Nursing Research—Principles and Methods

Thematic analysis methods, including the reflexive approach we have developed, are widely used in counselling and psychotherapy research, as are other approaches that seek to develop ‘patterns’ (themes, categories) across cases. Without a thorough grounding in the conceptual foundations of a wide variety of across‐case analytic approaches, and qualitative research more broadly—something rarely offered in counselling training—it can be difficult to understand how these differ, where they overlap, and which might be appropriate for a particular research project. Our aim in this paper is to support researchers in counselling and psychotherapy to select an appropriate across‐case approach for their research, and to justify their choice, by discussing conceptual and procedural differences and similarities between reflexive thematic analysis (TA) and four other across‐case approaches. Three of these are also widely used in counselling and psychotherapy research—qualitative content analysis, interpretative phenomenological analysis and grounded theory. The fourth—discourse analysis—is less widely used but importantly exemplifies the critical qualitative research tradition. We contextualise our comparative approach by highlighting the diversity within TA. TA is best thought of as a spectrum of methods—from types that prioritise coding accuracy and reliability to reflexive approaches like ours that emphasise the inescapable subjectivity of data interpretation. Although reflexive TA provides the point of comparison for our discussion of other across‐case approaches, our aim is not to promote reflexive TA as ‘best’. Rather, we encourage the knowing selection and use of analytic methods and methodologies in counselling and psychotherapy research.

Can I use TA? Should I use TA? Should I not use TA? Comparing reflexive thematic analysis and other pattern‐based qualitative analytic approaches

Qualitatives Design besteht aus verschiedenen Ansatzen zur Datenerhebung und -analyse, die insbesondere fur die Erstellung kultureller und kontextueller Beschreibungen und die Interpretation sozialer Phanomene anwendbar sind. Qualitative Inhaltsanalyse (QCA) und thematische Analyse (TA) stellen beides qualitative Ansatze dar, die ublicherweise von Forscher_innen aus unterschiedlichen Disziplinen gleichermasen eingesetzt werden. Allerdings besteht in der internationalen Literatur eine Leerstelle in Bezug auf den Begriff von "Thema" in beiden Ansatzen und des Prozesses der Entwicklung von Themen. Daher gehen wir in unserem Beitrag auf diese Leerstelle ein und stellen Unterschiede und Ahnlichkeiten zwischen beiden Methoden in Bezug auf das "Thema" als Endprodukt der Datenanalyse dar. Zur Unterstutzung unserer Sichtweisen und zur Erstellung international fundierter analytischer Begriffe von "Thema" greifen wir auf die aktuelle Literatur aus unterschiedlichen Disziplinen zuruck. Wir gehen davon aus, dass Forscher_innen von einem vertieften Verstandnis des Prozesses der Themenentwicklung in mehreren Hinsichten profitieren, namlich bei der Auswahl einer geeigneten Methode fur die Beantwortung ihrer Forschungsfrage, bei der Erzielung qualitativ hochwertiger und valider Ergebnisse sowie dabei, den analytischen Anforderungen an QCA und TA gerecht zu werden.

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Theme in Qualitative Content Analysis and Thematic Analysis

Background and objectives The coronavirus disease 2019 (COVID-19) pandemic is experienced differently across individuals, and older adults' different life experiences lead to a variety of ways of coping. The present study explores older adults' reports of what about the pandemic is stressful, and what brings joy and comfort in the midst of stress. Research design and methods An online survey asked 825 U.S. adults aged 60 and older to complete questionnaires assessing 3 psychological well-being indicators: perceived stress, negative affect, and positive affect. Participants also responded to open-ended questions about what was stressful and what brought joy or comfort at the time of the survey. A mixed-method approach first qualitatively analyzed the open-ended responses, content analysis identified themes most frequently reported, and quantitative analysis examined the associations between various stressors and joys and the psychological well-being indicators. Results Qualitative analysis revealed 20 stress categories and 21 joy/comfort categories. The most commonly reported stressors were confinement/restrictions, concern for others, and isolation/loneliness; the most commonly reported sources of joy/comfort were family/friend relationships, digital social contact, and hobbies. Demographic comparisons revealed variations in experience. Independent t tests revealed stress from concern for others, the unknown future, and contracting the virus to be significantly associated with poorer psychological well-being; faith, exercise/self-care, and nature were associated with more positive psychological well-being. Discussion and implications Results are discussed in the context of stress and coping theory, highlighting the importance of understanding the unique stress experience of each individual for effective distress intervention.

Older Adults' Experience of the COVID-19 Pandemic: A Mixed-Methods Analysis of Stresses and Joys.

OBJECTIVE : There is inadequate evidence of long-term benefit and growing evidence of the risks of chronic opioid therapy (COT). Opioid dose reduction, or opioid tapering, may reduce these risks but may also worsen pain and quality of life. Our objective was to explore patients' perspectives on opioid tapering. DESIGN : Qualitative study using in-person, semistructured interviews. SETTING AND PATIENTS : English-speaking, adult primary care patients (N = 24) in three Colorado health care systems. METHODS : Interviews were audio recorded, transcribed, and analyzed in ATLAS.ti. We used a team-based, mixed inductive and deductive approach guided by the Health Belief Model. We iteratively refined emergent themes with input from a multidisciplinary team. RESULTS : Participants had a mean age of 52 years old, were 46% male and 79% white. Six participants (25%) were on COT and not tapering, 12 (50%) were currently tapering COT, and 6 (25%) had discontinued COT. Emergent themes were organized in four domains: risks, barriers, facilitators, and benefits. Patients perceived a low risk of overdose and prioritized the more immediate risk of increased pain with opioid tapering. Barriers included a perceived lack of effectiveness of nonopioid options and fear of opioid withdrawal. Among patients with opioid tapering experience, social support and a trusted health care provider facilitated opioid tapering. These patients endorsed improved quality of life following tapering. CONCLUSIONS : Efforts to support opioid tapering should elicit patients' perceived barriers and seek to build on relationships with family, peers, and providers to facilitate tapering. Future work should identify patient-centered, feasible strategies to support tapering of COT.

Patients' Perspectives on Tapering of Chronic Opioid Therapy: A Qualitative Study.

Introduction Using an appropriate research method for inquiry is critical to successful research. Grounded theory and qualitative content analysis share similarities. Both are based on naturalistic inquiry that entails identifying themes and patterns and involves rigorous coding. They are both used to analyze and interpret qualitative data; however, the similarities and differences in grounded theory and qualitative content analysis have not been clarified in the literature (Priest, Roberts, & Woods, 2002), nor have they been consistently considered. To illustrate, both have been considered equivalent approaches to interpret qualitative data (e.g., Priest et al., 2002). Grounded theory was treated as a research methodology, and content analysis as a method (e.g., Crotty, 2003); furthermore, grounded theory was considered a theoretical framework and content analysis a research method of textual data analysis (e.g., Patton, 2002). Qualitative content analysis was considered a strategy for the analysis of qualitative descriptive studies (Sandelowski, 2000) and a technique with overtones of other research methods, such as ethnographic and grounded theory (Altheide, 1987). Qualitative content analysis was unknown as a research method until recently, especially in English-speaking countries, because of the dominance of quantitative content analysis (Schreier, 2012). Moreover, a researcher's approach purportedly following grounded theory actually seems closer to qualitative content analysis or other methods (Sandelowski & Barroso, 2003; Suddaby, 2006). Sandelowski and Barroso (2003) cited the discrepancy between "method claims and the actual use of methods" (p. 905) in research papers. Novice researchers, especially students who want to conduct qualitative research, are often confused by the characteristics of the two as result of the lack of comparative references. Some researchers who stated they had used grounded theory actually used qualitative content analysis, which incorporates some procedures of grounded theory, such as open coding or memoing (Sandelowski & Barroso, 2003). Thus, the purpose of this paper is to clarify ambiguities about the characteristics of grounded theory and qualitative content analysis. Using our own research as examples, we have discussed the similarities and differences in the two in the following six areas: a) background and philosophical basis, b) unique characteristics of each method, c) goals and rationale of each method, d) data analysis process, e) outcomes of the research, and f) evaluation of trustworthiness of research. We have also discussed the strengths and weaknesses of each. Through this paper, we expect to provide knowledge that can assist novice researchers in the selection of appropriate research methods for their inquiries. Background and Philosophical Basis Grounded Theory The term grounded theory was introduced in The Discovery of Grounded Theory (1967) by Glaser and Strauss as "the discovery of theory from data--systematically obtained and analyzed in social research" (p. 1). Instead of verification of theories, they introduced a research method to arrive at a "theory suited to its supposed uses" contrasting with a "theory generated by logical deduction from a priori assumptions" (p. 3). According to Strauss and Corbin (1994) it is "a general methodology, a way of thinking about and conceptualizing data" (p. 275). The Grounded Theory Institute, run by Glaser, one of the founders of grounded theory, defined it as follows: Grounded Theory is an inductive methodology. Although many call Grounded Theory a qualitative method, it is not. It is a general method. It is the systematic generation of theory from systematic research. It is a set of rigorous research procedures leading to the emergence of conceptual categories. …

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Eun-Hee Lee

Papers

Reducing Confusion about Grounded Theory and Qualitative Content Analysis: Similarities and Differences