Abstract
Doing Collaborative Research: The Good, the Bad, and the Politics
Simon Adam, University of Toronto
While the importance of collaborative research and collaborative discovery cannot be understated, what accompanies such work can be a myriad of difficulties for the researcher and a number of barriers for “the researched.” What are the rich possibilities of discovery that can be achieved by doing collaborative research? What are some inherent barriers in collaborative research work? How can an ethical review process become an institutionalized political process? How do institutional political interests trump those of discovery, knowledge production, and progress? In this presentation, I offer some answers to these questions and pose further ones for critical thought. I report on a current research project—an institutional ethnography—which involves several educational institutions (and at one point, a hospital). The very obstacles—the institutional “red tape”—and its implications for doing collaborative research are the focus of this presentation.
The Transaction “X-Ray”: Refreshing the Parts Other Peers Cannot Reach!
Alan Aitken, Glasgow Caledonian University
Robert Paton, Adam Smith Business School, University of Glasgow
Penetrating potentially sensitive areas for interviewees and, subsequently, aggregating interview outputs in a manner that avoids the effects of decontextulisation and decomposition are issues commonly faced by qualitative researchers. This paper, whose title is unashamedly borrowed from a long-running UK beer advert, presents a research method that seeks to overcome these issues. Using a web-based contemporary update of Diary-Diary Interview techniques, the researchers were able to penetrate the commercial sensitivity associated with the longitudinal study of presales interactions between business-to-business (B2B) buyers and sellers. The research methodology develops well-established techniques associated with qualitative content analysis to examine individual interactions and subsequently utilises an innovative graphical method of aggregation to present a nuanced view of groups of transactions that share common characteristics. The resulting transaction “X-rays” are used to explore emergent themes by comparing and contrasting X-rays across data sets. Although developed within the specific context of B2B negotiation, the authors contend that the methodology has significant cross-discipline potential. Applications suited to the method may include any context in which researchers seek to develop a deeper and more complete understanding of the interviewee than can be achieved by comparable techniques. The methodology is particularly suited to situations in which interviewees, although happy to participate in the interview process, may not respond to direct questioning for reasons of personal sensitivity. In this regard, presenting aggregated results in the form of transaction “X-rays” further gives assurance of interviewee anonymity.
Nurses and GPs Views on Facilitators and Barriers of Screening for Autism in Oman
Turkiya Al Maskari, University of Glasgow
Craig Melville, University of Glasgow
Rasha Ahmed Sultan, Qaboos University
Diane Willis, Edinburgh Napier University
Specific screening for autism has been recommended for toddlers within the routine paediatric practice to facilitate early identification and improve outcomes. No study has been undertaken previously to examine the readiness or capacity to screen children for autism in Oman. This qualitative study is an initial phase of a mixed methods design, aiming to explore the facilitators and barriers of screening for autism in Oman from the primary health-care provider’s perspective and to develop a questionnaire exploring the aspect from a wider perspective. Two focus group discussions were undertaken with 13 nurses (N = 7) and GPs (N = 6) from Muscat Health centres. This presentation will reflect the findings of the focus group. It will also discuss the process of analysing the data using the framework method for a novice researcher. Findings indicated that both GP and nurses were positive towards screening for autism but currently lacked knowledge about autism or information about the availability of current services for autism in Oman. Participants also identified potential barriers and facilitators to screen for autism in Oman. Feedback about developing a survey questionnaire exploring autism screening within the primary health-care settings across Oman was also discussed. If screening for autism was to be introduced, clinical staff will require more training and education about autism. Work is needed to increase awareness of the services currently provided for children with autism, whilst improving public awareness may help to reduce cultural sensitivity and social stigma.
Qualitative Data Analysis: Step by Step Guidelines From Collection to Analysis
Nada Alsaleh, King Saud University and University of Leicester
For many researchers, qualitative data analysis is a whirlwind of information that makes them feel lost; they often feel that they do not know where to start or where and when to end. Therefore, sharing experiences with other researchers is one of the most useful ways to guide them on how to conduct the process of qualitative data analysis successfully. During my PhD research, I had multiple sources of qualitative data collected using different methods such as focus groups, observations, and learner diaries. While drawing on ideas from research methods literature, the analytical methods felt like going through a trial-and-error process that lasted for more than 8 months, before I finally felt comfortable that I have achieved some reliable findings. This presentation will focus on, and provide, specific personal experiences to illustrate the steps and procedures that were followed to organize, understand, analyse, and interpret my qualitative data. In this presentation, I will clarify how to graduate from chunks of data to codes, themes, and subthemes. Moreover, this presentation will put a spotlight on the role of technology in supporting data analysis by giving a short introduction to the Atlas Software that was used to analyse the data. Additionally, I will show how the electronic version of the analysis can merge with a manual analysis to provide the best interpretation. It is hoped that this presentation will offer useful guideline for any researcher planning to start qualitative analysis.
Security or Collaboration? Balancing Both Within Qualitative Data Management
Marcy Antonio, University of Victoria
James Doiron, University of Alberta
Laurene Sheilds, University of Victoria
Emerging secure online data management systems allows the successful management of sensitive qualitative research, from data collection through dissemination. These secure virtual research environments (VREs) enable each researchers within a geographically dispersed research team to have ongoing 24/7 access to large sets of sensitive qualitative data and analytic software programs. However, these emerging system do not come without their own unique challenges, including appropriately downloading copies of data, attending to legislation requirements which may prohibit data exchange between two jurisdictions, and ethics boards’ unique requirements for privacy and security. Additionally, members within a research team may have different levels of experience using such emerging technologies as well as various computer platforms and specific preferences for document formats. This presentation will discuss the key learnings from a current qualitative narrative study that is utilizing a secure VRE for managing health-related data. This narrative inquiry study involves securely managing transcripts and visual data of 80 participants living with life-threatening illnesses. The 12 member research team transverses across two Canadian provinces and utilizes a single point of access for data management—the University of Alberta Health Research Data Repository. The presentation will provide (1) an overview of the successful strategies that were implemented to ensure systematic organization of the large qualitative data set, (2) the unique considerations in using a secure VRE for qualitative data management, (3) the challenges that were addressed in balancing the security requirements of the VRE, while promoting a collaborative research team environment.
Phenomenology in the Absence of Researcher Lived Experience: Can Trustworthiness Be Achieved?
Beth Archer-Kuhn, University of Calgary
Phenomenology is considered by some to be an appropriate methodology when studying lived experience, including researcher lived experience, allowing the researcher to suspend their standpoint. Researcher self-reflection is a critical component of phenomenology and, some believe, can allow the researcher to bracket their bias and assumptions. Data collection and analysis are conducted simultaneously within the tradition of phenomenology requiring a high level of researcher reflexivity. Given the subjective nature of qualitative research, is the researcher in the position to know when trustworthiness is achieved? What if the study topic is not part of the researcher lived experience? What level of rigour is required in phenomenology to explicate or illuminate consciousness or awareness? This discussion will focus on a process that reveals the multiple methods that have been employed to demonstrate rigour when the lived experience is not shared by the researcher and the audience is encouraged to participate through comments and questions that challenge our thinking about study rigour. This presentation reflects a phenomenological study with 18 parents about their perceptions and experiences with child custody decision-making, noting the complexities and differentiated experiences: low conflict, high conflict, and domestic violence. This is the first study, to my knowledge, to explore parents’ experiences from their own perspective and, at the same time, differentiate experiences of low conflict, high conflict, and domestic violence as distinct in a study population.
Polyethnography and Weight Bias: How Far Do You Dare to Go in Collaborative Research
Nancy Arthur, University of Calgary
Shelly Russell-Mayhew, University of Calgary
Darren Lund, University of Calgary
Sarah Nutter, University of Calgary
Monica Sesma, University of Calgary
Emily Williams, University of Calgary
Anusha Kassan, University of Calgary
Researchers are encouraged to position themselves in relation to the topic of their research. The process of reflection about positionality can be helpful to uncover assumptions, address potential biases, and also help to centre researchers for their interactions with research participants. In this paper, we argue that reflective practice about positionality is a priority for collaborative research in order for team members to be able to gain personal insights about their experience with the research topic and to share such insights with other team members, prior to engaging with research participants. However, there are few resources to guide collaborators about how to engage in reflective practice and the process of exploring positionality on collaborative research teams. In this study, based on a common research interest in the topic of weight bias, we embarked on a process of polyethnography to encourage reflection, input from other members of the research team, and to foster a deeper collective understanding of the research topic. This presentation will detail the process we used, including the insights and challenges that we faced together in this journey. A content analysis was conducted to examine the themes that surfaced through our team conversation. Results showed that childhood experiences with family and peer interactions, media influences, and gender dynamics strongly influence team members’ interest in research about weight bias. An overarching theme emerged in which members of the research team spoke about their desire to live more authentically in their personal lives and professional roles as researchers.
Critical Incidents in Professional Practice for Social Justice
Nancy Arthur, University of Calgary
Collecting critical incidents in qualitative research offers rich and vivid snapshots of meaningful experiences. This approach is useful for highlighting examples of what research participants find to be important or significant about their experiences. There are various approaches to using critical incidents in research, stemming from quantitative approaches to recent research based in constructivist meaning-making to understand processes of learning and development in professional education. In this presentation, an overview of approaches to using critical incidents in research will be provided. Next, an example of a study in professional education will be highlighted. Examples of critical incidents show how the concept of social justice was actively taken up by professionals in their work with real-life scenarios from their professional practice. Three critical incidents will be used to illustrate the multiple meanings of social justice and how professionals translated ideas about social justice to active practices.
Critical Incidents of Resiliency in Young Canadian Refugees
Nancy Arthur, University of Calgary
Helia Jafari, University of Calgary
Adam Horvath, Simon Fraser University
The Enhanced Critical Incident Technique (ECIT) was utilized to address the research question, “What helps or hinders adolescent refugees who have experienced war in their homeland to build resilience psychologically, socially, and academically as they resettle in Canada?” ECIT is an outgrowth of the enhancements made to the Critical Incident Technique (CIT). CIT is a qualitative research method that explores what helps or hinders during a particular experience or activity. The term incident represents experience, factors, events, or perceptions that either helped or hindered individuals in the phenomenon of interest. In this study, incident referred to all the personal and environmental factors that helped or hindered young refugees successful integration in Canadian society. Data were collected from 12 young refugees (between 13 and 19 years of age) from Iraq, Afghanistan, Burma, Honduras, and Congo, conducting CIT interviews. Findings from this study suggested that resilience in refugee youth is typically associated with the availability of human and social capital, more specifically in the form of personal qualities (e.g., adaptive copings, effective language-learning skills) and contextual qualities (e.g., social support, school climate, government and community resources). This presentation provides a detailed, practical guide based on our own experience using the ECIT research method with young refugee population.
Symposium: Longitudinal Qualitative Analysis—How Can It Be Done?
Åsa Audulv, Symposium Chair
Symposium Abstract #1: How Do We Understand Time and Change? Five Approaches to Longitudinal Qualitative Research in Nursing
Åsa Audulv, Mid Sweden University
Åsa Kneck, Ersta Sköndal Univeriversity College
Longitudinal qualitative research can give us new insights in social processes and experiences over time. In recent years, there has been a growing interest in conducting longitudinal qualitative research. However, the definition of what constitutes a longitudinal data presentation is unclear, the methodological literature scarce, and the variation of procedures great. Therefore, we undertook a review of longitudinal qualitative articles within the nursing field to identify and describe various types of qualitative longitudinal approaches. In this presentation, the five identified types of longitudinal qualitative approaches will be presented. In total, a large part of the papers described as having a longitudinal design in fact only performed a longitudinal data collection and did not integrate ideas of time or change in their analysis or results. This practice will be problematized and a definition for longitudinal qualitative research will be proposed. Three fruitful approaches to analyzing longitudinal qualitative data were identified: pool-, phase-, and pattern-oriented approaches. These practices focus upon different aspects of time, change, process, and context, thus presenting different kinds of results. A discussion of the pros and cons of these three practices will be held so researchers can make a more informed decision when choosing which approach they will take when analyzing longitudinal material.
Symposium Abstract #2: Longitudinal Qualitative Analysis: A Practical Guide to a Pattern-Oriented Analysis Approach
Åsa Audulv, Mid Sweden University
Åsa Kneck, Ersta Sköndal Univeriversity College
Despite the fact that longitudinal qualitative research has attained more attention over the last couple of years, there is little literature about the procedures of doing qualitative longitudinal analysis. This presentation will focus upon procedures of conducting a pattern-oriented longitudinal analysis. A pattern-oriented analysis focuses upon how individuals (or phenomena) move through a process/time in identifiable patterns. While other longitudinal analysis approaches might emphasize a main process, a pattern-oriented approach accounts for the individual variance in the context of time and change. We developed the pattern-oriented analysis approach after conducting two independent qualitative longitudinal studies concerning learning and enacting self-management in the context of chronic conditions. Examples from these studies will be discussed during the presentation. Both analyses were performed in several steps where the following key features included: “identifying the process,” “summarized description,” and “using matrixes.” The key features of the analysis procedure will be presented as well as pitfalls and possible solutions related to the approach.
Symposium Abstract #3: Learning to Live With Diabetes—A Changing Process Over Time
Åsa Kneck, Ersta Sköndal Univeriversity College
How time influences the learning process for persons living with diabetes is not fully understood. In previous research, learning to live with a lifelong illness has been described either as a linear process or a fluctuating process and consensus seems to be far away. In this longitudinal descriptive qualitative study, the aim was to identify patterns of learning in relation to living with newly diagnosed diabetes. Thirteen participants, with Type I or Type II diabetes, were interviewed at three occasions during a 3 years period. A qualitative content analysis was used with a pattern-oriented analysis approach. The result shows that the participants moved through their learning in conceptually different ways. In total, five patterns of the learning process were identified: (1) finding the balance to gradually letting oneself live; (2) being active in searching for knowledge in order to gain control; (3) despite obstacles, having the strength to maintain what is important; (4) increasingly difficult to obtain acceptable blood glucose level and to live well with diabetes; and (5) adapting to minor changes in daily life. This study challenges the common notion in health care of learning as linear and related to time since diagnosis. In the present study, duration of illness was not important for the learning process. Instead, participants’ needs, beliefs, and values related to illness differed in the patterns and changed over time. This study was able to present individuals’ differences and thereby show the value of using a pattern-oriented analysis approach in longitudinal qualitative research.
The Problem of Induction in Qualitative Nursing Research
Elisabeth Bergdahl, Research and development unit, FOU nu, SLSO and Nord University
It remains unclear what constitutes a good foundation for qualitative scientific inquiry in nursing. There is a tendency to define qualitative research as a form of inductive inquiry; deductive practice is seldom discussed or practiced. In some ways, this problem can be seen as an expression of a lack of understanding and knowledge about induction and the developments in the philosophy of science. The problem can and has already harmed nursing science and development of sound nursing theories. The problem with induction, as discussed by Popper, is that it is not possible to create theory by only using strict inductive practice nor is it possible to justify scientific knowledge. Formulating theory is a creative endeavor and a theory can be formulated from scientific studies or personal experience. In order for a theory to be scientific evidence, one needs to test the theory in order to corroborate or falsify it. A qualitative study can also test a hypothesis; however, this is seldom practiced. In nursing, there is also a tendency to “protect” theories, instead of testing. The conclusion is that a theoretical perspective that reconciles the misunderstandings is needed as well as openness towards deductive thinking and testing of hypotheses in qualitative nursing research. Induction alone cannot create theory, a creative leap is needed. There is also a need to further discuss how qualitative methods can be in line with hypothetical-deductive method and how, qualitative studies can be seen as scientific experiments, examples will be explored.
A Team Focused Ethnography in a Nationwide Study in Primary Care
Annemieke Bikker, University of Edinburgh
Heather Brant, University of Bristol
Tania Porqueddu, University of Oxford
Focused ethnography involves the use of tailored data collection methods to explore a specific social phenomenon amongst a subgroup of people, as it occurs in everyday life. The method has grown in popularity in health-care research. We use it in a collaborative project across five universities in the UK to assess the potential impact of using alternative methods (telephone, e-mail, or video) to face-to-face consultations in primary care. Conducting a nationwide-focused ethnography with a multidisciplinary team has various advantages. Firstly, the applied and pragmatic nature of focused ethnography enables us to collect data in a relatively short time span. Secondly, the team approach enables us to conduct the ethnography in eight general practices in locations across the UK. Thirdly, the sharing of experiences and observations between the ethnographers and the wider research team facilitates a more holistic understanding of the research topic. To date, little has been published on conducting team-focused ethnography in primary care and on what facilitates or hinders a collaborative approach to research in this setting. By using our study as an example, this presentation will focus on our experiences of this process, such as the mechanisms for creating communication flows within the research team, tools to understand team member’s viewpoints, dealing with different health-care systems in England and Scotland, and approaches to streamlining the recording and organising of the field data in such a way that all ethnographers work to the same format while assuring that the essence of each study site is maintained.
The Contribution of a Critical Realist Approach to Understanding the Symptoms and Causal Explanation of Postnatal Depression in Malaysia
Siti Roshaidai Binti Mohd Arifin, Nursing, Midwifery and Allied Health Professionals (NMAHP) Research Unit, University of Stirling
Helen Cheyne, Nursing, Midwifery and Allied Health Professionals (NMAHP) Research Unit, University of Stirling
Margaret Maxwell, Nursing, Midwifery and Allied Health Professionals (NMAHP) Research Unit, University of Stirling
Postnatal depression (PND) is considered to be a serious mental health problem for many women worldwide, contributing to increased maternal morbidity and mortality. Although it has been found to be associated with hormonal and sociocultural factors, it remains unclear why the experience of PND varies by context and culture. The aim of this presentation is to evaluate the contribution of critical realism in understanding the symptoms and the perceived causes of PND among women from three different cultural backgrounds. A total of 33 women from three different cultural backgrounds attending for care in six purposively selected Maternal and Child Health clinics in Kuala Lumpur, Malaysia, were individually interviewed. Data were analyzed using framework analysis. Symptoms of PND as explained by the women did not fully reflect medical diagnostic criteria, focusing instead on women’s emotional experiences and disturbances. Women’s causal explanations were different from one culture to another. For example, Malay and Chinese women felt traditional postnatal practices contributed to PND, whereas Indian women felt such practices actually served to promote maternal and child well-being. Whilst women have different experiences and explanations for PND, they also shared many common experiences reflected in a set of physical, psychological, and sociocultural causal factors.
The Role of Narrative Inquiry in Evidence-Based Practice
Angela Blackburn, University of West Florida
Definitions of evidence-based practice (EBP) aim to incorporate best research evidence, professional expertise, and patient preferences and values. However, patient preferences and values are largely underacknowledged in the EBP literature. Collaboration with research participants via narrative inquiry plays a central role in capturing the essence of patient experiences of illness and real-life clinical encounters. Patient narratives elucidate care that is preferred and valued contributing to this often overlooked aspect of EBP. The researcher uses an example from a narrative research study to illustrate how a relational methodology that values interpersonal relationships and empathetic listening can contribute to better understandings of patient preferences, values, and concerns. The researcher sampled four first-time mothers postdischarge from a neonatal intensive care unit (NICU) in a Level III regional referral center in the southeast United States. Data were generated from three separate semi-structured audio-taped interviews with each mother, photographs taken by families, the mother’s journal entries, and the mother’s NICU memorabilia. Data analysis was guided by two levels of reflection: an exploration of story types and narrative features with transcendent themes. The researcher’s selection of narrative inquiry reflects the researchers own values and beliefs about the importance of compassionate, patient-centered care. The researcher intends to make these values explicit, so that collective deliberation can take place on the complementary role of illness narratives in the constrained EBP landscape.
GP Referrals to Weight Management: A Mixed Methods Realist Case Study
David Blane, Institute of Health & Wellbeing, University of Glasgow
Sara Macdonald, Institute of Health & Wellbeing, University of Glasgow
David Morrison, Institute of Health & Wellbeing, University of Glasgow
Kate O’Donnell, Institute of Health & Wellbeing, University of Glasgow
Realist methodologies are gaining in popularity in health services research, particularly in evaluation (Realistic Evaluation; Pawson & Tilley, 1997) and in knowledge synthesis (Evidence-based policy: A realist perspective; Pawson, 2006). At the heart of the approach is a focus on uncovering the “mechanisms” at play within a policy, programme, or intervention and the various contextual factors that allow or prevent these mechanisms from “firing” to produce intended (and unintended) consequences. In the presentation, I draw on a mixed methods case study of GP referrals to an NHS weight management service to explore how realist thinking, and in particular, attempts to uncover views on mechanisms through semi-structured interviews informed the design and conduct of this study. The utility of the conceptual framework of “candidacy” theory (Dixon-Woods et al., 2006) in understanding the referral process will also be discussed.
Multi-dimensional Disadvantage: How Men With Intellectual Disability Experience Disability, Poverty, and Gender Impacting on Their Health
Martin Bollard, Coventry University
Symposium: Action Research—A Complex Collaborative Ocean of Possibilities
Johanne Alteren, Nord University and Symposium Chair
Symposium Abstract #1: Layered Data Collection and Metaphor in Theory Development in a Health Care Action Research
Terese Bondas, Nord University
The aim of this presentation is to show the possibilities of theory development with the help of layered data collection and metaphor in an action research study. The focus in the study was health-care professionals’ participation in innovation teams beside their professional work in an otherwise bureaucratic public health-care organization. Professional and academic collaboration resulted in a 2-year action research project in cycles in which both theory and practice were informed. Data with 21 participants were created in fieldwork notes beside formal and informal individual and group interviews and diaries. The move between the ordinary professional bureaucracy in their everyday work and the free collaboration in the adhocracy of the innovation team showed two worlds. In-depth reflections emerged on existential issues such as devotion to caring and the meaning of the organizational culture. The metaphor “jetlag,” the chosen theories and the different data layers, enabled a deeper understanding. Jetlag can occur when you travel quickly across time zones, and the crossing may lead to sleepiness, sluggishness, and inertia. When overcoming the jetlag of moving between different organizational zones, adhocracy seemed to be an organizational form that evoke creativity, communion, and ethical reflections. Innovative care solutions in another organizational “zone” of the ad hoc innovation team created circles of ideas and potential for personal, professional, and care development. The emergence of a metaphor, jetlag in the layered data collection will be described, and how this metaphor was used in the creation of a theory of care development
Symposium Abstract #2: Participatory Action Research—Cocreating Possibilities and Developing Nursing Care by Student Activities in Nursing Homes
Elisabeth Bergdahl, Research and development unit, FOU nu, SLSO and Nord University
Terese Bondas, Nord University
The presentation will focus on a complex participatory action research process that started in 2012 involving 14 nursing homes in seven municipalities. Collaborative research can be innovative. In this case, the process led to theory development, a model of development of care, and improved skills. Qualitative data collection was made over time in collaboration with management and staff. The research process started with the insight of the need to improve the quality of care and the level of competence among staff in nursing homes. Can we create a more sustainable structure that supports development of care and learning? We created a hypothesis: Through a good structure of student activities and collaboration with institutions of education, a learning culture can be achieved that contributes to the development and learning of staff and improved quality of care. A model for how the structure for receiving and supervising students may look like was created. The model gave the staff understanding of the complexity in student activities and how to cocreate possibilities after evaluations. The management that was open to change enabled a caring and learning culture to flourish, but obstacles were also a part of the process. The process is still going on, successfully. The staff experience that student activities give them new knowledge based on research. The model can promote structure and learning, and the process can improve quality of nursing care for elderly persons. Innovative perspectives on methodological, theoretical, and epistemological ways of understanding and doing action research will be presented.
Symposium Abstract #3: Appreciative Interaction Between Researcher and Staff in a Nursing Home Action Research—Thinking Outside the Box
Inger-Lise Magnussen, Nord University
Terese Bondas, Nord University
Johanne Alteren, Nord University
Based on an action research on developing knowledge and use of a sensory garden in a northern Norwegian nursing home, we will focus attention on the interaction between the researcher and participants (10 caregivers and 3 leaders) and theory. Based on an appreciative approach, the interaction takes place on different arenas such as interview situations, reflection meetings, the practice field, and several workshops. The study’s context, a nursing home for people that suffer with dementia, requires both ethical and practical considerations. A “cog in a wheel model” was developed in collaboration. The largest cogwheel consists of the participants’ experiences and wishes, the second cogwheel shows some of the researchers’ various challenges, and the third one is the theoretical perspective. The model highlights the complicity of the cyclical research process. Each tooth on the cogwheel represents the conditions under which the action research process moves forward, each “notch” may unite the contributions, and something new occurs in the interaction between the participants and the researcher. When bringing in the chosen theories, both the participants and the researcher come into new “think-paths,” and the participants may see the need for changes and improvements in practice and the researcher’s role as the catalyst becomes more visible. A reference group enables the researcher to reflect on the cogwheel and the direction of the movement in the research process. The appreciative processes and interactions, as well as elaboration of the “cogwheel model,” will be presented at the conference.
Qualitative Research in Tourism
Wannawee Boonkoum, Silpakorn University
Qualitative research is a well-established approach used in social science research. This is due to its ability to provide rich and in-depth data. The tourism sector is no exception. Many studies on tourism from different parts of the world reveal that qualitative research has been used in different stages of tourism development, for example, fieldwork at the early stage, following with interviews or focus group discussions. Thus, gaining more knowledge and understanding on qualitative research seem to be very important for researchers who are carrying out research on tourism. This presentation will provide more information on how qualitative methods have been applied in a study of one of the cultural tourist attractions in Thailand entitled: “The Development of Cultural Tourism Management Model for Strengthening of Identity and Sustainable Development in Suphanburi Province.” Three qualitative methods such as fieldwork, interview, and focus group discussions have been used. The presentation also shows how the researcher triangulated the collected data before conclusions based on the findings were drawn.
Returning to Creative, Responsive, and Collaborative Engagement in Narrative Research
Anne Bruce, University of Victoria
Anita Molzahn, University of Alberta
Rosanne Beuthin, Island Health Authority
In this paper, we examine how genuine collaboration necessitates a return to emergent research designs in narrative research. Situating the discussion within “the narrative turn,” we draw on a recent longitudinal narrative inquiry conducted over 6 years across two university sites and an advisory committee of community stakeholders. We contend that the principle of emergent design within narrative inquiry has been lost in recent years. Increasing demands for predetermined, fixed analytic approaches required by granting agencies and ethics review boards pose methodological challenges. In particular, evolving analytic approaches that are responsive to unanticipated participant data, surprising philosophical tensions, and the nature of innovative, emergent analysis in a longitudinal inquiry are explored. Using exemplars from recent research, we describe a synthesis of analytic approaches developed in response to such challenges. Throughout, we draw from a recent nursing study and conclude with how narrative inquiry can, and must, evolve as an emergent design to support genuine collaboration by researchers, study participants, and advisory committee members within the ever-maturing field of narrative research.
Rediscovering the Power of Participant Observation: Walking the Talk
Mary Butler, School of Occupational Therapy, Otago Polytechnic
Ethnography has always focused on participant observation, and it has traditionally recognised that doing activities together is remarkably effective as a way of gaining insights. More recently, the “mobility turn” in the social sciences has intensified the focus on the kinds of information gained as one moves from a “here” to a “there.” Walking in particular has become a focus and it is recognised that such bimbles/perambulations have the capacity to add depth and richness to the interview process. When one takes this method into the field of disability studies, the potency of “walking together” becomes very obvious. This walk lends itself to a range of affordances, including shifting the balance away from a clinical interview format, evoking a situated cognition where the person enacts a way of being in place and time, and rendering visibility to the disabled body. This presentation will argue for a renewed focus on participant observation as a method within qualitative research and disability studies in particular. It will discuss how interviews can be framed through an embodied process of engaging in specific activities, such as walking. This goes beyond mobility as the object of study, to examine the subjective experience of mobility as a method. It will explore the ontological positioning and epistemological stances that are generated by activity as a method.
Meditation as Method: Ontological and Epistemological Approaches to Reality
Mary Butler, School of Occupational Therapy, Otago Polytechnic
Just as exercise must be experienced, so must any form of contemplative practice. It is not enough to “know about” meditation, it has to be truly and routinely engaged and experienced. It seems that sustained and routine practice causes fundamental changes in the operating system of heart and mind. There is a profound connection between the contemplative approach and the particular way of knowing that ensues from this approach. In this paper, I describe how meditation can be both subject and object. Meditation is currently the object of intense scrutiny in positivist research, but in this paper, I am most interested in the meditator as subject. Meditation offers an ontology and an epistemology of its own, one where being silent leads to the stripping away of layers of illusion. This is very different to the social constructionist approach that underpins much thinking in qualitative research and pedagogy. Any meditation is essentially an experiment with the self, enabling an empirical approach to the various conditions that map a spiritual journey. In this paper, I draw on various traditions to explore the idea that “the heart has reasons, which reason does not know” and suggest that the experienced meditator in a specific tradition is engaged in a pragmatic experiment with reality.
Arts-Based Research: Collaborative Collage Inquiry
Lynn Butler-Kisber, McGill University
Mary Stewart, LEARN
The burgeoning interest in arts-based research, particularly in visual methodologies, has gained momentum because of the dissemination possibilities and visual capabilities that digital technologies permit. Collage, or the process of cutting and gluing found objects or fragments of images onto cardstock, is one such visual methodology. Collage has been used across a number of disciplines for eliciting information, for reflection/conceptualization, and in analysis and representation. Collage serves to bring tacit assumptions to the surface and produce meanings that otherwise might be obscured. This presentation will explore a 10-year collaborative project that focused on the use of collage as the mode of inquiry. It will describe the history of the group, its focus, and the process that guided the research. It will share how the creation of collages in the group, in synchronous time, slowed down the reflective process. This resulted in thoughtful, individual, and grounded input in the subsequent sharing and discussing phases of the group work. It will show, with examples, how when focusing on what it means to be a woman in academia, unexpected insights emerged as a result of collage creations and the ensuing process. The lessons learned about the nature and momentum of the group will be highlighted. This session will demonstrate how collective autonomy, focus and flexibility, and a growing trust produced in collage inquiry were essential for effective group functioning. The work suggests some fundamental considerations for collaborative research and how collage inquiry can inform this work.
Western Academics in Indigenous Research
Avery Calhoun, University of Calgary
Ralph Bodor, University of Calgary
How can Western social work academics be involved in research that is meaningful and useful to indigenous people and communities? This issue should feature highly in social work research in Canada, given the extent of the profession’s involvement with indigenous families and communities. For example, our research team studies public child welfare. This key social service institution has significantly failed to meet the ontologically distinct needs of indigenous families, which has contributed to their substantial overrepresentation in the system. Some child welfare organizations are attempting to adapt Western models to be “culturally competent.” An alternative is to develop indigenous child welfare. To be ontologically truthful and culturally sustaining, indigenous child welfare must be derived organically from within the indigenous worldview. Exploring this research area requires an Indigenous Research Methodology. This presentation will discuss the experiences of nonindigenous researchers attempting to understand indigenous knowledge development and appropriately participate in an indigenous research project. We will begin with questioning the involvement of Western academics in indigenous research. From there, we will describe the option of trying to take an “indigenist” research stance through remaining culturally humble while appreciating and participating in indigenous ways of knowing, allying with indigenous researchers, and advocating for the place of indigenous knowledge and scholarship in the academy. As allies to indigenous researchers and communities, we must be constantly engaged in decolonizing. This includes questioning our own roles in oppressive practices and taking personal responsibility for creating change in society.
Constructing Knowledge in Family Research: The Impact of Methodological Choices
Clare Carolan, University of Stirling
Annetta Smith, University of Stirling
Liz Forbat, Australian Catholic University
Researching families necessitates a series of methodological choices. These choices are shaped and informed by how we understand families ontologically, our epistemological beliefs, and our positioning as researchers. Family-related research examining the experience of one family member predominates in the literature, yet this research approach risks limited understanding of the complexity of the family system and experience therein. Using the example of a multiple case study that I conducted on the experience of emotional distress in families in palliative care, this presentation will demonstrate how and why deliberate choices were negotiated when conducting this research, which was informed by family systems theories. This will include for example how “family” was defined and how families were identified, accessed, consented, and ethical dilemmas faced. Moreover, I will reflect on the choice to conduct both individual and group family interviews and how my positioning as a researcher informed knowledge construction from multiple, differing perspectives within families. Explicit description of methodological choices made during the conduct of family research is critical to inform judgement about the quality and integrity of research findings.
Research as Hope-Intervention With Rural South African Children
Avivit Miriam Cherrington, Nelson Mandela Metropolitan University
There has been a drive in developing countries for qualitative collaborative community research focused on exploring and harnessing the strengths and resources of children and rural communities, thus contributing towards social transformative aims. Located in the broader field of well-being, hope is associated with the constructs of flourishing, life satisfaction, meaning, and resilience. Being hopeful bears advantages in all aspects of life, and these benefits have been well documented in literature. It is surprising then that there is a dearth of studies exploring how hope can be nurtured, shaped, and strengthened in children. In this presentation, I discuss a critical transformative study that explored how visual participatory “research as intervention” could enable rural South African children to explore their conceptualisations of hope, while simultaneously enabling critical awareness and strengthening of their hope. I therefore reflect on Kumashiro’s (2000) notion of movement in research, demonstrating how a participatory process of inquiry and engagement encouraged marginalised children to embrace the idea of local possibilities for movement, or towards thinking about things differently. In doing so, the children viewed themselves as hope champions in their community, expressing enhanced awareness of how they could play an active role in their own well-being.
A Visual Participatory Study Exploring Hope With Rural South African Children
Avivit Miriam Cherrington, Nelson Mandela Metropolitan University
This abstract will show how four visual participatory methods (collage-making, drawing, Mmogo-method©, and photovoice) were integrated into a doctoral research study to explore hope with marginalised primary school children living in a rural community. The visual participatory methodology created creative spaces for the children to collectively explore, share, and reflect on their perspectives of hope living in a rural community. By encouraging active participation, collective learning, and shared reflection on their unique perspectives and social world, the study viewed the children as autonomous and inherently agentic individuals. Multiple visual methods were selected for their ability to generate in-depth data, especially in visually rich cultural communities and in circumstances in which literacy and language are barriers. Further, a multimodal approach to data generation, which included visual artefacts, written descriptions, and verbal expressions, allowed the children to bring together a collection of extensive, information rich, and colourful data. As the data generating process comprised multiple levels of engagement, so too did the analysis. The presentation will also showcase how the copious amounts of data were analysed thematically during the engagement process by both the participants and the researcher. Therefore, this will serve as a demonstration of effectively combining visual participatory methods to access the voices of marginalised rural children.
Crafting Stories From Verbatim Data in Hermeneutic Phenomenology Is Trustworthy and Useful
Susan Crowther, Robert Gordon University
Hermeneutic phenomenology has grown in popularity by health-care researchers from various disciplines. The processes and strategies employed in enacting this methodology are varied and continue to evolve. The evolution of hermeneutic methodological approaches is congruent with the philosophical underpinnings that attunes researchers to an unbounded yet focused project. One area of debate is how this methodology uses and reports data from interviews. There remains controversy concerning how verbatim interview data are used in hermeneutic methodology. The belief that only using purely verbatim data is trustworthy is challenged in this presentation. Using examples from two multidisciplinary studies, the “how” and “why” of crafted stories is presented revealing how this approach maintains the congruence of the research design and philosophical thinking. Several philosophical notions are introduced in this presentation that question restrictive use of verbatim data. It is reasoned that the use of crafted stories in hermeneutic phenomenology is philosophically aligned and is a trustworthy and useful stratagem in hermeneutic phenomenology research projects.
Talking and Typing Race: Comparing Virtual and Non-Virtual Discussions About Racial and Ethnic Minorities
Adrian Cruz, University of Massachusetts
Kazuyo Kubo, Lesley University
The Internet, as an emergent social institution, has become the focus of scholarly research. Yet, race and ethnicity remain understudied terrain within that social institution. The objective of this paper is to explore methodological innovation in the study of racial attitudes and beliefs. The research design to carry out this research is threefold. First, we use coded data drawn from online postings by readers of news articles on issues of race and immigration. Second, we are currently conducting research using online discussion groups. This part of the study entails online focus group discussions among college-aged students. The participants are asked to post their reactions, in the form of discussion board comments, to several newspaper articles on immigration issues. Third, face-to-face focus group interviews are conducted with the same group of students who participated in the second phase of the research. The in-person focus group interviews aim to compare how individuals act in the online world vis-à-vis face-to-face interaction when talking about race and ethnicity. Based on the data we will collect, the study aims to chart the specific ways by which groups of color are racialized and subjected to both racist and antiracist sentiments in virtual and nonvirtual social settings.
Roses and Thorns: Issues in the Integration of Normalisation Process Theory and Theoretical Domains Framework Within a Single Study Design
Kay Currie, Glasgow Caledonian University
Caroline King, Glasgow Caledonian University
Lesley Price, Glasgow Caledonian University
Lynn Melone, Glasgow Caledonian University
Paul Flowers, Glasgow Caledonian University
The aim of this presentation is to explain the process of developing data collection instruments and an analytical framework which integrates the use of normalisation process theory (NPT; May et al., 2007) and theoretical domains framework (TDF; Francis et al., 2012) in a novel methodological approach that capitalises upon an understanding of the person as embedded within social and cultural contexts in order to develop future interventions. Both of these theoretical frameworks are widely cited; yet a robust literature search failed to locate any evidence discussing how they can be combined successfully within a single study. Our multidisciplinary research team was funded to investigate factors affecting the implementation of hospital screening policies for antimicrobial resistant organisms (AMRs). Implementing screening is complex and shaped by a range of psychological and social factors. Previous studies show that a simple clinical risk assessment tool is an effective means of identifying patients at risk, enabling appropriate management to reduce cross-transmission of infection (Health Protection Scotland, 2011); however, Scottish surveillance data indicate that compliance with this screening policy is below the target of 90%, impacting on the effectiveness of this approach. National guidance on AMR-related screening appears straightforward; therefore, the questions remain “Why is compliance variable; what are the barriers and enablers to screening?” Hospitals are undoubtedly complex systems, functioning at macro- and microlevels, with various social groups operating at organisational and team levels whilst the individuals embedded within these groups will bring their own unique perspectives to bear on their actions. To address the question of barriers and enablers to screening, we adopted both a sociological perspective, applying NPT to examine the work that takes place within organisations to embed screening as an intervention, and a psychological perspective using TDF to explore factors affecting the individuals’ decision to act in specific situations.
Big Data, Collaboration and Teaching Methods
Bruce Curtis, University of Auckland
If nothing else, Savage and Burrows’s (2007, 2009) pessimistic claims about the centrality of big data and the coming crisis of empirical sociology has sparked a wealth of responses about what to do with digital information. Much of this work is collaborative, in terms of an interdisciplinarity around data analysis but also in calling forth new associations between social scientists and computer scientists around data collection (Halavais, 2013; Housley et al., 2014). Social scientists may well be advised to “make friends with a computer scientist.” Indeed, there are obvious synergies for both enhancing relevance and impact. Such collaborations also provide a forum for advancing the skill sets of social scientists and, in particular, in the realm of teaching methods. In this respect, the challenge of big data isn’t simply that much of it is proprietary, protected, and inaccessible to public scrutiny (including for academic purposes), but that the initial collection, intended analysis, and even “secondary” analysis by academics are characterised by “black boxes” in the form of computing code and other algorithms. The extent to which a new generations of social scientists constitute digital natives, skilled practitioners in the new realm, or digital dupes is contentious. From a pedagogic perspective, this binary is not as significant as the potential for research and teaching collaborations to illuminate intangible black boxes, and the start point for this is surely the digital everyday: social media, entertainment, and consumption.
Giving Voice Versus Gatekeeping: Negotiating Complexities in Research Collaborations
Cate Curtis, School of Psychology, University of Waikato
This paper explores the potential for conflict within research collaborations with particular regard to the ethical principle of respect (as described in the Belmont Report) that individuals should be treated as autonomous agents yet those with diminished autonomy must be protected. In conducting research with young women on risk and resilience, including sensitive topics such as self-harm and sexual abuse, a number of challenges have arisen. These include access, recruitment, the development of trust, and managing potential vulnerability. At the same time, participants frequently report benefits from participation, even when distress is experienced. Although collaborating with service providers with which potential research participants engage may reduce some of these difficulties, other tensions frequently arise. Further, research on sensitive topics and/or with vulnerable people poses specific ethical difficulties. These include tensions between researcher and participant needs, such as conveying the possibility of distress while not discouraging participation and staying within the confines of the research topic (as described to ethics review boards and funders) versus allowing participants to influence the direction of the research. Service providers are often cognisant of some of these possible issues and may take on a gatekeeper role through a desire to protect their clients. In so doing, the autonomy of potential participants is diminished. Thus, the development of trusting relationships on the part of both collaborating services and participants is key to the opening of research spaces. The challenges of complex and competing needs in research collaborations will be examined.
Empowerment Considered: Critical Reflections on the (Dis)placement of Power in Participatory Research With Destitute Asylum Seekers in the UK
Fiona Cuthill, University of Edinburgh
Over the last two decades, qualitative researchers working within social justice frameworks have wrestled with dilemmas of oppression and empowerment enacted through the research process. In response, critical scholars have sought to develop participatory research methods using peer researchers to both represent the “voice” of people who are living in marginalized spaces in society and to level power differentials between the researcher and the researched. This is particularly so when these differentials cross the intersections of gender, culture, “race,” and socioeconomic status. The focus of much of this research has been on empowering individual peer researchers to be involved at every stage of the research process, from formulation of the research question to dissemination of the results. Nonetheless, the ways that power circulates in peer participatory research and the impact this has on the research process are less well defined. The aim of this presentation is to report on the experiences of academic and peer researchers as part of a research project to explore the lives of people who found themselves destitute following the asylum process in the UK. In particular, to uncover the ways that power differentials between academic and peer researchers in this project were both (re)placed and (dis)placed throughout the research process. In making visible some practical, gendered, class-based, and racialised sites of oppression within the research process, suggestions will be made for future research relationships with people from highly marginalised groups.
Applying Social Network Analysis to Research on Quality of Care in Health Services: The Case Study of Cultural Competence in Belgium
Marie Dauvrin, Université catholique de Louvain
Vincent Lorant, Université catholique de Louvain
Providing culturally competent care to migrants remains a sensitive topic in Europe. However, social network studies may help to understand the implementation of cultural competence in health-care services. Within this study, we report the methodological aspects of a qualitative case study using a one-mode social network survey among 24 health-care services in Belgium. Based on the data collected in the empirical study, we identified the difficulties and provided guidance when using methods of social network analysis in studying social ties and cultural competence among health professionals. We also identified the predictive variables of participation at individual and service levels. In particular, we assessed the bias related to popularity. We found that popular health professionals were more likely to participate than the nonpopular ones. Working in a primary care service was associated with higher participation than working in a hospital. The data collection process highlighted institutional network effects. Further studies should investigate alternative social network methods for one-mode survey in health services and invest in developing relevant feedbacks to health professionals. This presentation is likely to inform researchers willing to implement network studies on sensitive issues in health-care settings.
Thinking Collaboratively Over Time: Collaboration in, and Across, Qualitative Longitudinal Research Practice
Emma Davidson, University of Edinburgh
Susie Weller, University of Southampton
With its concern for understanding the passing of time, social change, and continuity, qualitative longitudinal research (QLR) has enormous possibilities for collaboration. Collecting data over time affords greater participation of, and collaboration with, those being studied. In larger QLR studies, collaborative approaches have increasingly become necessary for research teams working across field sites, or between different researchers across the course of a study. In recent years, QL researchers have also been working alongside archivists, creating opportunities for the reuse of data by secondary analysts. This presentation will reflect on how, within the context of secondary QL data analysis, the possibilities for collaboration shift. It draws on our experiences of our ongoing National Centre for Research Methods (NCRM)/European and Social Research Council (ESRC)-funded project, “Working Across Qualitative Longitudinal Studies.” Utilising archived data from “Timescapes,” the UK’s first major qualitative longitudinal study, the project aim is to develop methodological procedures for working with multiple sets of in-depth temporal qualitative data to produce analyses that scale up horizontally and vertically. While the research team is, in varying ways, distanced from the original research participants, the project has enabled new modes of collaboration: in our team’s own analytic practice, with the original team who created the data set, and with a wider community of QLR practitioners. Collaboration, we conclude, can extend beyond the original research team, providing secondary analysts the opportunity to contribute to emergent good practice and evolve theoretical thinking in this important field of qualitative research.
Visualizing Teachers’ Shifting Identities: Challenges and Possibilities
Ana Carolina de Laurentiis Brandao, UNEMAT, Brazil and Birkbeck, University of London
This presentation explores the challenges and possibilities that arise when using visual data in narrative research. In particular, visual narratives are considered, which address how research participants understand their experiences both visually and narratively (Bach, 2007). Using visual narratives presents a number of challenges. For example, asking participants to compose their visual narratives without predetermining the outcome can be difficult. Also, locating these analyses within the three-dimensional narrative inquiry space (Connelly & Clandinin, 2006), and relating them to other types of field texts, is not a trivial matter. The examples to be discussed in this presentation are drawn from an ongoing PhD narrative inquiry which explores six preservice English as First Language (EFL) teachers’ identity (re)construction, while they designed and implemented English materials at state schools as part of a Brazilian teacher education program. Preservice teachers composed three visual narratives, described in recorded conversations, between August and December 2014. The idea of using visual narratives came after implementing an activity, in which preservice teachers were asked to draw a representation of an English teacher and explain it to the whole group. In spite of the challenges outlined above, the visual narratives provided opportunities for summarized and creative accounts of the teachers’ beliefs, metaphors, struggles, imagined versions, and identity shifts, which complemented other types of field texts, allowing them to express aspects of their processes of identity (re)construction that could not be easily communicated through verbal means alone.
Am I a Researcher or Psychotherapist? Challenges for Researchers Who Are Also Psychotherapist
Jan De Mol, Catholic University Louvain
Rigorous qualitative research becomes more and more important in the domain of psychotherapy, for example, in narrative family therapy. The objective of this qualitative research is not to test the efficacy of interventions but to enrich our in-depth understanding of intrapersonal and interpersonal phenomena taking a collaborative position regarding our participants, a similar position as in the client–therapist relationship. However, the objectives of research and psychotherapy are different. From an ethical perspective, this difference must also be clear for our participants. Nevertheless, being a psychotherapist is enriching for my work as researcher and vice versa. But when I am doing research, I am not a psychotherapist and when I am doing psychotherapy, I am not a researcher. In this presentation, I would like to discuss, taking a collaborative stance, how rigorous methodological, theoretical, and epistemological positioning helps me to do something with this ambivalence. My current research with major depressed adolescents focusing on social representations restraining the process of social sharing of emotion for these adolescents will be used as an example.
It Makes Me Feel Humble: Exploring the Potential Value of Applying Social Network Research to Longitudinal Qualitative Research
Fiona Dobbie, University of Stirling
Gerda Reith, University of Glasgow
Susan McConville, ScotCen Social Research
Social network analysis (SNA) is often criticised for being too quantitative in focus, and network scientists have commented on the lack of engagement from qualitative researchers with SNA. This paper will contribute to both these debates by critically reflecting on a longitudinal, qualitative study of gambling where social network research methods were adapted and applied to qualitative interviews to aid data collection and recruitment. Egocentric sociograms (maps of participant social networks, using a name generation question and concentric circles) were created for 23 gamblers. These sociograms were then used as an interactive tool, using coloured dots, to explore the impact of problem gambling behaviour on social networks. This approach represents an extension to existing SNA methods that has not previously been tested.
An Exploration of the Student Paramedic Experience of Cultural Integration—From University Classroom Learning, to a Contrasting Ambulance Service Culture and Subsequent Relationship of Insider/Outsider Researcher
John Donaghy, University of Hertfordshire
In undertaking ethnographic research, the researcher often balances the dichotomy of insider/outsider relationships! This study explores the processes of acculturation and integration of UK university paramedic students into an ambulance workplace culture, from classroom to workplace. Drawing on a plethora of observational field notes and student interviews, underpinned by ethnographic principles, the notion of insider/outsider researcher becomes evident in the course of data collection and subsequent data analysis. As an experienced paramedic, with more than 30 years’ experience of an inner-city UK ambulance service, the concept of data collection, through the use of field notes, is somewhat challenging. Establishing the complex relationships of acculturation, integration, and subculture of students in the workplace requires boundaries to be drawn between the researcher, as an academic investigator, with that of an experienced paramedic, illustrating the uncertainty between the two paradigms. This relationship is somewhat “tested” in the field as paradoxical themes, such as attending operational shifts in ambulance uniform, as opposed to nonuniform, become evident, as students and staff view the researcher through multiple lenses. Burgess (1985) is clear that ethnographers are required to be accepted into the social context in which they are observing, therefore acceptance into that community becomes fundamental. This paper explores multiple examples whereby the resulting dynamics of insider/outsider researcher are challenged within the fieldwork and subsequent reflexively through data analysis.
Evaluating the Use of Life History Approaches in Financial Ethics Research
Yvonne Downs, University of Huddersfield
The view that the study of financial ethics proceeds from numerical conceptualisations is dominant. This means that financial ethics as an academic field often seems irrelevant to the very real and justifiable concerns people have about financial institutions and financial practices. These concerns also become more salient in the context of the comprehensive financialisation of everyday life. So what would it mean to use life history genres and approaches to research in this field? This is the overarching question I consider in this paper by drawing on my experience of conducting an exploratory study into the lived experience of someone working in a compliance role in financial services. I knew in advance he would be critical of the ethical basis on which he was expected to perform his role and therefore access to “rich data” was practically assured. But how far did a life history approach also contribute to ideas about human nature, to the socially constructed nature of financial systems, to the relationship between financial institutions and the individuals within it, to the way in which individuals negotiate social systems, and to how they mediate external influences and the balance of power between the systemic, the institutional, and the individual? I consider these questions in the light of the ethics and politics of doing research with a participant who was emotionally, and politically, invested in telling their story.
Recruiting Mothers of Children With Complex Needs—Overcoming the Challenges
Carmel Doyle, School of Nursing & Midwifery, Trinity College
Honor Nicholl, School of Nursing & Midwifery, Trinity College
In order to undertake research, recruitment is an essential element in accessing the best sources of data. Purposive sampling is used in qualitative research whereby participants represent the central phenomenon of the study. In this hermeneutic study, purposive sampling was used, purposefully seeking out mothers’ of children with complex needs who have lived experience of “giving medicines.” The sample for this study was drawn from a population of 1,200 children with complex needs in Ireland. This type of sampling is often problematic, as many of the sources (people in this instance) are “protected” and negotiation for access can be tedious and time consuming, albeit necessary. Adopting the example of my current PhD research study entitled “Mothers experiences of giving medicines to children with complex needs,” this presentation will focus on the challenges I experienced and have overcome in recruiting this sample. I sought to access mothers of children with complex needs (aged between 2 and 18 years) who experienced “giving medicines” on a daily basis. Initially, I sought access through two sites. However, with response rate low, alternative methods of recruitment had to be considered. This included selection of more sites and the use of social media. I have learned through this research study that what I deem to be conventional recruitment mechanisms are not always successful and that one needs to be open to revision of the recruitment plan.
Perception of Physical Ageing: An Interpretative Phenomenological Analysis Study Exploring the Views of Older Adults
Carol Duguid, Glasgow Caledonian University
The bodily ageing process is an unavoidable and unpredictable journey which is lived and experienced differently by human beings. As numbers of older people living longer are currently publicised within social, economic, and political policies, the concepts of “feeling old” and “looking old” are areas which require further attention within health and social care professions. This study embarks using an interpretative phenomenological analysis (IPA) approach using semi-structured interviews and individual diary writings to explore and interpret the lived world of bodily ageing. IPA is increasing in popularity and my research aims to provide an innovative approach towards making sense of the complexity of the ageing process. This presentation will explore research questions used with an IPA approach. Using examples of my data collection and analysis will provide an understanding how IPA is an evolving methodological approach that requires further attention within research settings.
“Trying to Get at the Bigger Things”: Collaboration and Change Arising From Research
Kathryn Edmunds, Western University
Helene Berman, Western University
The focus of this presentation is to explore the challenges and opportunities for social action and change arising from research with women from a variety of countries employed in Canadian temporary agricultural worker programs. Critical feminist ethnographic methodology specifically includes the analysis of gender and power relations that may act to limit knowledge and constrain choice. It was assumed that the broad social discourses surrounding gendered migration and temporary work served to reinforce some power relations and hide or distort others and that the collaborative nature of the research would lead to transformative change. Women workers who participated were quite interested in the long-term goals of the research related to systemic changes. However, their long work hours and precarious immigration and employment status hindered their engagement in public and collective actions. Sustained researcher involvement is needed to build and maintain trust and to support private and public expressions of agency and resistance during the incremental and often subtle emancipatory changes that occur over time. Researchers engaged in critical methodologies need to be aware of the complexities of power relations and interests at many levels, of operationalizing theory into action, and of the hierarchies of evidence involved in policy change. The contexts and realities of temporary contracts reinforce the importance of the creative and coordinated strategies across multiple levels needed to address the inequities experienced by temporary foreign workers in Canada. This requires participation in the collaborative social processes in building and sustaining inclusive partnerships with communities across professions and sectors.
Continuing the Depth of International Interconnectedness and Pictures of Qualitative Research
Sarah Fogarty, Walden University, Londes Strategic Healthcare Consulting
In this abstract, I would like to examine the dynamic and importance of international collaboration in research. Given the complexities of research in general and specifically qualitative research, I will examine two methods of qualitative research in relation to feelings and emotions in education/health care at younger and older age ranges. This would include an exploration of methodological methods and ethical components. Given the diversity across many communities, the potentials for qualitative research to open up new and interesting questions, discoveries, and solutions in changing and sometimes fast-paced environments. This is set against cultural backgrounds and foregrounds that merge overtime and include people, contexts, and resources.
Building a Collaborative in Academia: A New Paradigm
Lydia Forsythe, Walden University, Londes Strategic Healthcare Consulting
Creating action research to develop better learning experiences for students in a large for-profit university setting entails working with multiple internal cultures and stakeholders. We all have the same end goal in that we want to create superb student experiences where they can learn scholarly material to be applied in practical ways. However, there are specific belief systems and academic nuances, which need to be navigated in order to develop research together. These stakeholders include students, faculty members from multiple programs and disciplines, support departments, and an Institutional Review Board (IRB). Over the course of 1.5 years, the research team has grown to include multiple stakeholders and now has approval to complete research with a pool of students who are actively engaged as participants in the revision of a graduate course. This is dynamic conversation embedded in the ideals of social construction. The end goal is to develop a new paradigm and model for course development and revision that includes all stakeholders as a collaborative force across and supporting epistemic beliefs, professional differences, and various organizational cultures spanning virtual and geographic boundaries.
Developing a Meta-Ethnography Reporting Guideline for Research (eMERGE)
Emma France, NMAHP Research Unit, University of Stirling
Nicola Ring, University of Stirling
Ruth Jepson, University of Edinburgh
the eMERGe project team
With the plethora of published research studies, evidence-based policy and practice require robust evidence syntheses. Syntheses of qualitative studies can advance understanding of people’s experiences of a given issue (e.g., health care). One synthesis approach particularly suited to providing a nuanced understanding of experiences and developing theory to inform practice is meta-ethnography. However, meta-ethnography reporting—especially of the analytical processes and findings - is often poor quality, which discourages trust in, and use of, meta-ethnography findings. Tailored reporting guidelines for syntheses can raise reporting standards but none exists for meta-ethnography. The Meta-Ethnography Reporting Guideline for Research study aims to create an evidence-based meta-ethnography reporting guideline to improve reporting quality. The mixed-methods design of this National Institute of Health Research-funded study (http://www.stir.ac.uk/emerge/) follows good practice in research reporting guideline development comprising (1) a methodological systematic review of guidance in conducting/reporting meta-ethnography, (2) a review and audit of published meta-ethnographies to identify good practice principles, (3) consensus studies to agree guideline content, and (4) development and wide dissemination of the guideline. Meta-ethnography, devised in the field of education, is used widely in other disciplines. The extent of discipline-specific methodological adaptations and their fit with the underpinning philosophy of meta-ethnography require investigation. Well-reported meta-ethnography findings could inform evidence-based decision-making. A bespoke meta-ethnography reporting guideline is needed to improve reporting quality and will be developed in this rigorous study. By raising reporting quality, the guideline will maximise the likelihood that high-quality meta-ethnographies will contribute robust evidence to improve practice, policy, and service user outcomes in health and other fields.
Do Our Answers Fit Their Questions? Critical Humility in Patient-led Research
Julia Frost, University of Exeter Medical School
Nicky Britten, University of Exeter Medical School
Critical theorists have informed how we think about and undertake collaborative health services research, but while much attention has been given to how patients can participate in research design generally, less has been given to their role in the analysis of qualitative data specifically. Qualitative analysis is a labour intensive practice, typically informed by expert texts and rituals. However, critical theorists have warned that by obsessing about issues of technique, procedure, and correct method, we obscure the humanistic purpose of the research act. Using the example of a patient-led project about agenda setting in medical consultations—which we conducted with members of an established patient and public group and health professionals—this presentation will demonstrate how a democratic form of data analysis is required for collaborative research to achieve its emancipatory goal. Techniques to enhance meaningful participation in data analysis will be discussed, as will the implications for the products of this research. We suggest that a critical humility is required in order for academics to challenge and deconstruct our own qualitative practices to enable patients to participate in the interpretation of data and knowledge production. In order to render the personal political, we argue that the researcher must include the social frames of references of their collaborators as well as document and analyse the nature of the interpretation itself.
Action Research to Explore Strategies Favouring Family Retention in a Health Promotion Program
Frances Gallagher, Université de Sherbrooke
Linda Bell, School of Nursing, Université de Sherbrooke
Chantal Doré, School of Nursing, Université de Sherbrooke
Sandra Brassard, CIUSSS-CHUS
Yolande Grégoire, School of Nursing, Université de Sherbrooke
Conducting Interlinguistic Research: Dilemmas, Reflections and Opportunities
Lorena Georgiadou, The University of Edinburgh
This paper discusses the distinctive experiences of a nonnative English-speaking researcher conducting language-intensive research in English. Drawing upon research notes and data from my completed doctoral project, in this work, I explore some of the complexities I encountered in interviewing participants in a second language, and, in some cases, a lingua franca; and in engaging with language-focused coding and analysis in English. Through these anecdotes, I illuminate some often ignored advantages of second-language use when conducting research. Ultimately, I wish to draw attention to the volatile nature of any “shared” language, the fluidity of space(s) in-between researcher, participant and data, and the importance of reflexivity and cultural awareness in qualitative research practice.
Cultural Probes and Focus Groups: A Pathway to Empathic, Engaging, and Emancipatory Research
Suzanne Goopy, University of Calgary
Anusha Kassan, University of Calgary
Where participants are members of vulnerable populations, the distance and potentially contrived nature of traditionally designed research interview situations can limit the desire of some individuals to participate fully in research studies. This paper explores the value of taking a creative and collaborative approach to research design based in inspiration, participation, information, and dialogue. It presents a research design that brings together the somewhat experimental research methodology of rapid ethnography and the use of cultural probes, most often associated with design research, with the established methodology of the focus group, to promote a research pathway that is both reflexive and inclusive. Research techniques associated with cultural probes and focus groups will be described and discussed in the context of methodological process and theoretical intentionality, along with the value of the iterative and hybrid nature of this research design for working with vulnerable populations.
Narrative Inquiry: Positionality, Collaboration, and Coproduction
Helen Gough, Glasgow Caledonian University
Narrative inquiry is a systematic form of research used to explore people’s social worlds and identities. In everyday life, people construct stories to help explain episodes in their lives to themselves and others. These oral accounts offer access to an individuals’ inner world and provide a way of recording real-life stories that have not yet been heard. This paper will discuss positionality, collaboration, and coproduction, three key concepts that have framed a narrative inquiry that focuses on the stories of experienced nurse teachers who have been identified as an underrepresented group within nursing literature. Positionality relates to the researcher sharing their beliefs and values by acknowledging the factors that have influenced their assumptions. By recognising the influences that have shaped my own educational and professional journey, understandings are shared and made transparent. This reflexive approach initiates a relationship with participants and highlights the importance of collaboration between the researcher and the researched. Within the context of narrative inquiry, collaboration with participants utilises guided storytelling, a form of narrative interviewing, to gather oral accounts. This is followed by coproduction, a defining feature of narrative inquiry that involves the researcher recreating the participant’s story. In order to recreate the oral account, plots, subplots, and key events are identified in chronological order to construct one coherent core story or series of core stories.
A Queer Critical Approach to Exploring Trans* Male Identity Construction Using Mixed Qualitative Methods Research
Andre Grace, University of Alberta
Michel Lévesque, University of Alberta
Addressing subjectivities and systemic exclusions of trans* male youth in relation to gender identity constructions remains largely unexplored in qualitative research. In this oral presentation, we explore theoretical and methodological aspects of conducting this research with trans* male youth that links transformative research to advocacy focused on recognition and accommodation of gender diversity. We begin by examining our formation of queer critical theorizing that we use to frame the sociocultural construction of trans* male gender identity and our experimental, exploratory, and interpretivist studies with trans* male youth. Next we discuss our use of mixed qualitative methods. Here we consider how a reshaping of the interview has occurred for more than a decade in queer research in which styles of interviewing and analysis/interpretation recognize particularities of sexual and gender minority (SGM) identities, the nature of SGM experiences, and the importance of addressing systemic exclusion. Then we consider how arts-based methods, when used in tandem with interviews, enhance a queer critical research design focused on SGM youth-centered approaches, alternative knowledge production, enhancing communication to present authentic youth voices, and engendering the agency of research participants. As a specific example, we discuss our use of art jams as improvisational group art-making. We position the art jam as creative advocacy; that is, as a reflexive, organic, and iterative process that can elicit trans* male youths’ conceptions of gender identity while functioning as a medium in which they can challenge outsider ontological analyses and interpretations of trans* identities.
The Role of Ethnography in Understanding and Improving Healthcare Quality and Safety: The Case of High Volume Routines in UK General Practice
Suzanne Grant, University of Dundee
Within the field of health-care quality and safety, ethnographic methods are increasingly employed to examine the nature of safety, risk, and vulnerability within and across a range of health-care settings (e.g., general practices, hospitals). Drawing on ethnography’s ability to provide rich, holistic insights of everyday practices, these studies have highlighted the complexity of sociotechnical systems and the importance of developing an in-depth understanding of the sociocultural contexts in which quality and safety are achieved by multidisciplinary teams in everyday practice. The aim of this paper is to reflect on the methodological role of ethnography within the field of health-care quality and safety through the examination of its application across a range of high volume, safety-critical routines within the UK general practice. It will then go on to explore ways in which ethnography can be further developed as an improvement methodology within health-care organisations. The paper will reflect on multisited ethnographic fieldwork conducted across eight UK general practices from 2010 to 2014 involving 1,787 hr of observation of high volume routines (e.g., repeat prescribing, laboratory test ordering and results handling, medicines reconciliation); 62 interviews with clinical, administrative, and managerial staff; and documentary analysis of key documents (e.g., prescribing protocols). Reflecting on the data collection and analysis processes for this research, this paper seeks to contribute to current methodological understandings of the role of multisited ethnography in health-care quality and safety and to explore ways in which ethnography can be further developed as a collaborative improvement methodology through the application of video-reflexive ethnography.
Cross-Cultural Critical Bricolage: Respecting Multiple Epistemologies With a Mixed-Method Indigenist Research Methodology
Mirjam Held, Dalhousie University
Studying indigenous knowledge as a nonindigenous researcher entails a number of challenges, one of them being the quest for the most appropriate research paradigm and methodology for the inquiry. Is a Western approach the only option for a nonindigenous researcher in Western academia? Or is an indigenous research paradigm the only proper approach to indigenous knowledge research? Emerging scholarship on this question suggests that it does not have to be an either-or decision, even though a nonindigenous researcher can and shall not work within an indigenous paradigm. The growing pool of mixed methodologies encourages to borrow from indigenous methodologies and allow them to penetrate the research approach while at the same time adhering to a Western paradigm. Here I present the mixed methodological approach I propose to employ for my research into institutions and decision-making in fisheries management in Nunavut, Canada. I translated the Inuit-Canada relationship as laid out in the Nunavut Land Claims Agreement into a critical, indigenist research methodology that is respectful of both Western and Inuit ways of knowing values and ethics but also challenges established Western research traditions. Embracing multiple epistemologies, my methodological approach enables collaborative cross-cultural knowledge construction which in turn will provide a multifaceted picture of past, present, and future institutions and decision-making regimes in fisheries governance in Nunavut as a basis for informed political action.
Understanding Health Research: Developing an Online Intervention to Bridge the Communicative Gap Between Academics and Consumers of Research Evidence
Shona Hilton, MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
Chris Patterson, MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
Amy Nimegeer, MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
Dialogues With Sally Thorne. Establishing a National Interpretive Description Network
Bibi Hølge-Hazelton, Region Sjaelland/Roskilde and Koege Hospitals
Thora Grothe Thomsen, University Hospital Sjælland and University of Southern
Charlotte Handberg, Department of Public Health, Aarhus University
Despite a current international development of integrating nurse researchers in clinical practice, relevance and utility of research remains a debate among nursing clinicians and leaders. Interpretive description, a qualitative methodology developed by Sally Thorne, takes its point of departure in exactly a clinical practical everyday life and seeks to reach out and describe the complexity of this practice in order to develop meaningful and essentially useful new insights to nursing knowledge that can be returned into practice. In Denmark, there has been a growing interest in interpretive description and based on that a national network of junior and senior researchers all working with the interpretive description methodology was founded. The aim of the establishing of the network was to share experiences, discuss potentials, and elaborate our knowledge and understanding of interpretive description as a research methodology. The group consists of researchers across the country, most unknown to each other prior to the foundation of the group. This presentation highlights how this collaboration, despite geographically and organizational boundaries, has resulted in explorative and stimulating conversations regarding the epistemology of nursing in the group. The discussions are founded in literature evolving around interpretive description, that is, books, research papers, and via e-mails dialogues with Sally Thorne. The network may strengthen research within the interpretive description framework and further contribute to the international dialogues on the methodology by among other things contributing with a research paper founded in the network.
Migrating Within Methodologies—Exploring Some Methodological Challenges Within a Cross Disciplinary Approach
Ima Jackson, Glasgow Caledonian University
Teresa Piacentini, Glasgow University
Alison Phipps, Glasgow University
Tanveer Parnez, BEMIS Glasgow
Migration is arguably creating one of the biggest social changes in Europe and beyond—this study developed out of managing one aspect of migration’s impact in health care. The methodological challenges presented here seems in many ways to reflect the cross-cutting impact of migration itself. The synthesis of different approaches used to explore the research question raised interesting theoretical, conceptual, and methodological challenges for the research team at different points of the project. These included how to conceptualise migration and the category of migrant service user; how to approach data analysis; how to negotiate the perspectives of migrant, interpreter, clinician, and researcher using a mixed method research design that brought together disparate traditions and disciplines in new ways; and subsequently approaching the translation of interview data into film scripts using the medium of community theatre. Methodologically, this project was innovative in successfully bringing together these multiple perspectives, in developing narratives from those experiences, and then translating these into an educational tool which reflect the multiple perspectives. A second important methodological challenge which will be discussed was how we had to develop ways of learning as a multidisciplinary team to be able to (1) translate data and concepts across disciplines and (2) find ways to communicate data and findings in academic and nonacademic ways.
Methodological Reflections: Conducting Action Research in Contemporary Healthcare Practice
Jane Jervis, Keele University
Sue Read, Keele University
Michael Murray, Keele University
A participatory action research (PAR) PhD study is being conducted, which aims to identify and critically explore the issues surrounding children visiting adult relatives who are patients in a large teaching hospital in the UK. The primary objectives are to increase understanding into how staff could be better prepared to support children and their families when visiting acutely ill adult patients at the hospital and to explore the feasibility for staff to change current practice and improve the experience of both child visitors and their families. Data collection was performed using focus groups. Those involved in the research included nursing staff and young people from a local college. Health care in the UK is currently facing many challenges due to sustained increases in demand for some services, austerity causing a strain on public sector finances and the restructuring of some hospital services. The choice of research methodology in such an environment is a vital decision for the PhD student. This paper will provide a reflection upon the methodology chosen for this PhD study, including rationale for using PAR, the main challenges and successes, and the associated learning points.
Opportunities and Conundrums of Triangulation in Grounded Theory Research
Theresa Jubenville, University of Calgary
David Nicholas, University of Calgary
Rosslynn Zulla, University of Alberta
Triangulation involves multiple methods, with some arguing that triangulation offers broader and multidimensional findings in accounting for the complexities of social reality and improving study rigor. Triangulation entails varying approaches within a single study, generating disparate types of data. Benefits from triangulation in grounded theory include a potentially more fulsome understanding of the phenomenon being studied. Multiple converging or diverging perspectives can result in the amplification of rich, complex descriptions, understandings, and perspectives. However, researchers may also face challenges managing and synthesizing disparate approaches and types of data. This presentation will explore the process of this form of triangulation in grounded theory. Using the example of a study on adults with disabilities and their navigation of employment, the process of navigating disparate approaches and data via triangulation will be explored. The complexities, conundrums, and benefits, including advantages and disadvantages, will be discussed with recommendations and implementations for future research.
From Basic Research Towards a Middle-Range Theory About Relational Suffering Related to Care
Anne Kasén, University of Nordland
Suffering caused by the nursing care itself is a phenomenon already noted by Nightingale, but given surprisingly little attention in nursing research. Or attention is given, but seldom within an articulated theoretical perspective, thus generating different qualitative terms and concepts. Suffering related to care is a serious phenomenon that creates unnecessary suffering for the patient and his or her relatives. There is a need for integration of knowledge and cumulative theory building and subsequent practice use of theoretical knowledge on relational suffering related to care. In this study, a tentative conceptual model of a caring relationship outlined in basic research through hermeneutical semantic analysis is proposed as foundation for a middle-range theory for understanding and preventing relational suffering related to care. The meta-theory for the conceptual model is found in Eriksson’s theory of caritative caring, and the conceptualizations of suffering and health. The basis for the tentative conceptual model consists of the four dimensions in the conceptual family around the Swedish concept “relation.” Through this basic research study, we can see that a relationship is formed by the certain circumstances and conditions. It is characterised by a certain connection, a narrative that the people in the relationship share and there is also interaction and touch. This presentation will focus on the possibilities to develop theory on middle range level based on findings from basic research and using conceptual determination.
Crossing Over: Professional Identity and Qualitative Interviewing
Alice Keely, Edinburgh Napier University
It has been suggested that the goal of finding out about people through interviewing is best achieved when the relationship of interviewer and interviewee is nonhierarchical and when the interviewer is prepared to invest his or her own personal identity in the relationship. In addition, it has been observed that people may give “public” or “private” accounts of themselves, depending on who they are talking to. In this paper, I will discuss this within the context of the researcher’s professional identity and disclosure, drawing upon examples from my experiences undertaking a longitudinal interview study with pregnant women with a raised body mass index, exploring their experiences regarding health and pregnancy and their perceptions of risk. My interest in this group of women originated from my work as a clinical research midwife, and I am seeking to understand their lives and experiences; their private selves. However, in disclosing my professional identity to participants and thereby imposing hierarchy within the researcher–participant relationship, I would risk being allowed access only to their public selves. I will explore the dilemmas this has presented, focussing on the tensions which arise within attempts to establish a nonhierarchical relationship with participants, whilst withholding from them the professional—and at times personal—crossing over between my identity as a midwife and that of a qualitative researcher.
Symposium: The Messy Reality of Participatory Research: Moving Beyond the Idyllic Notion of Post-It Notes and White Paper
Amanda Kenny, Symposium Chair
Symposium Abstract #1: Balancing Creativity, Innovation and Disruption With Governance, Boundaries and Goodwill
John Aitken, La Trobe University Rural Health School
Virginia Dickson-Swift, La Trobe University Rural Health School
Amanda Kenny, La Trobe University Rural Health School
Rural people are socially diverse with varying demographics and health needs. They don’t always align with neat, government thinking about how services should be delivered. In this presentation, we highlight the possibilities, importance, and usefulness of allowing rural people to disrupt well-ordered approaches to what people think is good for them. Underpinned by an epistemology of constructivism, community members in a small rural community were encouraged to identify health challenges, develop and coproduce interventions, drive the results, and reflect on the outcomes. What started as a neat and orderly participatory project, with white paper and post it notes, developed into an enthusiastic, whole of community activity that was at times unpredictable and chaotic. Group meetings, interviews, participatory mapping, and photovoice; community conversation about health and well-being. The ordered lives of health service managers were momentarily disrupted. Community members were definitely empowered, and it was difficult to not get excited by the groundswell of creativity and innovation that was unleashed. Through agreed boundaries, governance structures, and the willingness of health service staff to be disrupted, well beyond their usual ways of working, great things have been achieved. For the researcher, working with people to become agents of change required perseverance and stamina. If you think participatory research is idyllic and ordered, you will be disappointed by this presentation. If you want to hear about the messy reality, you will love it and learn a multitude of tips, tricks, and strategies from someone who had a go and survived.
Symposium Abstract #2: Participatory Research: The Divergence of Lives, Ethics, and Research
Elena Wilson, La Trobe University Rural Health School
Amanda Kenny, La Trobe University Rural Health School
Virginia Dickson-Swift, La Trobe University Rural Health School
In this presentation, we bring together a body of work on ethical considerations in participatory research. We discuss the practical, ethical issues that we have encountered in our work and describe the use of innovative blog technology to source the global views of others. In our work, we were confronted by the ethical complexities of working closely with people who were the focus of our research. Contemporary authors have identified challenges when research and the existential practicalities of everyday life converge. Participatory research is inherently about change, and ideally there should be benefits for all involved. Our experience of the reality is that people, including researchers, can be pushed outside their comfort zone, as they are challenged to think differently. As our thinking, and the thinking of those we work with were challenged, we turned to the international literature for guidance on ethical issues that we encountered. We identified strong interest in the topic but a lack of knowledge on the ethical experiences of those at the grassroots level. Using the capacity of digital technology, we utilised a blog to gain insights across a multitude of boundaries. Partnership tensions, divergent ethical approaches and the role of researchers in participatory spaces were identified. Whilst participatory research is considered an equitable, empowering approach, our findings indicate that concrete approaches to ethics are often challenged at the messy, grassroots level. By presenting our findings, we aim to stimulate discussion about the numerous strategies needed when ethics, research, and practical lives collide.
Symposium Abstract #3: From the Bottom Drawer to the World: Rethinking Knowledge Translation in Participatory Research
Amanda Kenny, La Trobe University Rural Health School
Virginia Dickson-Swift, La Trobe University Rural Health School
Static words on paper do little to disrupt the thinking of the powerful; beautifully crafted reports and journal articles stored in a cabinet or filed on a computer server as a neat PDF file. In this presentation, we highlight the irony of participatory research focused on addressing power, change and the status quo, and the way in which many researchers disseminate their findings. Researchers laboriously craft their written work as they attempt to maintain the essence and power of messy, unpredictable, and inherently chaotic but fantastic participatory processes. What underpins the apparent mess and disorder, are stories and shared learnings that provide powerful connections across local and global borders. The reality is that many of these learnings are never shared or hardly read. Knowledge translation is a dynamic and active process that should involve synthesis, wide dissemination, and knowledge exchange. Why then do many reports end up so neatly filed? In our presentation, we will disrupt the status quo. Whilst we value beautifully crafted reports and journal publications as highly as any other researchers, we will challenge the audience to engage with knowledge translation in new ways. Using innovative digital methods, the power of social media, and techniques driven by community participants, we will share translation methods that we have used that create disquiet, unsettle the powerful, but have a profound impact on policy makers, practitioners, and the public. We challenge you to join us in our rebellion to move findings from the bottom drawer to the world.
The Participation of Disadvantaged Mothers in Qualitative Research: Collaboration and Thinking Creatively About Methodology
Caroline King, Glasgow Caledonian University
Rosie Gibson, no institutional affiliation
A substantive academic literature exists which explores issues and approaches relating to the inclusion of disadvantaged groups in qualitative research. While this is the case, a commonly cited limitation of studies is the predominance of study participants from more advantaged groups. In this paper, we reflect on the example of a qualitative exploration which the first author undertook with mothers exploring health visiting services following policy change within an NHS locality in Scotland, UK. First, we consider the barriers (personal and institutional) which were faced in recruiting disadvantaged mothers to the study. Second, we will talk about our collaboration between the first author, as researcher, and the second author, as artist in residence, and our unfulfilled proposal which would have attempted to address some of the barriers we identified. We proposed to use language as an underpinning theme in collaboration with mothers, creating spaces for multiple languages, through which research topics could be explored. We planned to use several strategies to enable this approach, including bringing children’s buggies into the room as accoutrements to the research; multiple meetings to develop communication; and ensuring an environment which would enable the collaboration to flourish, for example, in relation to warmth, food, and childcare. We will reflect on both our collaboration, between Researcher and Artist, and our potential collaborative work with disadvantaged mothers. Third, the first author will conclude by considering how social theory, for example, Butler’s performativity and Bourdieu’s habitus, can help us to better understand this phenomenon in social research, including its implications for the production of knowledge about the lives and experiences of disadvantaged mothers.
When Threads Unravel: Testing the Limits of Collaboration Within Primary Care
Larkin Lamarche, Department of Family Medicine, McMaster University
Laura Cleghorn, Department of Family Medicine/School of Nursing, McMaster University
Ruta Valaitis, School of Nursing, McMaster University
Lisa Dolovich, Department of Family Medicine, McMaster University
The Health Teams Advancing Patient Experience: Strengthening Quality (TAPESTRY) approach in Canada is a complex intervention which aims to optimize the health of older adults by meeting individuals’ health goals with the support of trained community volunteers, interprofessional primary care teams, community engagement, and the use of technology. It takes place within the context of significant reforms to primary care in Canada and is attempting to shift the paradigm of health care from a primarily disease- and crisis-oriented system to a proactive and person-centred approach. With 20 collaborators, this approach is also being evaluated across Canada in various settings, including Sturgeon Lake First Nation focusing on aboriginal health, Montreal focusing on new immigrants, Vancouver focusing on inner city, homebound frail elderly and their caregivers, and Newfoundland/Alberta focusing on rural community-based preventative care. The Health TAPESTRY approach is being evaluated using a delayed intervention pragmatic randomized controlled trial, with all players involved considered research participants’ the patients, volunteers, interprofessional health-care team, and even the researchers themselves. This presentation will explore the challenges of integration of approaches and interpretation of mixed methods data across a large research team. Learnings will be shared regarding our challenges: understanding key elements of implementation of an intervention with many moving parts, allowing organic changes to occur in a slow-to-change health-care system and testing the limits of collaboration. Further, the novel technological innovations for capturing a narrative in a complex intervention will be discussed.
The Use of Small Scale Evaluation Techniques in Community-Based Research: Evaluation of An Emotional Intelligence Application Aimed at Children and Parents
Sarah Lambert, University of Salford
Adam Galpin, University of Salford
Anna Cooper, University of Salford
Small-scale methods, which provide evaluation over a short timescale at a local level, can be more accessible than structured research settings. The aim is to remove barriers which can occur in research by facilitating interaction between researcher and participant and improving involvement in research by enabling initial analyses to be seen by participants as data is collected. The methods allow flexibility around tool design and administration, while still ensuring principles of research are adhered too. Methods can include bar charts (stickers represent answers which form the bars in the graph), body maps (to explore positive and negative responses relating to a person), evaluation person (post—it’s represent what participants thought, enjoyed, would use and would throw away), and clustering (opinions and answers are grouped into clusters). Using an example from a recent community research project, this presentation will explore the rationale for the use of small-scale evaluation methods, the attributes, unique characteristics, and the pitfalls from a methodological perspective. The aim of the research was to gain a wider view of how an app may help build emotional intelligence from parents and children aged 3–8. The results of the small-scale evaluation produced four main themes (emotions, physical and behavioural outcomes, app usability, and content), each comprising a number of subthemes. Although this approach has the potential to be used in a variety of settings with a range of participant groups, it is not often used in community research.
Criticizing NGO Activity and Biomedical Intervention, Understanding Health in the Global Context, Discerning Transnational Axes of Power and Disparity: Developing a Framework to Living Through Ethnography
Peter Lee, Brooklyn College, City University of New York
Global Brigades, a student-led nongovernmental organization servicing Honduras, Panama, Nicaragua, and Ghana, allegedly empowers communities in developing communities through the implementation of sustainable initiatives to improve health, well-being, and the quality of life. For 7–12 days, students are mobilized on various brigades that address endemic health, environment, and sanitation conditions within communities. At the conclusion of medical brigades, students depart and their conceptualizations, attitudes and perceptions of global health, sustainable development, and community well-being are notably structured by their limited biomedical interactions within mobile clinics. Ethnography, one of the oldest qualitative methods, has the potentiality not only to dispel top-down approaches of biomedicine which regard health as merely the absence of disease or infirmity but more importantly to enrich understandings of global issues that deter the health of marginalized and neglected people living in poverty. By navigating the long-standing historical, political, economic, and social contexts, ethnography develops a framework not to life but rather to living. As further inquiry into living reveals a constant process of the negotiation of survival to lead a life of subsistence, this framework through ethnography simultaneously grounds lived experiences and further enables a cultural consciousness of global health actors to discern the current, transnational existing dynamics of hegemony and power as manifestations of disparity in the local context. Drawing upon ethnographic and anthropological inquiry in the field post brigade, post biomedical intervention, this presentation will examine how ethnography serves as a tool of change capable of rehumanizing and repoliticizing lived on the ground realities.
Embodied and Relational Methodologies of Arts-Based Qualitative Research
Warren Linds, Symposium Chair
Symposium Abstract #1: Going Beyond “Butterflies in a Display Case”? The Promise and Challenges of a Multimodal Approach as a Method of Researching Embodied Interactions
Warren Linds, Concordia University
This presentation will explore a research methodology used by acting out! But in a good way, a decade long collaborative research partnership of indigenous and settler scholars in southern Canada. We use the arts, particularly theatre games, to explore participants’ relationships in the physical, intellectual, social/emotional, and spiritual domains, in accordance with an indigenous holistic view of health. Using theatre games and other activities, we create a space for youth to explore how the choices they make affect their well-being, such as peer pressure and drug and alcohol abuse. Theatre games, such as those we use, are the medium, subject, and representation of research and have a holistic focus, combining research with education and health. Because these research workshops involve movement, theatre games, and play, the dynamics of the workshop process are an important part of our research data collection and add to other sources such as interviews, focus groups, and other arts-based methods of data collection. But the challenge has been how to include embodied interactions in our data collection and analysis? We will present here one multimodal analysis methodology—that enables us to address this challenge. A multimodal approach to research requires us to attend to the whole range of modes involved in communication and relationships. Mode refers to a regularized organized set of resources for meaning-making, including image, gaze, gesture, movement, music, speech, and sound effect. Through the presentation of one recorded segment of a workshop and the complex transcriptions and analyses we have developed, we will explore the potential of such a multimodal analysis for researching embodied interactions that are integral to theatre as research methodology.
Symposium Abstract #2: The Evolving Self: The 6-Part-Story-Method as a Research Method Into the Development of Self-Knowledge of Educational Professionals
Elinor Vettraino, Bishop Grosseteste University
Stories offer spaces where trust becomes possible. Stories enable us to present ourselves and our histories to the world in ways that engender a shared knowing or understanding. Stories are therefore natural vehicles for finding out about oneself. Drawing on doctoral research carried out within the context of reflexive practice and embodied knowing, this presentation considers the use of a particular story creation and telling approach from the field of dramatherapy known as the 6-Part-Story-Method (6PSM; Lahad and Ayalon, 1992), as a research tool for individuals and groups to develop new self-knowledge. The 6PSM was originally developed as an assessment tool for dramatherapists to identify their client’s strategies for coping with trauma within the context of conflict. Using it as a tool for embodied reflexive practice enables researchers to use the method at three levels: as story creator, as storyteller, and as listener. Similar to the idea of Bruner’s spiral learning process, each iteration of narrative brings a new way of viewing the same material and feedback from the range of listeners the story is told to will shape the language and framing of the story as it progresses onwards to other individuals or through other communities. In this presentation, I will share how this method was used in researching issues professionals faced in educational leadership. The challenge of researcher as coparticipant and as observer will be explored along with the benefits and challenges of the 6PSM as a research methodology.
Symposium Abstract #3: Like Braiding Sweetgrass: Nurturing Relational Knowing in Indigenous Community-Based Research
Jo-Ann Episkenew, Indigenous Peoples Health Research Centre
Linda Goulet, First Nations University of Canada
Janice Victor, University of Lethbridge
The shifting environment of indigenous community-based research demands reflexivity since the negotiation and maintenance of relationships are central (Findlay, Ray, & Basualdo, 2014). This presentation will expand on the importance of social relationships in Nehinuw (Cree) worldview by reflecting on an ongoing arts-based research partnership between a team of indigenous and settler researchers from three universities and one indigenous community agency. The Nehinuw relationships of weechihitowin (supporting and helping each other), weechiyauguneetowin (partnership, collaborative or shared action), otootemitowin (respectful openness and acceptance of others), and weechiseechigemitowin (alliances for common action; Goulet & Goulet, 2014) form the theoretical framework for analyzing the challenges and successes that have sustained this collaboration for almost 10 years. This presentation will enhance understanding of indigenous community-based research to promote an epistemological shift toward indigenous modes of inquiry.
Bloom Where You Are Planted: Place Identity Construction of Third Culture Kids
Anastasia Lijadi, University of Macau
Third Culture Kids (TCK) experiences numerous life disruptions moving between countries and multiple cultures following their parents during their developmental years, which affects the negotiation and maintenance of a coherent sense of self (identity) in relation to a place called home. Using qualitative inquiry, this cross-sectional study explores and describes how TCK construct meaning of their high-mobility lifestyle and how their sense of place influenced their identity construction. The research was divided into two studies: Study 1 used a semistructured interview approach that employed the Collage Life Story Elicitation Technique to obtain life stories of 27 TCK (aged 7–17 years) and Study 2 involved an asynchronous Facebook online focus group with 33 adult TCK participants (aged 19 and above). These findings show that for all cohorts, their place identity or home is family, familiar traditions and rituals, the places from where the family came, and all places where they have lived. From preadolescence, TCK need to expand their social network and continue to learn and deal with their losses. Adolescent TCK claim they need to deal with frequent changes and that they are longing for direction for their future. The adult TCK report accumulated implications of the high-mobility lifestyles they led as children, all of which affected their sense of belonging and sense of community. In order to construct a coherent place identity for TCK, five enabling modalities are proposed.
Applying PRECIS-2 to Primary Care Trials (APT)—The Views of Those That Will Use the Results
Kirsty Loudon, University of Stirling
Gordon Forbes, Pragmatic Clinical Trials Unit (PCTU)
Sandra Eldridge, Pragmatic Clinical Trials Unit (PCTU)
Randomised trials are difficult and costly. Like most things that are hard, the effort expended is only worth it because we hope to make a difference. Sadly, the benefit to potential users such as patients, health-care professionals, and policy makers is often smaller than it should be because trial design decisions reduced the relevance of the trial to users. PRECIS-2 is a tool designed to help trialists match their design decisions to the information needs of those they hope will use the trial results. PRECIS-2 has a highly visual wheel format with nine design domains including eligibility, recruitment, setting, organisation, and primary outcome which are scored on a Likert-type scale from 1 (very explanatory)—ideal world to 5 (very pragmatic) just like usual care. We were keen to discuss with those synthesizing research evidence and those using it to determine how evidence is used and what aspects of trial design are important when deciding whether research is relevant to practice. Qualitative research was undertaken using semistructured interviews of academic GPs, funders, and policy makers. The interviews included questions on attitudes to the nine different PRECIS-2 domains as a tool to judge if a trial’s results would be useful. Framework analysis was used to pull out four key themes: aspects of trial results that are important when assessing evidence, how evidence is used, pragmatic and explanatory attitudes, and using the nine domains of PRECIS-2. These themes will be presented to assist future work to design trials that are fit for purpose.
Sampling Issues Using the Grounded Theory Methodology: Applicability to Family Caregiving Research of Clients With Dementia and Intellectual Disability
Lisa Low, Caritas Institute of Higher Education
Kim Pong FAN, School of Health Sciences, Caritas Institute of Higher Education
Sampling strategies and techniques should be strategically thought through and carefully written in a research proposal in such a way that when it comes to implementing the project these strategies can be flexibly followed so as to ensure smooth data collection. Ultimately, a well-planned sampling strategy is an important step to ensuring that the project also finishes on time. In undertaking funded grounded theory (GT) qualitative research projects on family caregiving of clients with dementia and intellectual disability, pertinent sampling issues encountered with these client groups have included sampling size, recruitment difficulties, disclosure resistance, social desirability bias, and data saturation. These issues will be discussed in relation to the past decade of published literature that uses the GT methodology, together with the sampling challenges we have encountered from our research on family caregivers whose relatives have used community care and residential care home services. Some suggestions to enhance recruitment efforts and sampling techniques in GT research projects will be provided so as to promote more fruitful discussions of the identified issues.
The Challenges of Working Collaboratively to Develop a Workplace Wellness Program With Health Care Providers in a Substance Abuse Agency
Leigh MacEwan, School of Social Work, Laurentian University
J. Beange, Monarch Recovery Services
M. P. Gagne, Monarch Recovery Services
M. Leduc, Monarch Recovery Services
A. Longstreet, Monarch Recovery Services
E. Pilon, Monarch Recovery Services
A growing body of literature is emerging, suggesting that health-care providers who work with people who have been traumatized are vulnerable themselves to experiencing the physical, emotional, cognitive, relational, spiritual, and/or interpersonal effects similar to those they are helping. Not only has compassion fatigue been identified as a potential occupational hazard for health-care workers who listen to traumatic narratives, but this complex issue is also being recognized as taking a toll on the workplace. Research on workplace wellness promotes organizational interventions that protect workers and encourage a healthy workforce. The goal of this study was to collaboratively design and develop a Workplace Wellness Program to ameliorate compassion fatigue in a substance abuse agency in Canada. Participatory action research was chosen to reduce inequities by involving interested health-care workers who would be in a position to develop strategies and take action to improve their own workplace health. These workers were invited to participate in all stages of the study, design, question formation, data collection, data analysis, and dissemination of the results. A steering committee of interested coresearchers was identified to guide the study. Data were collected using individual and group interviews. Thematic analysis revealed the importance of agency workers working together to develop a holistic agency wellness program. This presentation will discuss the challenges and limitations of a collaborative study that was designed to work with health-care workers rather than on health-care workers.
Enhancing Qualitative Research to Novice Researchers Through Training
Thuledi Makua, University of South Africa
Currently, in South Africa, research in the government institutions is in increasing demand for both the academic staff and other professionals. Training institutions offer little research information especially to the undergraduates. The purpose of this paper was to explore and develop the knowledge of the novice researchers who aspired to conduct the research for their professional and academic development. Participatory action research was chosen as an empowering approach, and 20 government employees were invited from Dennilton area, in Limpopo Province, South Africa to voluntarily participate over a period of 6 months of contacts. Through the interviews, the participants verbalized their frustrations and needs for research skills. Thematic analysis revealed that (1) participants do not have formal opportunities for research training from the basic training institutions and employer, and (2) not understanding what research is from basic education, participants do not have courage to register for research studies at tertiary institutions. Based on these themes, the project developed 6-month lectures on qualitative design; proposal development; and data collection, analysis, data transcribing, interpreting and presentation. The project enhanced the participants’ knowledge and understanding of qualitative research methodology in the way that they reflected it through diverse choices. Two participants were mentored into presenting qualitative research papers in the International Caritas Consortium, 2015, South Africa. Furthermore, from the project, four participants got encouraged to register for master’s degree and one for doctoral. The participants provided rich feedback highlighting the importance of the project to them and the sustainability of the project for the benefit of those who were still showing the interest of joining.
A Journey Into Data Analysis: Moving From Field Texts to Research Text in Narrative Inquiry
Louela Manankil-Rankin, Nipissing University
Gail Lindsay, University of Ontario Institute of Technology
Connelly and Clandinin’s (1990) narrative inquiry is about understanding the situated lives of people through reflection and reconstruction of experience. This methodology is situated in the interpretive paradigm and the constructivist tradition. It is based on Dewey’s (1938) philosophy of education grounded on inquiry. A three-dimensional (3-D) metaphorical space provides the analytic lens for exploring experience. Moving from field texts to research text requires the inquirer to use the 3-D space in specific ways in the analytic process. When moving from transcripts to the constructed stories of participants, the 3-D space takes a foreground role in analysis. It shifts to the background in the second phase of data analysis when an inquirer moves to generating meaning and contributions to knowledge for the wider landscape. At this phase, the three levels of interpretation that aim at addressing the personal, practical/professional, and social levels of experience takes a central role in the interpretive process. Using my experience in moving from field texts to research text in my dissertation, I will describe the intersections amongst the ontological, epistemological, and methodological commitments within narrative inquiry. I will discuss the use of the 3-D space and the three levels of interpretation to outline their distinct role in data analysis. I will discuss the challenges I encountered and the methodological decisions they entailed. Finally, I will outline my inquiry’s contributions to the conceptualization of data analysis in narrative inquiry.
Understanding the Lived Experience of Pregnant Women Practising Pica
Cynthia Mannion, Faculty of Nursing, University of Calgary
Pica is the craving and purposive, persistent consumption of nonnutritive substances by men, women, and children. It includes consumption of dirt, clay (geophagy), raw starches, cornstarch, raw rice, wheat (amylophagy), and ice or freezer frost (phagophagy). Pica is a covert behaviour because of its long-standing and dubious association with children, mental health, and autism but it is a cultural universal; a practice identified in antiquity in all cultures. Maternal and fetal complications vary but can include heavy metal toxicity, helminthes infection, iron deficiency anemia, premature birth, and low birth weight. Describing pica in pregnant women is a first step to understanding the behaviour. We recruited and interviewed five mothers, aged 18–35 years, of South Asian or African country of origin, English speaking, who practiced pica during pregnancy. The interviews lasted 1.5 hr were audiotaped and transcribed. We used thematic analysis consistent with the phenomenology of van Manen (1990) to analyse the data. Emergent themes included: Coefficient of crunch: Women are compelled to practice pica to experience the sensory attributes of the nonfood substances: crunchy, brittle, and aromatic. Nostalgia: All had eaten nonfood items as children. There was an element of nostalgia associated with the return to consumption. Ritual: Analysis revealed categories of ritualistic/repetitive behaviour and intense, addictive-type cravings. Pica is a complex behaviour and is largely hidden from others. It is experienced with great intensity and a strong motivation to satisfy. Considering pica as a ritualistic behaviour with nostalgic overtones adds to our understanding of this human behaviour.
The “Absent” Researcher: Reflections on Using Real-Time Observational Methods to Explore Young Peoples’ Online Behaviours
Susan Martin, MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
Lisa McDaid, MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
Shona Hilton, MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
Observational methods involve watching and recording what individuals do and say in particular settings and have been used frequently within the social sciences, in different ways and across varying contexts. They are valued for their potential to gain insights into “natural” behaviours through creating an environment closer to everyday life than a face-to-face interview, allowing observation of behaviours similar to those that may naturally be exhibited by participants. A number of studies exploring online health information seeking have incorporated such methods through the use of computer applications that allow recording and thus observation of online information searching behaviours in real time. However, few of these have included researchers’ reflections on carrying out this kind of research. This presentation will attempt to fill this gap by drawing on experiences of carrying out an exploratory qualitative study using paired interview and observational methods which explored how young people (aged 16–19) search for and evaluate online sexual health information. This presentation will focus on the use of observational methods as a way of grounding insights in “real life” situations and the opportunities and challenges with using this type of methodology, with a particular focus on the concept of the “absent” researcher and its effect on participants’ behaviours. This presentation will explore firsthand experiences of applying these methods, describing and reflecting on the practical, relational, and ethical concerns that arose and discussing ways to manage and respond to these.
Interpretive Phenomenology in Research on Knowledge Sharing Among Global Business Leaders: Collaboration or Conflict?
Gill Maxwell, Glasgow Caledonian University
P. Lang, Glasgow Caledonian University
Phenomenology is arguably an established epistemology in qualitative research. Descriptive phenomenology, stemming from Husserl, in particular is widely utilised. This proposed presentation however will focus on interpretive phenomenology, as derived from Heidegger and Husserl’s positionality. A relatively innovative approach to empirical data analysis, interpretive phenomenological analysis (IPA) will be discussed in the context of contemporary doctoral research on knowledge sharing among global business leaders. A signal characteristic of IPA is recognition of, even reliance on, the previous knowledge and experience of both the research informants and their researchers. Thus, IPA overtly and subjectively involves not only the research informants but also those conducting the research. In a sense, therefore, the researched and researcher are complicit agents in this philosophical paradigm and means of data analysis. The consequent and central question is: Does IPA constitute collaboration between, or conflict of, research interests? The proposed presentation will address this question, utilising extensive qualitative data derived from 24 in-depth interviews with business leaders in global organisations. The presentation will discuss the nature and implications of IPA in philosophical and practical terms, drawing on the tranche of empirical data. This will provide the foundation for offering a conclusion on IPA as constituting either collaborative or conflicting research interests.
Participant Observation as a Useful Method of Data Collection in Age-Related Vision Loss (ARVL) Research
Colleen McGrath, Ontario Shores Centre for Mental Health Sciences
Debbie Laliberte Rudman, Western University
Jan Polgar, Western University
Carspecken’s (1996) five-stage approach for critical ethnography includes an initial focus on building a primary record that refers to the unobtrusive and passive collection of observation data within a social site. Carspecken, an educational researcher, acknowledges that a process of passive observation may not be appropriate in situations where the researcher has no prior relationship with their participants. In such situations, a more active role may be appropriate. Such was the focus in the critical ethnographic study I conducted on environmental influences on the occupational engagement of older adults with age-related vision loss (ARVL). In this study, the second stage of data collection involved a participant observation session in which I participated in an activity (both community based and in home) chosen by the older adult participants. This presentation will focus on how this particular method of data collection enabled the building of rapport, helped to inform subsequent data collection, and provided the research team with both a better understanding of how older adults with ARVL negotiate their environments and how physical, social, cultural, political, and institutional environmental influences ultimately shape meaningful activity engagement. Important considerations when using this approach, such as issues related to documenting observation findings, integrating reflexivity into the observation process, and the importance of considering environmental factors (such as season, weather, day, and time of day) will also be shared.
Novel Methods to Understand Barriers to Technology Adoption for Older Adults: Emerging Results From the COBALT Project: McGrath, Astell, Hwang, Williams
Colleen McGrath, Ontario Shores Centre for Mental Health Sciences
The aging population is set to rise significantly over the next 30 years, and with this demographic change, the role of assistive living technology (ALT) will be central to helping older people live well now and in the future. One might imagine that an ALT is readily adopted by people who are adapting to the physical and cognitive changes associated with ageing, however, there is a significant gap between ALT development and the relatively low level of uptake in older people. Research into the barriers to technology adoption have tended to adopt traditional approaches to data collection including focus groups, surveys, and semistructured interviews. Although such approaches have provided rich data, they are not telling the whole story. As such, the Challenging Obstacles to Assisted Living Technologies (COBALT) project set out to identify how end users’ identity and behavior are impacted by ALT, though the use of novel methods such as “Show and Tell,” “Technology Tours,” and “Technology Interaction sessions.” These hands-on methods allowed for in-depth investigation of areas such as (a) how older people become aware, select, learn about, adopt, and make use of ALT and (b) how the attitudes and behavior of partners, friends, families and social networks affect these processes. This presentation will review what these three novel methods entail as well as the strengths and challenges of utilizing these participatory methods of data collection. This presentation will highlight the significance of interactive activity-based group sessions in encouraging maximum participation and discussion from older adults.
Innovations in Applied Research: A Second Generation Grounded Theory Approach to Working With People and Data
Joanne Mihelcic, Monash University
The postmodern and constructivist underpinnings of second generation grounded theory as a methodology sees a shift in how we understand the researcher’s interaction with participants in a study. It highlights the way relationships between researcher, participant, and research data are both inseparable and the product of their combined interactions. Hearing and knowing require methods and techniques sensitive not only to researcher and participants’ words but also their inherent meaning and actions. This presentation will describe the design of a second generation grounded theory research focused on reflexive practice for hearing and knowing the voices of three people diagnosed with early stage dementia. A unique repertoire of interview techniques were undertaken with participants to understand their experiences of memory and identity in the context of dementia. The interview process facilitated cocreating vignettes of stories which were centred on the person and their perspectives of life. The review of these vignettes with the participants furthered the exploration of the narratives and meaning captured in these records of self. The recorded stories and the processes for cocreating records of these stories were analysed to develop new theory and knowledge about the potential ways in which these records may support stories of self and personhood.
The Interpretive Approach as a Means of Understanding the Misunderstood
Doreen Molloy, University of Glasgow
Joyce Hendricks, Edith Cowan University
Anne Williams, Murdoch University
People’s experiences of health and illness are important areas of health research and practice. The interpretive process, and more significantly the biographical approach (Denzin, 1989), is an approach in which there is a focus on personal epiphanies which shape and reflect the stories people tell of their experiences. Dolby-Stahl (1985) contends stories of personal experience sit within the genre of folklore and that the reading of such stories must take into account the social, cultural, and historical contexts which influence and give meaning to experience. This presentation describes a folkloristic biographical method which was used to advance an understanding of a poorly understood and complex phenomenon. Using the example of women genetically predisposed to developing breast/ovarian cancer who refused risk reducing surgery, this innovative methodological approach allowed the stories of high-risk women to be interpreted from a number of different perspectives as no single interpretation is able to create meaning. This approach was useful in understanding the range of influences which impact upon health behaviours. Giving voice to women at high risk of developing cancer who refuse conventional treatment can be considered a collaborative approach which grounds the creation of new knowledge in real life experience. The weaknesses of employing traditional ways of measuring and investigating reasons for saying no to risk reducing surgery in this group of women are outlined and used to develop the strengths of the biographical method.
A System for Coding the Interaction in Focus Groups and Dyadic Interviews
David Morgan, Portland State University
Kim Hoffman, International Center for Advanced Research and Applied Science (INCAAS)
Despite numerous calls for ways to analyze the interaction in focus groups, there is still an unmet need for the development of such tools. In response, we present a coding scheme that investigates interaction by emphasizing the ways that participants use the substantive aspects of the topics they are discussing. In particular, we look at the connections between adjacent pairs of statements to examine how participants make the transition between what the previous speaker said and what the current speaker contributes. After describing this coding system, we apply it to the question of how the conversations in dyadic interviews (with two participants) compare to the discussions in focus groups (with four or more participants). Both focus groups and dyadic interviews rely on interaction between participants, but what remains unstudied is how these interactions may differ between these two types on interviews. Our results indicate that the interaction dyadic interviews generate notably more statements of agreement, indicating a higher degree of mutual attunement. In addition, participants in dyadic interviews are more likely to make explicit and active connections to the content of the previous speaker’s statement. These results demonstrate the effectiveness of our coding system in one particular context. Understanding how the dynamics between respondents can vary depending on the method, “individual vs. dyadic vs. focus group” may have implications for the kind of interview that a researcher selects. We conclude by considering both the limitations of this system and the possibilities for extending it in future research.
Student Nurses’ Perceptions of Dignity: An Innovative Use of Photo-Elicitation Within a Nominal Group Technique
Rosemary Mullen, University of the West of Scotland
Angela Kydd, University of the West of Scotland
Laura McMillan, University of the West of Scotland
Anne Fleming, Independent Researcher
Photo-elicitation is a technique involving the use of photographs in an interview setting. It was selected as a key component of the nominal group technique (NGT) in this study. The NGT consists of four key stages to establish group consensus: silent generation of ideas, sharing of ideas, group discussion, and individual voting and ranking. The application of photo-elicitation in this doctoral study used a suite of preexisting images with five nominal groups of student nurses to explore their perceptions of dignity. The decision to incorporate photo-elicitation into the NGT was guided by the complex nature of the concept of dignity and the need to bridge the gap between the participants’ perceptions and what they could articulate. The literature suggests that photo-elicitation can help overcome any perceived need to say the “right” thing? and can evoke a more authentic and spontaneous response by connecting with the unconscious. Furthermore, images are thought to stimulate broader discussion and reduce the awkwardness of the research setting. This paper will outline the practical application of photo-elicitation within NGT in this study. Participants were invited to select an image that captured something of the meaning of dignity and to explain their choice in writing during the silent generation stage. Images were available from the outset, and this was found to enhance participant engagement. In utilising photo-elicitation in NGT, participants were enabled to generate rich responses to a complex concept.
Sharing Stories: Engaging Underserved Youth and Community Members in Dissemination Efforts
Michelle Nichols, Medical University of South Carolina
Translational research is needed to substantially affect health behavior change. One approach is to engage individuals in the process of identifying and prioritizing needs and expanding community capacity through community-engaged research. Underserved, inner-city youth enrolled in a weight management program and their parents participated in a community-engaged qualitative study to explore the barriers and facilitators of weight throughout their daily lives. Primary emphasis was on access to nutritious foods and engaging in physical activity. Data were collected using photovoice as a data collection approach and semistructured interviews were analyzed inductively and deductively using thematic analysis based the levels of the social ecological model. Community members, youth participants, and their parents partnered with researchers to identify and implement a variety of dissemination methods to increase community awareness of the realities these young people face regarding health behaviors. Dissemination included traditional modalities as well as an art exhibition, presentation at school board meetings, dialogue with community stakeholders, and the use of data as an educational tool to increase awareness of the contextual factors influencing health promotion among an array of health students. Youth actively participated in sharing their stories and increasing awareness of factors affecting their health. Moreover, their involvement identified existing resources to be leveraged to expand community capacity in addressing the health needs pertinent to this community. Lessons learned from this research can be utilized by other research and community stakeholders to address community health needs and recognize community members as experts of their lives and their communities.
Collaborative Ethnography: Identifying Implicit Processes Influencing THRIVE
Rosaleen Obrien, Glasgow Caledonian University
Katie Buston, University of Glasgow
Marion Henderson, University of Glasgow
The Trial of Healthy Relationship Initiatives for the Very Early-years (THRIVE) is a three-arm randomised controlled trial (RCT) for mothers identified as vulnerable in pregnancy and their babies who are at high risk of maltreatment. The RCT is evaluating the efficacy and cost-effectiveness of two antenatal and very early postnatal interventions, Mellow Bumps (MB) and Enhanced Triple P for Baby (ETPB), for improving both mother–child interaction and maternal mental health. THRIVE’s realist process evaluation is critically examining (1) the mechanisms by which MB and ETPB work; if they do, who they work for and how; (2) how faithfully MB and ETPB are being implemented; and (3) the contextual factors that are necessary for the programmes to function or that might prevent them functioning. Complex and interdependent dynamics of context, practice, and agency can remain “hidden” in conventional reporting of trials. The process evaluation includes ethnography, using participant observation and multiperspective serial interviews, to make these complex processes more explicit. RCT researchers and fieldworkers were also encouraged to develop “ethnography skills” and were asked to reflect on, and write about, their interactions with key respondents and observations in different trial settings (e.g., clinics, participants’ homes); ethnography thus became a collaborative enterprise. Studies of implementation rarely present “thick” description which impedes their ability to draw conclusions on how local contextual factors contribute to intervention outcomes. Collaborating in ethnography, and having many eyes and ears in the field, as opposed to just one trained ethnographer can elicit critical details needed to produce these thick descriptions.
Academics Are From Mars, Practitioners Are From Venus: Challenges of Collaborative Qualitative Research Partnerships With Mental Health Professionals
Michelle O’Reilly, University of Leicester
Nikki Kiyimba, University of Chester
Evidence-based practice has largely dictated the direction of qualitative health research. Given, the complexities of knowledge exchange and translating research into practice, collaborative partnerships between academics and practitioners facilitates the mobilisation of research into usable evidence. However, this raises pragmatic difficulties for the qualitative community. In mental health, collaborative partnerships benefit translation but presents challenges. Our overcoming of these hurdles has been largely accomplished through collaboration with mental health practitioners. This paper identifies four challenges to establishing/maintaining effective collaborative relationships. First, finding common languages to conceptualise research projects and their parameters, where practitioners may underestimate the process constraints that boundary the work of academics. We argue that listening, patience, and communication enhance a mutual pedagogical experience. Second, qualitative researchers may acquire funding through health-related bodies, including NHS trusts. In these cases, funders often require clinical partnerships to ensure translation of evidence into practice. This necessitates convincing applications of the value of qualitative approaches. We argue that this is entirely possible if mutually beneficial partnerships are established. Third, while qualitative researchers recognise the importance of maintaining academic rigour, many mental health practitioners are unfamiliar with the terminology and premises upon which analyses are built. This presents challenges for presenting analysis as rigorous and accessible. We argue for some necessary compromise, including adding pedagogical features. Fourth, necessary academic requirement for publication invokes the dilemma of illuminating clinical application through publication in clinical journals/reports with real-world impact but less academic impact. We consider these challenges and potential solutions with reference to examples from our own research.
Then and Now: Temporality and Narrative Representation in Timeline Data Collected With People Living With Severe Mental Illnesses
Victoria Palmer, The Department of General Practice, The Melbourne Medical School, The University of Melbourne
Kali Godbee, The Department of General Practice, The Melbourne Medical School, The University of Melbourne
Timeline mapping is one tool used within qualitative interviewing to gain depth of understanding, ensure participant focus when a topic is complex or sensitive, or to examine key events in a life story. This presentation explores the use of timelines as a visual method to examine temporality and psychosocial recovery for 40 people living with severe mental illness. The 40 participants are a subsample from a cohort of 235 people in Victoria, Australia, recruited to a study about service experiences and recovery called the CORE study. Our timeline approach differed to standard uses within a face-to-face interview context. Instead, participants were posted a hard copy of a timeline with “then” and “now” printed on it with an arrow printed horizontally across the page. Participants were asked to use the timeline to share their life story, to tell as much or as little as they liked, and to think about the times they felt well or unwell including key events. This presentation examines how the timelines were portrayed by participants and the complexity of temporality in narrative representations of people living with severe mental illness.
Can You Tell Me About…? The Pros and Cons of Telephone Interviews and Leximancer Analysis for Experiential Data Collected With People Living With Severe Mental Illness
Victoria Palmer, The Department of General Practice, The Melbourne Medical School, The University of Melbourne
Kali Godbee, The Department of General Practice, The Melbourne Medical School, The University of Melbourne
Wayne Weavell, The Department of General Practice, The Melbourne Medical School, The University of Melbourne
Rosemary Callander, Tandem (Representing mental health carers)
Jane Gunn, The Department of General Practice, The Melbourne Medical School, The University of Melbourne
Mental health policies internationally all have a focus on involving service users, carers, and staff in policy development, service planning, and redesign. Experience-based codesign (EBCD) is one method of service involvement and improvement that shows good promise in the health-care setting. EBCD is undertaken using a two-stage approach. Stage 1 involves information gathering with service users and carers about what’s been going well in services (the high experiences) and what could be improved (the low experiences). These high and low experiences are explored in greater depth in focus groups with individual stakeholder groups (service users, carers, and staff). Stage 2 takes the commonly agreed upon low experiences and through a facilitated codesign process, service users, carers, and staff all work together to codevelop solutions. These solutions are then implemented to improve service experiences. This presentation explores the benefits and limitations to using the telephone to collect experience data with people living with severe mental illness and undertaking analysis using Leximancer software. This is considered in contrast with EBCD data collection methods that employ trigger films and in-depth interviews to collect depth data.
Hookup Apps and Dating Profiles: Culturally-rooted Focus Group Techniques for Discussing HIV Prevention With Gay Men
San Patten, Mount Allison University
Retaining Cross-Case Generalisability and Within-Case Specificity: A Methodological Exploration
Cath Quinn, University of Plymouth
Ian Porter, Exeter University
Vanessa Pinfold, McPin Foundation
Richard Byng, Plymouth University
Qualitative analytical approaches aim to gain deeper understandings of individuals and their experiences and may seek to apply these findings more widely. Thematic analyses produce results which highlight commonalities across cases, while also paying attention to deviant cases and silences within the data. Although this approach may be productive, particularly when considering the potential wider application of results, it risks losing both the richness of the specificity of individual cases and how themes interact with each other within an individual case. This presentation will demonstrate an analytical technique developed and used in two research studies which attempts to bring together within and cross-case analyses for the benefit of both. Cross-case, inductively derived, broad thematic codes were applied to interview transcripts and then reproduced in colour coded within-case illustrative diagrams. The studies, one examining the continuity of health care for offenders and the other exploring the people, place, and activity networks of people living with severe mental illnesses, purposively selected participants from wider quantitative studies to take part in semistructured interviews to gain deeper insights into the studies’ main foci. This participant and question preselection makes the ways in which the participants interrelated their own priorities with those of the wider studies of particular interest. The additional depth and understanding produced for the studies will be demonstrated and the challenges faced will be discussed. The presentation will conclude with a wider discussion about how this technique may be useful for other studies and any areas which may require further development.
Synthesizing Multiple Qualitative Data Sets and Refining the Results in Complex Settings: Power and Paradigms
Cath Quinn, University of Plymouth
Sarah Brand, Plymouth University
Christabel Owens, Exeter University
Richard Byng, Plymouth University
Qualitative researchers working in quantitative, thus largely positivist, fields have traditionally struggled to challenge the work of their quantitative colleagues. Qualitative insights, including challenging, questioning, and identifying gaps and silences, are thus marginalized. Health services research, particularly large trials of new interventions, for which funding bodies require quantitative and cost-effectiveness results, is one of the fields in which this can occur. This presentation will detail the challenges, solutions, and lessons learnt when a series of qualitative methodologies led the development and refinement of a health services intervention which is being tested in a multicenter randomised control trial. Particular attention will be paid to the ways in which power was negotiated and potential incommensurabilities between different ontological paradigms were discussed. The intervention was for male prison leavers with common mental health problems. A series of innovative qualitative approaches were used to lead the theoretically informed intervention development due to a lack of current best practice in the field. Data collection was driven by a reducing uncertainties approach. Key ways in which both paradigmatic and power imbalances were negotiated and addressed included: The lead researcher being committed to consensus decision making, a lived experience group being supported to challenge and disrupt, an external qualitative “critical friend,” and the wider study teams’ commitment to the value of the insights of practitioners delivering the intervention. This study demonstrates that when qualitative approaches are allowed to lead, traditional power imbalances are challenged and a more egalitarian range of voices can influence the research process.
Using Institutional Ethnography to Collaborate Across Organisations and Empirically Map How Social Problems Are Being Produced
Lorna Reid, Edinburgh Napier University
Social problems are complex to unpick and/or understand, leaving knowledge gaps about how they are produced. Institutional ethnography (IE) is an emancipatory method of inquiry that brings participants from diverse disciplinary and organisational backgrounds together to bridge this knowledge gap. IE begins in the everyday work of people involved in an activity they find “troubling.” Its aim is to identify the relations of ruling (RoR) that may have (inadvertently) helped bring that situation about. RoR are powerful (but often unnoticed) organising forces within modern institutions, for example, an admission checklist may be linked to national standards, linked to government policy, and linked to international policy. While RoR are not deliberately malignant they are powerful organising (and at times dis-organising) forces, so neither are they neutral nor begin. One of the outcomes of IE is the production of an ethnographically based cartography of the RoR entering and directing the process under investigation. This means it can be used to empirically map how complex social situations arise and develop. This presentation will describe how IE was used to collaborate with diverse participants across organisational and geographic boundaries to identify the local, national, and international RoR that entered and directed the everyday working life of underqualified nonhealth-care staff and made them accountable for raising the complex health-care topic of resuscitation with proxy decision makers. It will outline the techniques employed in this doctoral study, including how narrative vignettes were used to uncover and map the key RoR involved.
Collaborating With Peers in Mental Health Research: Promoting Equity or Reinforcing Marginalization?
Colleen Reid, Faculty of Child, Family, and Community Studies, Douglas College
Marina Morrow, Faculty of Health Sciences, Simon Fraser University
Peer support models are considered standard practice in community-based approaches to research in mental health (Davidson, et al., 2010) and are supported through a major initiative launched by the Mental Health Commission of Canada (2009). Despite evidence for the benefits of peer research models, they have been criticized for being tokenist, creating a marginalized and precarious work force, and making assumptions that all “peers” can beneficially and safely integrate their lived experience into their work (Morrow & Weisser, 2012). In this presentation, we draw on our experiences in Imagining Inclusion—a 2-year community-based participatory research project—to examine the promises, challenges, and pitfalls of integrating peer researchers into all phases of the research process. In imagining inclusion, we examined experiences of community inclusion, health, and well-being for people with lived experience of mental illness. Thirty-two individuals participated in the photovoice stage of the project, and 19 remained involved in data analysis and dissemination activities. Although many participants reported major personal and social benefits, challenges emerged. Peer involvement in research was resource intensive and required ongoing one-on-one support and management. Some peers felt the burden of representing “lived experience” through their individual lenses, and others were concerned that their full involvement might inhibit their access to other necessary resources. Indeed, the project’s commitment to a fully collaborative and equitable research process was not realized due to systemic and sociodemographic inequalities. In this presentation, we explore strategies for more authentic and sustainable peer involvement in research in the mental health system.
Thinking With Stories: Reconsidering Community Development Work
Corinne Rogers, University of Alberta
In the retelling of my experiences as a community development worker in Khao Lak, Thailand, in 2004, I attend to possible shifts in community development practice through narrative pedagogy. In this moral space, I encounter the dominant community development story alongside the stories of displaced persons. Although this encounter, I begin to retell the dominant community development story by thinking with stories rather than about stories. It is here in the reconsideration that I wonder about the possibilities when one begins with the sacred stories of a sense of community as lived out in unfamiliar places.
Perceptions of Personhood and the Early Onset Dementia Experience: I’m Still Here
Mariko Sakamoto, Athabasca University
Early onset dementia (EOD) is dementia before the age of 65. This presentation will summarize a master’s research study that examined the EOD experience from the point of view of four adults under the age of 65 living with dementia, in particular examining how these individuals perceived their own personhood. Using interpretative phenomenological analysis (IPA) as the research method as well as integrating an arts-based approach, this qualitative study revealed that the EOD experience can be incorporated into six themes: A Personal Journey, Navigating the System, The Stigma of Dementia, Connecting to the World, A Story Worth Telling and I’m Still Here. The participants’ stories as presented via these six thematic threads show that despite the challenges of living with dementia, people with EOD can have a strong sense of personhood.
Collaborating Through Arts-Informed Narrative Inquiry Across Education and Practice in Mental Health: An Exemplar
Jasna Schwind, Ryerson University
Gail Lindsay, University of Ontario Institute of Technology
Valuing educational research that partners academia with practice, we collaborated with colleagues (researchers, educators, practitioners, and administrators) in university, college, and tertiary care organizations on an arts-informed narrative inquiry (AINI) into person-centred care (PCC) in mental health. AINI is informed by Connelly and Clandinin’s narrative inquiry and includes storytelling, metaphors, cocreative art activities, and reflective dialogue. We first explored how students and nurses conceptualize and enact PCC with those in their care. As a result of collaboratively engaging in the inquiry, students communicated an expanded definition of PCC to include both the patient and the caregiver, while nurses expressed a new perspective on students’ learning process within practice. This inquiry led to exploring how PCC in mental health practice is constructed and lived by practicing nurses within the care delivery innovation of a relationship-based care approach (RBCA). Through collaborative approach to inquiry, nurses are empowered to articulate their values and to critique organizational policies that impact PCC. This inquiry highlights the mutual shaping of relationships between patients, caregivers, and organizations. Outcomes reveal how arts-informed approaches may be used with patients and interprofessional care teams to build capacity and to demonstrate knowledge construction, illuminating a practice-based theory that is person centred. The significance of this research extends to curriculum building and professional development of teachers and nurses in education and practice. An experiential exercise and discussion about the transferability of this collaborative research to other settings and populations is included in our presentation.
The Power of Representation: Using Arts and Creativity to Explore Transformational Resilience in Communities
Pete Seaman, Glasgow Centre for Population Health
Claire Mckechnie-Mason, Glasgow Centre for Population Health
Issie MacPhail, Division of Health Research, Rural Health & Wellbeing, University of Highlands and Islands
There is growing recognition in policy making of a need to move beyond narrow definitions of evidence yet a legacy of the recent dominance of the evidence-based policy and practice model is a narrowed scope as to what counts as legitimate knowledge. This has implications for communities, leading to the construction of knowledge that define them being limited not only what is measurable but through choices collectively made around what should be measured. The use of “policy defined indices” to describe the character of areas can lead to people and places to be seen through a deficit lens, as “passive, stuck, and disconnected.” The representing communities project explores the potential for creative practices to provide space to illuminate the everyday contexts in which people strive to maintain well-being. Looking at five UK communities undergoing rapid change, where existing “official” narratives (often of poverty or conflict) do not positively indicate a direction of positive growth and development, we have worked with artists to explore the relationship between representation and identity. The knowledge produced brings forward new representations that reflect the contemporary experience and aspirations of communities in transition. However, tensions exist around the policy usefulness of such engagement activity beyond those who have been directly affected by the process. This leads to a question of how we view the outcomes of arts and creativity, not only as intervention but as a source of evidence, about the aspirations, ambitions, and assets of communities, to be acted upon through a practical policy lens.
Philosophical Grounding in a Reflective Lifeworld Research Approach: Where Is the Place for Description vs. Interpretation?
Linda Sellin, School of Health, Care and Social Welfare, Malardalen University
Margareta Asp, School of Health, Care and Social Welfare, Malardalen University
Tuula Wallsten, Centre for Clinical Research, County Hospital, Uppsala University
Lena Wiklund Gustin, School of Health, Care and Social Welfare, Malardalen University
Based on a Reflective Lifeworld Research approach, the aim of this study was to describe the phenomenon of recovery in a caring context as experienced by persons at risk of suicide. This approach is rooted in phenomenological philosophy where the concept lifeworld is central. The lifeworld is a subjective world of meaning that also involves intersubjectivity. This implies that the person share and experience the world together with other humans. Human beings access this personal and intersubjective world through the lived body. The notion of the lived body and the lifeworld provides possibilities to study the phenomenon in focus from the persons’ own lived experiences. Adoption of a phenomenological attitude enables the researcher to maintain openness and sensitivity to the complexities of lived experiences. In particular, the process of bridling the researcher’s understanding allows the researcher to position oneself in relation to the phenomenon, to actively await its meanings to appear, and simultaneously maintain sensitivity in the continuing process of discovery. However, striving to understand meanings in the relationship between humans and their world involves the challenge not to make definite what is indefinite. This presentation will articulate how this approach supports the researchers’ reflexivity and their ethical accounts. Especially arguments for how to encounter description vs. interpretation in understanding of the phenomenon will be explicated with roots in Merleau-Ponty’s philosophy. Thus, the analysis of data in the context of descriptive phenomenology is considered as a resource for the attention paid to the lived experiences and also to the phenomenon itself.
Thematic or Content Analysis: That’s the Question
Maya Shaha, University of Lausanne and University Medical Centre of Lausanne
Wilfried Schnepp, University of Witten/Herdecke
The Hidden Power in Communication: An Example of Reconstructive Analysis in Critical Qualitative Research
Sandra Sharp, Edinburgh Napier University
Communication is pragmatic, aimed at directing and organising human activity. Every time we talk we convey more than just information; we validate ideas, reproduce and challenge cultural norms and values. Cultural norms impose limits of acceptable behaviours and describe how one should act in a particular circumstance. Much of this is accomplished subconsciously as human actors interpret and understand communicative acts in a holistic way. Therefore, how we communicate influences the listener’s beliefs, gains their trust, and agreement and represents events in such a way that emphasises particular aspects and minimises others. In this way, we know the meaning of a communicative act and therefore how we should act. The hidden elements, the omitted and unarticulated aspects of culture, are the focus of a hermeneutic approach to data analysis used in critical research. Analysis is hermeneutic and also reconstructive in the way that it takes the data and makes explicit cultural and subjective factors that are tacit in nature. In other words, the reconstructive process unpacks the narrative and then proceeds to articulate potential meanings. With exemplars from a critical ethnography examining the culture of nursing in an acute surgical ward, this presentation details the use of reconstructive analysis in critical qualitative research. Adopting a critical approach to research acknowledges that all relationships involve power differentials, and therefore this nursing culture is examined through the lens of power, privilege, and authority to uncover unfair and unjust systems. Participants are collaborators and cocreators and empowered to generate new ideas for practice.
A Case Study Design in Two Phases for In-depth Understanding of a Complex Phenomenon
Rita Solbakken, University of Nordland
Terese Bondas, University of Nordland
Different case study research designs have evolved over the past few years. The case study has especially been used in social science, psychology, anthropology, and ecology. A case study involves in-depth and detailed examination of a single entity or a small number of entities (the case) as well as its related contextual conditions and the historical development or circumstances of the entity under study. In case studies, the case itself is central. The method is a disciplined process that requires systematic data collection and analysis. By using case study design, we wanted to obtain in-depth knowledge on how first line nurse managers focus on adverse events in their own unit. A coupling between the adverse events and the managers’ responsibility and activities was made in the data collection. We strived to explore their understanding of their own responsibility and specific activities in particular and not only an understanding in general of their attitudes. To illuminate the research question, we chose to use a two-phase study design. In Phase 1, we studied data on fall events, amounts, and circumstances in a Norwegian municipality. In Phase 2, we used the results to investigate the development of care concerning falls from the managers’ point of view by conducting a focus group interview with the nurse managers from the same municipality. We will present the two-phase data collection and analysis of the case study as a means to create an in depth understanding via links to the participants’ world and evidence from it.
Reaching the Right Participants: Reflexive Practice to Support Effective Recruitment
Jacqui Stevenson, University of Greenwich
Recruiting participants to qualitative studies is often a challenge reaching the right people, and the right people choosing to participate, is a primary consideration for researchers. For research on HIV, as a condition which continues to be stigmatised, leading many people living with HIV to avoid disclosing their status, this can be magnified. However, being part of the HIV voluntary sector and occupying a role of “HIV advocate” can provide routes to overcome this challenge. Using the example of the researcher’s transition from voluntary sector worker to academic PhD researcher, this presentation explores how recruitment can be facilitated by utilising personal and professional networks, and how in turn this can present new challenges in reaching participants who are not “research regulars” who are experienced in participating in qualitative research. It further explores reflexive, feminist methodologies as applied to participatory research on HIV and ageing as it affects women in the UK and asks how the roles of “advocate” and “researcher” complement and challenge one another. Reflexive practice and an analysis of the researcher’s motives and how this impacts on recruitment, participation, and dissemination will also be considered. By situating the researcher in the participatory research process, community, organisational, and institutional support can be sought, achieved, and ultimately invested in enabling recruitment and participation in research. This model of collaboration, built on participating actively in the field of research outside and beyond academia, presents opportunities to innovate and practice reflexive and feminist methodologies.
Employing Intervention Mapping for HIV-Related Stigma Reduction: The Challenges and Successes of Collaborative Intervention Development and Implementation
Sarah E. Stutterheim, Maastricht University
Gerjo Kok, Maastricht University
Arjan E. R. Bos, Open University of the Netherlands
Intervention mapping is a systematic, socioecological approach to behaviour change interventions that relies on theory and practice, as well as target group participation, to develop and implement multilevel and multitarget interventions. It employs a number of iterative steps that guide interventionists and their collaborators from the identification of a problem or need through to the development, implementation, adoption, and evaluation of an intervention (Bartholomew, Parcel, Kok, Gottlieb, & Fernandez, 2011). In this presentation, we outline in detail the various steps involved in the intervention mapping protocol and discuss the challenges and successes we encountered with collaboration in defining a need (via participative mixed methods research) and, subsequently, in the development, implementation, adoption, and evaluation of an intervention that aimed to reduce HIV-related stigma and optimize interactions between people living with HIV and health-care professionals in the Netherlands. We discuss the fluid nature of collaboration and how collaboration takes different forms dependent on the intervention stage. We further outline the challenges involved in finding a balance between bottom-up intervention planning and applying our expertise as interventionists trained in health behaviour change and stigma reduction. We conclude that, although time-consuming, collaboration with stakeholders, including but not limited to members of the target population, in all phases of intervention development and implementation is not only beneficial but, in fact, imperative to an intervention’s success and sustainability.
Art and Science: An Empirically Grounded Construction of Types Through Interdisciplinary Data Triangulation of Pictures and Texts in an Ethnomethodological Research in Early Childhood Art Education
Ulrike Stutz, University of Erfurt
I wish to demonstrate how an interdisciplinary triangulation of picture and text based upon different scientific disciplines, the social, linguistic, and pictorial sciences can lead to an understanding of practical knowledge gained through the analysis of structures of verbal and visible articulations (body language, positioning of bodies in spaces, actions, and interactions with others). Linguistic and social science provide different methods of interpreting texts such as interviews and group discussions, including methods of discourse analysis and conversational analysis. To interpret the aesthetic structure of pictures (photos and videos), methods of art and pictorial science can be used. Thereby an iconic analysis (Imdahl) is employed to include the inherent logic of the visual and its syntactical density (Goodman). To create an interdisciplinary interrelationship of the outcomes of a social and pictorial scientific analysis, a scientific approach is needed which focuses on a practical construction of reality and therefore the formal structures of actions. For this purpose, ethnomethodology (Garfinkel) provides a theoretical frame. For my contribution, I will offer insights into my interdisciplinary ethnomethodological research into the interprofessional work of artists within a project for early childhood art education. The presented segment of the study focuses on the question concerning how children react to different impulses initiated by the artists. These may be stimulated via verbal requests or through actions, for example, with material. I will emphasize how an empirically grounded construction of types is made possible within a comparative analysis using the triangulation of pictures and texts.
“Narratives of Hidden Lives”: A Psychosocial Approach to Giving Voice to Adults With Intellectual Disabilities and Mental Health Needs
Paul Sutton, University of West London
The significance of the interaction between internal and external worlds has evolved in a substantial way during the past two decades into the discipline that is known as psychosocial studies. Narratives and personal testimonies are important resources for psychosocial approaches. Historically, the use of narrative research methods has provided a means of gaining access to the viewpoints and experiences of disadvantaged groups which lack the power to press for their voices to be heard through the customary approaches of academic discourse. This presentation will discuss the experience of conducting a study that involved adapting a recognized psychosocial conception of subjectivity and methodological framework and employing this as a means of enabling the inclusion, and active participation, of adults with intellectual disabilities in knowledge production concerning their care and support needs. Data production was based on case studies of seven service users who have manifested mental health issues. Methods for data production included “free association narrative interviews,” an examination of relevant case records, and information provided by key care staff. Data analysis involved exploring the whole of the material gained during fieldwork and paying particular attention to links and inconsistencies within the material related to individual research participants. The free associations of the participants were afforded precedence over narrative coherence. Interpretation was theoretically informed, and researcher reflexivity was interwoven throughout the process. Overall, it was found that the free association narrative interview method provided an innovative and effective way of addressing the power asymmetry between the researcher and research participants.
Qualitative Metasynthesis: Have We Created a Monster?
Sally Thorne, University of British Columbia
Health research journal editors have noted a recent proliferation of a species of “quick and dirty” technical papers positioned as products of “qualitative meta-synthesis.” In keeping with the general Cochrane style, they focus considerable effort on search, retrieval, and selection decisions, including the deployment of rather arbitrary “quality checklists,” such that the majority of available qualitative publications are generally excluded from their final data set. From there, they tend to report superficial findings comprised of thematic similarities, rarely tapping into anything of interest relative to methodological, theoretical, or contextual variance within the selected set of studies. Although they often cite classic qualitative metasynthesis methods references as their analytic resource, the final products reflect very little by way of inductive analysis or interpretive examination. Unfettered, this trend in what a qualitative meta-synthesis represents could serve to greatly discredit the methodological genre. In this presentation, we revisit the foundational ideals of adapting sociological meta-synthetic methods for the health research field. Designed to capitalize on extensive investment of original scholars across contexts and settings, meta-synthesis entered them into interactive dialogue about complex human phenomena, enriched by their distinct disciplinary traditions, methodologies, and interpretive lenses. Drawing upon a critically reflective comparison between what qualitative meta-synthesis was designed to accomplish and what it seems to have become in the hands of a growing cadre of researchers, we can begin to propose terminological and epistemological solutions to prevent the undoing of what still may be among the most marvelous methodological tools in our health research armament.
Qualitative Inquiry and the Sociological Imagination: Narrative Collisions, Sociocultural Pressures and Dementia
Edward Tolhurst, Staffordshire University
The concept of personhood highlights that the experience of dementia has relational dimensions that transcend the neurodegenerative impacts of the condition. Qualitative dementia research, nevertheless, has failed to employ a robust methodological approach with regard to this relational basis. For example, dyadic studies that seek to illuminate the experience of living with dementia tend to neglect the interactional basis of relationship dynamics; joint interviews are undertaken with couples, but data are presented in an individualised format with interactions remaining unexplored. Furthermore, the manner in which broader sociocultural factors frame lived experience and relationships is underplayed. A failure to recognise the complex links between subjective experience, interaction, and broader social contexts has potentially serious consequences: It is not just the case that this reductionist approach is at risk of misdescribing a complex reality, but that it could also contribute to societal discourses that compound the pressures of living with dementia. Informed by data from research that employed joint interviews with men with dementia and their spousal partners, this presentation sets out to establish means by which this narrow orientation can be addressed. The focus on a dyadic case study from this research enables consideration of the (socially framed) perspective of each person, and then how these perspectives are interwoven within interactional exchanges. This prompts recognition that a more sociologically informed direction for qualitative dementia research is required, which can account for the relational foundations of experience in a more expansive manner.
Registered General Nurses Caring for Mental Health Clients in Remote Areas of Australia: An Interpretive Case Study
Scott Trueman, James Cook University
Jane Mills, James Cook University/Royal Melbourne Institute of Technology
Tanya Park, University of Alberta
Karen Yates, James Cook University
This was a single, explanatory, and holistic case study, examining the social world of remote general nurses delivering mental health care in Australia. The data analysis primarily utilised situational analysis (Clarke, 2005). The presentation outlines, discusses, and demonstrates how the researcher progressively created three types of situational maps in accordance with Clarke’s postmodernist turn, qualitative analysis of the data; messy, order/working and relational. Utilising the three maps, the researcher will outline and demonstrate how he then created a representative social world/arena map. The researcher will conclude by explaining how he utilised actor-network theory (Callon, 1986; Ball, 1996; Law & Callon, 1992; Law, 2005) to analyse and explain how the actors and nonhuman actants, within the social world/arena map, assist and coordinate action(s). The thrust of the presentation relates to demonstrating and explaining the methods of undertaking situational analysis combined with actor-network theory within a case study.
From Participants to Collaborators: Engaging Genetic Counselor Participants in the Design of a Qualitative Study Within Their Services
Danya Vears, KU Leuven–University of Leuven and University of Melbourne
Collaboration is critical in the development and execution of robust research. Engagement of research participants in study design is becoming more widely recognized for its potential to enhance the research process and outcomes. However, when these collaborators have previously been your participants, it can present a number of challenges. In this paper, I reflect on an experience of this and discuss how reflexivity helped me identify and manage the challenges this presented. I initially interviewed genetic health professionals about their practices with genetic testing in children. At the conclusion of the study, I enlisted the expertise of a subset of these genetic counselors to develop a subsequent study which would use semistructured interviews to explore parents’ perspectives. Involving the genetic counselors was incredibly beneficial to the study. Their “insider” perspectives helped to identify the most fruitful recruitment strategies. Their interest in how the outcomes of the study could benefit their practice meant they were motivated to involve families from their patient pool. Drawing on the emic knowledge I gained in the initial interviews, combined with my own etic approach, also provided a richer understanding of the interviews with the parents. However, while their contributions to the study design were invaluable, they also presented ethical and practical challenges. These included issues relating to ensuring voluntariness of parents’ participation and maintaining the confidentiality of the parent participants both during recruitment but also in the dissemination of the findings. Reflexivity in research is helpful in the recognition and management of the challenges of collaborating with others outside the professional research community.
Exploring Service Innovation Practices Through a Longitudinal Ethnographic Case Study
Vessela Warren, Worcester Business School, University of Worcester
Case study research has the advantage of investigating issues that are embedded within the context of the case. A novel approach to investigation of the implementation of service innovation process has been adopted through a longitudinal ethnographic case study. This approach was found useful, as the outcome of the study was intended to be an in-depth understanding of firm’s current innovation practices and its consequences with the implementation of a novel business process. In this applied research, an array of longitudinal data was generated chiefly through the technique of participant observation. Participant observation as a qualitative or naturalistic method has its roots in ethnographic research. Participant observation involves “participating in the social world, in whatever role, and reflecting on the products of that participation” (Hammersley & Atkinson, 1983, p. 16). This method offers a degree of understanding of the context under study that can come only from personal experience. In this presentation, I discuss the role of the researcher-practitioner as participant-observer and the usefulness of ethnographic case study methodology and participant observation technique to investigate service innovation practices that are embedded within the context-specific setting of the case.
Can Participatory Methods Result in Improved Translation of Research Findings?
Emma Webster, University of Sydney
Craig Johnson, Western NSW Local Health District
Bernie Kemp, Dubbo Aboriginal Medical Service
Val Smith, Dubbo Aboriginal Medical Service
Monica Johnson, Marathon Health
Billie Townsend, University of Sydney
One of the proposed solutions for the “problem” of research translation is the cocreation or coproduction of research. This study on aboriginal people’s stories of diabetes care in a regional Australian city takes collaboration to the fullest extent enabling coproduction and cocreation of the design, procedures, and findings. Taking this approach means working with coresearchers who do not generally have prior research skills or experience. The effect on research translation will be discussed in terms of who translates, how and what is translated, and in which settings translation took place for this example of participatory research. This will be contrasted with forms of research translation from more traditional forms of research. Perceptions of the value of the research itself from the perspective of the research team will also be explored.
The Evolution of Self in the Presence of Illness and Injury: Using Narrative Inquiry to Facilitate Our Understanding
Charlotte Whiffin, University of Derby
Christopher Bailey, University of Southampton
Caroline Ellis-Hill, Bournemouth University
Nikki Jarrett, University of Southampton
Peter Hutchinson, University of Cambridge/Addenbrooke’s Hospital
Stories are an integral part of our sense of self for our stories define who we are and how we understand the world around us. As researchers we can gain insight into people’s lives by listening to their story and interpreting what these stories tell us about the meaning these experiences hold. However in the presence of illness or injury what has been assumed about our lives and our perception of the future may shift or alter completely. Therefore, these life events challenge the “known self” and can be the catalyst for deconstruction and reconstruction of identity. This presentation will explore the relationship between narratives and the construction of self by drawing on seminal texts and chronic illness literature. The use of narrative inquiry will then be evaluated as a research method to examine how people live with long-term illness. Finally, the use of narrative inquiry to examine postinjury change following traumatic brain injury (TBI) will be discussed. Unlike chronic illness, a TBI is immediate and often life threatening and from that point, life and perception of the future may be changed for injured and noninjured family members alike. This presentation will draw on research that used a narrative framework to facilitate exploration of how the noninjured family members made sense of their relative’s TBI. These stories illuminated the complex processes involved in the judgement of pre- and postinjury change.
Developing and Evaluating Complex Interventions: Enhancing the Role of Qualitative Research
Lisa Whitehead, Edith Cowan University
Marie Crowe, University of Otago
Carol Bugge, University of Stirling
Kirsten Coppell, University of Otago
The use of qualitative research methods alongside randomized controlled trials of health-care interventions have the potential to contribute to the development and evaluation of both complex and other health interventions. Qualitative evaluations of interventions are rarely reported but can provide insight into the intervention process, and the feasibility and acceptability of the intervention, to improve and adapt interventions. Qualitative research postintervention can provide valuable insight into the study outcomes generated by quantitative measures. Although the need for methodological research on the use of qualitative approaches in randomised controlled trials has been widely discussed few publications exist. This presentation will explore how qualitative data can be collected and analysed to enhance understanding of the feasibility, acceptability, and outcomes of interventions with reference to two interventions in which the author has collected qualitative data.
Co-creation of Narrative Data—An Ethical and Methodological Challenge
Lena Wiklund Gustin, School of Health, Care and Social Welfare, Malardalen University/
In qualitative research articles, different approaches to narrative analysis are frequently described. Even though methods for collecting data are described, less focus has been put on narrative data from an epistemological point of view. However, as humans, we live in a storied world. To narrate is a way to create meaning by organizing and structuring events, and the narrative is also considered to have an identity-creating nature. This has implications for research not only for how we represent the world in our research but also for how we understand the interaction between interviewer and interviewee. Hence, narration cannot be reduced to the transformation of data from the participant to the researcher. Rather narration must be understood as a way to relate to another human being. In this presentation, I will take my point of departure in narration as an aspect of self-understanding, and the ethical and methodological challenges associated with the dialogical relationship between the researcher and the participant. Influenced by Paul Ricoeur’s philosophy as well as theories about caring conversation I will reflect on the significance of concepts like autonomy, mutuality, asymmetry, and presence in relation to narrative research. This reflection will provide basis not only for ethical reflections but also for methodological considerations concerning trustworthiness and narrative truth.
Developing a Structured Diary as a Source of Qualitative Data: Value, Benefits and, Methodological Challenges
Jane Wray, Hull University
Uduak Archibong, Centre for Inclusion and Diversity, University of Bradford
Sean Walton, University of Salford
Using a diary or journal entries as a source of data is an accepted practice within disciplines using qualitative methodologies. In the field of nursing research, directed diary or journals are increasingly common enabling participants to provide a personalised account of an event or capture their thoughts and reflections on a particular topic. Solicited or structured diaries have a different focus to unsolicited diaries in that the participant completes the diary in the knowledge that this will be read and interpreted by the researcher. They can be a rich source of data, however imposing a structure defines the research agenda and achieving the appropriate balance between the researcher and the researched is fraught with methodological difficulties. This presentation will share with participants the development and use of a structured diary sheet used as part of my PhD study examining perceptions of cultural competence by newly qualified nurses. This will include collaborative work undertaken with a patient and carer group to develop the structured diary sheet, the experiences gained and lessons learnt whilst undertaking some pilot work with student nurses and subsequent changes and adaptations to the directed diary sheet prior to the main study. The presentation will explore the value, benefits, and challenges of using a directed or structured diary as a data collection tool within a qualitative framework and discuss how the methodological issues were addressed.
Walking Research Paths Together: A Story of Nurse Clinicians and Nurse Researchers
Karen Yates, James Cook University
Jane Mills, James Cook University
Andrea O’Shea, Cairns and Hinterland Hospital and Health Service
The path between work practice environments and research environments is not always well worn in the health sector, particularly in nursing. In Australia, a case study research project in a busy regional hospital has provided a way in to research for its clinical champions and improved academics’ access to and knowledge of the hospital and its people. The project was sparked by concerns at the hospital that newly registered nurses were leaving the profession soon after they entered it. Nursing managers approached the university to gather evidence and develop strategies. Case study was chosen as the most appropriate methodology to meet both the hospital’s and the researchers’ needs. Data were collected from participants (n = 30) during focus groups and face-to-face interviews. Involvement of senior management helped to maximise response rates. Nurses were invited and encouraged to participate in the sessions during paid work time, contributing to a healthy 51.7% response rate. The key themes identified during analysis were finding your place and support. Nurses talked often about the need to “find a niche.” The research partnership resulted in ongoing practical and intellectual benefits for academics and clinical managers. One of the strategies developed by the study team—lunchtime leadership sessions—is now the subject of an action research project being led this time by the nurse manager in collaboration with university academics. The project, therefore, continues to build evidence and research capacity as well as strengthening pathways.
Developing HIV Literacy’ With Communities Affected by HIV in the UK: Reflections on the Participatory Process of Intervention Development
Ingrid Young, University of Glasgow
The importance of public and patient involvement (PPI) has grown considerably in the UK, to the point where many funding bodies and health organisations now require the inclusion of PPI activities to inform research design and implementation. Grounded in the premise that patient involvement not only in health provision but research design will give voice to potential research recipients, and better inform research acceptability, the move to including patients and other key stakeholders in research activities is now seen as essential. But how far can PPI initiatives go towards shaping research design and practice? How can patients and other key stakeholders be included in a research process in ways that are practical, sustainable, and meaningful? “Developing HIV literacy” is a 3 year, Scottish Chief Science Office–funded project grounded in a collaborative research process which aims to support and better understand inclusive intervention development. The project is currently working with key health and community practitioners and stakeholders to inform intervention development in the context of HIV prevention and inequalities in existing HIV literacy skills amongst communities affected by HIV in Scotland. This presentation will describe and reflect on the use of participatory workshops with an “intervention development group,” comprised of health, HIV, and community stakeholders, including community members from groups most affected by HIV (men who have sex with men, migrant African men and women living in Scotland, people living with HIV). The workshops aim to draw on and map out the experiences of key stakeholders to inform the clarification and contextualization of the HIV literacy “problem,” identify existing, local practices in this area, and identify potential opportunities for intervention. The presentation will critically reflect on the challenges and opportunities of using participatory methods within this framework, and how theoretical approaches to intervention development can be applied in practice.