Content analysis is a widely used qualitative research technique. Rather than being a single method, current applications of content analysis show three distinct approaches: conventional, directed, or summative. All three approaches are used to interpret meaning from the content of text data and, hence, adhere to the naturalistic paradigm. The major differences among the approaches are coding schemes, origins of codes, and threats to trustworthiness. In conventional content analysis, coding categories are derived directly from the text data. With a directed approach, analysis starts with a theory or relevant research findings as guidance for initial codes. A summative content analysis involves counting and comparisons, usually of keywords or content, followed by the interpretation of the underlying context. The authors delineate analytic procedures specific to each approach and techniques addressing trustworthiness with hypothetical examples drawn from the area of end-of-life care.

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Three Approaches to Qualitative Content Analysis

Background. Qualitative research explores complex phenomena encountered by clinicians, health care providers, policy makers and consumers. Although partial checklists are available, no consolidated reporting framework exists for any type of qualitative design. Objective. To develop a checklist for explicit and comprehensive reporting of qualitative studies (indepth interviews and focus groups). Methods. We performed a comprehensive search in Cochrane and Campbell Protocols, Medline, CINAHL, systematic reviews of qualitative studies, author or reviewer guidelines of major medical journals and reference lists of relevant publications for existing checklists used to assess qualitative studies. Seventy-six items from 22 checklists were compiled into a comprehensive list. All items were grouped into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. Duplicate items and those that were ambiguous, too broadly defined and impractical to assess were removed. Results. Items most frequently included in the checklists related to sampling method, setting for data collection, method of data collection, respondent validation of findings, method of recording data, description of the derivation of themes and inclusion of supporting quotations. We grouped all items into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. Conclusions. The criteria included in COREQ, a 32-item checklist, can help researchers to report important aspects of the research team, study methods, context of the study, findings, analysis and interpretations.

Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups

자연주의적 탐구조사(Naturalistic Inquiry)

Qualitative case study methodology provides tools for researchers to study complex phenomena within their contexts. When the approach is applied correctly, it becomes a valuable method for health science research to develop theory, evaluate programs, and develop interventions. The purpose of this paper is to guide the novice researcher in identifying the key elements for designing and implementing qualitative case study research projects. An overview of the types of case study designs is provided along with general recommendations for writing the research questions, developing propositions, determining the “case” under study, binding the case and a discussion of data sources and triangulation. To facilitate application of these principles, clear examples of research questions, study propositions and the different types of case study designs

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Qualitative Case Study Methodology: Study Design and Implementation for Novice Researchers

Aim. The aim of this paper is to distinguish the integrative review method from other review methods and to propose methodological strategies specific to the integrative review method to enhance the rigour of the process.

Background.  Recent evidence-based practice initiatives have increased the need for and the production of all types of reviews of the literature (integrative reviews, systematic reviews, meta-analyses, and qualitative reviews). The integrative review method is the only approach that allows for the combination of diverse methodologies (for example, experimental and non-experimental research), and has the potential to play a greater role in evidence-based practice for nursing. With respect to the integrative review method, strategies to enhance data collection and extraction have been developed; however, methods of analysis, synthesis, and conclusion drawing remain poorly formulated.

Discussion.  A modified framework for research reviews is presented to address issues specific to the integrative review method. Issues related to specifying the review purpose, searching the literature, evaluating data from primary sources, analysing data, and presenting the results are discussed. Data analysis methods of qualitative research are proposed as strategies that enhance the rigour of combining diverse methodologies as well as empirical and theoretical sources in an integrative review.

Conclusion.  An updated integrative review method has the potential to allow for diverse primary research methods to become a greater part of evidence-based practice initiatives.

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The integrative review: updated methodology

The generalizations developed by qualitative researchers are embedded in the contextual richness of individual experience. Qualitative data management strategies that depend solely on coding and sorting of texts into units of like meaning can strip much of this contextual richness away. To prevent this, some authors have recommended treating individual accounts as whole cases or stories, but whole cases are difficult to compare with one another when the goal of the research is to develop generalizations that represent multiple accounts. In this article, the authors describe the ways in which three different qualitative researchers combined across-case coding and sorting with a variety of within-case data management and analysis techniques to produce contextually grounded, generalizable findings.

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Within-case and across-case approaches to qualitative data analysis.

Triangulation in Qualitative Research: Issues of Conceptual Clarity and Purpose

Introduction to Concept Development in Nursing * Philosophical Foundations of Concept Development * Knowledge Synthesis and Concept Development in Nursing * The Wilson Method of Concept Analysis * Wilsonian Concept Analysis: Applying the Technique * Concept Analysis: An Evolutionary View * The Concept of Grief: An Evolutionary Perspective * Grief in a Cultural Context: Expanding Concept Analysis Beyond the Professional Literature * An Expansion and Elaboration of the Hybrid Model of Concept Development * A Concept Analysis of Withdrawal: Application of the Hybrid Model of Concept Development * Concept Clarification: Using the Norris Method in Clinical Research * Simultaneous Concept Analysis: A Strategy for Developing Multiple Interrelated Concepts * Integrative Literature Reviews for the Development of Concepts * A Multiphase Approach to Concept Analysis and Development * Methods and Application of Dimensional Analysis: A Contribution to Concept and Knowledge Development in Nursing * Beyond Analysis: Further Adventures in Concept Development * Exploring Pragmatic Utility: Concept Analysis by Critically Appraising the Literature * Research Careers and Concept Development: The Case of Normalization * Concept Development Situated in the Critical Paradigm * Concept Development of Nursing-Sensitive Patient Outcomes * Applications and Future Directions for Concept Development in Nursing

Concept Development in Nursing: Foundations, Techniques, and Applications

Cognitive interviews assess respondents' understanding of questionnaire items and are increasingly used to improve instrument design. Although investigators have described the contributions of cognitive interviews for instrument development, few guidelines are available for analyzing data from cognitive interviews when they are used for that purpose. In this article we address the development and application of analytic strategies for summarizing, interpreting, and using data from cognitive interviews that were conducted during the process of creating a measure of parental management of childhood chronic conditions. We discuss the contribution of cognitive interviews to establishing content validity and address the importance of developing standardized guidelines for analyzing and interpreting cognitive interviews in order to maximize their usefulness for instrument development.

Kathleen A. Knafl

Papers

The integrative review: updated methodology

Within-case and across-case approaches to qualitative data analysis.

Triangulation in Qualitative Research: Issues of Conceptual Clarity and Purpose

Concept Development in Nursing: Foundations, Techniques, and Applications

The analysis and interpretation of cognitive interviews for instrument development