Qualitative & Mixed-Methods

ResearchSohail Bajammal, MBChB, MSc, FRCS(C), PhD(c)

Assistant Professor of Orthopaedics, Faculty of MedicineVice Dean, Academic Development, Faculty of Dentistry

Umm Al-Qura University, Makkah, Saudi Arabiassbajammal@uqu.edu.sa

Quantitative Qualitative

Mixed-Methods

Numbers WordsActions

Reactions

Not everything that can be counted counts,

and not everything that counts

can be counted.

Albert Einstein

EBM

Clinical Context

Research Evidence

Patients’ Preferences

Clinical Expertise

Haynes et al. BMJ 2002;324:1350

Everyday• New Patient–QUALITATIVE quantitative

• Follow-up Patient–QUANTITATIVE qualitative

Questions• How do trauma patients with

quadriplegia in the Western region – Saudi Arabia rehabilitate?

• What are the important aspects of quality of life for Saudi patients?

• What are the barriers to conduct RCTs in Saudi Arabia?

Learning Outcomes

By the end of the lecture, you will be able to:

• Identify:– What is qualitative research? characteristics?– When to use it?

• Identify:– What is mixed-methods research? types?– When to use it?

Qualitative Research

Types of Research Questions• Quantitative: (cause, determine, relate, influence)– Does A cause/correlate with B?– Which is better A or B in terms of diagnosis,

treatment, or prognosis?

• Qualitative: (discover, understand, explore, describe)– What?– How?– Why?

Quantitative Qualitative

Research Methods

Closed-ended questionsPre-defined approachesNumeric data

Open-ended questionsEmerging approachesText or image data

Features

• Test theories• Variables to study• Use standards of

reliability & validity• Unbiased approaches• Statistical procedures

• Generate theories• Collect participants meanings• Study the context• Bring personal values• Validate accuracy of data• Create an agenda for reform

Creswell J. Research Design. 2009

Characteristics of Qualitative

• Natural settings• Researcher as key instrument• Multiple sources of data: interviews, observations,

documents• Inductive data analysis• Participants’ meanings• Emergent design• Theoretical lens: sampling, saturation, integrating• Interpretive• Holistic account

Creswell J. Research Design. 2009

When to use qualitative?

1. Investigate complex phenomena that are difficult to measure quantitatively

2. Generate data necessary for a comprehensive understanding of a problem

3. Gain insights into potential causal mechanisms

4. Develop quantitative measurement instruments

5. Study special populations (those traditionally underrepresented in research, low literacy)

Curry et al, Circulation 2009

Investigate complex phenomena that are difficult to measure quantitatively

Generate data necessary for a comprehensive understanding of a problem

Common Strategies (Approaches) of Qualitative Research

• Ethnography• Phenomenology• Narrative research• Case studies• Grounded theory

Culture-sharing behavior of groups

Individuals

Explore processes, activities, events

Data Collection Methods• Observation field notes

• Interviews transcripts–One-on-one: in-depth, open-ended– Focus group

• Documents content analysis

• Audio-visual materials analysis

Qualitative Data Analysis

Data Collection

Data Analysis

Qualitative Data AnalysisRaw Data (transcripts, field notes, images)

Organizing data for analysis

Reading through all data

Coding the data Themes

Integrating themes, diagramming Interpreting

Data

Computer-Aided Qualitative Analysis

• ATLAS.ti• NVivo• MAXqda

NVivo

NVivo

www.researchsupport.com.au

“Validity” Strategies

• Rationale for choosing an approach• Triangulation of methods• Interviewers training• Member checking• Rich, thick description• Reflectivity• Peer debriefing Cross-coding• Documentation External auditor

Mixed-Methods

What is mixed-methods research?

Combining qualitative & quantitative research

1960s

Aspects in Mixed-Methods

• Timing: sequentially or concurrently

• Emphasis: qualitative, quantitative, or both

• Mixing: integrating, connecting, or embedding

1. Sequential Explanatory

QUAN qual

Creswell J. Research Design. 2009

2. Sequential Exploratory

QUAL quan

Creswell J. Research Design. 2009

3. Concurrent Triangulation

QUANData Collection

QUANData Analysis

QUALData Collection

QUALData Analysis

Data Results Compared

QUALQUAN

Creswell J. Research Design. 2009

4. Concurrent Embedded

QUAN

qual

Creswell J. Research Design. 2009

Lewin et al, BMJ 2009

Publishing

Resources

Books• Research Design: Qualitative, Quantitative,

and Mixed Methods Approaches. John Creswell. 3rd Edition. 2009. SAGE Publications.

Articles

People• Look around in your university:–Nursing–Medical Educationalist–Psychology–Sociology–Medical Geography

Questions• How do Saudi patients with quadriplegia

in the Western region rehabilitate?

• What are the important aspects of quality of life for Saudi patients?

• What are the barriers to conduct RCTs in Saudi Arabia?

Summary• Patients talk, act & react not numbers

• Qualitative is helpful when nothing or little is known about a condition or environment

• GOOD qualitative research needs lots of work

• Be pragmatic

ssbajammal@uqu.edu.sa