qualitative research: generating useful knowledge for practice · richardson b 2006 an ethnography...
TRANSCRIPT
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Qualitative research: generating
useful knowledge for practice
Centre for Health Research, School of Health Sciences
Dr Nikki Petty
Created from conference abstract titles
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What is nature of clinical
practice
Qualitative research
Methodological approaches
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Research (systematic investigation) that
collects/analyses data that is:
What is ‘qualitative’ research?
Text
Documents
Emails
Transcribed
interviews
Images
Videos
observation
Sound
Audio of
individual/fo
cus group
interviews
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Ontology Epistemology Methodology Methods
What is
the nature
of X ?What can
we know
of X ?How can we
go about
acquiring
knowledge
about X ?
What
procedures
can we use to
collect and
analyse data?
Research question leads to:
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Nature of clinical practice
Technical rationality
high hard ground
Professional artistry
swampy lowlands
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Technical rationale viewEraut 1994, Fish 1998, Fish & Coles 1998, Schon 1987)
Application of skills, theory and research to
solve simple predictable, unproblematic,
objective clinical problems
Biomedical model
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Technical rationality assumptions
Nature of clinical practice - ontology is realism
• Ordered world represented by universal
propositions (incidence of back pain) with causal
relations between events (lack of exercise and LBP)
• Human behaviour (taking exercise) due to external
factors (education, weight)
What can we know – epistemology is positivism
We can explain and predict physical and social
aspects of clinical practice
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Professional artistryEraut 1994, Fish 1998, Fish & Coles 1998, Schon 1987
Application of principles, context-specific judgments to construct & solve complex,
uncertain, unpredictable clinical problems
Biopsychosocial model
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Professional artistry assumptions
Nature of clinical practice - ontology is relativism
• Human experience & behaviour involves & depends
on our interpretation of sensory information (pain in
the back) and situations (seeing a therapist)
• Interpretations influenced socially, culturally,
historically and by language
What can we know – epistemology is interpretivism
We can explore the socially constructed meanings
held by individuals
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Technical
rationalityProfessional
artistry
Nature of
clinical practice
RealistNature of the
phenomenon Relativist
PositivistWhat can we know
of the phenomenon Interpretivist
Qualitative methodology and methods
will differ
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Physiotherapy UK 2015
37
145
Qualitative
research studies
20%
Quantitative research
studies 80%
BAD STATS !
4% qualitative research - 4 PT journals in 2003 (Gibson &
Martin 2003)
Every 3 years there is a 4% increase.
60 years time - Physiotherapy UK 100% qualitative
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Qualitative methodologies
• Phenomenology
• Ethnography
• Grounded theory
• Case Study
• Narrative/discourse inquiry
• Action/Participatory action
research
Created from abstract titles for Physiotherapy UK 2015
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meaning of a
phenomenon
or
experience
Phenomenology
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• Understanding the lived experience of patients (Greenfield & Jensen 2010)
• Reflection in physical therapy practice:
phenomenological inquiry into oral and written
narratives (Knab 2012)
• Developing professionalism in physiotherapy students
in professional entry courses (Grace & Trede 2013)
• Awareness of subjective interests and their fulfillment
are crucial for the student’s work-placement
assessment experience (Vuoskoski 2014)
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Ethnography
‘writing about people’
description of
customs, beliefs
behaviours
of a group or culture
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• Illuminating working culture of the physiotherapy
assistant (Smith 1996)
• Physiotherapists perceptions of their interactions with
patients on a chronic pain unit (Thomson 2009)
• The social meaning and function of humour in physiotherapy practice (Thomson 2010)
• Exploring rehabilitation for people with CNS
tumours: patients perspectives (Hackman 2010)
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Grounded theory
generate theory to
explain a process,
action or interaction
about a substantive
topic
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• Expert practice in physical therapy (Jensen et al 2000)
• Patient education in physical therapy practice (Rindflesch 2009)
• Patient-centredness: a conceptual framework for
MSK Physiotherapy (Sexton 2011)
• Experiences of low back pain in adolescents in
relation to physiotherapy intervention Ahlqwist & (Sallfors 2012)
• Nature of female patient-physiotherapist
relationship in Saudi Arabia MSK outpatient
setting (Altamimi 2014)
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Case studyScience of the singular
Exploring in depth an
individual,
group
or
population
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• Exploring role of physiotherapy in an occupational
health setting (Chetty 2013)
• Physiotherapists’ discursive construction of their role
in patient education (Caladine 2011)
• Master’s level study: learning transitions towards
clinical expertise in physiotherapy (Petty 2011)
• Clinical reasoning of pain by experienced musculoskeletal physiotherapists (Smart & Doody 2000)
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Narrative inquiry/analysis and
Discourse studies/analysis
Narrative: stories, autobiography, journals to
understand the way people create meaning
in their lives
Discourse: analysis of language ‘beyond the
sentence’. Characteristics or understanding of
discourse or sociological explanation of
discourse
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• Personal accounts of acute non-specific low back pain
experiences (McCrum 2011)
• The clinical education experience of student-
physiotherapists within a transformed model of
healthcare (Ramkiass 2013)
• Doing gender in physiotherapy education: a critical
pedagogic approach to understanding how students
construct gender identities in an undergraduate
physiotherapy programme in the UK (Hammond 2013)
• Deconstructing the evidence-based discourse in
health sciences: truth, power and fascism (Holmes et al 2006)
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Action Research and Participatory
Action Research
Cyclical process to enhance something
Participants’ are co-researchers
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• Maintaining the quality of clinical education in physiotherapy (Bennett 2008)
• Reviewing work-based learning opportunities in the
community for physiotherapy students (Stainsby & Bannigan 2012)
• Explinging, implementing and evaluating use of
rehabilitation guidelines for physiotherapy in the
critically ill (Elliott 2015 PHYSIO UK)
• Introducing acceptance and commitment therapy to a
physiotherapy-led pain rehabilitation programme (Barker, Heelas,
Toye 2015)
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Methodologies used by
presenters
at Physiotherapy UK 2015
0
2
4
6
8
10
12
14
16
18
20
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Thank you for listening
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Barker KL, Heelas L, Toye F 2015 Introducing acceptance and commitment therapy to a physiotherapy-led pain rehabilitation: an action research study. British Journal of Pain 1-7
Bennett R 2008 Maintaining the quality of clinical education in physiotherapy. PhD University of Birmingham
Booyawiroj EB 1996 Physiotherapy re-entry a case study. Physiotherapy 82(8): 447-455
Caladine L 2011 Physiotherapists’ discursive construction of their role in patient education. EdD thesis, University of Brighton
Chetty L 2013 Innovative interpretive qualitative case study research method aligned with systems theory for physiotherapy and rehabilitation research: a review of the methodology. African Journal of Physiotherapy and Rehabilitation Sciences 5(1/2): 40-44
Edwards I 2000 Clinical reasoning in three different fields of physiotherapy: a qualitative case study. PhD thesis, University of South Australia.
Greenfield BH, Jensen GM 2010 Understanding the lived experience of patients: application of a phenomenological approach to ethics. Physical Therapy 90(8): 1185-1197
Hackman D 2010 ‘What’s the point?’exploring rehabilitation for people with 1o CNS tumours using ethnography: patients’ perspectives. Physiotherapy Research International 16(4)
Hammond J 2013 Doing gender in physiotherapy education: a critical pedagogic approach to understanding how students construct gender identities in anundergraduate physiotherapy programme in the UK. EdD thesis, Kingston University
Holmes D, Stuart M et al 2006 Deconstructing the evidence-based discourse in health sciences: truth, power and fascism. International Journal of Evidence-based Healthcare 4(3): 180-186
Janssen J 2012 Building research capacity in a clinical setting using a participatory action research approach. PhD thesis, Otago University
Knab MS 2012 Reflection in physical therapy practice: a phenomenologiccal inquiry into oral and written narratives. PhD thesis
McCrum C 2011 Personal accounts of acute non-specific low back pain experiences. ProfD thesis, University of Brighton
Olen AM 2007 Narratives of embodied experiences – Therapy processes in Norwegian psychomotor physiotherapy. Advances in Physiotherapy 9(1): 31-39
Ramklass S 2013 The clinical education experience of student-physiotherapists within a transformed model of healthcare. The Internet Journal of Allied Health Sciences and Practice 11(2)
Richardson B 2006 An ethnography of physiotherapy culture. In Qualitative Research for Allied Health Professionsals: Challenging choices. Wiley. P79-92
Smart K, Doody C 2007 The clinical reasoning of pain by experienced musculoskeletal physiotherapists. Manual Therapy 12: 40-49
Smith S 1996 Ethnographic inquiry in physiotherapy research. Physiotherapy 82(6)
Stainsby K, Bannigan K 2012 Reviewing work-based learning opportunities in the community for physiotherapy students. Journal of Further and Higher Education 36(4): 459-476
Tasker D, Loftus S, Higgs J ? Mindful embodied dialogues in community-based physiotherapy. International Journal of the Humanities 9(12): 181-192
Thomson D 2009 An ethnographic study of physiotherapists’ perceptions of their interactions with patients on a chronic pain unit. Physiotherapy Theory and Practice 24(6)
Thomson D 2010 The social meaning and function of humour in physiotherapy practice. Physiotherapy Theory and Practice 26(1)
Vuoskoski P 2014 Work-placement assessment as a lived-through educationally meanful experience of the student: an application of the phenomenological descriptive approach
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Heidegger interpretive
Schutz
social construction of meanings
Merleau-Ponty
embodied
van Manen
Practical contexts
Husserl
descriptive
Phenomenology
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Discourse analysis