Narrative Analysis in Injury Research

This injury was due to …….

Thomas Songer, PhDUniversity of Pittsburgh

tjs@pitt.edu

Aims

• Recognize the value of narrative data that accompanies coded data

• Provide a framework for exploring narratives

• Ultimate Goal: see to better understand circumstances of an injury

Qualitative Data

• Data in the form of words, language in the form of extended text

• Can be an alternative research strategy

• The underlying assumptions, methods, and research procedures of qualitative approaches are often very different from quantitative approaches

Thomas DR

Qualitative Research Approaches

• Phenomenology

• Ethnography

• Narrative analysis

• Grounded theory

• General inductive

• Discourse analysis

• Case studies

Thomas DR

Comparison of descriptive ability:Fx ankle running on base after dark; stepped in pothole

Activity = RunningMechanism* = PotholeTime = 2200 hrsOn_Base = YESNarrative: “Jogging on running trail, detoured onto Center St due to mud . . . .”

Inj Type = Fracture Body Part = Foot/ ankle

Hierarchical taxonomy &

narrative textSafety

Not available824.1

Fx of ankle--Medial malleolus, open

ICD codes (N)Medical

(outpatient)

239Athletics/sports incl

PT, other

824.1Fx of ankle--Medial

malleolus, openICD codes (N)

STANAG (E)

Medical (inpatient)

External cause (E)Nature of injury (N)Data TypeDomain

* Derived from narrative

Text data accompanies computerized coded data

029801340982110000 TWISTED ANKLE WHILE WALKING888015690134234520112952589301300000 POSSIBLE FOOD POISONING111436012045021439210001214234131980888121200012314521013298231343287821 WOUNDED BY GUNSHOT977237211010132123012128881234100010 FELL AND STRUCK BED

Analytic Approaches

• Computerized keyword search using automated coding software

• manual keyword search• manual review

– create new variables– recategorize data– code into categories– identify summary themes

Developing Categories for Analysis

• Initial categories should be determined by the objectives of the research

• Specific categories can be developed from the review of the data and the identification of frequent or significant themes, words, circumstances

Thomas DR

Data Consistency

• Identify a “case definition” or “eligibility criteria”

• Go through data several times to check consistency of coding applied to the categories

• Consider the use of an independent coder

An Alternative Approach

• Analysis of narrative text structure– setting– individuals involved– problem– initiating event– 2nd event– 3rd event– 4th event– resolution

Limitations

• No guidelines for what is entered as text

• Manual review is time intensive

• Purpose of data collection may not mirror underlying needs of injury research

Key Lecture Points

• Narrative analysis is another research technique in the injury field.

• It is advocated in situations where existing data contain very little information on the circumstances surrounding an injury.

• The analytic approaches in narrative analysis are often subjective, and great care must be taken to develop data consistency to support the results of the analysis.