dynamics work well the participants work alongside the researcher,

taking the research in new and often unexpected directions.

Drawing attention to the diversity of uses of the term `focus

groups', Kitzinger and Barbour (1999, p. 4) initially de®ne

them as `group discussions exploring a speci®c set of issues'

that are `focused' because the process involves `some kind of

collective activity'. This is done by the researcher èncoura-

g(ing) participants to talk to one another: asking questions,

exchanging anecdotes, and commenting on each others'

experiences and points of view'. However, while distin-

guishing other methods such as group interviews, nominal

groups, brainstorming, Delphi groups and other consensus

groups from focus groups, they conclude that the key feature

of focus groups is the active encouragement of group

interaction among participants.

Thus, all de®nitions of focus groups centre on the use of

interaction among participants as a way of accessing data

that would not emerge if other methods were used. Interac-

tion is the key to the method, giving the method a high level

of face validity (Krueger 1994) because what participants say

can be con®rmed, reinforced or contradicted within the group

discussion.

Focus groups and phenomenology: methodological

incompatibility

A number of variants of phenomenology have become the

basis of approaches to qualitative research and a brief

overview of these is given by Holloway and Wheeler

(1996). However, it is fundamental to phenomenology that

it:

thematizes the phenomenon of consciousness, and, in its most

comprehensive sense, it refers to the totality of the lived experiences

that belong to a single person (Giorgi 1997, p. 236).

The goal of phenomenological research is to seek the

èssences', essential or invariant characteristics of phenomena

and to achieve this, `naõÈve' subjects are asked to `respond to a

research question, either by interview or description' (Giorgi

1989, p. 72). In other words, an individual is encouraged,

through asking them a broad and general question of the type

`Tell me what it was like to be told that you had cancer', to

describe their experiences of a phenomenon. A phenomeno-

logical approach requires that an individual describes their

experiences in a relatively ùncontaminated' way and there-

fore a group method of data collection involving interaction

between several participants is not compatible with phenom-

enological research.

Despite the fact that a phenomenological approach is

incompatible with a focus group method, a number of the

research reports traced in the search have used this combi-

nation. It therefore seems appropriate to discuss this incom-

patibility in further detail in order to demonstrate the

problems that can arise from this mismatch.

Issues of rigour in focus group research have been

addressed by suggesting that more than one researcher

analyse the data to establish reliability (McDaniel 1996,

Higginbottom 1998) and that the data analysis be fed back to

participants for `member checking' of its validity or plaus-

ibility as an explanation of what was said (Higginbottom

1998). However, this too would not be compatible with a

phenomenological approach, which recognizes that Ìf the

essential description truly captures the intuited essence, one

has validity in a phenomenological sense' (Giorgi 1988,

p. 173). That is, if a description is judged plausible by the

researcher who has written it, who has used a transparent

and systematic approach to data analysis and has communi-

cated this to others, including accounting for the steps of the

analysis process, then that description is `valid'. Another

researcher or any of the research participants might produce

another version, but that in itself does not render the ®rst

version ìnvalid' ± it merely adds another plausible descrip-

tion for readers to examine. This argument applies equally to

the descriptive phenomenological approach taken by Giorgi

and to the interpretive or hermeneutic approach of

Heidegger, Van Manen and colleagues. Thus, some of the

procedures recommended by users of focus groups to ensure

`validity' or rigour are not compatible with a phenomeno-

logical approach. There is not space here to consider the

debate about the use of terms such as `validity' and `reliab-

ility' and alternative approaches to `rigour' in evaluating

qualitative research, but these have been addressed elsewhere

(See for example, Morse 1991, 19946 ).

Nevertheless, Gray-Vickrey (19937 , p. 21) claims that:

Focus groups are well suited for a full range of qualitative studies

including grounded theory, ethnography, and phenomenology.

She claims to have carried out a phenomenologic [sic] study

using a focus group to study the experiences of caregivers of

relatives with Alzheimer's disease. The picture is further

complicated because, as is appropriate to phenomenological

research, the focus group was begun by asking two general,

open questions: `Tell me what is has been like to take care of

¼' and `What are your feelings about this caregiving

experience?' (p. 24) However, Gray-Vickrey justi®es asking

these questions by appealing to the work of Spradley and

C. Webb and J. Kevern

800 Ó 2001 Blackwell Science Ltd, Journal of Advanced Nursing, 33(6), 798±805

calling them `grand tour questions'. Spradley's work is

grounded in an ethnosemantic and not a phenomenological

approach (Spradley 1979). There is no discussion of phenom-

enology in the article and no reference to phenomenological

sources. This article therefore represents an example of the

point made earlier about the adoption of a research approach

without going back to primary sources, resulting in claims

that do not stand up to any attempt at rigorous criticism.

A confusion between methodology and methods or tech-

niques is also made by Nyamathi and Schuler (1990, p. 1283)

when they write that focus groups are:

a qualitative method which bears similarities to ethnography,

grounded theory, phenomenology and participant observation.

This reveals a confusion between the concepts of methodo-

logy and methods and reinforces the point about not relying

on secondary sources. This article by Nyamathi and Schuler

is frequently quoted as a principal source of information by

writers of the articles reviewed here without critical appraisal

of its content (DiIorio et al. 1994, Macleod Clark et al. 1996,

McDaniel 1996, Stevens 1996, Reed & Payton 1997, Idvall

& Rooke 1998, Sim 1998, Sloan 1998, Twinn 1998).

Data analysis

Techniques of data analysis are seldom discussed in any detail

or at all in accounts of focus groups research (Carey 1995,

Frankland & Bloor 1999) and this was also the case in the

nursing research focus groups identi®ed earlier. Stevens

(1996, p. 172) claims that àny number of qualitative analysis

strategies can be adapted to these purposes' and Sloan (1998,

p. 41) similarly states that ànalysing data from focus groups

is essentially the same as analysing qualitative data from

other sources'. Carey (1995, p. 126) writes of analysis

processes varying from the `less intense' (coding and categ-

orizing) to the `more intense' (grounded theory). Apparently

taking the same position, many authors write about using

various techniques of cutting and pasting, both manual and

computerized, in a process of coding, categorizing and

identifying themes (e.g. Reiskin 1992, Fox 1993a8,9 , Fox

1993b8,9 , DiIorio et al. 199410,1110,11 , Idvall & Rooke 199810,1110,11 , Morrison

& Peoples 1999). Some writers recommend the use of

analysis grids drawn out on paper to aid organization of

data and identi®cation of themes (Miles & Huberman 1994,

Higginbottom 1998, Robinson 1999).

Sometimes the analysis process is referred to as `content

analysis (McDaniel 1996, McFarland et al. 1998, Sim 1998),

but this term is more usually reserved for techniques used

to quantify qualitative data by counting frequencies of

occurrences of words, phrases or themes as discussed by

Krippendorff (1980) and Stewart and Shamdasani (1990).

`Latent' as well as `manifest' content may be identi®ed using

this method, but this may also rely on quanti®cation of data.

Carey (1995, p. 492) points out that any attempt at counting

frequencies in this way is inappropriate ùnless a question is

directly asked or probed for¼ across groups', and Robinson

(1999, p. 909) agrees that ìt is not appropriate to give

percentages'. In other words, quanti®cation should only be

used when all respondents (in the case of individual inter-

views) or groups (in the case of focus groups) have been asked

the same question. Otherwise the results of counts are merely

serendipitous and `will generally not be meaningful' (Carey

1995, p. 492).

Reports do not give details of whether focus groups were

conducted in the same way when more than one was used in a

particular study. Therefore it is plausible to assume that they

were similarly conducted. Thus, as Robinson (1999, p. 909)

points out, èach transcript must be looked at in the same

way, and all the transcripts must be used' so that analysis is

systematic. However, some reports claim to have used

`grounded theory' as a data analysis method and the next

section will consider the appropriateness of this.

Grounded theory and focus groups

According to Strauss and Corbin (1990, p. 23):

A grounded theory is one that is ¼ discovered, developed, and

provisionally veri®ed through systematic data collection and analysis

of data pertaining to that phenomenon. Therefore, data collection,

analysis, and theory stand in reciprocal relationship with each other.

The method is characterized by the use of theoretical

sampling, constant comparative data analysis, theoretical

sensitivity, memo writing, identi®cation of a core category

and the concept of `theoretical saturation'.

Four of the articles identi®ed in the literature search for this

article claim to have used grounded theory as a method for

data analysis. However, they do not report having used

concurrent data generation and analysis as would be required

in grounded theory. As the above criteria demonstrate, for

grounded theory method to be claimed, data should be

subjected to constant comparative analysis as additional data

are collected. On the basis of the developing coding system

and increasing theoretical sensitivity developed by the resear-

cher as the analysis continues, theoretical sampling should be

used to gather additional data in an attempt to corroborate or

otherwise existing data and to elaborate on the categories and

their properties and interlinkages. This process of iteration

continues until a core category is identi®ed and there is

theoretical saturation. That stage marks the end of data



collection because additional data is not adding to the

analysis.

It is clear that, if several focus groups are conducted in a

similar way and then the transcripts are subjected to a

grounded theory type of analysis, this does not ful®l the

criteria for grounded theory. Sim (1998) argues that data

analysis of several groups should be done concurrently in

order to determine when there is consensus on the issues

considered relevant by group members, and refers to this

consensus as `saturation'. However, he does not discuss

grounded theory as such, and indeed writes that ànalysis of

focus group data is likely to follow the same process as for

other sources of qualitative data' and that `many of the

problems that arise in analysing focus group data are those

relating to qualitative data in general' (Sim 1998, p. 348).

Thus, he seems to miss the point that data collection methods

will vary in order to be consistent with a researcher's

underlying methodological approach. Also, he selectively

adopts some but not all of the features of grounded theory

without explaining the reasons for this.

An example of this claimed ground theory method being

used but only after data had been collected is provided by the

report of Goss (1998) who used ®ve focus groups to study

nurses working in women's health care and the topic of

violence against women. The report mainly discusses meth-

odological issues and very little detail is given of the

substantive research project. However, Goss reports using

à four-step process of data analysis for focus group data'

(p. 33) developed by Koniak-Grif®n et al. (1994). Following

transcription and accuracy checking, step 2 ìnvolves the

techniques borrowed from grounded theory' of coding and

developing themes and categories. Step 3 uses `constant

comparative procedures, both within and among groups' and

this is continued ùntil saturation is reached'. Step 4 involves

validation using àn outside researcher familiar with the focus

group method but uninvolved with the data collection' and

`respondent validation' (p. 33). Thus it seems that all data

were collected and the analysis was conducted afterwards

rather than concurrently. The method cannot then legitim-

ately be called `grounded theory', because the essence of the

method is that it is `cumulative', as was discussed earlier and

as Strauss and Corbin themselves explain:

Each event sampled builds from and adds to previous data collection

and analysis. Moreover, sampling becomes more speci®c with time

because the analyst is directed by the evolving theory (Strauss &

Corbin 1998, p. 203).

Carey and Smith (199412 ) term grounded theory a `more

intense' method of analysing focus group data but Carey's

later methodological article on the analysis of focus group

data does not use the term explicitly. Instead she writes that

`purposively sampling within relevant categories will enhance

the likelihood of saturation of data' as will conducting `more

than one group for each salient segment (of the population)'

(p. 491). She also writes that:

Often it is useful for the guideline questions to be re®ned with

increased understanding of the topic as the study progresses.

Although analysis across sessions will be somewhat limited by the

lack of total comparability of data, the re®ned questions should

provide more useful data (Carey 1995, p. 491).

This approach therefore closely parallels the grounded theory

method but does not use that term and does not speak of core

category identi®cation or theorizing that are basic features of

grounded theory.

Grounded theory was the approach chosen by Donovan

(1995) for a study of men during their partners' pregnancies.

This was the only nursing study traced which explicitly

described all stages of the method as being used in the

research in an appropriate way. Men were recruited via a

general practice and focus group data were collected with

them over a 6-month period. These data were supplemented

by observations in antenatal classes conducted by midwives.

A research diary was also recorded. Donovan describes how:

coding, analysis of data and theorizing occurred simultaneously¼Logic diagrams¼ and memos were written throughout the process to

guide thinking and to record analytical insights and interpretations¼the researcher employed the steps of reduction, selective sampling of

the literature, and selective sampling of the data for the purpose of

describing the analysis and presenting substantiation for the conclu-

sions drawn (Donovan 1995, p. 712).

If a grounded theory method is to be used for data analysis,

then, this must be built in to a study from its conception

because data generation and analysis need to occur concur-

rently. If this is not done, it is hard to see the justi®cation for

calling an analytic method `grounded theory' rather than

`thematic analysis', which is what seems to have been used in

most of the articles traced for this review. Thematic analysis

is described by Kitzinger and Barbour (1999, p. 16) as:

Drawing together and comparing discussion of similar themes and

examining how these related to the variation between individuals and

between groups.

Reporting focus group ®ndings: interaction

As the de®nitions of focus groups have shown, a key feature

of the method is the exploitation of group interaction among

participants to stimulate the generation of data that might



not otherwise emerge, for example in a series of single-

respondent interviews. This emphasis on interaction is àn

integral component that cannot be teased out' (Carey 1995,

p. 488). Therefore, as Carey states:

An appropriate description of the nature of the group dynamics is

necessary to incorporate (sic) in analysis ± for example, heated

discussion, a dominant member, little agreement (p. 488).

However, Kitzinger (1994, p. 104), in a review of over 40

reports of focus group studies reports:

I could not ®nd a single one concentrating on the conversation

between participants and very few that even included any quotations

from more than one participant at a time.

Similarly, there were very few examples in the articles

identi®ed for this review in which there was any discussion

of interaction in the focus groups studied, and only one

(Twinn 1998) included details of the kind that Carey

suggests.

Twinn's (1998) article is a methodological discussion

about using focus groups with Chinese populations and the

appropriateness of the method in this culture, as distinct from

the Ànglo-Celtic' groups with which they have previously

been used. Twinn considers speci®cally issues of òne member

dominance', the effect of `signi®cant group members',

offering alternative opinions, the effect of the number of

group members and the status and relationships of partici-

pants with the group leader. She gives quotations from the

data to support her conclusion that the project yielded rich

data, participants from that particular ethnic group were

willing to participate, and that therefore the method is

appropriate, with the proviso that groups and analysis are

conducted in the ®rst language of participants.

In an article that uses examples of research into sexual

health to illustrate the use of focus groups, Robinson advises

that:

The impact of the group dynamics and speci®c comments, jokes,

anecdotes, questions, censorship, changes of mind, deferring to the

opinion of others are all equally important (Robinson 1999, p. 909).

However, in the section of the article discussing her four

examples she merely reports that the method was èncour-

aged interaction', was useful for studying `social process in

action' and that `reports of sexual activity were often

untruthful' (p. 911). Beyond this, however, no detail is given

about social interaction in the groups.

Macleod Clark et al's (1996) methodological discussion

article is based on their study of the perceptions of the

philosophy and practice of nursing in Project 2000

programmes. They note that:

Focus groups are different to other methods of data collection, and it

is important to maintain a sense of the whole group within the

analysis (p. 150).

This also presents a `challenge' in presenting data and this

should:

ideally contain examples of the discursive nature of the method, by

using two or more participants in any quotations rather then (sic)

presenting isolated excerpts from one individual (p. 151).

`Sequences of discussion' are given by Reed and Payton

(1997) in their article discussing ìssues of analysis and

interpretation' in their study of the experiences of older

people moving into residential care. The sequences are used

to illustrate how consensus evolved as opinions were modi-

®ed and developed through discussion. Using sequence

analysis of this kind also allowed the researchers to see

how processes varied in their different groups. They also

comment on the dominance of one member in a group, where

a manager dominated the discussion so much that it was

more like an interview with one person. This raises questions

about the way the group was moderated and the skills of the

moderator, which are discussed in a number of articles

(Morgan 1995, Macleod Clark et al. 1996, Sim 1998,

Kitzinger & Barbour 1999).

Idvall and Rooke (1998) used ìnteraction quotations'

(p. 518) to illustrate process aspects of their focus group

study of nursing care in surgical wards. This involved a

coding system to identify individual speakers and the groups

in which they participated. In addition an arrow was used

between quotations to illustrate interactions. However,

speci®c points identi®ed from this interaction coding system

are not discussed in the article and the conclusion drawn

from this aspect is disappointing in view of the promise raised

by the coding system:

(It) can be considered an effective use of time to conduct focus group

interviews if you are interested in group rather than individual

opinions (p. 518).

The only speci®c guidance found in the articles traced for this

review was given by Stevens (1996). In an article reporting on

focus groups as a method for studying community health

issues, and in particular her own work with lesbians' health

care experiences, she proposes the following questions as a

basis for analysing group interaction:

How closely did the group adhere to the issues presented for

discussion?

Why, how and when were related issues brought up?

What statements seemed to evoke con¯ict?



What were the contradictions in the discussion?

What common experiences were expressed?

Were alliances formed among group members?

Was a particular member or viewpoint silenced?

Was a particular view dominant?

How did the group resolve disagreements?

What topics produced consensus?

Whose interests were being represented in the group?

How were emotions handled?

(Stevens 1996, p. 172)

In the section of the article reporting on the àpplication of

focus group method' in her lesbian health project, a para-

graph is speci®cally devoted to describing interaction and

reporting jokes, disagreements, and a `growing consciousness

of collective phenomena' (p. 173) as the discussion

progressed. The groups also allowed members to gain

ìnsights about their own experiences ¼ that they had not

had before the discussion' (p. 174) and to share solutions to

problems of how to access the health care system. The focus

groups thus had a `consciousness raising' effect for partici-

pants. In further sections giving `selected ®ndings' Stevens

gives more information on group processes in order to

contextualize quotations from the transcripts. Stevens, then,

goes further than any of the other nursing articles discussed

both in giving explicit guidelines on analysing process aspects

of focus groups and also in actually discussing her data in

terms of group interaction. It would be useful for other

researchers to experiment with applying her scheme to their

own data and to modify and develop it on the basis of their

own experiences.

Summary and conclusions

The CINAHL-based literature search that formed the basis

for this discussion identi®ed only a small number of articles

reporting empirical research using focus groups in the period

1990±1999. Scrutiny of these articles and discussions of the

method by nurse authors revealed disappointingly super®cial

and uncritical discussions and implementations of the

method. In particular, methodological incompatibilities had

not been recognized between phenomenology and focus

groups, and the requirements of a grounded theory approach

to data generation and analysis had not been respected. It was

common for authors to rely on secondary rather than primary

sources and this may help to account for the misinterpreta-

tions. The principal advantage claimed for focus groups,

namely the ability to use participant interaction to gain

in-depth and rich data that would not be obtained through

individual interviews, was rarely capitalized on. One author

proposed a list of questions to guide analysis of group

processes and this is recommended to future researchers as a

possible aid to gaining the bene®ts of this aspect of the

method.

A more general conclusion is that nurse researchers should

study in greater depth the methodological underpinnings of

their proposed methods and should discuss these fully in their

reports. Where the word limits of journals prohibit a full

discussion of methodology then a separate article may be

needed, and this should be based on consultation of primary

sources. Whether articles are published in àcademic' or

`professional' journals a rigorous approach to methodology is

essential, not only to ensure the integrity of the research being

reported but also because these articles will be consulted by

nurses and students attempting to develop their research

knowledge. Nursing research does not stand in isolation from

research in other disciplines, particularly the social sciences.

It is to be hoped that nursing scholarship will lead to

methodological learning and progress both for the discipline

of nursing and more widely, and not be con®ned to abstract

empiricist research of interest only to nurses. The social

sciences contribute to the knowledge base of nursing and this

relationship should be reciprocal if nursing knowledge is to

achieve higher status and wider recognition. This article is

intended to be a contribution towards this development.

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