example of qualitative research interview report

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Top 10 Qualitative Research Report Templates with Samples and Examples

“Research is to see what everybody else has seen, and to think what nobody else has thought, ” said Hungarian biochemist and Nobel laureate Albert Szent-Gyorgyi, who discovered Vitamin C. This fabulous statement on research as a human endeavor reminds us that execution matters, of course, but the solid pillar of research that backs it is invaluable as well.

Here’s an example to illustrate this in action.

Have you ever wondered what makes Oprah Winfrey a successful businesswoman? It's her research abilities. Oprah might not have been as successful as a news anchor and television show host if she hadn't done her exploratory research on key topics and public figures. Additionally, without the research and development that went into the internet, there was no way that you could be reading this post right now. Research is an essential tool for understanding the intricacies of many topics and advancing knowledge.

Businesses in the modern world are, increasingly, based on research. Within research too, the qualitative world of non-numerical observations, data, and impactful insights is what business owners are most interested in. This is not to say that numbers or empirical research is not important. It is, of course, one of the founding blocks of business.

In this blog, however, we focus on qualitative research PPT Templates that help you move forward and get on the profitable highway and take the best decisions for your business.

These presentation templates are 100% customizable, and editable. Use these to leave a lasting impact on your audience and get recall for your business value offering.

Top 10 Qualitative Research Report Templates

The goal of qualitative research methods is to monitor market trends and attitudes through surveys, analyses, historical research, and open-ended interviews. It helps interpret and comprehend human behavior using data. With the use of qualitative market research services, you may get access to the appropriate data that could help you make decisions.

After finishing the research portion of your assignment effectively, you'll need a captivating way to present your findings to your audience. Here, SlideTeam's qualitative research report templates come in handy. Our top ten qualitative research templates will help you effectively communicate your message. Let’s start a tour of this universe.

Template 1 : Qualitative Research Proposal Template PowerPoint Presentation Slides

For the reader to understand your research proposal, you must have well-structured PPT slides. Don't worry, SlideTeam has you covered. Our pre-made research proposal template presentation slides have no learning curve. This implies that any user may rapidly create a powerful professional research proposal presentation using our PPT slides. Download these PowerPoint slides in a way that will convince your reviewers to accept your strategy.

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Template 2 : Qualitative Research Powerpoint PPT Template Bundles

You may have observed that some brands have taken the place of generic words for comparable products in our language.  Even though we are aware that Band-Aid is a brand, we always ask for Band-Aid whenever we require a plastic bandage. The power of branding is quite astounding. This is the benefit that our next PPT template bundles will provide for your business. Potential customers will find it simpler to recognize your brand and correctly associate it with a certain good or service because of our platform-independent PowerPoint Slides. Download now!

Template 3 : Qualitative Research Interviewing Presentation Deck

Do you find it hard to handle challenging conversations at work? Then, you may conduct effective interviews employing this PowerPoint presentation. Our presentation on qualitative research interviews aimed to "give voice" to the subjects. It provides details on interviews, information, research, participant, and study methodologies. Download this PowerPoint Presentation if you need to introduce yourself effectively during a quick visual communication.

Template 4 : Thematic Analysis Qualitative Research PPT PowerPoint Presentation Outline Rules CPB

Thematic analysis is a technique used in qualitative research to arrive at  hidden patterns and other inferences based on a theme. Any research can employ our Thematic analysis qualitative research PPT. By using all the features of this adaptable PPT, you may convey information well. By including the proper icons and symbols, this presentation can be improved as an instructional tool and opened on any platform. Download now!

Template 5 : Comparative Analysis of Qualitative Research Methods

Conducting a successful comparison analysis is essential if you or your company wants to make sure that your decision-making process is efficient. With the help of our comparative analysis of qualitative research techniques, you can make choices that work for both your company and your clients. Focus Group Interviews, Cognitive Mapping, Critical Incident Technique, Verbal Protocol, Data Collection, Data Analysis, Research Scope, and Objective are covered in this extensive series of slides. Download today to carry out efficient business operations.

Template 6 : Five-Type of Qualitative Research Designs

Your business can achieve significant results with the help of our five  qualitative research design types. Given that it incorporates layers of case studies, phenomenology, historical studies, and action research, it qualifies as a full-fledged presentation. Download this presentation template to perform an objective, open-ended technique and to carefully consider probable sources of errors.

Template 7 : Key Phases for the Qualitative Research Process

Any attempt at qualitative research, no matter how small, must follow the prescribed procedures. The key stages of the qualitative research method are combined in this pre-made PPT template. This set of slides covers data analysis, research approach, research design, research aim, issue description, research questions, philosophical assumptions, data collecting, and result interpretation. Get it now.

Template 8 : Thematic Analysis of Qualitative Research Data

Thematic analysis is performed on the raw data that is acquired through focus groups, interviews, surveys, etc. We go over each and every critical step in our slides on thematic analysis of qualitative research data, including how to uncover codes, identify themes in the data, finalize topics, explore each theme, and analyze documents. This completely editable PowerPoint presentation is available for instant download.

Template 9 : Swot Analysis of Qualitative Research Approach

Use this PowerPoint set to determine the strengths, weaknesses, opportunities, and threats facing your company. Each slide comes with a unique tool that may be utilized to strengthen your areas of weakness, grasp opportunities, and lessen risks. This template can be used to collect statistics, add your own information, and then begin considering how you might get better.

Download now!

Template 10 : Qualitative Research through Graph Showing Revenue Growth

A picture truly is worth a thousand words even when it comes to summarizing your research's findings. Researchers encounter an unavoidable issue when presenting qualitative study data; to address this challenge, Slide Team has created a user-responsive Graph Showing Revenue Growth template. This slideshow graph could help you make informed decisions and encourage your company's growth.

Template 11 : Qualitative Research Data Collection Approaches and Implications

Like blood moving through the circulatory system, data moves through an organization. Businesses cannot run without data. The first step in making better decisions is gathering data. This presentation template includes all the elements necessary to create a successful business plan, from data collection to analysis of the best method to comprehend concepts, opinions, or experiences. Get it now.

Template 12 : Qualitative Research Analysis of Comments with Magnify Glass

The first step in performing a qualitative analysis of your data is gathering all the comments and feedback you want to look at. Our templates help you document those comments. These slides are fully editable and contain a visual accessibility function. The organization and formatting of the sections are excellent. Download it now.

PS For more information on qualitative and quantitative data analysis, as well as to determine which type of market research is best for your company, check out this blog.

FAQs on Qualitative Research 

Writing a qualitative research report.

A qualitative report is a summary of an experience, activity, event, or observation. The format of a qualitative report includes an abstract, introduction, background information on the issue, the researcher's role, theoretical viewpoint, methodology, ethical considerations, results, data analysis, limitations, discussion, conclusions, implications, references, and an appendix. A qualitative research report requires extensive detail and is typically divided into several sections. These start with the title, a table of contents, and an abstract; these form the beginning. Then, the meat of a qualitative report comprises an introduction, the literature review, an account of investigation, findings, discussion, and conclusions. The final section is references.

How do you Report Data in Qualitative Research?

A qualitative research report is frequently built around themes. You should be aware that it can be difficult to express qualitative findings as thoroughly as they deserve. It is customary to use direct quotes from sources like interviews to support the viewpoint. To develop a precise description or explanation of the primary theme being studied, it is also crucial to clarify concepts and connect them. There is the need to state about design, which is how were the subject choices made, leading through other steps to documenting that how the researcher verified the research’s findings/results.

What is an Example of a Report of Qualitative Data?

Qualitative data are categorical by nature. Reports that use qualitative data make it easier to present complex information. The semi-structured interview is one of the best illustrations of a qualitative data collection technique that provides open-ended responses from informants while allowing researchers to ask questions based on a set of predetermined themes. Since they enable both inductive and deductive evaluative reasoning, these are crucial tools for qualitative research.

How do you write an Introduction for a Qualitative Report?

A qualitative report must have a strong introduction. In this section, the researcher emphasizes the aims and objectives of the methodical study. It also addresses the problem that the systematic study aims to solve. In this section, it's imperative to state whether the research's goals were met. The researcher goes into further depth about the research problem in the introduction part and discusses the need for a methodical enquiry. The researcher must define any technical words or phrases used.

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How to conduct qualitative interviews (tips and best practices)

Last updated

18 May 2023

Reviewed by

Miroslav Damyanov

However, conducting qualitative interviews can be challenging, even for seasoned researchers. Poorly conducted interviews can lead to inaccurate or incomplete data, significantly compromising the validity and reliability of your research findings.

When planning to conduct qualitative interviews, you must adequately prepare yourself to get the most out of your data. Fortunately, there are specific tips and best practices that can help you conduct qualitative interviews effectively.

• What is a qualitative interview?

A qualitative interview is a research technique used to gather in-depth information about people's experiences, attitudes, beliefs, and perceptions. Unlike a structured questionnaire or survey, a qualitative interview is a flexible, conversational approach that allows the interviewer to delve into the interviewee's responses and explore their insights and experiences.

In a qualitative interview, the researcher typically develops a set of open-ended questions that provide a framework for the conversation. However, the interviewer can also adapt to the interviewee's responses and ask follow-up questions to understand their experiences and views better.

• How to conduct interviews in qualitative research

Conducting interviews involves a well-planned and deliberate process to collect accurate and valid data. 

Here’s a step-by-step guide on how to conduct interviews in qualitative research, broken down into three stages:

1. Before the interview

The first step in conducting a qualitative interview is determining your research question . This will help you identify the type of participants you need to recruit . Once you have your research question, you can start recruiting participants by identifying potential candidates and contacting them to gauge their interest in participating in the study. 

After that, it's time to develop your interview questions. These should be open-ended questions that will elicit detailed responses from participants. You'll also need to get consent from the participants, ideally in writing, to ensure that they understand the purpose of the study and their rights as participants. Finally, choose a comfortable and private location to conduct the interview and prepare the interview guide.

2. During the interview

Start by introducing yourself and explaining the purpose of the study. Establish a rapport by putting the participants at ease and making them feel comfortable. Use the interview guide to ask the questions, but be flexible and ask follow-up questions to gain more insight into the participants' responses. 

Take notes during the interview, and ask permission to record the interview for transcription purposes. Be mindful of the time, and cover all the questions in the interview guide.

3. After the interview

Once the interview is over, transcribe the interview if you recorded it. If you took notes, review and organize them to make sure you capture all the important information. Then, analyze the data you collected by identifying common themes and patterns. Use the findings to answer your research question. 

Finally, debrief with the participants to thank them for their time, provide feedback on the study, and answer any questions they may have.

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• What kinds of questions should you ask in a qualitative interview?

Qualitative interviews involve asking questions that encourage participants to share their experiences, opinions, and perspectives on a particular topic. These questions are designed to elicit detailed and nuanced responses rather than simple yes or no answers.

Effective questions in a qualitative interview are generally open-ended and non-leading. They avoid presuppositions or assumptions about the participant's experience and allow them to share their views in their own words. 

In customer research , you might ask questions such as:

What motivated you to choose our product/service over our competitors?

How did you first learn about our product/service?

Can you walk me through your experience with our product/service?

What improvements or changes would you suggest for our product/service?

Have you recommended our product/service to others, and if so, why?

The key is to ask questions relevant to the research topic and allow participants to share their experiences meaningfully and informally. 

• How to determine the right qualitative interview participants

Choosing the right participants for a qualitative interview is a crucial step in ensuring the success and validity of the research . You need to consider several factors to determine the right participants for a qualitative interview. These may include:

Relevant experiences : Participants should have experiences related to the research topic that can provide valuable insights.

Diversity : Aim to include diverse participants to ensure the study's findings are representative and inclusive.

Access : Identify participants who are accessible and willing to participate in the study.

Informed consent : Participants should be fully informed about the study's purpose, methods, and potential risks and benefits and be allowed to provide informed consent.

You can use various recruitment methods, such as posting ads in relevant forums, contacting community organizations or social media groups, or using purposive sampling to identify participants who meet specific criteria.

• How to make qualitative interview subjects comfortable

Making participants comfortable during a qualitative interview is essential to obtain rich, detailed data. Participants are more likely to share their experiences openly when they feel at ease and not judged. 

Here are some ways to make interview subjects comfortable:

Explain the purpose of the study

Start the interview by explaining the research topic and its importance. The goal is to give participants a sense of what to expect.

Create a comfortable environment

Conduct the interview in a quiet, private space where the participant feels comfortable. Turn off any unnecessary electronics that can create distractions. Ensure your equipment works well ahead of time. Arrive at the interview on time. If you conduct a remote interview, turn on your camera and mute all notetakers and observers.

Build rapport

Greet the participant warmly and introduce yourself. Show interest in their responses and thank them for their time.

Use open-ended questions

Ask questions that encourage participants to elaborate on their thoughts and experiences.

Listen attentively

Resist the urge to multitask . Pay attention to the participant's responses, nod your head, or make supportive comments to show you’re interested in their answers. Avoid interrupting them.

Avoid judgment

Show respect and don't judge the participant's views or experiences. Allow the participant to speak freely without feeling judged or ridiculed.

Offer breaks

If needed, offer breaks during the interview, especially if the topic is sensitive or emotional.

Creating a comfortable environment and establishing rapport with the participant fosters an atmosphere of trust and encourages open communication. This helps participants feel at ease and willing to share their experiences.

• How to analyze a qualitative interview

Analyzing a qualitative interview involves a systematic process of examining the data collected to identify patterns, themes, and meanings that emerge from the responses. 

Here are some steps on how to analyze a qualitative interview:

1. Transcription

The first step is transcribing the interview into text format to have a written record of the conversation. This step is essential to ensure that you can refer back to the interview data and identify the important aspects of the interview.

2. Data reduction

Once you’ve transcribed the interview, read through it to identify key themes, patterns, and phrases emerging from the data. This process involves reducing the data into more manageable pieces you can easily analyze.

The next step is to code the data by labeling sections of the text with descriptive words or phrases that reflect the data's content. Coding helps identify key themes and patterns from the interview data.

4. Categorization

After coding, you should group the codes into categories based on their similarities. This process helps to identify overarching themes or sub-themes that emerge from the data.

5. Interpretation

You should then interpret the themes and sub-themes by identifying relationships, contradictions, and meanings that emerge from the data. Interpretation involves analyzing the themes in the context of the research question .

6. Comparison

The next step is comparing the data across participants or groups to identify similarities and differences. This step helps to ensure that the findings aren’t just specific to one participant but can be generalized to the wider population.

7. Triangulation

To ensure the findings are valid and reliable, you should use triangulation by comparing the findings with other sources, such as observations or interview data.

8. Synthesis

The final step is synthesizing the findings by summarizing the key themes and presenting them clearly and concisely. This step involves writing a report that presents the findings in a way that is easy to understand, using quotes and examples from the interview data to illustrate the themes.

• Tips for transcribing a qualitative interview

Transcribing a qualitative interview is a crucial step in the research process. It involves converting the audio or video recording of the interview into written text. 

Here are some tips for transcribing a qualitative interview:

Use transcription software

Transcription software can save time and increase accuracy by automatically transcribing audio or video recordings.

Listen carefully

When manually transcribing, listen carefully to the recording to ensure clarity. Pause and rewind the recording as necessary.

Use appropriate formatting

Use a consistent format for transcribing, such as marking pauses, overlaps, and interruptions. Indicate non-verbal cues such as laughter, sighs, or changes in tone.

Edit for clarity

Edit the transcription to ensure clarity and readability. Use standard grammar and punctuation, correct misspellings, and remove filler words like "um" and "ah."

Proofread and edit

Verify the accuracy of the transcription by listening to the recording again and reviewing the notes taken during the interview.

Use timestamps

Add timestamps to the transcription to reference specific interview sections.

Transcribing a qualitative interview can be time-consuming, but it’s essential to ensure the accuracy of the data collected. Following these tips can produce high-quality transcriptions useful for analysis and reporting.

• Why are interview techniques in qualitative research effective?

Unlike quantitative research methods, which rely on numerical data, qualitative research seeks to understand the richness and complexity of human experiences and perspectives. 

Interview techniques involve asking open-ended questions that allow participants to express their views and share their stories in their own words. This approach can help researchers to uncover unexpected or surprising insights that may not have been discovered through other research methods.

Interview techniques also allow researchers to establish rapport with participants, creating a comfortable and safe space for them to share their experiences. This can lead to a deeper level of trust and candor, leading to more honest and authentic responses.

• What are the weaknesses of qualitative interviews?

Qualitative interviews are an excellent research approach when used properly, but they have their drawbacks. 

The weaknesses of qualitative interviews include the following:

Subjectivity and personal biases

Qualitative interviews rely on the researcher's interpretation of the interviewee's responses. The researcher's biases or preconceptions can affect how the questions are framed and how the responses are interpreted, which can influence results.

Small sample size

The sample size in qualitative interviews is often small, which can limit the generalizability of the results to the larger population.

Data quality

The quality of data collected during interviews can be affected by various factors, such as the interviewee's mood, the setting of the interview, and the interviewer's skills and experience.

Socially desirable responses

Interviewees may provide responses that they believe are socially acceptable rather than truthful or genuine.

Conducting qualitative interviews can be expensive, especially if the researcher must travel to different locations to conduct the interviews.

Time-consuming

The data analysis process can be time-consuming and labor-intensive, as researchers need to transcribe and analyze the data manually.

Despite these weaknesses, qualitative interviews remain a valuable research tool . You can take steps to mitigate the impact of these weaknesses by incorporating the perspectives of other researchers or participants in the analysis process, using multiple data sources , and critically analyzing your biases and assumptions.

Mastering the art of qualitative interviews is an essential skill for businesses looking to gain deep insights into their customers' needs , preferences, and behaviors. By following the tips and best practices outlined in this article, you can conduct interviews that provide you with rich data that you can use to make informed decisions about your products, services, and marketing strategies. 

Remember that effective communication, active listening, and proper analysis are critical components of successful qualitative interviews. By incorporating these practices into your customer research, you can gain a competitive edge and build stronger customer relationships.

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• What Is Qualitative Research? | Methods & Examples

What Is Qualitative Research? | Methods & Examples

Published on June 19, 2020 by Pritha Bhandari . Revised on June 22, 2023.

Qualitative research involves collecting and analyzing non-numerical data (e.g., text, video, or audio) to understand concepts, opinions, or experiences. It can be used to gather in-depth insights into a problem or generate new ideas for research.

Qualitative research is the opposite of quantitative research , which involves collecting and analyzing numerical data for statistical analysis.

Qualitative research is commonly used in the humanities and social sciences, in subjects such as anthropology, sociology, education, health sciences, history, etc.

• How does social media shape body image in teenagers?
• How do children and adults interpret healthy eating in the UK?
• What factors influence employee retention in a large organization?
• How is anxiety experienced around the world?
• How can teachers integrate social issues into science curriculums?

Table of contents

Approaches to qualitative research, qualitative research methods, qualitative data analysis, advantages of qualitative research, disadvantages of qualitative research, other interesting articles, frequently asked questions about qualitative research.

Qualitative research is used to understand how people experience the world. While there are many approaches to qualitative research, they tend to be flexible and focus on retaining rich meaning when interpreting data.

Common approaches include grounded theory, ethnography , action research , phenomenological research, and narrative research. They share some similarities, but emphasize different aims and perspectives.

Note that qualitative research is at risk for certain research biases including the Hawthorne effect , observer bias , recall bias , and social desirability bias . While not always totally avoidable, awareness of potential biases as you collect and analyze your data can prevent them from impacting your work too much.

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Each of the research approaches involve using one or more data collection methods . These are some of the most common qualitative methods:

• Observations: recording what you have seen, heard, or encountered in detailed field notes.
• Interviews:  personally asking people questions in one-on-one conversations.
• Focus groups: asking questions and generating discussion among a group of people.
• Surveys : distributing questionnaires with open-ended questions.
• Secondary research: collecting existing data in the form of texts, images, audio or video recordings, etc.
• You take field notes with observations and reflect on your own experiences of the company culture.
• You distribute open-ended surveys to employees across all the company’s offices by email to find out if the culture varies across locations.
• You conduct in-depth interviews with employees in your office to learn about their experiences and perspectives in greater detail.

Qualitative researchers often consider themselves “instruments” in research because all observations, interpretations and analyses are filtered through their own personal lens.

For this reason, when writing up your methodology for qualitative research, it’s important to reflect on your approach and to thoroughly explain the choices you made in collecting and analyzing the data.

Qualitative data can take the form of texts, photos, videos and audio. For example, you might be working with interview transcripts, survey responses, fieldnotes, or recordings from natural settings.

Most types of qualitative data analysis share the same five steps:

• Prepare and organize your data. This may mean transcribing interviews or typing up fieldnotes.
• Review and explore your data. Examine the data for patterns or repeated ideas that emerge.
• Develop a data coding system. Based on your initial ideas, establish a set of codes that you can apply to categorize your data.
• Assign codes to the data. For example, in qualitative survey analysis, this may mean going through each participant’s responses and tagging them with codes in a spreadsheet. As you go through your data, you can create new codes to add to your system if necessary.
• Identify recurring themes. Link codes together into cohesive, overarching themes.

There are several specific approaches to analyzing qualitative data. Although these methods share similar processes, they emphasize different concepts.

Qualitative research often tries to preserve the voice and perspective of participants and can be adjusted as new research questions arise. Qualitative research is good for:

• Flexibility

The data collection and analysis process can be adapted as new ideas or patterns emerge. They are not rigidly decided beforehand.

• Natural settings

Data collection occurs in real-world contexts or in naturalistic ways.

• Meaningful insights

Detailed descriptions of people’s experiences, feelings and perceptions can be used in designing, testing or improving systems or products.

• Generation of new ideas

Open-ended responses mean that researchers can uncover novel problems or opportunities that they wouldn’t have thought of otherwise.

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Researchers must consider practical and theoretical limitations in analyzing and interpreting their data. Qualitative research suffers from:

• Unreliability

The real-world setting often makes qualitative research unreliable because of uncontrolled factors that affect the data.

• Subjectivity

Due to the researcher’s primary role in analyzing and interpreting data, qualitative research cannot be replicated . The researcher decides what is important and what is irrelevant in data analysis, so interpretations of the same data can vary greatly.

• Limited generalizability

Small samples are often used to gather detailed data about specific contexts. Despite rigorous analysis procedures, it is difficult to draw generalizable conclusions because the data may be biased and unrepresentative of the wider population .

• Labor-intensive

Although software can be used to manage and record large amounts of text, data analysis often has to be checked or performed manually.

If you want to know more about statistics , methodology , or research bias , make sure to check out some of our other articles with explanations and examples.

• Chi square goodness of fit test
• Degrees of freedom
• Null hypothesis
• Discourse analysis
• Control groups
• Mixed methods research
• Non-probability sampling
• Quantitative research
• Inclusion and exclusion criteria

Research bias

• Rosenthal effect
• Implicit bias
• Cognitive bias
• Selection bias
• Negativity bias
• Status quo bias

Quantitative research deals with numbers and statistics, while qualitative research deals with words and meanings.

Quantitative methods allow you to systematically measure variables and test hypotheses . Qualitative methods allow you to explore concepts and experiences in more detail.

There are five common approaches to qualitative research :

• Grounded theory involves collecting data in order to develop new theories.
• Ethnography involves immersing yourself in a group or organization to understand its culture.
• Narrative research involves interpreting stories to understand how people make sense of their experiences and perceptions.
• Phenomenological research involves investigating phenomena through people’s lived experiences.
• Action research links theory and practice in several cycles to drive innovative changes.

Data collection is the systematic process by which observations or measurements are gathered in research. It is used in many different contexts by academics, governments, businesses, and other organizations.

There are various approaches to qualitative data analysis , but they all share five steps in common:

• Prepare and organize your data.
• Review and explore your data.
• Develop a data coding system.
• Assign codes to the data.
• Identify recurring themes.

The specifics of each step depend on the focus of the analysis. Some common approaches include textual analysis , thematic analysis , and discourse analysis .

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Qualitative research communities.

• Types of Interviews
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• Transcription
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• Interviews as a Method for Qualitative Research (video) This short video summarizes why interviews can serve as useful data in qualitative research.  
• InterViews by Steinar Kvale  Interviewing is an essential tool in qualitative research and this introduction to interviewing outlines both the theoretical underpinnings and the practical aspects of the process. After examining the role of the interview in the research process, Steinar Kvale considers some of the key philosophical issues relating to interviewing: the interview as conversation, hermeneutics, phenomenology, concerns about ethics as well as validity, and postmodernism. Having established this framework, the author then analyzes the seven stages of the interview process - from designing a study to writing it up.  
• Practical Evaluation by Michael Quinn Patton  Surveys different interviewing strategies, from, a) informal/conversational, to b) interview guide approach, to c) standardized and open-ended, to d) closed/quantitative. Also discusses strategies for wording questions that are open-ended, clear, sensitive, and neutral, while supporting the speaker. Provides suggestions for probing and maintaining control of the interview process, as well as suggestions for recording and transcription.  
• The SAGE Handbook of Interview Research by Amir B. Marvasti (Editor); James A. Holstein (Editor); Jaber F. Gubrium (Editor); Karyn D. McKinney (Editor)  The new edition of this landmark volume emphasizes the dynamic, interactional, and reflexive dimensions of the research interview. Contributors highlight the myriad dimensions of complexity that are emerging as researchers increasingly frame the interview as a communicative opportunity as much as a data-gathering format. The book begins with the history and conceptual transformations of the interview, which is followed by chapters that discuss the main components of interview practice. Taken together, the contributions to The SAGE Handbook of Interview Research: The Complexity of the Craft encourage readers simultaneously to learn the frameworks and technologies of interviewing and to reflect on the epistemological foundations of the interview craft.
• International Congress of Qualitative Inquiry They host an annual confrerence at the University of Illinois at Urbana-Champaign, which aims to facilitate the development of qualitative research methods across a wide variety of academic disciplines, among other initiatives.
• METHODSPACE An online home of the research methods community, where practicing researchers share how to make research easier.
• Social Research Association, UK The SRA is the membership organisation for social researchers in the UK and beyond. It supports researchers via training, guidance, publications, research ethics, events, branches, and careers.
• Social Science Research Council The SSRC administers fellowships and research grants that support the innovation and evaluation of new policy solutions. They convene researchers and stakeholders to share evidence-based policy solutions and incubate new research agendas, produce online knowledge platforms and technical reports that catalog research-based policy solutions, and support mentoring programs that broaden problem-solving research opportunities.
• << Previous: Taguette
• Next: Types of Interviews >>

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• Published: 05 October 2018

Interviews and focus groups in qualitative research: an update for the digital age

• P. Gill 1 &
• J. Baillie 2  

British Dental Journal volume  225 ,  pages 668–672 ( 2018 ) Cite this article

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Highlights that qualitative research is used increasingly in dentistry. Interviews and focus groups remain the most common qualitative methods of data collection.

Suggests the advent of digital technologies has transformed how qualitative research can now be undertaken.

Suggests interviews and focus groups can offer significant, meaningful insight into participants' experiences, beliefs and perspectives, which can help to inform developments in dental practice.

Qualitative research is used increasingly in dentistry, due to its potential to provide meaningful, in-depth insights into participants' experiences, perspectives, beliefs and behaviours. These insights can subsequently help to inform developments in dental practice and further related research. The most common methods of data collection used in qualitative research are interviews and focus groups. While these are primarily conducted face-to-face, the ongoing evolution of digital technologies, such as video chat and online forums, has further transformed these methods of data collection. This paper therefore discusses interviews and focus groups in detail, outlines how they can be used in practice, how digital technologies can further inform the data collection process, and what these methods can offer dentistry.

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Interviews in the social sciences

Professionalism in dentistry: deconstructing common terminology

A review of technical and quality assessment considerations of audio-visual and web-conferencing focus groups in qualitative health research, introduction.

Traditionally, research in dentistry has primarily been quantitative in nature. 1 However, in recent years, there has been a growing interest in qualitative research within the profession, due to its potential to further inform developments in practice, policy, education and training. Consequently, in 2008, the British Dental Journal (BDJ) published a four paper qualitative research series, 2 , 3 , 4 , 5 to help increase awareness and understanding of this particular methodological approach.

Since the papers were originally published, two scoping reviews have demonstrated the ongoing proliferation in the use of qualitative research within the field of oral healthcare. 1 , 6 To date, the original four paper series continue to be well cited and two of the main papers remain widely accessed among the BDJ readership. 2 , 3 The potential value of well-conducted qualitative research to evidence-based practice is now also widely recognised by service providers, policy makers, funding bodies and those who commission, support and use healthcare research.

Besides increasing standalone use, qualitative methods are now also routinely incorporated into larger mixed method study designs, such as clinical trials, as they can offer additional, meaningful insights into complex problems that simply could not be provided by quantitative methods alone. Qualitative methods can also be used to further facilitate in-depth understanding of important aspects of clinical trial processes, such as recruitment. For example, Ellis et al . investigated why edentulous older patients, dissatisfied with conventional dentures, decline implant treatment, despite its established efficacy, and frequently refuse to participate in related randomised clinical trials, even when financial constraints are removed. 7 Through the use of focus groups in Canada and the UK, the authors found that fears of pain and potential complications, along with perceived embarrassment, exacerbated by age, are common reasons why older patients typically refuse dental implants. 7

The last decade has also seen further developments in qualitative research, due to the ongoing evolution of digital technologies. These developments have transformed how researchers can access and share information, communicate and collaborate, recruit and engage participants, collect and analyse data and disseminate and translate research findings. 8 Where appropriate, such technologies are therefore capable of extending and enhancing how qualitative research is undertaken. 9 For example, it is now possible to collect qualitative data via instant messaging, email or online/video chat, using appropriate online platforms.

These innovative approaches to research are therefore cost-effective, convenient, reduce geographical constraints and are often useful for accessing 'hard to reach' participants (for example, those who are immobile or socially isolated). 8 , 9 However, digital technologies are still relatively new and constantly evolving and therefore present a variety of pragmatic and methodological challenges. Furthermore, given their very nature, their use in many qualitative studies and/or with certain participant groups may be inappropriate and should therefore always be carefully considered. While it is beyond the scope of this paper to provide a detailed explication regarding the use of digital technologies in qualitative research, insight is provided into how such technologies can be used to facilitate the data collection process in interviews and focus groups.

In light of such developments, it is perhaps therefore timely to update the main paper 3 of the original BDJ series. As with the previous publications, this paper has been purposely written in an accessible style, to enhance readability, particularly for those who are new to qualitative research. While the focus remains on the most common qualitative methods of data collection – interviews and focus groups – appropriate revisions have been made to provide a novel perspective, and should therefore be helpful to those who would like to know more about qualitative research. This paper specifically focuses on undertaking qualitative research with adult participants only.

Overview of qualitative research

Qualitative research is an approach that focuses on people and their experiences, behaviours and opinions. 10 , 11 The qualitative researcher seeks to answer questions of 'how' and 'why', providing detailed insight and understanding, 11 which quantitative methods cannot reach. 12 Within qualitative research, there are distinct methodologies influencing how the researcher approaches the research question, data collection and data analysis. 13 For example, phenomenological studies focus on the lived experience of individuals, explored through their description of the phenomenon. Ethnographic studies explore the culture of a group and typically involve the use of multiple methods to uncover the issues. 14

While methodology is the 'thinking tool', the methods are the 'doing tools'; 13 the ways in which data are collected and analysed. There are multiple qualitative data collection methods, including interviews, focus groups, observations, documentary analysis, participant diaries, photography and videography. Two of the most commonly used qualitative methods are interviews and focus groups, which are explored in this article. The data generated through these methods can be analysed in one of many ways, according to the methodological approach chosen. A common approach is thematic data analysis, involving the identification of themes and subthemes across the data set. Further information on approaches to qualitative data analysis has been discussed elsewhere. 1

Qualitative research is an evolving and adaptable approach, used by different disciplines for different purposes. Traditionally, qualitative data, specifically interviews, focus groups and observations, have been collected face-to-face with participants. In more recent years, digital technologies have contributed to the ongoing evolution of qualitative research. Digital technologies offer researchers different ways of recruiting participants and collecting data, and offer participants opportunities to be involved in research that is not necessarily face-to-face.

Research interviews are a fundamental qualitative research method 15 and are utilised across methodological approaches. Interviews enable the researcher to learn in depth about the perspectives, experiences, beliefs and motivations of the participant. 3 , 16 Examples include, exploring patients' perspectives of fear/anxiety triggers in dental treatment, 17 patients' experiences of oral health and diabetes, 18 and dental students' motivations for their choice of career. 19

Interviews may be structured, semi-structured or unstructured, 3 according to the purpose of the study, with less structured interviews facilitating a more in depth and flexible interviewing approach. 20 Structured interviews are similar to verbal questionnaires and are used if the researcher requires clarification on a topic; however they produce less in-depth data about a participant's experience. 3 Unstructured interviews may be used when little is known about a topic and involves the researcher asking an opening question; 3 the participant then leads the discussion. 20 Semi-structured interviews are commonly used in healthcare research, enabling the researcher to ask predetermined questions, 20 while ensuring the participant discusses issues they feel are important.

Interviews can be undertaken face-to-face or using digital methods when the researcher and participant are in different locations. Audio-recording the interview, with the consent of the participant, is essential for all interviews regardless of the medium as it enables accurate transcription; the process of turning the audio file into a word-for-word transcript. This transcript is the data, which the researcher then analyses according to the chosen approach.

Types of interview

Qualitative studies often utilise one-to-one, face-to-face interviews with research participants. This involves arranging a mutually convenient time and place to meet the participant, signing a consent form and audio-recording the interview. However, digital technologies have expanded the potential for interviews in research, enabling individuals to participate in qualitative research regardless of location.

Telephone interviews can be a useful alternative to face-to-face interviews and are commonly used in qualitative research. They enable participants from different geographical areas to participate and may be less onerous for participants than meeting a researcher in person. 15 A qualitative study explored patients' perspectives of dental implants and utilised telephone interviews due to the quality of the data that could be yielded. 21 The researcher needs to consider how they will audio record the interview, which can be facilitated by purchasing a recorder that connects directly to the telephone. One potential disadvantage of telephone interviews is the inability of the interviewer and researcher to see each other. This is resolved using software for audio and video calls online – such as Skype – to conduct interviews with participants in qualitative studies. Advantages of this approach include being able to see the participant if video calls are used, enabling observation of non-verbal communication, and the software can be free to use. However, participants are required to have a device and internet connection, as well as being computer literate, potentially limiting who can participate in the study. One qualitative study explored the role of dental hygienists in reducing oral health disparities in Canada. 22 The researcher conducted interviews using Skype, which enabled dental hygienists from across Canada to be interviewed within the research budget, accommodating the participants' schedules. 22

A less commonly used approach to qualitative interviews is the use of social virtual worlds. A qualitative study accessed a social virtual world – Second Life – to explore the health literacy skills of individuals who use social virtual worlds to access health information. 23 The researcher created an avatar and interview room, and undertook interviews with participants using voice and text methods. 23 This approach to recruitment and data collection enables individuals from diverse geographical locations to participate, while remaining anonymous if they wish. Furthermore, for interviews conducted using text methods, transcription of the interview is not required as the researcher can save the written conversation with the participant, with the participant's consent. However, the researcher and participant need to be familiar with how the social virtual world works to engage in an interview this way.

Conducting an interview

Ensuring informed consent before any interview is a fundamental aspect of the research process. Participants in research must be afforded autonomy and respect; consent should be informed and voluntary. 24 Individuals should have the opportunity to read an information sheet about the study, ask questions, understand how their data will be stored and used, and know that they are free to withdraw at any point without reprisal. The qualitative researcher should take written consent before undertaking the interview. In a face-to-face interview, this is straightforward: the researcher and participant both sign copies of the consent form, keeping one each. However, this approach is less straightforward when the researcher and participant do not meet in person. A recent protocol paper outlined an approach for taking consent for telephone interviews, which involved: audio recording the participant agreeing to each point on the consent form; the researcher signing the consent form and keeping a copy; and posting a copy to the participant. 25 This process could be replicated in other interview studies using digital methods.

There are advantages and disadvantages of using face-to-face and digital methods for research interviews. Ultimately, for both approaches, the quality of the interview is determined by the researcher. 16 Appropriate training and preparation are thus required. Healthcare professionals can use their interpersonal communication skills when undertaking a research interview, particularly questioning, listening and conversing. 3 However, the purpose of an interview is to gain information about the study topic, 26 rather than offering help and advice. 3 The researcher therefore needs to listen attentively to participants, enabling them to describe their experience without interruption. 3 The use of active listening skills also help to facilitate the interview. 14 Spradley outlined elements and strategies for research interviews, 27 which are a useful guide for qualitative researchers:

Greeting and explaining the project/interview

Asking descriptive (broad), structural (explore response to descriptive) and contrast (difference between) questions

Asymmetry between the researcher and participant talking

Expressing interest and cultural ignorance

Repeating, restating and incorporating the participant's words when asking questions

Creating hypothetical situations

Asking friendly questions

Knowing when to leave.

For semi-structured interviews, a topic guide (also called an interview schedule) is used to guide the content of the interview – an example of a topic guide is outlined in Box 1 . The topic guide, usually based on the research questions, existing literature and, for healthcare professionals, their clinical experience, is developed by the research team. The topic guide should include open ended questions that elicit in-depth information, and offer participants the opportunity to talk about issues important to them. This is vital in qualitative research where the researcher is interested in exploring the experiences and perspectives of participants. It can be useful for qualitative researchers to pilot the topic guide with the first participants, 10 to ensure the questions are relevant and understandable, and amending the questions if required.

Regardless of the medium of interview, the researcher must consider the setting of the interview. For face-to-face interviews, this could be in the participant's home, in an office or another mutually convenient location. A quiet location is preferable to promote confidentiality, enable the researcher and participant to concentrate on the conversation, and to facilitate accurate audio-recording of the interview. For interviews using digital methods the same principles apply: a quiet, private space where the researcher and participant feel comfortable and confident to participate in an interview.

Box 1: Example of a topic guide

Study focus: Parents' experiences of brushing their child's (aged 0–5) teeth

1. Can you tell me about your experience of cleaning your child's teeth?

How old was your child when you started cleaning their teeth?

Why did you start cleaning their teeth at that point?

How often do you brush their teeth?

What do you use to brush their teeth and why?

2. Could you explain how you find cleaning your child's teeth?

Do you find anything difficult?

What makes cleaning their teeth easier for you?

3. How has your experience of cleaning your child's teeth changed over time?

Has it become easier or harder?

Have you changed how often and how you clean their teeth? If so, why?

4. Could you describe how your child finds having their teeth cleaned?

What do they enjoy about having their teeth cleaned?

Is there anything they find upsetting about having their teeth cleaned?

5. Where do you look for information/advice about cleaning your child's teeth?

What did your health visitor tell you about cleaning your child's teeth? (If anything)

What has the dentist told you about caring for your child's teeth? (If visited)

Have any family members given you advice about how to clean your child's teeth? If so, what did they tell you? Did you follow their advice?

6. Is there anything else you would like to discuss about this?

Focus groups

A focus group is a moderated group discussion on a pre-defined topic, for research purposes. 28 , 29 While not aligned to a particular qualitative methodology (for example, grounded theory or phenomenology) as such, focus groups are used increasingly in healthcare research, as they are useful for exploring collective perspectives, attitudes, behaviours and experiences. Consequently, they can yield rich, in-depth data and illuminate agreement and inconsistencies 28 within and, where appropriate, between groups. Examples include public perceptions of dental implants and subsequent impact on help-seeking and decision making, 30 and general dental practitioners' views on patient safety in dentistry. 31

Focus groups can be used alone or in conjunction with other methods, such as interviews or observations, and can therefore help to confirm, extend or enrich understanding and provide alternative insights. 28 The social interaction between participants often results in lively discussion and can therefore facilitate the collection of rich, meaningful data. However, they are complex to organise and manage, due to the number of participants, and may also be inappropriate for exploring particularly sensitive issues that many participants may feel uncomfortable about discussing in a group environment.

Focus groups are primarily undertaken face-to-face but can now also be undertaken online, using appropriate technologies such as email, bulletin boards, online research communities, chat rooms, discussion forums, social media and video conferencing. 32 Using such technologies, data collection can also be synchronous (for example, online discussions in 'real time') or, unlike traditional face-to-face focus groups, asynchronous (for example, online/email discussions in 'non-real time'). While many of the fundamental principles of focus group research are the same, regardless of how they are conducted, a number of subtle nuances are associated with the online medium. 32 Some of which are discussed further in the following sections.

Focus group considerations

Some key considerations associated with face-to-face focus groups are: how many participants are required; should participants within each group know each other (or not) and how many focus groups are needed within a single study? These issues are much debated and there is no definitive answer. However, the number of focus groups required will largely depend on the topic area, the depth and breadth of data needed, the desired level of participation required 29 and the necessity (or not) for data saturation.

The optimum group size is around six to eight participants (excluding researchers) but can work effectively with between three and 14 participants. 3 If the group is too small, it may limit discussion, but if it is too large, it may become disorganised and difficult to manage. It is, however, prudent to over-recruit for a focus group by approximately two to three participants, to allow for potential non-attenders. For many researchers, particularly novice researchers, group size may also be informed by pragmatic considerations, such as the type of study, resources available and moderator experience. 28 Similar size and mix considerations exist for online focus groups. Typically, synchronous online focus groups will have around three to eight participants but, as the discussion does not happen simultaneously, asynchronous groups may have as many as 10–30 participants. 33

The topic area and potential group interaction should guide group composition considerations. Pre-existing groups, where participants know each other (for example, work colleagues) may be easier to recruit, have shared experiences and may enjoy a familiarity, which facilitates discussion and/or the ability to challenge each other courteously. 3 However, if there is a potential power imbalance within the group or if existing group norms and hierarchies may adversely affect the ability of participants to speak freely, then 'stranger groups' (that is, where participants do not already know each other) may be more appropriate. 34 , 35

Focus group management

Face-to-face focus groups should normally be conducted by two researchers; a moderator and an observer. 28 The moderator facilitates group discussion, while the observer typically monitors group dynamics, behaviours, non-verbal cues, seating arrangements and speaking order, which is essential for transcription and analysis. The same principles of informed consent, as discussed in the interview section, also apply to focus groups, regardless of medium. However, the consent process for online discussions will probably be managed somewhat differently. For example, while an appropriate participant information leaflet (and consent form) would still be required, the process is likely to be managed electronically (for example, via email) and would need to specifically address issues relating to technology (for example, anonymity and use, storage and access to online data). 32

The venue in which a face to face focus group is conducted should be of a suitable size, private, quiet, free from distractions and in a collectively convenient location. It should also be conducted at a time appropriate for participants, 28 as this is likely to promote attendance. As with interviews, the same ethical considerations apply (as discussed earlier). However, online focus groups may present additional ethical challenges associated with issues such as informed consent, appropriate access and secure data storage. Further guidance can be found elsewhere. 8 , 32

Before the focus group commences, the researchers should establish rapport with participants, as this will help to put them at ease and result in a more meaningful discussion. Consequently, researchers should introduce themselves, provide further clarity about the study and how the process will work in practice and outline the 'ground rules'. Ground rules are designed to assist, not hinder, group discussion and typically include: 3 , 28 , 29

Discussions within the group are confidential to the group

Only one person can speak at a time

All participants should have sufficient opportunity to contribute

There should be no unnecessary interruptions while someone is speaking

Everyone can be expected to be listened to and their views respected

Challenging contrary opinions is appropriate, but ridiculing is not.

Moderating a focus group requires considered management and good interpersonal skills to help guide the discussion and, where appropriate, keep it sufficiently focused. Avoid, therefore, participating, leading, expressing personal opinions or correcting participants' knowledge 3 , 28 as this may bias the process. A relaxed, interested demeanour will also help participants to feel comfortable and promote candid discourse. Moderators should also prevent the discussion being dominated by any one person, ensure differences of opinions are discussed fairly and, if required, encourage reticent participants to contribute. 3 Asking open questions, reflecting on significant issues, inviting further debate, probing responses accordingly, and seeking further clarification, as and where appropriate, will help to obtain sufficient depth and insight into the topic area.

Moderating online focus groups requires comparable skills, particularly if the discussion is synchronous, as the discussion may be dominated by those who can type proficiently. 36 It is therefore important that sufficient time and respect is accorded to those who may not be able to type as quickly. Asynchronous discussions are usually less problematic in this respect, as interactions are less instant. However, moderating an asynchronous discussion presents additional challenges, particularly if participants are geographically dispersed, as they may be online at different times. Consequently, the moderator will not always be present and the discussion may therefore need to occur over several days, which can be difficult to manage and facilitate and invariably requires considerable flexibility. 32 It is also worth recognising that establishing rapport with participants via online medium is often more challenging than via face-to-face and may therefore require additional time, skills, effort and consideration.

As with research interviews, focus groups should be guided by an appropriate interview schedule, as discussed earlier in the paper. For example, the schedule will usually be informed by the review of the literature and study aims, and will merely provide a topic guide to help inform subsequent discussions. To provide a verbatim account of the discussion, focus groups must be recorded, using an audio-recorder with a good quality multi-directional microphone. While videotaping is possible, some participants may find it obtrusive, 3 which may adversely affect group dynamics. The use (or not) of a video recorder, should therefore be carefully considered.

At the end of the focus group, a few minutes should be spent rounding up and reflecting on the discussion. 28 Depending on the topic area, it is possible that some participants may have revealed deeply personal issues and may therefore require further help and support, such as a constructive debrief or possibly even referral on to a relevant third party. It is also possible that some participants may feel that the discussion did not adequately reflect their views and, consequently, may no longer wish to be associated with the study. 28 Such occurrences are likely to be uncommon, but should they arise, it is important to further discuss any concerns and, if appropriate, offer them the opportunity to withdraw (including any data relating to them) from the study. Immediately after the discussion, researchers should compile notes regarding thoughts and ideas about the focus group, which can assist with data analysis and, if appropriate, any further data collection.

Qualitative research is increasingly being utilised within dental research to explore the experiences, perspectives, motivations and beliefs of participants. The contributions of qualitative research to evidence-based practice are increasingly being recognised, both as standalone research and as part of larger mixed-method studies, including clinical trials. Interviews and focus groups remain commonly used data collection methods in qualitative research, and with the advent of digital technologies, their utilisation continues to evolve. However, digital methods of qualitative data collection present additional methodological, ethical and practical considerations, but also potentially offer considerable flexibility to participants and researchers. Consequently, regardless of format, qualitative methods have significant potential to inform important areas of dental practice, policy and further related research.

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Gill, P., Baillie, J. Interviews and focus groups in qualitative research: an update for the digital age. Br Dent J 225 , 668–672 (2018). https://doi.org/10.1038/sj.bdj.2018.815

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DOI : https://doi.org/10.1038/sj.bdj.2018.815

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• Fostering Empathy through Design Thinking Among Fourth Graders in Trinidad and Tobago Includes quotes, photos, diagrams, and other artifacts from qualitative study
• Examining the Use and Perception of Harm of JUULs by College Students: A Qualitative Study Another interesting example to consider
• NLM Informationist Supplement Grant: Daring to Dive into Documentation to Determine Impact An example from the Carolina Digital Repository discussed in a class more... less... Allegri, F., Hayes, B., & Renner, B. (2017). NLM Informationist Supplement Grant: Daring to Dive into Documentation to Determine Impact. https://doi.org/10.17615/bk34-p037
• Qualitative Posters in F1000 Research Archive (filtered on "qualitative" in title) Sample qualitative posters
• Qualitative Posters in F1000 Research Archive (filtered on "qualitative" in keywords) Sample qualitative posters

Michelle A. Krieger Blog (example, posts follow an APA convention poster experience with qualitative posters):

• Qualitative Data and Research Posters I
• Qualitative Data and Research Posters II

"Oldies but goodies":

• How to Visualize Qualitative Data: Ann K. Emery, September 25, 2014 Data Visualization / Chart Choosing, Color-Coding by Category, Diagrams, Icons, Photographs, Qualitative, Text, Timelines, Word Clouds more... less... Getting a little older, and a commercial site, but with some good ideas to get you think.
• Russell, C. K., Gregory, D. M., & Gates, M. F. (1996). Aesthetics and Substance in Qualitative Research Posters. Qualitative Health Research, 6(4), 542–552. Older article with much good information. Poster materials section less applicable.Link is for UNC-Chapel Hill affiliated users.

Additional resources

• CDC Coffee Break: Considerations for Presenting Qualitative Data (Mark D. Rivera, March 13, 2018) PDF download of slide presentation. Display formats section begins on slide 10.
• Print Book (Davis Library): Miles, M. B., Huberman, A. M., & Saldaña, J. (2014). Qualitative data analysis: A methods sourcebook, 3rd edition From Paul Mihas, Assistant Director of Education and Qualitative Research at the Odum Institute for Research in Social Science at UNC: Qualitative Data Analysis: A Methods Sourcebook (4th ed.) by Miles, Huberman, and Saldana has a section on Displaying the Data (and a chapter on Designing Matrix, Network, and Graphic Displays) that can help students consider numerous options for visually synthesizing data and findings. Many of the suggestions can be applied to designing posters (April 15, 2021).
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Research questions for qualitative research: examples.

Home » Research Questions for Qualitative Research: Examples

Qualitative Research Questions guide researchers in exploring complex human experiences, beliefs, and motivations. They delve into the "why" and "how" behind human behavior, allowing researchers to gain insights into participants' perspectives. By crafting effective questions, researchers can uncover deeper connections and meanings that quantitative data might overlook.

In the realm of qualitative research, understanding the nuances of individual experiences is crucial. These questions not only shape the direction of a study but also influence data collection methods and analysis. Developing well-formulated qualitative research questions is essential for drawing meaningful conclusions and enhancing the overall quality of research outcomes.

Importance of Qualitative Research Questions

Qualitative research questions hold significant importance in guiding effective research processes. These questions, when well-formed, illuminate the underlying motivations and perspectives of participants. They enable researchers to delve deep into complex topics, revealing nuanced insights that quantitative methods may overlook. Understanding the personal experiences and feelings of individuals is critical, especially when addressing sensitive or subjective subjects.

Moreover, qualitative research questions lay the foundation for data collection strategies, determining the types of interviews and focus groups conducted. Crafting clear and engaging questions fosters participant reflection and encourages richer responses. This richness in data empowers researchers to construct compelling narratives and more relevant findings. To maximize effectiveness, it's crucial to continually refine these questions based on initial findings, ensuring they remain aligned with the evolving landscape of the research topic. Through careful consideration of these elements, researchers can significantly enhance the quality and impact of their qualitative research.

Characteristics of Effective Qualitative Research Questions

Effective qualitative research questions serve as the cornerstone of any qualitative inquiry, guiding the research process and shaping the findings. The best qualitative research questions are open-ended, inviting participants to share their perspectives and experiences freely. This depth of engagement allows for a rich understanding of the subject matter, emphasizing the importance of context in qualitative research.

Additionally, effective questions should be clear and focused, ensuring that they address specific aspects of the phenomenon being studied. They should encourage exploration and reflection, prompting respondents to delve deeper into their thoughts. It's essential that these questions also align with the research objectives, providing a roadmap for data collection and analysis. Overall, well-crafted qualitative research questions will not only reflect the complexity of human experiences but also facilitate meaningful dialogue between researchers and participants.

Identifying the Right Qualitative Research Questions

Identifying the right qualitative research questions is crucial for obtaining meaningful insights. Effective qualitative research questions delve into participants' thoughts, feelings, and experiences to uncover rich narratives. Begin by considering the core objectives of your research. What specific phenomena or experiences do you wish to explore? This understanding will guide you in formulating questions that are open-ended and thought-provoking.

Reflect on the population or group you are studying. Who are they, and what unique perspectives might they offer? Questions should encourage respondents to share their personal viewpoints and stories. Moreover, employ techniques such as brainstorming or discussions with peers to refine your questions further. Aim for clarity and simplicity so your questions resonate with participants, encouraging deeper engagement. Remember, the quality of qualitative research questions directly influences the richness of the insights gained.

Examples of Qualitative Research Questions

Qualitative research questions aim to explore the depth of human experience and understanding. They can guide researchers in gaining insights into behaviors, motivations, and perspectives. Here are several examples that aptly illustrate this concept.

What factors influence individuals' perceptions of mental health treatment? This question seeks to understand the varying viewpoints on mental health support, potentially uncovering cultural stigmas or personal experiences that influence these perceptions.

How do parents navigate the challenges of remote learning during a pandemic? This question explores the experiences of parents, giving voice to their struggles and adaptations during unprecedented times.

What are the lived experiences of individuals who identify as LGBTQ+ in conservative communities? This inquiry invites participants to share their personal stories, shedding light on the intersection of identity and community values.

How do employees perceive workplace diversity initiatives? This question delves into the effectiveness and reception of diversity programs, revealing insights into employee sentiments and organizational culture.

These qualitative research questions exemplify the type of inquiries that can provide rich, nuanced data, enhancing our understanding of various social phenomena.

Examples in Social Sciences

Qualitative research questions in the social sciences can dramatically enhance our understanding of complex human behaviors and societal dynamics. For instance, researchers might explore how cultural narratives shape individual identities within diverse communities. Such inquiries not only reveal underlying motivations but also highlight the nuances of social interaction.

Another compelling example might involve examining the experiences of marginalized groups in educational settings. This line of questioning can uncover barriers to success and inform policies promoting equity. Ultimately, these qualitative research questions enable researchers to gather rich, descriptive data that offers deep insights into social phenomena. By focusing on lived experiences, qualitative research fosters a comprehensive understanding of the intricate web connecting individuals, their environments, and societal structures.

Examples in Education Research

In education research, qualitative research questions are essential for uncovering the complexities of teaching and learning experiences. Researchers might explore how specific educational practices influence student engagement and motivation. For instance, a question like, "How do teachers perceive the impact of technology in the classroom?" can lead to insightful narratives about educators' experiences and attitudes.

Another vital area of focus might involve understanding the challenges faced by diverse learners. Questions such as, "What are the lived experiences of students from underrepresented backgrounds in higher education?" can highlight disparities and inform strategies for improving inclusivity. By framing qualitative research questions in this manner, educators can gather rich, detailed data that informs policy, curriculum design, and pedagogical approaches, ultimately enhancing the educational experience for all students.

Conclusion on Qualitative Research Questions

Qualitative Research Questions serve as essential tools that guide the exploration of human experiences, behaviors, and emotions. These open-ended inquiries encourage deeper understanding and rich insights, allowing researchers to capture the nuances of complex phenomena. By framing effective qualitative research questions, researchers can encourage participants to share their stories, thus illuminating various aspects of the topic at hand.

In conclusion, crafting thoughtful qualitative research questions is a vital step in qualitative research design. Such questions not only drive data collection but also shape the analysis and interpretation process. Ultimately, well-formulated questions can lead to transformative findings that enhance our understanding of diverse social contexts and human experiences.

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This paper is in the following e-collection/theme issue:

Published on 16.8.2024 in Vol 26 (2024)

Factors Influencing the Implementation of Digital Advance Care Planning: Qualitative Interview Study

Authors of this article:

Original Paper

• Andy Bradshaw 1 , BSc, PhD   ; 
• Jacqueline Birtwistle 2 , BSc, MSc   ; 
• Catherine J Evans 1, 3 , BSc, MSc, RGN, SPQDN, PhD   ; 
• Katherine E Sleeman 1 , BSc, MBBS, MRCP, PhD   ; 
• Suzanne Richards 2 , BSc, PhD   ; 
• Robbie Foy 2 , MBChB, MRCGP, MSc, MFPHM, PhD   ; 
• Pablo Millares Martin 4 , LMS, DCS, MSc   ; 
• Paul Carder 5 , BSc   ; 
• Matthew J Allsop 2 , BSc, PhD, CPsychol   ; 
• Maureen Twiddy 6 , BSc, MSc, PhD  

1 Cicely Saunders Institute, Kings College London, London, United Kingdom

2 Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom

3 Sussex Community NHS Foundation Trust, Brighton, United Kingdom

4 Whitehall Surgery, Leeds, United Kingdom

5 NHS West Yorkshire Integrated Care Board, White Rose House, Wakefield, United Kingdom

6 Hull York Medical School, Institute of Clinical and Applied Health Research, Allam Medical Building, University of Hull, Hull, United Kingdom

Corresponding Author:

Matthew J Allsop, BSc, PhD, CPsychol

Leeds Institute of Health Sciences

University of Leeds

Worsley Building

Leeds, LS2 9LU

United Kingdom

Phone: 44 1133434185

Email: [email protected]

Background: Palliative care aims to improve the quality of life for people with life-limiting illnesses. Advance care planning conversations that establish a patient’s wishes and preferences for care are part of a person-centered approach. Internationally, electronic health record systems are digital interventions used to record and share patients’ advance care plans across health care services and settings. They aim to provide tools that support electronic information sharing and care coordination. Within the United Kingdom, Electronic Palliative Care Coordination Systems (EPaCCS) are an example of this. Despite over a decade of policy promoting EPaCCS nationally, there has been limited implementation and consistently low levels of use by health professionals.

Objective: The aim of this study is to explore the factors that influence the implementation of EPaCCS into routine clinical practice across different care services and settings in 2 major regions of England.

Methods: A qualitative interview study design was used, guided by Normalization Process Theory (NPT). NPT explores factors affecting the implementation of complex interventions and consists of 4 primary components (coherence, cognitive participation, collective action, and reflexive monitoring). Health care and social care practitioners were purposively sampled based on their professional role and work setting. Individual web-based semistructured interviews were conducted. Data were analyzed using thematic framework analysis to explore issues which affected the implementation of EPaCCS across different settings at individual, team, organizational, and technical levels.

Results: Participants (N=52) representing a range of professional roles were recruited across 6 care settings (hospice, primary care, care home, hospital, ambulatory, and community). In total, 6 themes were developed which mapped onto the 4 primary components of NPT and represented the multilevel influences affecting implementation. At an individual level, these included (1) EPaCCS providing a clear and distinct way of working and (2) collective contributions and buy-in. At a team and organizational level, these included (3) embedding EPaCCS into everyday practice and (4) championing driving implementation. At a technical level, these included (5) electronic functionality, interoperability, and access. Breakdowns in implementation at different levels led to variations in (6) confidence and trust in EPaCCS in terms of record accuracy and availability of access.

Conclusions: EPaCCS implementation is influenced by individual, organizational, and technical factors. Key challenges include problems with access alongside inconsistent use and engagement across care settings. EPaCCS, in their current format as digital advance care planning systems are not consistently facilitating electronic information sharing and care coordination. A redesign of EPaCCS is likely to be necessary to determine configurations for their optimal implementation across different settings and locations. This includes supporting health care practitioners to document, access, use, and share information across multiple care settings. Lessons learned are relevant to other forms of digital advance care planning approaches being developed internationally.

Introduction

Palliative care aims to improve the quality of life for people with life-limiting illnesses through a person-centered, multidisciplinary, and holistic approach [ 1 ]. The focus on person-centeredness is reflected in health policy both within the United Kingdom and internationally [ 2 - 5 ]. Key to facilitating person-centered care in palliative services is the concept of advance care planning. This involves having planned conversations with a patient around their individual goals, wishes, and preferences for their current and future care [ 6 ]. If a person’s preferences are documented and shared, there is evidence of beneficial outcomes. Advance care planning has been associated with better quality of care, helping people to be cared for and die in their usual place of residence, and preventing unplanned hospital admissions [ 7 - 9 ]. However, other studies indicate that it has no impact on patient outcomes or quality of life [ 10 - 12 ]. Despite this uncertainty, advance care planning has been adopted by health care systems internationally as a key feature of person-centered care.

While there are benefits associated with advance care planning, delivery of palliative care requires the involvement of, and communication between, multiprofessional services across different settings of care (ie, hospice, general practice, community-based care, out-of-hours services, hospitals, emergency services, care homes, and social care) [ 13 , 14 ]. To overcome the need for information sharing across multiple health care providers and settings, electronic health record systems are increasingly being used to document and share advance care planning information. This approach has been reported across countries that include the United States [ 15 , 16 ], Australia [ 17 ], and the United Kingdom. In the United Kingdom, the use of electronic health record systems for documenting and sharing advance care plans are called Electronic Palliative Care Coordination Systems, often referred to using the acronym EPaCCS.

EPaCCS emerged in response to the Department of Health’s 2008 End of Life Care Strategy, which advocated for improved coordination of care at the end of life for people with life-limiting conditions (ie, cancer and noncancer conditions, including dementia) [ 18 ]. Policy drivers for the widespread use of electronic systems (such as EPaCCS) across health and social care providers have continued to the present day [ 19 , 20 ]. This includes, for example, an expectation that care records for all people living with a long-term condition should include a person’s care needs and preferences, and should be shared with all those involved in their care [ 19 ]. The development of EPaCCS sought to overcome challenges arising through the fragmentation of health systems that can lead to patients not receiving person-centered care at the right time and in the right place [ 21 , 22 ]. This can result in patient needs not being met, unplanned and avoidable hospital admissions, and patients not being cared for, or dying in a place of their choice [ 23 - 25 ].

EPaCCS have been developed across the United Kingdom since 2008 and multiple variants have arisen. These include standalone web-based electronic registers such as Coordinate my Care which was implemented in London [ 26 ], and template forms integrated into already-existing electronic patient records, such as in Leeds [ 27 ] and the Key Information Summary in Scotland [ 28 ]. Regardless of the mode used for implementing EPaCCS locally across regions, the Palliative and End of Life Care Information Standard specifies the core content that should be recorded and shared (eg, demographic information, diagnosis, medication, advance care planning information, Do Not Attempt Cardiopulmonary Resuscitation decisions, and preferred places of care and death) [ 29 ]. The expectation is that once this information is stored, it should be possible to share across all settings involved in the delivery of palliative and end-of-life care, as well as sharing any updates on the care plan.

However, there is widespread variation with regard to how EPaCCS are implemented within local health care systems (eg, who initiates the creation of a record, which settings of care can access and edit information in EPaCCS records) [ 14 ] which has resulted in variable levels of interoperability and access [ 14 , 30 - 33 ]. In part, this may be a factor influencing the low use rates reported for EPaCCS, with 9%-43% of people with palliative care needs having an EPaCCS record created before death [ 14 , 27 , 34 , 35 ]. Alongside low use, there is uncertainty about how EPaCCS are being used in routine practice and limited evidence of their impact, inhibiting the development of an evidence base to guide how their implementation might be optimized [ 13 , 14 , 30 , 36 , 37 ]. The aim of this study was to explore health care professionals’ perspectives on factors that influence the implementation of EPaCCS in routine clinical practice across different care settings in England.

We undertook a qualitative interview study. This approach was selected as we sought to develop new insights and knowledge on a relatively understudied topic area [ 38 ]. Our study was informed by an interpretative paradigm [ 39 ]. That is, we explored the study aim from the standpoint of ontological relativism (the acceptance of multiple, mind-dependent realities) and epistemological constructionism (an appreciation that knowledge generated during data analysis and write-up reflected interpretations made collectively by the research team) [ 40 ]. We reported the research in line with the consolidated criteria for reporting qualitative research (COREQ [consolidated criteria for reporting qualitative research], see Multimedia Appendix 1 ) [ 41 ].

Theoretical Perspective

EPaCCS can be conceptualized as a complex intervention. This is because they comprise multiple interacting components and operate at the interface of different health care professionals, organizations, settings of care, and patients and their families [ 42 ]. Normalization Process Theory (NPT) is an implementation theory that is used to explain how complex interventions are normalized (ie, deeply embedded into, and used as part of, routine practice) [ 43 - 45 ].

In explaining the different types of “work” that people do in normalizing complex interventions, NPT consists of 4 interlinked primary constructs ( Table 1 ) [ 46 , 47 ]. We used these primary constructs of NPT as a guiding theoretical framework to guide data collection, analysis, and interpretation in understanding the factors affecting the implementation of EPaCCS into routine clinical practice.

a Definitions derived from May et al (2022) [ 46 ].

b How definitions of NPT constructs were “in the simplest possible terms” [ 48 ] and applied to data collection, analysis, and interpretation.

c EPaCCS: Electronic Palliative Care Coordination Systems.

Recruitment and Settings

Recruitment took place in 2 UK regions in London (population circa 9 million) and West Yorkshire (population circa 2.3 million). Participants comprised a subsample of respondents to an earlier survey who had agreed to be contacted for follow-up interviews. In West Yorkshire, EPaCCS comprise a template that is embedded within a patient’s electronic record, generally in the electronic record system used by primary care providers that can share information across different care settings within a defined geographical area. Within London, at the time of this study, the most used EPaCCS system was “Coordinate My Care” (CMC). This was a standalone system (eg, it operated outside routinely used patient records), and enabled patients to access their own records [ 14 ]. Since the conception of this study, it has been superseded by an EPaCCS system called “Universal Care Plan.”

Participants were initially selected using purposive maximum variation sampling to gather the widest range of perspectives [ 49 ]. This entailed sampling participants based on specific criteria (geographical location, professional role, setting of care, and levels of understanding of or engagement with EPaCCS based on previous survey responses). The logic underpinning this approach was to explore our research aim from diverse perspectives [ 49 ]. We worked across primary, secondary, and tertiary care settings in purposefully recruiting doctors, nurses, care home staff, paramedics, and general practitioners. Difficulties in recruitment, however, meant that we supplemented our recruitment approach with convenience sampling using the same criteria.

Participants were approached via email and provided with a participant information sheet. A combination of verbal and written informed consent was obtained, either by AB or JB, prior to interviews being conducted. Recruitment ran concurrently with data collection between November 2021 and June 2022. The concept of “information power” [ 50 ] was used to guide decisions on when to halt recruitment and data collection. This entailed several meetings during which research team members (AB, JB, MT, MA, CE, and KS) considered whether and when data collected from our sample held enough relevant and detailed information to comprehensively understand our research aim.

Data Collection

Single, web-based interviews were conducted by 1 of 2 researchers, both of whom had prior experience in qualitative interviewing [AB (male, research fellow) and JB (female, research fellow)]. The topic guide (provided in Multimedia Appendix 2 ) comprised questions about how participants used EPaCCS, alongside the factors that they perceived affected their implementation. During development, these questions were mapped onto the 4 primary constructs of NPT. Interviews were audio recorded, anonymized, and transcribed verbatim. All participant personal data were stored in a secure cloud storage platform within password-protected files. These data were only accessible to, shared between, and used by members of the research team, using data-sharing agreements.

Interview data were managed using NVivo (version 12; Lumivero) [ 51 ] and analyzed using thematic Framework analysis [ 52 ]. The 4 primary constructs of NPT were used as the theoretical framework to guide the coding and interpretation of data. Data analysis included moving between induction and deduction. We first used NPT to deductively build our initial analytic framework and then supplemented this through inductive coding in which we explored how patterns grounded in the data related to and enriched our analytic framework. Analysis consisted of seven iterative steps: (1) familiarization (through rereading transcripts), (2) coding (by labeling relevant segments of transcripts that aligned with our research aims), (3) creation of an initial analytic framework (by grouping similar codes into categories and categories into themes), (4) indexing (by applying our analytic framework back to raw data and refining it where appropriate), (5) charting (by creating a matrix that explored differences in data across region, role, and setting of care), (6) description (through defining and describing themes), and (7) interpretation (using our theoretical framework to further interpret our findings through the write-up of data). This approach allowed us to conduct within- and between-case pattern matching to explore where participant accounts on the use and implementation of EPaCCS converged or diverged, and how this was influenced by contextual factors (ie, setting, region, and role). Data analysis was led by AB, with fortnightly meetings between authors (AB, JB, MT, and MJA) to review the ongoing coding and analysis.

Multiple approaches were used to ensure rigor during data analysis. Throughout data collection and analysis, the researchers engaged in different forms of reflexivity. This included reflecting introspectively (inward reflections on how they impacted the research process and vice versa) and intersubjectively (reflections on relationships between them and participants) [ 53 ]. These were used as a “springboard for interpretations and more general insight” into the ways through which understandings of the research aim were being co-constructed through the research process, including analysis [ 53 ]. This included regular discussions with JB, who shared data collection and who was familiar with the data corpus. Moreover, throughout the analytical process, members of the wider interdisciplinary research team (consisting of academics and clinicians with experience in palliative care research and practice from across care settings including hospital, community, and primary care) acted as “critical friends” [ 54 ]. This entailed working collaboratively through regular meetings and written feedback in which findings were constructively challenged, reflexivity encouraged, and alternative interpretations of the data proposed. This process took place until the research team agreed that the final analytic framework accurately reflected participant accounts.

Ethical Considerations

The North of Scotland Research Ethics Committee approved the research (reference 21/PR/0428). In this study, we also recognized ethics as a reflexive process through engaging in “ethics in practice” [ 55 ]. This approach was used to remain responsive to and navigate ongoing and potentially unexpected ethical issues that may have arisen throughout data collection, analysis, and write-up (eg, by reflecting on how the research might affect professionals’ clinical practice and potential impact on patients and carers). All participants provided written consent prior to participating in the study. Before analysis, all interview transcripts were deidentified and stored on a secure cloud storage platform only accessible to the study team. Organizations in which participants were based were offered reimbursement of £75 (US $95.91) for allowing a professional to participate in the study. The level of the incentive payment was based on the cost of 1 hour of a locum doctor in the United Kingdom and was agreed upon by the research ethics committee and study funder.

A total of 52 people (characterized in Table 2 ) participated out of the 99 people approached for interview participated (characterized in Table 2 ), from London (n=29) and West Yorkshire (n=23). These participants represented a range of different professionals who work across hospice, primary care, care home, hospital, and community settings.

Six themes were developed and are represented under the corresponding constructs of NPT (coherence, cognitive participation, collective action, and reflexive monitoring). Figure 1 provides an overview of these main themes.

Coherence: How Participants Understood EPaCCS—Theme 1: A Clear and Distinct Way of Working

For a complex intervention to be normalized, it needs to be understood as a clear and distinct way of working that enhances patient care. In the case of EPaCCS, this required health care professionals to appreciate how adding all relevant advance care planning information onto a single digital platform allowed for easier sharing among organizations. Across all settings of care, however, participants did not always see how EPaCCS enhanced patient care and outcomes compared to traditional channels of communication. These included using paper-based discharge summaries, cover letters, face-to-face conversations, emails, and telephone for direct communication of advance care plans across settings:

I don’t think it [EPaCCS] changes much in terms of our GP engagement with patients … our primary channel of communication is telephone, face to face, perhaps email and EPaCCS doesn’t sort of sit with any of those. Our primary function really is to provide the clinical care and record that clinical care and those are traditional methods of doing that. EPaCCS is an add-on, and I think because it’s an add-on, it’s not the primary form of communication. [Lon18, GP, London]

Participants working in care homes across London and West Yorkshire reported using a range of different electronic patient record systems for documenting their residents’ care plans. These systems facilitated the documentation of patient wishes and preferences that could be easily accessed, reviewed, and updated internally by care home staff. Some electronic record systems used in care homes were also capable of integrating and sharing data with other systems across different settings, but this was often limited to those in general practice and not on the scale envisaged by EPaCCS:

The electronic care plan system that we are using, it’s something called PCS, so Person Centred Software. You can do your usual stuff like you said, day-to-day care notes and things like that. There also with PCS, the party piece it has is something called GP connect … with PCS if you do kind of speak with them, they are able to kind of merge certain systems together with their [other healthcare settings’] system … as far as I know PCS works with all of them [WY12&WY13, care home managers, West Yorkshire]

Cognitive Participation: How Participants Built Networks of Practice Around and Bought Into EPaCCS

Theme 2: embedding epaccs into everyday practice.

The service-wide embedding of EPaCCS into everyday practice varied and was partly influenced by the extent to which they were an integral part of everyday care processes, structures, and settings. In some contexts, entire services had no access to EPaCCS. Where EPaCCS were present and accessible across multiple settings, implementation was still thwarted because they were not used consistently by some health care professionals:

it can be like an easy thing to do and I think it gets ingrained in your normal kind of process of doing a patient’s notes … but I think when people just don’t know about it or don’t know how to access it, it then becomes, it seems more of a challenge to actually set one up whereas once you’ve got used to it, it just becomes part of your normal routine first assessment, set up CMC and then it’s done. [Lon5, hospice community doctor, London]

Some participants reported that EPaCCS were integrated into everyday clinical routines. In these instances, EPaCCS were referred to as being “part of what we do” [WY2, community/hospice, West Yorkshire]. This included ensuring that EPaCCS management was integrated into key care processes such as initial assessments, caseload reviews, admission and discharge planning, multidisciplinary team meetings, handover sheets, and standard operating procedures:

Whenever we take on a new patient onto the caseload, we will do our level best to have a conversation about the current EPaCCS system we use, which is Coordinate My Care, to get consent to put people on that system … it’s very much part of our mantra, it’s something that we do … We talk about Coordinate My Care at our weekly multidisciplinary team meetings, so we ask people to check that people are on there and if they’re not, we try and think of a plan to get somebody on there. [Lon26, hospice consultant nurse, London]

Theme 3: Championing Driving Implementation

Participants across all professional groups in both regions reflected on the role of colleagues who championed the use of EPaCCS. Champions were typically individuals who had been given dedicated time within their role to promote implementation and who encouraged staff engagement with EPaCCS. Champions used a range of approaches including offering peer support, taking active roles in teaching and education, presenting the potential benefits of EPaCCS, and keeping them present or “in view” in everyday clinical practice:

Having local champions who are just, [I] don’t want to say checking, but just ensuring that locally they’re being completed, that they’re demonstrating a difference. You know, there’s no point doing it if it’s not demonstrating any benefit really is there? [WY2, community/hospice consultant, West Yorkshire]

There were examples where engaging staff in the use of EPaCCS and learning how different systems work was described as a “constant recurring battle” [Lon06, hospital Clinical Nurse Specialist, London] that required time, dedication, and energy. This view was particularly present in hospital settings and the challenge was mainly attributed to high staff turnover. Different staff meant that the same messages and training had to be repeated continuously for EPaCCS to remain a priority for teams. However, such training did not always translate into increases in health professional use:

The reality is, I think that EPaCCS is underused, but generally across the hospital. That's why I have to be out there doing education and encouragement… it's continually education, trial, training, nudging, pushing to get them to use it because, a level of busyness, a churn of staff, you know they’re churning staff all the time, they’re coming from different Trusts who are not used to SystmOne, never mind EPaCCS, so it's a continual, continual, continual thing and training [WY7, hospital nurse, West Yorkshire]

Collective Action: How People Enact EPaCCS

Theme 4: collective contributions and buy-in.

Collective contributions referred to the extent to which health care professionals across settings of care contributed to the creation, sharing, updating, and use of EPaCCS records to inform care. Underpinning collective contributions was the degree to which health care professionals “bought into” EPaCCS by seeing them as a legitimate part of their role or as supporting the work of others. There was a general agreement that EPaCCS needed “buy-in from everyone - not just palliative care teams – for it to work ” [WY2, consultant, community/hospice consultant, West Yorkshire]. Despite this, health care professionals working in specialist palliative care were often the ones creating and updating EPaCCS records.

Participants had different perceptions in terms of the skills and capacity of professionals across different care settings to support advance care planning. Some felt that staff working in specialist palliative care were best placed to initiate sensitive conversations about advance care planning and end-of-life choices. Others reflected that although they believed health care professionals working outside of palliative care settings could broach advance care planning conversations, they did not always have the confidence to do so. Indeed, participant accounts suggested that when palliative care services were not involved in a patient’s care, this led to a general lack of clarity over who should do what, when, and how, which often resulted in the ad hoc creation of records.

If they’re working in specialist palliative care, most of those people will have those skills [for advance care planning]. If we then look at people who don’t deal exclusively with palliative care but see a lot of it, so district nurses, elderly medicine doctors, general practitioners, I think there is a lot of skill there. There’s not always the skill and there’s often a gap in confidence to apply the skills that people have … when people don’t have the skills and confidence, that first conversation where we seek, where we explain to the patient where they are in their illness and the fact that they’re in a palliative phase of their illness and seeking consent to use an EPaCCS doesn’t happen [WY6, hospice, West Yorkshire]

…in [our] Community Trust we’ve also got a respiratory service who are involved with people that are end stage of respiratory failure and we also have heart failure nurses and diabetic nurse specialists, and you know, those sorts of questions are talked about with patients often. But what we’re trying to do as a service in palliative care [non-specialist palliative care in Community Nurse Team] is encourage that to be done because it isn’t done as much as it should be really. You know when people are actually reaching sort of end-stage heart failure but yet nobody’s actually spoken to them about their wishes at the end of life. They feel it’s not their responsibility. [WY9, community nurse, West Yorkshire]

A concern among participants working in general practice was that it was difficult to contribute to EPaCCS because they did not always fit with their existing ways of working. Given the time constraints and competing priorities in general practice, accessing an EPaCCS record and then conducting and documenting advance care planning conversations was often seen as unmanageable and unrealistic:

we’ve only got a 10- or 15-minute window to see that patient for their current problem, so we don’t bother to update the CMC after just because of sheer time. So, unless you’re having a special CMC kind of session and you’ve dedicated a bit of time to go and do a home visit on someone or you’ve planned it in that you’re going to update the CMC and those wishes and concerns etc, that’s only when it really gets touched by the GP practice. [Lon16, GP, London]

Conversely, paramedics with access in London were likely to use EPaCCS records, typically because it helped decision-making around the urgent management of patients that they were hitherto unfamiliar with:

…we use it just as part of our decision making … I would say it’s a big part of my role… in the main bulk of my role which is in an ambulance setting I use it all the time, it’s second nature and it’s very valuable. [Lon29, paramedic, London]

Theme 5: Electronic Functionality, Interoperability, and Access

At a technical level, the integration of EPaCCS within existing electronic systems was important to their implementation. However, according to participants, this process of integration had not always occurred. Across most care settings in London, participants were frustrated that CMC was not seamlessly interoperable with existing electronic patient record systems. This lack of technical interoperability (ie, basic data exchange capabilities between systems) created a restrictive process that resulted in additional work because health care professionals had to remember (and frequently update) log-in details and enter duplicate information across different systems:

Coordinate My Care for us is a completely separate system … it doesn’t pull data from the current electronic system, you still have to kind of manually enter the patient’s name, address, NHS number … it is extra work … that kind of influence[s] how detailed a care record might be. Sometimes we will just put on the basic information that you think’s important … if it was integrated into a current kind of electronic system then I guess it would just make it easier. [Lon5, hospice community doctor, London]

In services across West Yorkshire, problems were caused by the fact that EPaCCS were embedded within several different electronic health record systems. However, because no mechanism in place allowed for the sharing of information between these systems, health care professionals could not always access relevant information from EPaCCS records when they needed it:

In this area a lot of folks were using SystmOne and we use EMIS … So, they [hospice services] can’t see what we’ve done on our system and it’s a bit messy … I know EPaCCS is supposed to be a document that everyone can access and fill in, but you can’t, ours is just on our system and ‘cos no one else can fill it in or see what’s been changed that’s where it falls down…. it is stupid that you can’t share an EPaCCS with anyone, it seems like a bit pointless [WY17, GP, West Yorkshire]

Reflexive Monitoring (“Appraisal Work”): Appraising the Value of EPaCCS—Theme 6: Confidence and Trust in EPaCCS

Participants across different regions and settings reflected on the potential value of EPaCCS as a tool that could facilitate the coordination of care. Others reflected on first-hand experiences of how EPaCCS were valuable in the context of crisis and out-of-hours care. In particular, paramedics who had access felt that EPaCCS provided vital information needed to effectively support person-centered decision-making with people whom they did not know:

If I saw a CMC for example where it was recorded that the patient had a preference for treatment care in the home, that would make it much more likely that I would dispatch one of my colleagues because we already know that that is the patient’s preferences and so as far as possible, we’re going to work to make that happen … End of life care pushes against the normal direction of paramedic care, [the] normal direction of paramedic care is rescue, save … end of life care obviously isn’t about life-saving, it’s about dignified death, symptom control management. It’s a change of thinking and so a lot of paramedics struggle with that, and I think they will look for anything that will help them guide them in that process and I think CMC is one that people are very familiar with using and generally find quite helpful. [Lon29, paramedic, London]

I’ve worked with the ambulance service in the time before it [EPaCCS] was standard practice and I would say it’s such a necessity now that we’ve got it, if we lost it I think it would literally be like losing my hand … it cuts out awkward conversations and it also cuts out us doing something that may be an issue would be against their wishes … it takes that anxiety or the uncertainty out of the what are we going to do and see what’s best for this patient. [Lon28, paramedic, London]

However, other professionals reported that EPaCCS records were sometimes of poor quality and that there were frequent problems with accessing the system. Consequently, this reduced their confidence that EPaCCS records contained sufficiently up-to-date information to support decision-making. Concerns were not about the potential of EPaCCS to improve care but regarding implementation issues such as restricted access, shareability, and inconsistent use of these records by staff. There was a fear that such problems could lead to patients receiving interventions and treatments that were against their stated and recorded wishes and preferences. This was particularly the case for paramedics who, without access to records, were more likely to make risk-averse decisions to hospitalize patients in the absence of knowing their wishes:

I can tell you categorically that we have not acted in the patient’s best interest … I’ll have taken somebody into hospital without my knowledge that [they have] an end-of-life care plan somewhere [WY21, paramedic, West Yorkshire]

Principal Results

This study explored factors that influenced the implementation of EPaCCS in routine clinical practice across different care settings in 2 major regions of England. It identifies and elaborates on challenges around the implementation of EPaCCS, including problems with access, and inconsistent use and engagement across settings. A key issue was technological limitations, with separate electronic health records often operating in parallel systems or failing to provide sufficient documentation or access. Such problems have led to the potential value of EPaCCS being unrealized.

Guided by sociotechnical systems theory [ 56 ], Figure 2 summarizes these issues by highlighting how interactions between the individual, team, organizational, and technical dimensions of EPaCCS affected implementation. The content of this figure is grounded in the data. It was generated inductively through highlighting relationships between each of our themes alongside how they related to different levels of practice. This allowed us to move beyond description by explaining linkages between themes and bringing them together in a way that tells an overarching story of health care professionals’ perspectives on the processes that influenced the implementation of EPaCCS.

Comparison With Prior Work

A key theme in this study was that limited buy-in and collective contributions to the creation, initiation, and use of EPaCCS across care settings affected implementation. Previous research has primarily used quantitative approaches to explore EPaCCS implementation, such as determining the proportion of EPaCCS records created across a specified population, and the average number of days that EPaCCS records are created before death [ 27 , 34 ]. However, our findings add novel and unique contributions by describing who initiates EPaCCS records, the factors that influence this, and the differences across regions. While some general practitioners and community nurses reported recording advance care planning discussions electronically, our study also highlights contributions made by health care professionals working across specialist palliative care settings. For some participants, providers of specialist palliative care were perceived as being better placed to initiate advance care planning conversations. A referral of a patient to specialist palliative care was perceived as affording greater time to interact with patients and other staff groups, alongside their experience in facilitating advance care planning discussions with patients and their families.

Participant experiences resonate with previously documented challenges related to advance care planning such as perceived lack of time, hesitancy in initiating conversations, and lack of care continuity [ 57 - 59 ]. Lack of clarity over who contributed to records and the timing of these contributions often resulted in poor-quality data. Such issues led to fears that EPaCCS records were incomplete or out of date, with some records being overly detailed or conversely, insufficiently informative to effectively support decision-making in out-of-hours or emergency care. The successful implementation of interventions that work across organizations (such as EPaCCS) relies on “whole systems” thinking [ 35 ]. Such implementation entails those involved in the use and implementation of EPaCCS (including commissioners and those responsible for service [re]design) accounting for the needs and influence of people working across different care settings and specialties.

In this study, care home staff reported having detailed discussions regarding residents’ wishes and preferences for care and documenting these within their own electronic systems. This aligns with previous research that the close relationships between care home staff and residents mean that staff are also well placed to have the sensitive and in-depth conversations required for advance care planning [ 60 ]. In this study, while electronic systems were reported to be used and engaged across care homes, the information contained within them was mostly inaccessible to external services. Care homes were also largely unable to access or provide helpful and detailed information from EPaCCS that could be used by other services. This highlights a key gap in the “whole systems” approach to EPaCCS. Addressing this gap is especially important given that care homes are projected to be the most common place of death in England by 2040 [ 61 ].

The implementation of EPaCCS at the individual, team, and organizational levels was affected by wider technological challenges. Issues related to the technical dimensions of EPaCCS have been well documented in the literature [ 13 , 30 , 33 , 36 ]. However, this study provides novel findings relating to health professional experiences of EPaCCS, further strengthened by its collection of data across 2 large geographical regions. This study builds on previous work and contributes details of how and why issues with access, functionality, and technical interoperability (ie, data integration, presentation, and exchange) [ 62 ] affected the implementation of EPaCCS across the United Kingdom. In London, challenges were experienced around the ability to move data between EPaCCS and existing electronic patient record systems (and vice versa) without duplication. Across West Yorkshire, a major interoperability issue was the failure of different electronic patient record systems to exchange advance care planning information. Moreover, while paramedics were most likely to use information within EPaCCS records in London to support decision-making in crisis contexts, they did not have this access across West Yorkshire. While these interoperability limitations affected health care professionals in different ways, they ultimately hindered the harnessing of the electronic information sharing and care coordination that EPaCCS is intended for.

Implications for Policy and Practice

Our findings highlight implications for practice relating to the use and implementation of electronic systems for palliative and end-of-life care. For complex interventions like EPaCCS to become normalized into everyday practice, they must fit within and enhance established systems of care [ 63 ]. It is also crucial that users can see their benefits to patient care and clinical practice compared to traditional ways of working [ 64 , 65 ]. However, these findings suggest that, in their current format, EPaCCS are not working as intended for facilitating person-centered care. Implementation challenges which resulted in missed opportunities to deliver care in line with recorded patient wishes, sometimes led to a loss of trust and confidence in EPaCCS, instead staff opted for more traditional means of communication and a return to traditional communication methods. Consequently, a redesign of EPaCCS is likely to be necessary to achieve the optimal configuration for successful implementation across different settings of care and geographical locations. To this end, we have generated a set of questions focusing on factors that were found to be influencing the uptake and use of EPaCCS across different settings of care (see Table 3 ).

While this study was conducted within England and discussed within the policy context of the United Kingdom, the policy implications have international relevance. The global strategy on digital health from the World Health Organization calls for the implementation of functional and interoperable electronic health records that can contribute to informed decision-making and high-quality, person-centered care [ 66 ]. Our findings highlight factors to consider when developing electronic systems for use in the delivery of palliative and end-of-life care. The questions presented in Table 3 , therefore, are likely to have relevance to policy makers and practitioners seeking to use and implement similar complex digital interventions (including electronic information-sharing systems) across multiple country and health care contexts. With increasing governmental policies on the development and implementation of health information technologies within the United Kingdom [ 62 ], these questions can guide efforts in the context of palliative and end-of-life care.

Strengths and Limitations

A strength and novelty of this work lies in the adoption of NPT to explain the processes across different levels of the health care system which affected whether and how EPaCCS were normalized into everyday practice. Through recruiting a wide range of health care professionals, across 5 settings of care, and 2 major regions within the United Kingdom, naturalistic generalizations [ 67 ] may be made from this work. That is, the findings of this study are likely to resonate with the personal experiences of healthcare professionals who use EPaCCS and similar health information technologies across end-of-life settings. We highlight 4 study limitations. First, we struggled to recruit community nurses across London, meaning that the application of study findings to this professional group is likely to be limited. Second, this study only sought the perspectives of health care professionals. Future research should explore patients' preferences on the content, sharing, and accessibility of their electronic records, alongside the impact of such digital interventions on the patient experience and clinical outcomes. Third, in line with other studies [ 68 ] throughout analysis, we found that the technical language of NPT and the overlapping of its components made deductively coding and interpreting data using this theoretical framework challenging. Fourth, we also appreciate that constructs comprising NPT focus on specific factors that influenced the implementation of EPaCCS in routine practice. Other implementation theories, models, and frameworks (eg, the Consolidated Framework for Implementation Research [ 69 ], Promoting Action on Research Implementation in Health Services [ 70 ], Capability, Opportunity, Motivation and Behaviour Theory [ 71 ]) may have provided different, yet equally valuable insights into answering the research question.

Conclusions

The successful implementation of digital interventions into routine care depends on the extent to which they enhance established ways of working with minimal disruption. EPaCCS represents just 1 approach to the electronic sharing of advance care plans, and other forms of digital advance care planning exist internationally. Integral to the implementation of digital advance care planning systems for palliative care is ensuring they can allow health care practitioners to document, access, use, and share information across multiple care settings. There also needs to be an effort at individual, team, and organizational levels to make sure that these tools are embedded into everyday care practices. It is paramount that they are championed within and between services, and that people know when, how, and why to use them. Commissioners, health care services, and practitioners should consider these multilevel factors when planning and rolling out digital advance care planning approaches.

Acknowledgments

This study is funded by the NIHR Health and Social Care Delivery Research Programme (NIHR129171). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. MA is a University Academic Fellow, funded through a research fellowship from Yorkshire Cancer Research. We wish to acknowledge Dr Samantha Coster, our colleague at King's College London, for her support and guidance in editing this article. This manuscript is published on behalf of the wider Optimal Care project team. Members of the team who are not included as authors on this manuscript but who were coapplicants and made significant contributions to the conceptualization and design of the project include Prof Michael Bennett (University of Leeds) and Dr Samuel Relton (University of Leeds, United Kingdom). We would also like to extend specific acknowledgment and recognition of our patient and public involvement lead for the Optimal Care project, Mrs Barbara Hibbert, who supported the development of project plans, formed our patient involvement group and facilitated inclusive and insightful patient and public involvement group meetings.

Data Availability

Deidentified transcripts generated and analyzed during this study are available from the corresponding author on reasonable request.

Authors' Contributions

MJA is the grant holder and Chief Investigator and was responsible for study conceptualization and development of the study protocol, with critical input from grant coapplicants, SR, RF, MT, KES, CJE, PC, and PMM. AB and JB conducted interviews with study participants. Analysis was led by AB and conducted with critical input and supervision from JB, MT, and MA. All authors had access to all study data, discussed the interpretation of findings, take responsibility for data integrity and analysis, contributed to the analysis plan, and provided critical comments and contributed to the writing and development of the manuscript. All authors reviewed the final manuscript. Artificial Intelligence was not used to generate any portions of the submitted manuscript.

Conflicts of Interest

This study is funded by the NIHR Health and Social Care Delivery Research Programme (NIHR129171). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. KES is the Laing Galazka chair at King’s College London, funded through an endowment from Cicely Saunders International and the Kirby Laing Foundation. MJA is a University Academic Fellow, funded through a research fellowship from Yorkshire Cancer Research. RF receives funding from the UK National Institute for Health and Care Research and is chair of the National Institute for Health and Care Excellence Implementation Strategy Group. We wish to acknowledge Dr Samantha Coster, our colleague at King's College London, for her support and guidance in editing this article. This manuscript is published on behalf of the wider Optimal Care project team. Members of the team who are not included as authors on this manuscript but who were coapplicants and made significant contributions to the conceptualization and design of the project include Prof Michael Bennett (University of Leeds) and Dr Samuel Relton (University of Leeds, United Kingdom). We would also like to extend specific acknowledgment and recognition of our patient and public involvement lead for the Optimal Care project, Mrs Barbara Hibbert, who supported the development of project plans, formed our patient involvement group and facilitated inclusive and insightful patient and public involvement group meetings.

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Abbreviations

Edited by A Mavragani; submitted 23.06.23; peer-reviewed by C Laranjeira, T Phenwan; comments to author 14.09.23; revised version received 18.10.23; accepted 30.05.24; published 16.08.24.

©Andy Bradshaw, Jacqueline Birtwistle, Catherine J Evans, Katherine E Sleeman, Suzanne Richards, Robbie Foy, Pablo Millares Martin, Paul Carder, Matthew J Allsop, Maureen Twiddy. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 16.08.2024.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research (ISSN 1438-8871), is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.

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The power of a belief system: a systematic qualitative synthesis of spiritual care for patients with brain tumors.

1. Introduction

2. materials and methods, 2.1. literature search and methodology, 2.2. screening and data extraction, 2.3. data synthesis and analysis, search results, 4. discussion, 4.1. patient, 4.2. family or care givers, 4.3. provider, 4.4. future directions and limitations, 5. conclusions, author contributions, data availability statement, conflicts of interest.

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Click here to enlarge figure

Share and Cite

Mehta, N.H.; Prajapati, M.; Aeleti, R.; Kinariwala, K.; Ohri, K.; McCabe, S.; Buller, Z.; Leskinen, S.; Nawabi, N.L.; Bhatt, V.; et al. The Power of a Belief System: A Systematic Qualitative Synthesis of Spiritual Care for Patients with Brain Tumors. J. Clin. Med. 2024 , 13 , 4871. https://doi.org/10.3390/jcm13164871

Mehta NH, Prajapati M, Aeleti R, Kinariwala K, Ohri K, McCabe S, Buller Z, Leskinen S, Nawabi NL, Bhatt V, et al. The Power of a Belief System: A Systematic Qualitative Synthesis of Spiritual Care for Patients with Brain Tumors. Journal of Clinical Medicine . 2024; 13(16):4871. https://doi.org/10.3390/jcm13164871

Mehta, Neel H., Megh Prajapati, Rishi Aeleti, Kush Kinariwala, Karina Ohri, Sean McCabe, Zachary Buller, Sandra Leskinen, Noah L. Nawabi, Vatsal Bhatt, and et al. 2024. "The Power of a Belief System: A Systematic Qualitative Synthesis of Spiritual Care for Patients with Brain Tumors" Journal of Clinical Medicine 13, no. 16: 4871. https://doi.org/10.3390/jcm13164871

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Qualitative research method-interviewing and observation

Shazia jamshed.

Department of Pharmacy Practice, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan Campus, Pahang, Malaysia

Buckley and Chiang define research methodology as “a strategy or architectural design by which the researcher maps out an approach to problem-finding or problem-solving.”[ 1 ] According to Crotty, research methodology is a comprehensive strategy ‘that silhouettes our choice and use of specific methods relating them to the anticipated outcomes,[ 2 ] but the choice of research methodology is based upon the type and features of the research problem.[ 3 ] According to Johnson et al . mixed method research is “a class of research where the researcher mixes or combines quantitative and qualitative research techniques, methods, approaches, theories and or language into a single study.[ 4 ] In order to have diverse opinions and views, qualitative findings need to be supplemented with quantitative results.[ 5 ] Therefore, these research methodologies are considered to be complementary to each other rather than incompatible to each other.[ 6 ]

Qualitative research methodology is considered to be suitable when the researcher or the investigator either investigates new field of study or intends to ascertain and theorize prominent issues.[ 6 , 7 ] There are many qualitative methods which are developed to have an in depth and extensive understanding of the issues by means of their textual interpretation and the most common types are interviewing and observation.[ 7 ]

Interviewing

This is the most common format of data collection in qualitative research. According to Oakley, qualitative interview is a type of framework in which the practices and standards be not only recorded, but also achieved, challenged and as well as reinforced.[ 8 ] As no research interview lacks structure[ 9 ] most of the qualitative research interviews are either semi-structured, lightly structured or in-depth.[ 9 ] Unstructured interviews are generally suggested in conducting long-term field work and allow respondents to let them express in their own ways and pace, with minimal hold on respondents’ responses.[ 10 ]

Pioneers of ethnography developed the use of unstructured interviews with local key informants that is., by collecting the data through observation and record field notes as well as to involve themselves with study participants. To be precise, unstructured interview resembles a conversation more than an interview and is always thought to be a “controlled conversation,” which is skewed towards the interests of the interviewer.[ 11 ] Non-directive interviews, form of unstructured interviews are aimed to gather in-depth information and usually do not have pre-planned set of questions.[ 11 ] Another type of the unstructured interview is the focused interview in which the interviewer is well aware of the respondent and in times of deviating away from the main issue the interviewer generally refocuses the respondent towards key subject.[ 11 ] Another type of the unstructured interview is an informal, conversational interview, based on unplanned set of questions that are generated instantaneously during the interview.[ 11 ]

In contrast, semi-structured interviews are those in-depth interviews where the respondents have to answer preset open-ended questions and thus are widely employed by different healthcare professionals in their research. Semi-structured, in-depth interviews are utilized extensively as interviewing format possibly with an individual or sometimes even with a group.[ 6 ] These types of interviews are conducted once only, with an individual or with a group and generally cover the duration of 30 min to more than an hour.[ 12 ] Semi-structured interviews are based on semi-structured interview guide, which is a schematic presentation of questions or topics and need to be explored by the interviewer.[ 12 ] To achieve optimum use of interview time, interview guides serve the useful purpose of exploring many respondents more systematically and comprehensively as well as to keep the interview focused on the desired line of action.[ 12 ] The questions in the interview guide comprise of the core question and many associated questions related to the central question, which in turn, improve further through pilot testing of the interview guide.[ 7 ] In order to have the interview data captured more effectively, recording of the interviews is considered an appropriate choice but sometimes a matter of controversy among the researcher and the respondent. Hand written notes during the interview are relatively unreliable, and the researcher might miss some key points. The recording of the interview makes it easier for the researcher to focus on the interview content and the verbal prompts and thus enables the transcriptionist to generate “verbatim transcript” of the interview.

Similarly, in focus groups, invited groups of people are interviewed in a discussion setting in the presence of the session moderator and generally these discussions last for 90 min.[ 7 ] Like every research technique having its own merits and demerits, group discussions have some intrinsic worth of expressing the opinions openly by the participants. On the contrary in these types of discussion settings, limited issues can be focused, and this may lead to the generation of fewer initiatives and suggestions about research topic.

Observation

Observation is a type of qualitative research method which not only included participant's observation, but also covered ethnography and research work in the field. In the observational research design, multiple study sites are involved. Observational data can be integrated as auxiliary or confirmatory research.[ 11 ]

Research can be visualized and perceived as painstaking methodical efforts to examine, investigate as well as restructure the realities, theories and applications. Research methods reflect the approach to tackling the research problem. Depending upon the need, research method could be either an amalgam of both qualitative and quantitative or qualitative or quantitative independently. By adopting qualitative methodology, a prospective researcher is going to fine-tune the pre-conceived notions as well as extrapolate the thought process, analyzing and estimating the issues from an in-depth perspective. This could be carried out by one-to-one interviews or as issue-directed discussions. Observational methods are, sometimes, supplemental means for corroborating research findings.

Home > Blog >

Transcription in qualitative research: a comprehensive guide for ux researchers, theertha raj.

August 15, 2024

As a UX researcher, you're likely familiar with the importance of gathering qualitative data through interviews, focus groups, and observational studies. But what happens after you've collected all that valuable audio or video content? That's where transcription for qualitative research comes into play. 

In this article, we'll dive deep into the world of transcription, exploring its importance, types, and best practices for UX researchers.

What is transcription in qualitative research?

Transcription in qualitative research is the process of converting spoken words or recorded audio into written text. 

This crucial step allows researchers to analyze, code, and interpret the data collected during interviews, focus groups, or other qualitative research methods. 

This written format makes it easier to review, share, and analyze the data, ultimately leading to more informed design choices and improved user experiences.

What are the 4 types of transcription?

When it comes to transcription qualitative research, there are four main types that researchers should be aware of:

• Verbatim transcription: This type captures every utterance, including filler words, false starts, and non-verbal sounds. It's the most detailed form of transcription and is often used when analyzing speech patterns or conducting linguistic studies.
• Intelligent verbatim transcription: Also known as "clean verbatim," this type removes filler words and false starts while maintaining the essence of the conversation. It's more readable than strict verbatim transcription and is commonly used in qualitative research.
• This type focuses on capturing the main ideas and content of the conversation while cleaning up grammar and removing unnecessary repetitions. It's useful when the primary goal is to understand the content rather than analyze speech patterns.
• This specialized type uses phonetic symbols to represent the sounds of speech. It's primarily used in linguistic research and is less common in UX research contexts.

What type of transcription is used in qualitative research?

In qualitative research, intelligent verbatim transcription is often the preferred choice . This type of transcription strikes a balance between capturing the essence of the conversation and maintaining readability. It preserves the interviewee's words and intent while removing unnecessary filler words and false starts that can distract from the main content.

This type of transcription in qualitative research makes it easier to identify key themes, pain points, and user needs that can inform design decisions.

What type of transcription is used in thematic analysis?

Thematic analysis , a common method used in qualitative research to identify patterns and themes within data, typically relies on intelligent verbatim transcription . It provides enough detail to capture the nuances of participants' responses while maintaining readability, making it ideal for identifying recurring themes and concepts.

What is the average price for transcription services?

The cost of transcription services for qualitative research can vary widely depending on factors such as turnaround time, audio quality, and the level of detail required. On average, professional qualitative transcription services may charge anywhere from $1 to $3 per audio minute for standard turnaround times (typically 3-5 business days).

For UX researchers working on time-sensitive projects, expedited services are available but often come at a premium, with prices potentially doubling or tripling. 

It's worth noting that some of the best transcription services for qualitative research offer discounts for bulk orders or ongoing projects, which can be beneficial for researchers conducting multiple interviews or focus groups.

When considering the cost, it's important to weigh the value of professional qualitative research transcription services against the time and effort required to transcribe in-house. While DIY transcription might seem cost-effective, it can be time-consuming and may not yield the same level of accuracy as professional services.

How to write a transcript for qualitative research

Writing a transcript for qualitative research involves more than just typing out what you hear. 

Here are some key steps to ensure your transcripts are accurate, useful, and ready for analysis:

• Prepare your tools: Choose reliable transcription software for qualitative research or a word processing program. Ensure you have a good quality audio playback device and headphones for clear listening.
• Listen to the entire recording: Before you start transcribing, listen to the entire recording to familiarize yourself with the content, speakers, and any potential audio issues.
• Create a template: Set up a consistent format for your transcripts, including headers for participant information, date, time, and any other relevant details.
• Transcribe the content: Begin typing out the conversation, following the intelligent verbatim method unless your research requires a different approach. Include speaker labels to differentiate between the interviewer and participant(s).
• Add time stamps: Regularly insert timestamps throughout the transcript. This helps in referencing specific parts of the conversation later and syncing the transcript with the original audio if needed.
• Note non-verbal cues: When relevant, include descriptions of significant non-verbal communication or environmental factors in square brackets, e.g., [laughs], [long pause], [background noise].
• Review and edit: Once you've completed the initial transcription, review it while listening to the audio again. Correct any errors and ensure the transcript accurately represents the conversation.
• Format for readability: Use paragraphs to separate distinct topics or questions. While it's best to keep bullet points and lists to a minimum, you can use them sparingly to highlight key points if necessary.

How do you transcribe audio data in qualitative research?

Transcribing audio data in qualitative research is a process that requires careful consideration of several factors. 

What are the aims of the research project?

Before you begin transcribing, it's crucial to clearly understand the goals of your research project . Are you looking to gather specific user feedback on a product feature? Or are you conducting a broader study on user behavior and preferences? The aims of your project will influence the level of detail and focus required in your transcriptions.

For example, if you're researching user reactions to a new app interface, you might pay special attention to comments about the layout, navigation, and visual elements. On the other hand, if you're exploring user motivations and decision-making processes, you might focus more on capturing the reasoning and emotions behind their responses.

What level of detail is required?

The level of detail in your transcriptions should align with your research goals and analysis methods. For most UX research projects, intelligent verbatim transcription provides an ideal balance of detail and readability. However, there may be instances where more or less detail is necessary.

If you're conducting a usability test and need to capture specific user actions along with their verbal feedback, you might include more detailed notes about their interactions with the product. Conversely, if you're more interested in high-level themes and general user sentiment, a slightly less detailed transcription might suffice.

Who should do the transcribing?

Deciding who should handle the transcription is an important consideration. You have several options:

• DIY transcription: As the researcher, you might choose to transcribe the audio yourself. This can be time-consuming but allows you to immerse yourself in the data and potentially identify themes early on.
• Team member transcription: Assigning transcription tasks to other team members can distribute the workload and provide multiple perspectives on the data.
• Professional transcription services: Opting for qualitative research transcription services can save time and ensure high-quality, accurate transcripts. Many services specialize in research transcription and understand the specific needs of qualitative researchers.
• Transcription software: Using qualitative research transcription software can speed up the process, especially for clear audio recordings. However, it's important to review and edit machine-generated transcripts for accuracy.

What contextual detail is necessary to interpret data?

Context is crucial in qualitative research, and your transcripts should include relevant contextual details that aid in interpreting the data. This might include:

• Background information about the participant (e.g., age range, profession, relevant experience)
• The setting of the interview or focus group
• Any visual aids or prototypes used during the session
• Significant non-verbal cues or reactions

How should data be represented?

When it comes to representing data in your transcripts, clarity and consistency are key. Use a clear, consistent format for speaker labels (e.g., "Interviewer:", "Participant 1:"). Include time stamps at regular intervals or at the beginning of new topics. Consider using bold or italics to highlight key quotes or themes, but use this sparingly to maintain readability.

What is an example of a transcription? 

Here’s an example of what an AI-generated transcript looks like, with time-stamps and Speaker labels. The transcript also features text highlighted in green for positive responses, and blue for questions.

Best Automated Transcription Services for Qualitative Research

When conducting qualitative research, choosing the right transcription service is crucial for efficient data analysis. Here's a comparison of some popular transcription tools used in qualitative research:

NVivo is primarily a qualitative data analysis tool that offers transcription services as part of its feature set.

Price: NVivo's pricing is on the higher end, with users required to purchase blocks of transcription time (e.g., €80 for 10 hours).

• NVivo allows uploading of various audio and video file formats to its online platform.
• Allows you to edit and make changes, tag speakers, and ensure proper formatting 
• Offers encrypted and secure storage, adhering to HIPAA standards and GDPR compliance

Languages Supported: NVivo supports transcription in 42 languages.

Time taken: Specific time is not mentioned, but it's noted to be generally slower compared to other tools.

Accuracy: NVivo's transcription accuracy is lower compared to competitors, especially in noisy environments and with accents.

How much does NVivo transcription cost?

NVivo transcription costs around €80 for 10 hours of transcription time. The pricing structure is based on purchasing blocks of time rather than a subscription model.

Is NVivo transcription free?

No, NVivo transcription is not free. It requires purchasing transcription time.

Is NVivo good at transcription?

NVivo's transcription capabilities are considered less accurate compared to some competitors, especially in challenging audio conditions or with accented speech.

Is NVivo used for qualitative research?

Yes, NVivo is widely used for qualitative research, primarily as a data analysis tool. Its transcription feature is an additional service within this broader qualitative research platform.

Dovetail is a comprehensive research repository that includes transcription, coding, and data analysis features.

Price: Dovetail offers a free plan with 1 project per month, while paid plans start at $29 per user per month.

• Does automated transcription of video and audio recordings
• Does sentiment analysis of transcripts with highlights for positive and negative responses
• Also offers built-in analysis tools for coding and tagging of transcripts

Languages Supported: Supports 41 languages, including Japanese, Finnish, Hindi, and Malay.

‍ Time taken: Transcription is completed within minutes.

Accuracy: While generally considered accurate, specific accuracy metrics are not provided.

Looppanel is an AI-powered research repository tool that can do extremely accurate interview transcription for UX research, among other cool features. It’s special compared to other transcription services on this list, as it also lets you record your calls directly, and receive high-quality transcripts within mere minutes. 

Price: Paid plans start at $30 per month, with a 15-day free trial available.

‍ Features:

• Collaboratively take notes with colleagues during your user interviews 
• Save key time-stamps of important quotes as they come up
• Sentiment analysis of transcripts with highlights for questions, positive and negative responses
• Generate AI-powered notes from your transcript for you, with a dedicated analysis space where you can see all your data by question or tags
• Do Google-like search within your research repository to find any quote or data point you need, in minutes.

Languages Supported: Supports 8 languages, including English, Spanish, French, German, Italian, Portuguese, Dutch, and Hindi.

Time taken: Provides near-instant transcripts for recorded calls.

Accuracy: Looppanel boasts over 90% accuracy in transcription.

MAXQDA is a research analysis tool that’s more complex than the others, but is ideal for academics and scientists who need deep, detailed analysis. MAXQDA offers transcription services alongside qualitative analysis tools.

Price: Approximately $20 for 2 hours of transcription, with varying plans based on industry and use case.

• MAXQDA offers a customizable dictionary for accuracy
• Does automatic speaker detection, and timestamps. 
• It's GDPR-compliant 
• Doesn't require a subscription or MAXQDA license for transcription services.

Languages Supported: Supports over 48 languages.

Time taken: Transcription is completed within minutes.

‍ Accuracy: Claims over 90% accuracy

Otter.ai is a transcription tool that doesn’t offer any in-app analysis features, unlike the other tools on this list.

Price: Offers a free tier with 300 minutes of transcription; paid plans start at $8.33 per month.

‍ Features: 

• Otter.ai can record and transcribe meetings on various platforms in real-time, capture slides, and generate summaries
• It also allows for YouTube video transcription
• Exports to various file formats.

Languages Supported: Only English

Time taken: Within minutes

Accuracy: Generally high accuracy, especially in structured meeting environments.

Challenges in transcription

Transcription in qualitative research can face several challenges:

• Audio quality issues
• Multiple speakers or overlapping speech
• Accents or dialects
• Background noise
• Jargon or specialized terminology
• Time-consuming nature of manual transcription
• Maintaining consistency across multiple transcripts

Best Practices for Transcription in Action

How to do it:

• Use high-quality recording equipment
• Conduct interviews in quiet environments when possible
• Consider using a foot pedal for manual transcription to improve efficiency
• Use transcription software or services for larger projects

What to include:

Speaker identification, time stamps, non-verbal cues (laughter, pauses, sighs), contextual information and consistent formatting

How to record for optimal use in your study:

• Test your recording equipment before the interview
• Use external microphones for better audio quality
• Inform participants about the recording
• Take brief notes during the interview to supplement the recording
• Back up your recordings immediately after the interview

‍ What is the difference between transcription and translation in qualitative research?

Transcription involves converting spoken language into written text in the same language, while translation involves converting text from one language to another. In qualitative research, transcription is typically done first, followed by translation if the research is conducted in a language different from the one used for analysis.

What are the different types of transcription process?

The main types of transcription processes are:

1. Verbatim transcription (including all utterances and sounds) 2. Intelligent verbatim (removing fillers and false starts) 3. Edited transcription (cleaning up grammar and removing repetitions) 4. Phonetic transcription (using phonetic symbols to represent sounds)

What transcription services for qualitative data?

Transcription services for qualitative data include automated tools like NVivo, Dovetail, Looppanel, MAXQDA, and Otter.ai, as well as human transcription services. The choice depends on factors such as budget, accuracy requirements, and the complexity of the audio data.

Can I use NVivo for transcription?

Yes, you can use NVivo for transcription. However, it's important to note that while NVivo offers transcription services, it may not be as accurate or cost-effective as some alternatives, especially for large-scale projects or challenging audio conditions.

What is the alternative to NVivo transcription?

Alternatives to NVivo transcription include Dovetail, Looppanel, MAXQDA, and Otter.ai, each offering different features and pricing structures.

Is NVivo transcription worth it?

The value of NVivo transcription depends on your specific needs. While it integrates well with NVivo's analysis tools, its lower accuracy and higher price point may make it less appealing for some researchers.

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Resources & Guides

How to Transcribe Interviews for UX Research

Best Transcription Services for Market Research

June 8, 2023

The Best Transcription Services for User Research

Looppanel automatically records your calls, transcribes them, and centralizes all your research data in one place