Peggy Anne Field

Aggregating Qualitative Findings: An Approach to Theory Development

The authors suggest that findings of independent, similar research articles may be aggregated into a cohesive study. Such a procedure greatly enhances the generalizability of the original studies and produces a relatively solid mid-range theory. In this article, the criteria for selecting studies, possible problems inherent in the aggregation approach, and potential areas for application are discussed.

Practices and Policies in the Initiation of Breastfeeding

Despite increasing knowledge about factors affecting the initiation of breastfeeding, many mothers still encounter problems and discontinue breastfeeding earlier than desired. Many hospitals still have not implemented the practices that are known to be helpful in the establishment of breastfeeding. As a result, a study was conducted to examine the policies and practices affecting breastfeeding in hospitals in Alberta, Canada. A questionnaire-based survey of all Alberta hospitals (including directors of nursing and staff nurses) found that many practices were still relatively inflexible; did not always reflect accurate, research-based information; and were not geared to the needs of mothers and infants. The implications of these findings are discussed.

Principles of data analysis

Two components of the research process complement each other to ensure that the finished product is excellent qualitative research. The first is the collection of adequate and appropriate data, and the second is creativity in data analysis. In this chapter, the process of creative data analysis will be addressed. First, the cognitive process of doing qualitative data analysis will be presented. Next, data preparation and data management techniques that facilitate analysis will be described, and last, procedures to verify the analysis process (i.e. an audit trail) and procedures of verifying the emerging theory will be presented.

Maternity nurses: how parents see us

A major study of obstetrical units was conducted as far back as 1956 by Lesser and Keane in the United States. They found inadequacies in the emotional care and support given to labouring mothers. Danzinger (1979) observed women’s interactions with staff members in a traditional obstetrical setting and found both nurses and doctors offered arbitrary, uniform and, in her opinion, often inappropriate responses to labouring women. The rules for birthing conduct were laid down by professional rather than negotiated with individual women. Parents, however, tended to accept the rules and constraints and rarely violated them. Another study (Shields, 1978) examined subjective needs of labouring women. Supportive care was found to be most critical in the way mothers viewed their labour. Congruency between the mother’s expectation and perception of the time the nurse spent with her in labour also appeared to be important to mother’s satisfaction. Nunnally and Aguiar (1974) reported that attenders at prenatal classes had a significantly more favourable attitude to labour than did non-attenders. Birch (1982) examined the congruence between the anticipated and actual extent to which 30 mothers participated in decision making in labour. The majority of the mothers felt it important for them to have a say in decisions related to pain medication, privacy and ambulation during labour. Just over half of the mothers in her sample wanted a say in relating to fetal monitoring, internal examinations, whether or not they would receive food and fluids and choice of position for delivery. Approximately 40% of the women wanted a say as to when hospital personnel would be present, whether or not labour would be induced and whether or not they would have an enema. Ball (1981) undertook an extensive study in England to identify the patterns of care associated with different levels of emotional satisfaction or distress in the mother. Differences in levels of emotional satisfaction experienced by mothers were found to be statistically significant in relation to the type of parent craft classes attended, the social class of the mother and the mother’s feelings at the birth of her baby and the mother’s perception of postnatal care, as recalled 6-8 weeks after birth. One major cause of emotional distress reported by the mothers was feeling alone while they were in labour, particularly if they felt that labour had been difficult.

Effectiveness and efficacy of antenatal care

Antenatal care is recommended to pregnant women to improve the outcomes of childbirth. A common pattern of provision is seen in those parts of the industrialised world which have been influenced by British settlers. This paper presents the evolution of the current patterns of care, and the effectiveness and efficacy of the present system are discussed.

An overview of qualitative methods

In the previous chapter, the rationale for a qualitative approach for research was presented. In this chapter, some of the methods that may be used to examine phenomena qualitatively will be introduced, and then factors to consider when selecting a qualitative method will be discussed.

Reporting qualitative research

The purpose of doing any research is to answer a question. The completed research should advance knowledge and therefore be of interest to the scientific community. As the questions to be answered in applied sciences are often derived from the clinical setting, the final phase of the research process is the application and evaluation of the research. Therefore, unless the results are written up and published, they cannot fulfil any useful purpose, and the effort in conducting the research is for nought. These issues are, of course, in addition to any personal gain that the researcher may have as a student, which is the completion of requirements for a degree or a personal contractual obligation to a funding agency that has supported the research. Besides, it is thrilling to be able to contribute in a small way to the development of knowledge: to provide information for teachers to teach, for researchers to build on, for clinicians to use and to improve patient care. This is only possible if the results are disseminated.

The purpose of qualitative research

Research fills a vital and important role in society: it is the means by which discoveries are made, ideas are confirmed or refuted, events controlled or predicted and theory developed or refined. All of these functions contribute to the development of knowledge. However, no single research approach fulfills all of these functions, and the contribution of qualitative research is both vital and unique to the goals of research in general. Qualitative research enables us to make sense of reality, to describe and explain the social world and to develop explanatory models and theories. It is the primary means by which the theoretical foundations of social sciences may be constructed or re-examined.

Principles of conceptualizing a qualitative project

When preparing a qualitative research proposal, researchers often find themselves in a paradoxical situation. Researchers have deliberately selected a qualitative method because little is known about the area — yet how can they write about, for instance how they are going to analyse data when the nature of these data are not known? How can a qualitative researcher convince a funding agency that a study is worthwhile when so much is unknown? Whereas quantitative research proposals are generally highly structured and serve to guide the research process, it is not possible to develop a rigid protocol for a qualitative research proposal while still remaining true to the principles of qualitative inquiry. While the quantitative proposal may serve as an indicator that the student is ready to collect data, has identified a theoretical framework and has a sound protocol for data analysis, the qualitative proposal serves only to convince the committee that the topic is worth studying. Despite the fact that the qualitative researcher may not know very much about the research topic or what will be found out, she or he must entice the committee in order to be allowed to proceed. This lack of development may be a handicap if the qualitative proposal is to be submitted to a funding agency, and the onus is on the researcher to convince the granting agency that funding the research is ‘a good risk.’

Principles of doing research

Once the proposal is approved, and institutional approvals and funding have been obtained, the actual research can start. Beginning researchers (and even the more experienced embarking on a new project) report that starting is a very stressful time, and that knocking on the door of the first participant was the most difficult thing they had ever done. This difficulty may arise from the lack of structure in the qualitative research process, which leaves the researcher feeling that a lot could possibly go wrong (for example, that a prospective participant will refuse to enter the study). On the other hand, if participant observation is a part of the design, there is the awkwardness of not knowing ‘what to do’ or how to fit into the research setting.