By applying qualitative methods to research, our conceptual understanding of social phenomena in natural (rather than experimental) settings can be improved, with emphasis placed on the meanings, views and experiences described by participants(183). Qualitative studies can produce a large amount of textual data, for example from transcribed recordings of
interviews and focus groups, as well as “field notes” or reflective notes detailing the researcher’s observations: These data are descriptive in the sense that they explore some aspect of human experience in-depth rather than providing
explanations per se. In contrast to quantitative data, the researcher is required to sift through the data and interpret them(184). Qualitative methods such as interviewing enable researchers to explore processes that occur in people’s daily lives and reveal determinants that may have been omitted from previous theory-driven research(185). In addition, qualitative research may be used to assess social practices and processes, identify barriers and facilitators to change, discover the cause of interventions’ successes or failures, and investigate meanings or understandings(186).
Much qualitative research is interview based, of which there are three types: structured, semi-structured, and depth interviews(183). According to Patton, qualitative interviews should contain questions that are open-ended, neutral, sensitive, and clear to the interviewee(187). Whilst structured interviews comprise questions asked in the same order with the same wording in
accordance with a rigid interview schedule, semi-structured and depth
61
common type used in qualitative studies, employing a loose structure consisting of open-ended questions that target the topic under investigation, whilst also enabling the interviewer (or interviewee) to diverge and explore an idea in more detail(183, 188). Thus, the spontaneous aspect of semi-structure interviews allows the interviewer to pursue new paths that that may not have been
considered initially(189), as well as word questions instinctively and so develop a more natural, conversational style(190). Given the exploratory nature of the interviews with care home residents, a semi-structured approach was
considered the most appropriate for this study. In depth interviews may have been unnecessarily onerous for participants, and would have limited interview coverage to one or two topics only(183).
Field notes are gathered during participant interviews, designed to capture the researcher’s thoughts about the atmosphere and interaction – including nonverbal expressions and gestures – contributing to a more comprehensive understanding of the data(191). These notes are used alongside interview transcripts during data analysis to help make sense of participant experiences and emerging insights(183). Observations of the natural setting (e.g., mealtimes) should also be included in the field notes to provide context and enable the researcher to try to interpret a situation from the participants’ perspective(192).
In qualitative research, the analytical process often starts during data collection and continues iteratively, with participant responses prompting the researcher to refine questions, develop hypotheses and investigate emerging themes in the data(184). Unlike quantitative methods of research, qualitative sampling strategies are not intended to identify a statistically representative group of respondents, but rather gather data that can be used to create or
62
develop analytical categories and theoretical explanations of the phenomena under scrutiny(183). Therefore, sampling is not designed to produce findings which maximise external validity or generalisability. Analytical categories which describe and explain social phenomena may be derived inductively, that is, using a “bottom up” approach(193), or used deductively, where data are assigned to a set of a priori categories either at the beginning or part way through the analysis, for example in the “framework approach”(184).
The inductive process of identifying analytical categories as they emerge from the data and developing hypotheses from the ground or research field upwards is known as “grounded theory”(194). Grounded theory is distinct from other qualitative methods because it derives themes and categories from the data rather than from pre-set aims and objectives or pre-defined analytical categories(194, 195). Crucially however, its goal is to produce a plausible theory of a particular phenomenon by searching for, and describing, patterns grounded in the data(196, 197). Where theory building is not the primary
research objective, thematic analysis has been proposed as a more accessible and flexible form of analysis, as researchers need not adhere to the implicit theoretical commitments of fully-fledged grounded theory(197).
This was the approach taken for the interview study. In trying to gain an insight into residents’ perspectives on mealtimes and elicit the important issues that impact on the dining experience, the interviews sought to produce
conceptually-informed interpretations of the data rather than developing a theory. Like grounded theory, thematic analysis identifies, analyses and reports themes within the data (and can be carried out inductively). Moreover, it often extends beyond this, and interprets various elements of the research topic(198). Though it is widely used within different theoretical frameworks and
63
epistemologies, it can complement a constructionist approach, which explores the ways in which identity, experiences, and perceptions are described within the context of the research topic (e.g., the mealtime).
An inductive approach to thematic analysis indicates a strong link
between the themes identified and the data themselves(199). Thus, the themes that emerge from coding interview or focus group transcripts may not
correspond directly to the questions posed by the researcher, meaning that analysis is data-driven and not beholden to analytic preconceptions(197). This approach is aligned to the broader theoretical underpinnings of the current thesis, which aims to interpret the forms, functions, and consequences of the mealtime experience in order to inform the development of an intervention. In general terms, thematic analysis can usefully summarise key elements of a large data set, and/or offer a “thick description” of the data(191), as well as highlight the similarities and differences across the data set(197). It is also conducive to social and psychological interpretations of the data(197). For these compelling reasons, thematic analysis was selected as the method to analyse participant interview transcripts. As data were collected, repeated ideas (e.g., views and opinions) were tagged with codes, which could then be grouped into analytical categories. It was an iterative, emergent process, which helped to conceptualise the mealtime experience of care home residents. Moreover, analysing the interview data in this way helped to build an interpretive account of this experience. It was anticipated at the start of the thesis that the findings from both the primary research study and the systematic review would be used to inform the development of an intervention.
64