This paper introduces focus group methodology, gives advice on group composition, running the groups, and analysing the results. Focus groups have advantages for researchers in the field of health and medicine: they do not discriminate against people who cannot read or write and they can encourage participation from people reluctant to be interviewed on their own or who feel they have nothing to say.

This is the fifth in a series of seven articles describing non-quantitative techniques and showing their value in health research

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Focus groups are a form of group interview that capitalises on communication between research participants in order to generate data. Although group interviews are often used simply as a quick and convenient way to collect data from several people simultaneously, focus groups explicitly use group interaction as part of the method. This means that instead of the researcher asking each person to respond to a question in turn, people are encouraged to talk to one another: asking questions, exchanging anecdotes and commenting on each other's experiences and points of view.1 The method is particularly useful for exploring people's knowledge and experiences and can be used to examine not only what people think but how they think and why they think that way.

Focus groups were originally used within communication studies to explore the effects of films and television programmes,2 and are a popular method for assessing health education messages and examining public understandings of illness and of health behaviours.3 4 5 6 7 They are widely used to examine people's experiences of disease and of health services.8 9 and are an effective technique for exploring the attitudes and needs of staff.10 11

The idea behind the focus group method is that group processes can help people to explore and …

Qualitative Research: Introducing focus groups

There is a growing recognition of the value of synthesising qualitative research in the evidence base in order to facilitate effective and appropriate health care. In response to this, methods for undertaking these syntheses are currently being developed. Thematic analysis is a method that is often used to analyse data in primary qualitative research. This paper reports on the use of this type of analysis in systematic reviews to bring together and integrate the findings of multiple qualitative studies. We describe thematic synthesis, outline several steps for its conduct and illustrate the process and outcome of this approach using a completed review of health promotion research. Thematic synthesis has three stages: the coding of text 'line-by-line'; the development of 'descriptive themes'; and the generation of 'analytical themes'. While the development of descriptive themes remains 'close' to the primary studies, the analytical themes represent a stage of interpretation whereby the reviewers 'go beyond' the primary studies and generate new interpretive constructs, explanations or hypotheses. The use of computer software can facilitate this method of synthesis; detailed guidance is given on how this can be achieved. We used thematic synthesis to combine the studies of children's views and identified key themes to explore in the intervention studies. Most interventions were based in school and often combined learning about health benefits with 'hands-on' experience. The studies of children's views suggested that fruit and vegetables should be treated in different ways, and that messages should not focus on health warnings. Interventions that were in line with these suggestions tended to be more effective. Thematic synthesis enabled us to stay 'close' to the results of the primary studies, synthesising them in a transparent way, and facilitating the explicit production of new concepts and hypotheses. We compare thematic synthesis to other methods for the synthesis of qualitative research, discussing issues of context and rigour. Thematic synthesis is presented as a tried and tested method that preserves an explicit and transparent link between conclusions and the text of primary studies; as such it preserves principles that have traditionally been important to systematic reviewing.

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Methods for the thematic synthesis of qualitative research in systematic reviews

http://www.columbia.edu/~mvp19/RMC/M5/QualQual.pdf

Qualitative research: standards, challenges, and guidelines

Qualitative research is increasingly common in health services research (Shortell 1999; Sofaer 1999). Qualitative studies have been used, for example, to study culture change (Marshall et al. 2003; Craigie and Hobbs 2004), physician–patient relationships and primary care (Flocke, Miller, and Crabtree 2002; Gallagher et al. 2003; Sobo, Seid, and Reyes Gelhard 2006), diffusion of innovations and quality improvement strategies (Bradley et al. 2005; Crosson et al. 2005), novel interventions to improve care (Koops and Lindley 2002; Stapleton, Kirkham, and Thomas 2002; Dy et al. 2005), and managed care market trends (Scanlon et al. 2001; Devers et al. 2003). Despite substantial methodological papers and seminal texts (Glaser and Strauss 1967; Miles and Huberman 1994; Mays and Pope 1995; Strauss and Corbin 1998; Crabtree and Miller 1999; Devers 1999; Patton 1999; Devers and Frankel 2000; Giacomini and Cook 2000; Morse and Richards 2002) about designing qualitative projects and collecting qualitative data, less attention has been paid to the data analysis aspects of qualitative research. The purpose of this paper is to offer practical strategies for the analysis of qualitative data that may be generated from in-depth interviewing, focus groups, field observations, primary or secondary qualitative data (e.g., diaries, meeting minutes, annual reports), or a combination of these data collection approaches.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1475-6773.2006.00684.x

Qualitative data analysis for health services research: developing taxonomy, themes, and theory.

Qualitative research methods are enjoying unprecedented popularity. Although checklists have undoubtedly contributed to the wider acceptance of such methods, these can be counterproductive if used prescriptively. The uncritical adoption of a range of “technical fixes” (such as purposive sampling, grounded theory, multiple coding, triangulation, and respondent validation) does not, in itself, confer rigour.

In this article I discuss the limitations of these procedures and argue that there is no substitute for systematic and thorough application of the principles of qualitative research. Technical fixes will achieve little unless they are embedded in a broader understanding of the rationale and assumptions behind qualitative research.

#### Summary points

Checklists can be useful improving qualitative research methods, but overzealous and uncritical use can be counterproductive

Reducing qualitative research to a list of technical procedures (such as purposive sampling, grounded theory, multiple coding, triangulation, and respondent validation) is overly prescriptive and results in “the tail wagging the dog”

None of these “technical fixes” in itself confers rigour; they can strengthen the rigour of qualitative research only if embedded in a broader understanding of qualitative research design and data analysis

Otherwise we risk compromising the unique contribution that systematic qualitative research can make to health services research

In medical research the question is no longer whether qualitative methods are valuable but how rigour can be ensured or enhanced. Checklists have played an important role in conferring respectability on qualitative research and in convincing potential sceptics of its thoroughness.1–3 They have equipped those unfamiliar with this approach to evaluate or review qualitative work (by providing guidance on crucial questions that need to be asked) and in reminding qualitative researchers of the need for a systematic approach (by providing an aide-memoire of the various stages involved in research design and data analysis4).

Qualitative researchers stress the …

Checklists for improving rigour in qualitative research: a case of the tail wagging the dog?

Various strategies are available within qualitative research to protect against bias and enhance the reliability of findings This paper gives examples of the principal approaches and summarises them into a methodological checklist to help readers of reports of qualitative projects to assess the quality of the research

In the health field--with its strong tradition of biomedical research using conventional, quantitative, and often experimental methods--qualitative research is often criticised for lacking scientific rigour To label an approach “unscientific” is peculiarly damning in an era when scientific knowledge is generally regarded as the highest form of knowing The most commonly heard criticisms are, firstly, that qualitative research is merely an assembly of anecdote and personal impressions, strongly subject to researcher bias; secondly, it is argued that qualiative research lacks reproducibility--the research is so personal to the researcher that there is no guarantee that a different researcher would not come to radically different conclusions; and, finally, qualitative research is criticised for lacking generalisability It is said that qualitative methods tend to generate large amounts of detailed information about a small number of settings

The pervasive assumption underlying all these criticisms is that quantitative and qualitative approaches are fundamentally different in their ability to ensure the validity and reliability of their findings This distinction, however, is more one of degree than of type The problem of the relation of a piece of research to some presumed underlying “truth” applies to the conduct of any form of social research “One of the greatest methodological fallacies of the last half century in social research is the belief that science is a particular set of techniques; it is, rather, a state of mind, or attitude, and the organisational conditions which allow that attitude to be expressed”1 In quantitative data analysis it is possible to generate statistical …

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Rigour and qualitative research.

Clinicians used to observing individual patients, and epidemiologists trained to observe the course of disease, may be forgiven for misunderstanding the term observational method as used in qualitative research. In contrast to the clinician or epidemiologist, the qualitative researcher systematically watches people and events to find out about behaviours and interactions in natural settings. Observation, in this sense, epitomises the idea of the researcher as the research instrument. It involves “going into the field”—describing and analysing what has been seen. In health care settings this method has been insightful and illuminating, but it is not without pitfalls for the unprepared researcher.

The term “observational methods” seems to be a source of some confusion in medical research circles. Qualitative observational studies are very different from the category of observational studies (non-experimental research designs) used in epidemiology, nor are they like the clinical observation of a patient. Observational methods used in social science involve the systematic, detailed observation of behaviour and talk: watching and recording what people do and say. Goffman neatly captured this distinct research method with his recommendation that, in order to learn about a social group, one should “submit oneself in the company of the members to the daily round of petty contingencies to which they are subject.”1 Thus, observational methods can involve asking questions and analysing documents, but the primary focus on observation makes it distinct from a qualitative research interview (see the next paper in this series) or history taking during patient consultation. Another crucial point about qualitative observation is that it takes place in natural settings not experimental ones; hence, this type of work is often described as “naturalistic research.”

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In an attempt to minimise the impact on the environment being studied the researcher sometimes adopts a “participant observer” role, becoming involved in the activities …

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Qualitative Research: Observational methods in health care settings

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quality in qualitative research Qualitative research in health care: Assessing

Can primary care and community-based models of emergency care substitute for the hospital accident and emergency (A & E) department?

Synthesing Qualitative and Quantitative Health Evidence , Synthesing Qualitative and Quantitative Health Evidence , کتابخانه دیجیتال جندی شاپور اهواز

Nicholas Mays

Papers

Rigour and qualitative research.

Qualitative Research: Observational methods in health care settings

quality in qualitative research Qualitative research in health care: Assessing

Can primary care and community-based models of emergency care substitute for the hospital accident and emergency (A & E) department?

Synthesing Qualitative and Quantitative Health Evidence