Basics of qualitative research: Grounded theory procedures and techniques

https://science.sciencemag.org/content/sci/5/110/206.full.pdf

The american psychological association.

Professor Titmuss, an eminent English social theorist, believes that man is inherently altruistic and that the duty of government is to create that social and economic climate which best channels man's drive to work together for the common good. In support of this belief, he has written a book about the procurement, distribution, and transfusion of human blood, a medical topic which he employs as an illustrative social and economic microcosm. The conclusion he reaches is foregone: "The voluntary socialized system in Britain is economically, professionally, administratively and qualitatively more efficient than the mixed, commercialized, and individualistic American system" (Titmuss, R.M: "Why Give to Strangers?" Lancet 1 :123-125, 1971). As the book was written with a bias, so will it be read with bias. My own bias is that of an American and a blood-banker. I am only too conscious of many deficiencies in the American complex of arrangements—it isn't

The Gift Relationship: From Human Blood to Social Policy

In March 2015, an impressive set of guidelines for best practice on how to incorporate psychosocial care in routine infertility care was published by the ESHRE Psychology and Counselling Guideline Development Group (ESHRE Psychology and Counselling Guideline Development Group, 2015). The authors report that the guidelines are based on a comprehensive review of the literature and we congratulate them on their meticulous compilation of evidence into a clinically useful document. However, when we read the methodology section, we were baffled and disappointed to find that evidence from research using qualitative methods was not included in the formulation of the guidelines. Despite stating that ‘qualitative research has significant value to assess the lived experience of infertility and fertility treatment’, the group excluded this body of evidence because qualitative research is ‘not generally hypothesis-driven and not objective/neutral, as the researcher puts him/herself in the position of the participant to understand how the world is from the person’s perspective’. Qualitative and quantitative research methods are often juxtaposed as representing two different world views. In quantitative circles, qualitative research is commonly viewed with suspicion and considered lightweight because it involves small samples which may not be representative of the broader population, it is seen as not objective, and the results are assessed as biased by the researchers’ own experiences or opinions. In qualitative circles, quantitative research can be dismissed as oversimplifying individual experience in the cause of generalisation, failing to acknowledge researcher biases and expectations in research design, and requiring guesswork to understand the human meaning of aggregate data. As social scientists who investigate psychosocial aspects of human reproduction, we use qualitative and quantitative methods, separately or together, depending on the research question. The crucial part is to know when to use what method. The peer-review process is a pillar of scientific publishing. One of the important roles of reviewers is to assess the scientific rigour of the studies from which authors draw their conclusions. If rigour is lacking, the paper should not be published. As with research using quantitative methods, research using qualitative methods is home to the good, the bad and the ugly. It is essential that reviewers know the difference. Rejection letters are hard to take but more often than not they are based on legitimate critique. However, from time to time it is obvious that the reviewer has little grasp of what constitutes rigour or quality in qualitative research. The first author (K.H.) recently submitted a paper that reported findings from a qualitative study about fertility-related knowledge and information-seeking behaviour among people of reproductive age. In the rejection letter one of the reviewers (not from Human Reproduction) lamented, ‘Even for a qualitative study, I would expect that some form of confidence interval and paired t-tables analysis, etc. be used to analyse the significance of results’. This comment reveals the reviewer’s inappropriate application to qualitative research of criteria relevant only to quantitative research. In this commentary, we give illustrative examples of questions most appropriately answered using qualitative methods and provide general advice about how to appraise the scientific rigour of qualitative studies. We hope this will help the journal’s reviewers and readers appreciate the legitimate place of qualitative research and ensure we do not throw the baby out with the bath water by excluding or rejecting papers simply because they report the results of qualitative studies.

Qualitative research methods: when to use them and how to judge them

This review provides an overview of how women adjust emotionally to the various phases of IVF treatment in terms of anxiety, depression or general distress before, during and after different treatment cycles. A systematic scrutiny of the literature yielded 706 articles that paid attention to emotional aspects of IVF treatment of which 27 investigated the women's emotional adjustment with standardized measures in relation to norm or control groups. Most studies involved concurrent comparisons between women in different treatment phases and different types of control groups. The findings indicated that women starting IVF were only slightly different emotionally from the norm groups. Unsuccessful treatment raised the women's levels of negative emotions, which continued after consecutive unsuccessful cycles. In general, most women proved to adjust well to unsuccessful IVF, although a considerable group showed subclinical emotional problems. When IVF resulted in pregnancy, the negative emotions disappeared, indicating that treatment-induced stress is considerably related to threats of failure. The concurrent research reviewed, should now be underpinned by longitudinal studies to provide more information about women's long-term emotional adjustment to unsuccessful IVF and about indicators of risk factors for problematic emotional adjustment after unsuccessful treatment, to foster focused psychological support for women at risk.

Women’s emotional adjustment to IVF: a systematic review of 25 years of research

This article explores the issues surrounding the notions of secrecy and openness in donor insemination (DI). Secrecy in DI is first placed in historical context, with an outline of some of the main reasons that secrecy has been advocated. The concept of openness is then introduced, and some of the arguments for a more open approach to DI are presented. On this basis, the responses of various governments to calls for more openness are outlined, and the social policy implications of these are discussed. It is concluded that more openness in DI would be advantageous to all of those involved. Couples, professionals, and policymakers are therefore urged to reexamine their views about the need for maintaining secrecy in the area.

Secrecy and openness in donor insemination.

The Guidelines for Counselling in Infertility describe the purpose, objectives, typical issues and communication skills involved in providing psychosocial care to individuals using fertility services. The Guidelines are presented in six sections. The first section describes how infertility consultations differ from other medical consultations in obstetrics and gynaecology, whereas the second section addresses fundamental issues in counselling, such as what is counselling in infertility, who should counsel and who is likely to need counselling. Section 3 focuses on how to integrate patient-centred care and counselling into routine medical treatment and section 4 highlights some of the special situations which can provoke the need for counselling (e.g. facing the end of treatment, sexual problems). Section 5 deals exclusively with third party reproduction and the psychosocial implications of gamete donation, surrogacy and adoption for heterosexual and gay couples and single women without partners. The final section of the Guidelines is concerned with psychosocial services that can be used to supplement counselling services in fertility clinics: written psychosocial information, telephone counselling, self-help groups and professionally facilitated group work. This paper summarizes the different sections of the Guidelines and describes how to obtain the complete text of the Guidelines for Counselling in Infertility.

https://doc.rero.ch/record/290254/files/0161301.pdf

Guidelines for counselling in infertility: outline version

Background A major concern in relation to donor insemination (DI) is whether children should be told about their genetic origins. This study compared the thoughts, feelings and experiences of DI parents who were inclined towards openness with those who were inclined towards non-disclosure. Methods Forty-six families with a 4- to 8-year-old DI-conceived child were interviewed about their decision, their reasons and subsequent concerns regarding disclosure. Results Thirty-nine percent of parents were inclined towards disclosure whilst the remaining 61% were not. The two main reasons for favouring disclosure were to avoid accidental discovery and a desire for openness. Non-disclosing parents felt that there was no reason to tell and wished to protect family members. The children who had been told reacted with either curiosity or disinterest. Conclusions In spite of donor anonymity, parents who were intending to tell their child in the future had optimistic expectations of their child's reaction. Parents who had already told their child generally described the telling experience as a positive one.

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School-aged children of donor insemination: a study of parents' disclosure patterns

Offspring created as a result of donor insemination: a study of family relationships, child adjustment, and disclosure.

Sweden was in 1985 the first country in the world to enact legislation concerned with the practice of donor insemination (DI). Included in this legislation was the requirement that information about the identity of the donors be kept and be made available to the resultant offspring upon 'maturity', should they seek this. This provision has attracted much interest, debate and criticism, and claims have been made that this has led to a decline in the numbers of men coming forward to donate semen in Sweden. This paper presents data covering the pre- and post-legislation period from one clinic, along with the only available data on all the Swedish clinics providing DI, which covers a more limited post-legislation period. This data shows that there has been an increase in number of donors being recruited, suggesting that the possibility of future contact by genetic offspring has not had the negative impact on the availability of donors predicted.

Ken Daniels

Papers

Secrecy and openness in donor insemination.

Guidelines for counselling in infertility: outline version

School-aged children of donor insemination: a study of parents' disclosure patterns

Offspring created as a result of donor insemination: a study of family relationships, child adjustment, and disclosure.

The Swedish insemination act and the availability of donors.