The most fundamental characteristic of qualitative research is its express commitment to viewing events, action, norms, values, etc. from the perspective of the people who experience them in everyday life. (Bryman, 2004: p. 61)
The term “qualitative research” refers to an umbrella concept that encompasses many different forms of inquiry and methodological practices. It engages a variety of theoretical lenses, strategies, and techniques. Different from quantitative research, which is based on probability and measurement (quantity), qualitative research is based on the quality of the data generated to explain a phenomenon (e.g., why older adults would resist using some kinds of mobility devices) (Gardner, 2014). Traditionally, in the health sciences, qualitative research has been defined in opposition to quantitative research. A stereotypical view of qualitative research is that it is defined by its data generation methods, such as interviews and observations. These techniques are in fact shared with quantitative research; for example in psychological studies, observation is a commonly used strategy for quantification of behaviours (Green & Thorogood, 2004). We caution against these simplistic generalizations. As illustrated in this chapter, all qualitative health methodologies and methods are centred around the notion of knowledge production grounded in the quality (the explanatory potential) of the information generated about a phenomenon.
Qualitative research is best defined by its aims: it asks different questions and has a different focus than quantitative research. It is concerned with questions of how, why, and what (Green & Thorogood, 2004). Qualitative research is rooted in the social sciences and is concerned with people and their social realities (Bryman, 2004), with how the social world is understood, experienced, interpreted, and constituted; with individual and collective meanings, interpretations, practices/behaviours, and social processes. Its perspective is emic; it focuses on the subjectivity of human experiences (de la Cuesta, 2015). In the health sciences, qualitative research is the ideal approach for studying the meanings people give to their experiences and how they make sense of their social worlds (e.g., patients’ perceptions of self-care education or reasons for adherence, or not, to prescribed medication). Health care and health promotion are largely shaped by people’s perceptions, social norms, and organizational standards and practices; all these issues are social in nature and hence can be studied qualitatively.
Qualitative research is also based on a naturalistic approach to data generation. This means that people, situations, and events are studied where they happen, in their “natural settings,” and thus all qualitative data are contextual, connected to the people, places, times, events, and the everyday social interactions – or “social and cultural contexts” – in which the data are generated. Context is also essential for understanding social behaviours and for making sense of or analyzing data produced. Context includes considerations such as who, when, where, why, class, race/ethnicity/gender, age, and circumstances (Holstein & Gubrium, 2004; Korstjens & Moser, 2017).
Qualitative research has also been described in terms of its broad purposes or goals: exploratory, where researchers investigate phenomena about which little is known; explanatory, where relationships, events, behaviours, or beliefs related to a group are explained; descriptive, where experiences or events are documented; and emancipatory, where the goal is to create opportunities for people to engage in social action (Agee, 2009). While these objectives can be helpful in situating a study, they are artificial distinctions because qualitative researchers often combine more than one goal in their study design. For example, answering a question such as “what are the processes that shape the ability of patients with diabetes to follow a prescribed diet?” requires both description and explanation.
Additionally, qualitative research traditions vary according to the uses researchers in distinct disciplines make of them. Within health sciences, for example, there is a particular way to think about “types” of qualitative research. Eakin (2016) refers to the dominance of post-positivist qualitative research (PPQR) in the health sciences, where qualitative data is viewed through a positivist lens: for instance, data are “real” and speak for themselves; findings “emerge” from the data independently of the researcher, who assumes a veneer of neutrality; and “findings” are reported mainly in implicitly quantitative terms (“some,” “most”). In PPQR, qualitative research is conceived of as purely a “method or technique, a ‘toolbox’ of procedures divorced from their philosophical undercarriage” (Eakin, 2016: p.111). Eakin concludes that this type of qualitative research has “limited value either as positivist or interpretive enterprise [because] it cannot satisfy the criteria for adequate positivist design (objective standardized procedure, statistical generalizability) or for adequate interpretive design (researcher as instrument, conceptual generalizability)” (p. 111).
As we are interested in doing the most we can when we use qualitative research to improve health care delivery and to challenge the ways we think about health issues broadly (e.g., social discourses, policies, programs), we engage with an interpretive, rather than a post-positivist, form of qualitative research. This is also called “interpretive research” (Schwartz-Shea & Yanow, 2012). Interpretive qualitative research is rooted in the assumption that meaning is discerned by the researcher. Through language use, human interaction, and meaning-making, the researcher and participant create the conditions for an in-depth understanding of a phenomenon (e.g., the stigma associated with TB treatment).
This type of interpretive qualitative research strives for what Eakin (2016) calls “value-added” analysis. It is an approach that refuses a mere cataloguing of pre-conceived or common-sense ideas, maximizes the “creative presence” of the researcher, and deploys theoretical abstraction as a key methodological strategy for reconceptualizing phenomena and creating generalizable knowledge, through the process of theorization (Eakin, 2016). Here the researcher goes beyond mere description of an experience or a phenomenon to question, for instance, commonly held notions and assumptions, or the everyday experiences that are taken for granted. The researcher does not take data as given but works hard to interpret it, considers the story behind the story, questions common-sense and received understandings, and asks questions about the nature of the phenomenon under study (Eakin, 2016). (see also Ward, Hoare & Gott, 2015).