QUALITATIVE METHODS IN HEALTH

TECHNOLOGY ASSESSMENT .

Paper by: Levis KAHANDUKYA NYAVANDA

Great Lakes University of Kisumu, Kenya (EA), October 2016

Qualitative research involves the collection, analysis and interpretation of data that are noteasily reduced to numbers

Qualitative process of inquiry has the goal of understanding a social human problem from multiple perspectives.

Qualitative research is conducted in a natural setting and involves a process of building a complex and holistic picture of the phenomenon of interest

Qualitative research

These data relate to the social world and the concepts and behaviours of people within it

Qualitative research can be found in all social sciences in the applied fields that derive from them, for example, research in health services, nursing and pharmacy

Qualitative research

These research methods are not a recent invention but their application in health technology assessment (HTA) or health services research may be fresh

it is important that researchers under-stand the principles of qualitative methods and the way they may be used to set benchmark and standards.

Qualitative research

Perspective- Idealists

Qualitative work is often identified with idealism while quantitative work is identified with realism.

Most qualitative researchers accept that there is an objective, material world, as do realists, but question our ability to know this directly.

In the social sciences, what people perceive or believe is the basis of their actions rather than what an impartial observer might think was actually true

Multiple realities exist in any given situation – the researcher’s those of the individuals being investigated and the reader or audience interpreting the results;

These multiple perspectives or voices of informants are included in the study

The researcher interacts with those he studies and actively works to minimize the distance between the researcher and those being researched

Assumptions underlying Qualitative methods

Research is context bound Research is based on inductive forms of logic;

categories of interest emerge from informants (subjects) rather than being identified a priori by the researcher

The goal is to uncover and discover patterns or theories that help explain a phenomenon of interest; and determinations of accuracy involve verifying the information with informants or ‘triangulating’ among different sources of information (e.g, collecting information from different sources)

Assumptions …..

1. Case studies –

In a case study the researcher explores a single entity of phenomenon (the case) bounded by time and activity (e.g. a program, event, institution, or social group) collects detailed information through a variety of

data collection procedures over a sustained period of time.

The case study is a descriptive record of an individuals experiences and or behaviours kept by an outside observer

Three general types of qualitative methods

in ethnographic research the researcher studies an intact cultural group in a natural setting over a specific period of time.

A cultural group can be any group of individuals who share a common social experience, location or other social characteristic of interest –

This could range from an ethnographic study of rape victims in crisis shelters, to children in foster care, to a study of a cultural group in Europe

2.Ethnographic studies

Human experiences are examined through the detailed description of the people being studied –

the goal is to understand the ‘lived experience’ of the individuals being studied.

This approach involves researching a small group of people intensively over a long period of time.

3’ Phenomenological Studies

Complete participation

Non participant observation

The observer is a full member of the group

The observer takes no part at all in activities and has no contact with those being observed

Observation

Advantages and limitations

Advantages Limitations

An observer need not specify the research problem as someone designing a survey, but can be flexible examining events as they happen, understanding how social relationships reflect values and beliefs and the meaning people give to events

Only some activities can be observed – easiest in countries where much of daily life goes on in public

As societies become larger in scale, they get beyond the capacity of a single observer and the problem of sampling arises

Observation

Advantages Limitations

Participant observers get a fuller understanding of a society than those who appear, take a survey and leave

Rules of interaction, the effects of relationships on behaviour, quality of life all need observation

The presence of an observer will have some effect on group activities, especially when using a tape recorder, camera or camcorder (this can be minimized by becoming as psychologically invisible as possible)

Observation

Advantages Limitations

It can be more reliable to observe and record behaviour than to ask people to generalize about it

Observation can generalize on little data (the observer may have seen a rare case)

Generalization about attitudes can also be subject to faulty impressions (attitudes are available to an observer if they are reflected in behaviour)

Involve a small, purposive sample and are less structured and usually longer than survey interviews

Informants are selected because they have knowledge and so interviews vary with what the information has to contribute

Informant Interviews

Requires considerable preparation Work out what you want to ask, in

approximately what order Put the informants at ease and encourage

full discussion of each topic with as few probes as possible

Encourage precision and specific examples where answers are vague or rhetorical

Do’s of Informant Interviews

o Check each statement against what has gone before and your information from other informants and tactfully question contradictions

o Let informants carry the discussion. Say as little as possible yourself

o An interview should not last too long unless if the informant is enjoying the experience

Key Informant Interviewing

How does the informant know this – from personal experience, a report or merely opinion?

To what extent is the report affected by the informant’s position in the community, personality?

What evidence have I that this person is usually accurate? Is the report internally consistent?

Points to consider in informant interviews

Consist of one-on-one interviews with participants that a researcher is seeking to better understand

In – Depth interviews last anywhere from a half hour to two hours

A moderator takes the participant through a discussion guide and as topics come up the moderator may probe for further insights

In-Depth Interviews

Involves bringing a group of people into one setting and a moderator facilitates group discussions about a topic

The group dynamic leads to brainstorming, generating ideas, and a deepening of the discussion because of the variety of participants and their experiences

Typically focus group participants are chosen because of their profile (experience)

Focus Group Discussions

Peil, M. Social Science Research Methods, a Handbook for Africa, Second Revised Edition, East African Educational publishers, Nairobi, 1995.

References