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Content Analysis | Guide, Methods & Examples

Published on July 18, 2019 by Amy Luo . Revised on June 22, 2023.

Content analysis is a research method used to identify patterns in recorded communication. To conduct content analysis, you systematically collect data from a set of texts, which can be written, oral, or visual:

  • Books, newspapers and magazines
  • Speeches and interviews
  • Web content and social media posts
  • Photographs and films

Content analysis can be both quantitative (focused on counting and measuring) and qualitative (focused on interpreting and understanding).  In both types, you categorize or “code” words, themes, and concepts within the texts and then analyze the results.

Table of contents

What is content analysis used for, advantages of content analysis, disadvantages of content analysis, how to conduct content analysis, other interesting articles.

Researchers use content analysis to find out about the purposes, messages, and effects of communication content. They can also make inferences about the producers and audience of the texts they analyze.

Content analysis can be used to quantify the occurrence of certain words, phrases, subjects or concepts in a set of historical or contemporary texts.

Quantitative content analysis example

To research the importance of employment issues in political campaigns, you could analyze campaign speeches for the frequency of terms such as unemployment , jobs , and work  and use statistical analysis to find differences over time or between candidates.

In addition, content analysis can be used to make qualitative inferences by analyzing the meaning and semantic relationship of words and concepts.

Qualitative content analysis example

To gain a more qualitative understanding of employment issues in political campaigns, you could locate the word unemployment in speeches, identify what other words or phrases appear next to it (such as economy,   inequality or  laziness ), and analyze the meanings of these relationships to better understand the intentions and targets of different campaigns.

Because content analysis can be applied to a broad range of texts, it is used in a variety of fields, including marketing, media studies, anthropology, cognitive science, psychology, and many social science disciplines. It has various possible goals:

  • Finding correlations and patterns in how concepts are communicated
  • Understanding the intentions of an individual, group or institution
  • Identifying propaganda and bias in communication
  • Revealing differences in communication in different contexts
  • Analyzing the consequences of communication content, such as the flow of information or audience responses

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  • Unobtrusive data collection

You can analyze communication and social interaction without the direct involvement of participants, so your presence as a researcher doesn’t influence the results.

  • Transparent and replicable

When done well, content analysis follows a systematic procedure that can easily be replicated by other researchers, yielding results with high reliability .

  • Highly flexible

You can conduct content analysis at any time, in any location, and at low cost – all you need is access to the appropriate sources.

Focusing on words or phrases in isolation can sometimes be overly reductive, disregarding context, nuance, and ambiguous meanings.

Content analysis almost always involves some level of subjective interpretation, which can affect the reliability and validity of the results and conclusions, leading to various types of research bias and cognitive bias .

  • Time intensive

Manually coding large volumes of text is extremely time-consuming, and it can be difficult to automate effectively.

If you want to use content analysis in your research, you need to start with a clear, direct  research question .

Example research question for content analysis

Is there a difference in how the US media represents younger politicians compared to older ones in terms of trustworthiness?

Next, you follow these five steps.

1. Select the content you will analyze

Based on your research question, choose the texts that you will analyze. You need to decide:

  • The medium (e.g. newspapers, speeches or websites) and genre (e.g. opinion pieces, political campaign speeches, or marketing copy)
  • The inclusion and exclusion criteria (e.g. newspaper articles that mention a particular event, speeches by a certain politician, or websites selling a specific type of product)
  • The parameters in terms of date range, location, etc.

If there are only a small amount of texts that meet your criteria, you might analyze all of them. If there is a large volume of texts, you can select a sample .

2. Define the units and categories of analysis

Next, you need to determine the level at which you will analyze your chosen texts. This means defining:

  • The unit(s) of meaning that will be coded. For example, are you going to record the frequency of individual words and phrases, the characteristics of people who produced or appear in the texts, the presence and positioning of images, or the treatment of themes and concepts?
  • The set of categories that you will use for coding. Categories can be objective characteristics (e.g. aged 30-40 ,  lawyer , parent ) or more conceptual (e.g. trustworthy , corrupt , conservative , family oriented ).

Your units of analysis are the politicians who appear in each article and the words and phrases that are used to describe them. Based on your research question, you have to categorize based on age and the concept of trustworthiness. To get more detailed data, you also code for other categories such as their political party and the marital status of each politician mentioned.

3. Develop a set of rules for coding

Coding involves organizing the units of meaning into the previously defined categories. Especially with more conceptual categories, it’s important to clearly define the rules for what will and won’t be included to ensure that all texts are coded consistently.

Coding rules are especially important if multiple researchers are involved, but even if you’re coding all of the text by yourself, recording the rules makes your method more transparent and reliable.

In considering the category “younger politician,” you decide which titles will be coded with this category ( senator, governor, counselor, mayor ). With “trustworthy”, you decide which specific words or phrases related to trustworthiness (e.g. honest and reliable ) will be coded in this category.

4. Code the text according to the rules

You go through each text and record all relevant data in the appropriate categories. This can be done manually or aided with computer programs, such as QSR NVivo , Atlas.ti and Diction , which can help speed up the process of counting and categorizing words and phrases.

Following your coding rules, you examine each newspaper article in your sample. You record the characteristics of each politician mentioned, along with all words and phrases related to trustworthiness that are used to describe them.

5. Analyze the results and draw conclusions

Once coding is complete, the collected data is examined to find patterns and draw conclusions in response to your research question. You might use statistical analysis to find correlations or trends, discuss your interpretations of what the results mean, and make inferences about the creators, context and audience of the texts.

Let’s say the results reveal that words and phrases related to trustworthiness appeared in the same sentence as an older politician more frequently than they did in the same sentence as a younger politician. From these results, you conclude that national newspapers present older politicians as more trustworthy than younger politicians, and infer that this might have an effect on readers’ perceptions of younger people in politics.

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.

  • Normal distribution
  • Measures of central tendency
  • Chi square tests
  • Confidence interval
  • Quartiles & Quantiles
  • Cluster sampling
  • Stratified sampling
  • Thematic analysis
  • Cohort study
  • Peer review
  • Ethnography

Research bias

  • Implicit bias
  • Cognitive bias
  • Conformity bias
  • Hawthorne effect
  • Availability heuristic
  • Attrition bias
  • Social desirability bias

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Home » Case Study – Methods, Examples and Guide

Case Study – Methods, Examples and Guide

Table of Contents

Case Study Research

A case study is a research method that involves an in-depth examination and analysis of a particular phenomenon or case, such as an individual, organization, community, event, or situation.

It is a qualitative research approach that aims to provide a detailed and comprehensive understanding of the case being studied. Case studies typically involve multiple sources of data, including interviews, observations, documents, and artifacts, which are analyzed using various techniques, such as content analysis, thematic analysis, and grounded theory. The findings of a case study are often used to develop theories, inform policy or practice, or generate new research questions.

Types of Case Study

Types and Methods of Case Study are as follows:

Single-Case Study

A single-case study is an in-depth analysis of a single case. This type of case study is useful when the researcher wants to understand a specific phenomenon in detail.

For Example , A researcher might conduct a single-case study on a particular individual to understand their experiences with a particular health condition or a specific organization to explore their management practices. The researcher collects data from multiple sources, such as interviews, observations, and documents, and uses various techniques to analyze the data, such as content analysis or thematic analysis. The findings of a single-case study are often used to generate new research questions, develop theories, or inform policy or practice.

Multiple-Case Study

A multiple-case study involves the analysis of several cases that are similar in nature. This type of case study is useful when the researcher wants to identify similarities and differences between the cases.

For Example, a researcher might conduct a multiple-case study on several companies to explore the factors that contribute to their success or failure. The researcher collects data from each case, compares and contrasts the findings, and uses various techniques to analyze the data, such as comparative analysis or pattern-matching. The findings of a multiple-case study can be used to develop theories, inform policy or practice, or generate new research questions.

Exploratory Case Study

An exploratory case study is used to explore a new or understudied phenomenon. This type of case study is useful when the researcher wants to generate hypotheses or theories about the phenomenon.

For Example, a researcher might conduct an exploratory case study on a new technology to understand its potential impact on society. The researcher collects data from multiple sources, such as interviews, observations, and documents, and uses various techniques to analyze the data, such as grounded theory or content analysis. The findings of an exploratory case study can be used to generate new research questions, develop theories, or inform policy or practice.

Descriptive Case Study

A descriptive case study is used to describe a particular phenomenon in detail. This type of case study is useful when the researcher wants to provide a comprehensive account of the phenomenon.

For Example, a researcher might conduct a descriptive case study on a particular community to understand its social and economic characteristics. The researcher collects data from multiple sources, such as interviews, observations, and documents, and uses various techniques to analyze the data, such as content analysis or thematic analysis. The findings of a descriptive case study can be used to inform policy or practice or generate new research questions.

Instrumental Case Study

An instrumental case study is used to understand a particular phenomenon that is instrumental in achieving a particular goal. This type of case study is useful when the researcher wants to understand the role of the phenomenon in achieving the goal.

For Example, a researcher might conduct an instrumental case study on a particular policy to understand its impact on achieving a particular goal, such as reducing poverty. The researcher collects data from multiple sources, such as interviews, observations, and documents, and uses various techniques to analyze the data, such as content analysis or thematic analysis. The findings of an instrumental case study can be used to inform policy or practice or generate new research questions.

Case Study Data Collection Methods

Here are some common data collection methods for case studies:

Interviews involve asking questions to individuals who have knowledge or experience relevant to the case study. Interviews can be structured (where the same questions are asked to all participants) or unstructured (where the interviewer follows up on the responses with further questions). Interviews can be conducted in person, over the phone, or through video conferencing.

Observations

Observations involve watching and recording the behavior and activities of individuals or groups relevant to the case study. Observations can be participant (where the researcher actively participates in the activities) or non-participant (where the researcher observes from a distance). Observations can be recorded using notes, audio or video recordings, or photographs.

Documents can be used as a source of information for case studies. Documents can include reports, memos, emails, letters, and other written materials related to the case study. Documents can be collected from the case study participants or from public sources.

Surveys involve asking a set of questions to a sample of individuals relevant to the case study. Surveys can be administered in person, over the phone, through mail or email, or online. Surveys can be used to gather information on attitudes, opinions, or behaviors related to the case study.

Artifacts are physical objects relevant to the case study. Artifacts can include tools, equipment, products, or other objects that provide insights into the case study phenomenon.

How to conduct Case Study Research

Conducting a case study research involves several steps that need to be followed to ensure the quality and rigor of the study. Here are the steps to conduct case study research:

  • Define the research questions: The first step in conducting a case study research is to define the research questions. The research questions should be specific, measurable, and relevant to the case study phenomenon under investigation.
  • Select the case: The next step is to select the case or cases to be studied. The case should be relevant to the research questions and should provide rich and diverse data that can be used to answer the research questions.
  • Collect data: Data can be collected using various methods, such as interviews, observations, documents, surveys, and artifacts. The data collection method should be selected based on the research questions and the nature of the case study phenomenon.
  • Analyze the data: The data collected from the case study should be analyzed using various techniques, such as content analysis, thematic analysis, or grounded theory. The analysis should be guided by the research questions and should aim to provide insights and conclusions relevant to the research questions.
  • Draw conclusions: The conclusions drawn from the case study should be based on the data analysis and should be relevant to the research questions. The conclusions should be supported by evidence and should be clearly stated.
  • Validate the findings: The findings of the case study should be validated by reviewing the data and the analysis with participants or other experts in the field. This helps to ensure the validity and reliability of the findings.
  • Write the report: The final step is to write the report of the case study research. The report should provide a clear description of the case study phenomenon, the research questions, the data collection methods, the data analysis, the findings, and the conclusions. The report should be written in a clear and concise manner and should follow the guidelines for academic writing.

Examples of Case Study

Here are some examples of case study research:

  • The Hawthorne Studies : Conducted between 1924 and 1932, the Hawthorne Studies were a series of case studies conducted by Elton Mayo and his colleagues to examine the impact of work environment on employee productivity. The studies were conducted at the Hawthorne Works plant of the Western Electric Company in Chicago and included interviews, observations, and experiments.
  • The Stanford Prison Experiment: Conducted in 1971, the Stanford Prison Experiment was a case study conducted by Philip Zimbardo to examine the psychological effects of power and authority. The study involved simulating a prison environment and assigning participants to the role of guards or prisoners. The study was controversial due to the ethical issues it raised.
  • The Challenger Disaster: The Challenger Disaster was a case study conducted to examine the causes of the Space Shuttle Challenger explosion in 1986. The study included interviews, observations, and analysis of data to identify the technical, organizational, and cultural factors that contributed to the disaster.
  • The Enron Scandal: The Enron Scandal was a case study conducted to examine the causes of the Enron Corporation’s bankruptcy in 2001. The study included interviews, analysis of financial data, and review of documents to identify the accounting practices, corporate culture, and ethical issues that led to the company’s downfall.
  • The Fukushima Nuclear Disaster : The Fukushima Nuclear Disaster was a case study conducted to examine the causes of the nuclear accident that occurred at the Fukushima Daiichi Nuclear Power Plant in Japan in 2011. The study included interviews, analysis of data, and review of documents to identify the technical, organizational, and cultural factors that contributed to the disaster.

Application of Case Study

Case studies have a wide range of applications across various fields and industries. Here are some examples:

Business and Management

Case studies are widely used in business and management to examine real-life situations and develop problem-solving skills. Case studies can help students and professionals to develop a deep understanding of business concepts, theories, and best practices.

Case studies are used in healthcare to examine patient care, treatment options, and outcomes. Case studies can help healthcare professionals to develop critical thinking skills, diagnose complex medical conditions, and develop effective treatment plans.

Case studies are used in education to examine teaching and learning practices. Case studies can help educators to develop effective teaching strategies, evaluate student progress, and identify areas for improvement.

Social Sciences

Case studies are widely used in social sciences to examine human behavior, social phenomena, and cultural practices. Case studies can help researchers to develop theories, test hypotheses, and gain insights into complex social issues.

Law and Ethics

Case studies are used in law and ethics to examine legal and ethical dilemmas. Case studies can help lawyers, policymakers, and ethical professionals to develop critical thinking skills, analyze complex cases, and make informed decisions.

Purpose of Case Study

The purpose of a case study is to provide a detailed analysis of a specific phenomenon, issue, or problem in its real-life context. A case study is a qualitative research method that involves the in-depth exploration and analysis of a particular case, which can be an individual, group, organization, event, or community.

The primary purpose of a case study is to generate a comprehensive and nuanced understanding of the case, including its history, context, and dynamics. Case studies can help researchers to identify and examine the underlying factors, processes, and mechanisms that contribute to the case and its outcomes. This can help to develop a more accurate and detailed understanding of the case, which can inform future research, practice, or policy.

Case studies can also serve other purposes, including:

  • Illustrating a theory or concept: Case studies can be used to illustrate and explain theoretical concepts and frameworks, providing concrete examples of how they can be applied in real-life situations.
  • Developing hypotheses: Case studies can help to generate hypotheses about the causal relationships between different factors and outcomes, which can be tested through further research.
  • Providing insight into complex issues: Case studies can provide insights into complex and multifaceted issues, which may be difficult to understand through other research methods.
  • Informing practice or policy: Case studies can be used to inform practice or policy by identifying best practices, lessons learned, or areas for improvement.

Advantages of Case Study Research

There are several advantages of case study research, including:

  • In-depth exploration: Case study research allows for a detailed exploration and analysis of a specific phenomenon, issue, or problem in its real-life context. This can provide a comprehensive understanding of the case and its dynamics, which may not be possible through other research methods.
  • Rich data: Case study research can generate rich and detailed data, including qualitative data such as interviews, observations, and documents. This can provide a nuanced understanding of the case and its complexity.
  • Holistic perspective: Case study research allows for a holistic perspective of the case, taking into account the various factors, processes, and mechanisms that contribute to the case and its outcomes. This can help to develop a more accurate and comprehensive understanding of the case.
  • Theory development: Case study research can help to develop and refine theories and concepts by providing empirical evidence and concrete examples of how they can be applied in real-life situations.
  • Practical application: Case study research can inform practice or policy by identifying best practices, lessons learned, or areas for improvement.
  • Contextualization: Case study research takes into account the specific context in which the case is situated, which can help to understand how the case is influenced by the social, cultural, and historical factors of its environment.

Limitations of Case Study Research

There are several limitations of case study research, including:

  • Limited generalizability : Case studies are typically focused on a single case or a small number of cases, which limits the generalizability of the findings. The unique characteristics of the case may not be applicable to other contexts or populations, which may limit the external validity of the research.
  • Biased sampling: Case studies may rely on purposive or convenience sampling, which can introduce bias into the sample selection process. This may limit the representativeness of the sample and the generalizability of the findings.
  • Subjectivity: Case studies rely on the interpretation of the researcher, which can introduce subjectivity into the analysis. The researcher’s own biases, assumptions, and perspectives may influence the findings, which may limit the objectivity of the research.
  • Limited control: Case studies are typically conducted in naturalistic settings, which limits the control that the researcher has over the environment and the variables being studied. This may limit the ability to establish causal relationships between variables.
  • Time-consuming: Case studies can be time-consuming to conduct, as they typically involve a detailed exploration and analysis of a specific case. This may limit the feasibility of conducting multiple case studies or conducting case studies in a timely manner.
  • Resource-intensive: Case studies may require significant resources, including time, funding, and expertise. This may limit the ability of researchers to conduct case studies in resource-constrained settings.

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Chapter 17. Content Analysis

Introduction.

Content analysis is a term that is used to mean both a method of data collection and a method of data analysis. Archival and historical works can be the source of content analysis, but so too can the contemporary media coverage of a story, blogs, comment posts, films, cartoons, advertisements, brand packaging, and photographs posted on Instagram or Facebook. Really, almost anything can be the “content” to be analyzed. This is a qualitative research method because the focus is on the meanings and interpretations of that content rather than strictly numerical counts or variables-based causal modeling. [1] Qualitative content analysis (sometimes referred to as QCA) is particularly useful when attempting to define and understand prevalent stories or communication about a topic of interest—in other words, when we are less interested in what particular people (our defined sample) are doing or believing and more interested in what general narratives exist about a particular topic or issue. This chapter will explore different approaches to content analysis and provide helpful tips on how to collect data, how to turn that data into codes for analysis, and how to go about presenting what is found through analysis. It is also a nice segue between our data collection methods (e.g., interviewing, observation) chapters and chapters 18 and 19, whose focus is on coding, the primary means of data analysis for most qualitative data. In many ways, the methods of content analysis are quite similar to the method of coding.

case study research qualitative content analysis

Although the body of material (“content”) to be collected and analyzed can be nearly anything, most qualitative content analysis is applied to forms of human communication (e.g., media posts, news stories, campaign speeches, advertising jingles). The point of the analysis is to understand this communication, to systematically and rigorously explore its meanings, assumptions, themes, and patterns. Historical and archival sources may be the subject of content analysis, but there are other ways to analyze (“code”) this data when not overly concerned with the communicative aspect (see chapters 18 and 19). This is why we tend to consider content analysis its own method of data collection as well as a method of data analysis. Still, many of the techniques you learn in this chapter will be helpful to any “coding” scheme you develop for other kinds of qualitative data. Just remember that content analysis is a particular form with distinct aims and goals and traditions.

An Overview of the Content Analysis Process

The first step: selecting content.

Figure 17.2 is a display of possible content for content analysis. The first step in content analysis is making smart decisions about what content you will want to analyze and to clearly connect this content to your research question or general focus of research. Why are you interested in the messages conveyed in this particular content? What will the identification of patterns here help you understand? Content analysis can be fun to do, but in order to make it research, you need to fit it into a research plan.

New stories Blogs Comment posts Lyrics
Letters to editor Films Cartoons Advertisements
Brand packaging Logos Instagram photos Tweets
Photographs Graffiti Street signs Personalized license plates
Avatars (names, shapes, presentations) Nicknames Band posters Building names

Figure 17.1. A Non-exhaustive List of "Content" for Content Analysis

To take one example, let us imagine you are interested in gender presentations in society and how presentations of gender have changed over time. There are various forms of content out there that might help you document changes. You could, for example, begin by creating a list of magazines that are coded as being for “women” (e.g., Women’s Daily Journal ) and magazines that are coded as being for “men” (e.g., Men’s Health ). You could then select a date range that is relevant to your research question (e.g., 1950s–1970s) and collect magazines from that era. You might create a “sample” by deciding to look at three issues for each year in the date range and a systematic plan for what to look at in those issues (e.g., advertisements? Cartoons? Titles of articles? Whole articles?). You are not just going to look at some magazines willy-nilly. That would not be systematic enough to allow anyone to replicate or check your findings later on. Once you have a clear plan of what content is of interest to you and what you will be looking at, you can begin, creating a record of everything you are including as your content. This might mean a list of each advertisement you look at or each title of stories in those magazines along with its publication date. You may decide to have multiple “content” in your research plan. For each content, you want a clear plan for collecting, sampling, and documenting.

The Second Step: Collecting and Storing

Once you have a plan, you are ready to collect your data. This may entail downloading from the internet, creating a Word document or PDF of each article or picture, and storing these in a folder designated by the source and date (e.g., “ Men’s Health advertisements, 1950s”). Sølvberg ( 2021 ), for example, collected posted job advertisements for three kinds of elite jobs (economic, cultural, professional) in Sweden. But collecting might also mean going out and taking photographs yourself, as in the case of graffiti, street signs, or even what people are wearing. Chaise LaDousa, an anthropologist and linguist, took photos of “house signs,” which are signs, often creative and sometimes offensive, hung by college students living in communal off-campus houses. These signs were a focal point of college culture, sending messages about the values of the students living in them. Some of the names will give you an idea: “Boot ’n Rally,” “The Plantation,” “Crib of the Rib.” The students might find these signs funny and benign, but LaDousa ( 2011 ) argued convincingly that they also reproduced racial and gender inequalities. The data here already existed—they were big signs on houses—but the researcher had to collect the data by taking photographs.

In some cases, your content will be in physical form but not amenable to photographing, as in the case of films or unwieldy physical artifacts you find in the archives (e.g., undigitized meeting minutes or scrapbooks). In this case, you need to create some kind of detailed log (fieldnotes even) of the content that you can reference. In the case of films, this might mean watching the film and writing down details for key scenes that become your data. [2] For scrapbooks, it might mean taking notes on what you are seeing, quoting key passages, describing colors or presentation style. As you might imagine, this can take a lot of time. Be sure you budget this time into your research plan.

Researcher Note

A note on data scraping : Data scraping, sometimes known as screen scraping or frame grabbing, is a way of extracting data generated by another program, as when a scraping tool grabs information from a website. This may help you collect data that is on the internet, but you need to be ethical in how to employ the scraper. A student once helped me scrape thousands of stories from the Time magazine archives at once (although it took several hours for the scraping process to complete). These stories were freely available, so the scraping process simply sped up the laborious process of copying each article of interest and saving it to my research folder. Scraping tools can sometimes be used to circumvent paywalls. Be careful here!

The Third Step: Analysis

There is often an assumption among novice researchers that once you have collected your data, you are ready to write about what you have found. Actually, you haven’t yet found anything, and if you try to write up your results, you will probably be staring sadly at a blank page. Between the collection and the writing comes the difficult task of systematically and repeatedly reviewing the data in search of patterns and themes that will help you interpret the data, particularly its communicative aspect (e.g., What is it that is being communicated here, with these “house signs” or in the pages of Men’s Health ?).

The first time you go through the data, keep an open mind on what you are seeing (or hearing), and take notes about your observations that link up to your research question. In the beginning, it can be difficult to know what is relevant and what is extraneous. Sometimes, your research question changes based on what emerges from the data. Use the first round of review to consider this possibility, but then commit yourself to following a particular focus or path. If you are looking at how gender gets made or re-created, don’t follow the white rabbit down a hole about environmental injustice unless you decide that this really should be the focus of your study or that issues of environmental injustice are linked to gender presentation. In the second round of review, be very clear about emerging themes and patterns. Create codes (more on these in chapters 18 and 19) that will help you simplify what you are noticing. For example, “men as outdoorsy” might be a common trope you see in advertisements. Whenever you see this, mark the passage or picture. In your third (or fourth or fifth) round of review, begin to link up the tropes you’ve identified, looking for particular patterns and assumptions. You’ve drilled down to the details, and now you are building back up to figure out what they all mean. Start thinking about theory—either theories you have read about and are using as a frame of your study (e.g., gender as performance theory) or theories you are building yourself, as in the Grounded Theory tradition. Once you have a good idea of what is being communicated and how, go back to the data at least one more time to look for disconfirming evidence. Maybe you thought “men as outdoorsy” was of importance, but when you look hard, you note that women are presented as outdoorsy just as often. You just hadn’t paid attention. It is very important, as any kind of researcher but particularly as a qualitative researcher, to test yourself and your emerging interpretations in this way.

The Fourth and Final Step: The Write-Up

Only after you have fully completed analysis, with its many rounds of review and analysis, will you be able to write about what you found. The interpretation exists not in the data but in your analysis of the data. Before writing your results, you will want to very clearly describe how you chose the data here and all the possible limitations of this data (e.g., historical-trace problem or power problem; see chapter 16). Acknowledge any limitations of your sample. Describe the audience for the content, and discuss the implications of this. Once you have done all of this, you can put forth your interpretation of the communication of the content, linking to theory where doing so would help your readers understand your findings and what they mean more generally for our understanding of how the social world works. [3]

Analyzing Content: Helpful Hints and Pointers

Although every data set is unique and each researcher will have a different and unique research question to address with that data set, there are some common practices and conventions. When reviewing your data, what do you look at exactly? How will you know if you have seen a pattern? How do you note or mark your data?

Let’s start with the last question first. If your data is stored digitally, there are various ways you can highlight or mark up passages. You can, of course, do this with literal highlighters, pens, and pencils if you have print copies. But there are also qualitative software programs to help you store the data, retrieve the data, and mark the data. This can simplify the process, although it cannot do the work of analysis for you.

Qualitative software can be very expensive, so the first thing to do is to find out if your institution (or program) has a universal license its students can use. If they do not, most programs have special student licenses that are less expensive. The two most used programs at this moment are probably ATLAS.ti and NVivo. Both can cost more than $500 [4] but provide everything you could possibly need for storing data, content analysis, and coding. They also have a lot of customer support, and you can find many official and unofficial tutorials on how to use the programs’ features on the web. Dedoose, created by academic researchers at UCLA, is a decent program that lacks many of the bells and whistles of the two big programs. Instead of paying all at once, you pay monthly, as you use the program. The monthly fee is relatively affordable (less than $15), so this might be a good option for a small project. HyperRESEARCH is another basic program created by academic researchers, and it is free for small projects (those that have limited cases and material to import). You can pay a monthly fee if your project expands past the free limits. I have personally used all four of these programs, and they each have their pluses and minuses.

Regardless of which program you choose, you should know that none of them will actually do the hard work of analysis for you. They are incredibly useful for helping you store and organize your data, and they provide abundant tools for marking, comparing, and coding your data so you can make sense of it. But making sense of it will always be your job alone.

So let’s say you have some software, and you have uploaded all of your content into the program: video clips, photographs, transcripts of news stories, articles from magazines, even digital copies of college scrapbooks. Now what do you do? What are you looking for? How do you see a pattern? The answers to these questions will depend partially on the particular research question you have, or at least the motivation behind your research. Let’s go back to the idea of looking at gender presentations in magazines from the 1950s to the 1970s. Here are some things you can look at and code in the content: (1) actions and behaviors, (2) events or conditions, (3) activities, (4) strategies and tactics, (5) states or general conditions, (6) meanings or symbols, (7) relationships/interactions, (8) consequences, and (9) settings. Table 17.1 lists these with examples from our gender presentation study.

Table 17.1. Examples of What to Note During Content Analysis

What can be noted/coded Example from Gender Presentation Study
Actions and behaviors
Events or conditions
Activities
Strategies and tactics
States/conditions
Meanings/symbols
Relationships/interactions
Consequences
Settings

One thing to note about the examples in table 17.1: sometimes we note (mark, record, code) a single example, while other times, as in “settings,” we are recording a recurrent pattern. To help you spot patterns, it is useful to mark every setting, including a notation on gender. Using software can help you do this efficiently. You can then call up “setting by gender” and note this emerging pattern. There’s an element of counting here, which we normally think of as quantitative data analysis, but we are using the count to identify a pattern that will be used to help us interpret the communication. Content analyses often include counting as part of the interpretive (qualitative) process.

In your own study, you may not need or want to look at all of the elements listed in table 17.1. Even in our imagined example, some are more useful than others. For example, “strategies and tactics” is a bit of a stretch here. In studies that are looking specifically at, say, policy implementation or social movements, this category will prove much more salient.

Another way to think about “what to look at” is to consider aspects of your content in terms of units of analysis. You can drill down to the specific words used (e.g., the adjectives commonly used to describe “men” and “women” in your magazine sample) or move up to the more abstract level of concepts used (e.g., the idea that men are more rational than women). Counting for the purpose of identifying patterns is particularly useful here. How many times is that idea of women’s irrationality communicated? How is it is communicated (in comic strips, fictional stories, editorials, etc.)? Does the incidence of the concept change over time? Perhaps the “irrational woman” was everywhere in the 1950s, but by the 1970s, it is no longer showing up in stories and comics. By tracing its usage and prevalence over time, you might come up with a theory or story about gender presentation during the period. Table 17.2 provides more examples of using different units of analysis for this work along with suggestions for effective use.

Table 17.2. Examples of Unit of Analysis in Content Analysis

Unit of Analysis How Used...
Words
Themes
Characters
Paragraphs
Items
Concepts
Semantics

Every qualitative content analysis is unique in its particular focus and particular data used, so there is no single correct way to approach analysis. You should have a better idea, however, of what kinds of things to look for and what to look for. The next two chapters will take you further into the coding process, the primary analytical tool for qualitative research in general.

Further Readings

Cidell, Julie. 2010. “Content Clouds as Exploratory Qualitative Data Analysis.” Area 42(4):514–523. A demonstration of using visual “content clouds” as a form of exploratory qualitative data analysis using transcripts of public meetings and content of newspaper articles.

Hsieh, Hsiu-Fang, and Sarah E. Shannon. 2005. “Three Approaches to Qualitative Content Analysis.” Qualitative Health Research 15(9):1277–1288. Distinguishes three distinct approaches to QCA: conventional, directed, and summative. Uses hypothetical examples from end-of-life care research.

Jackson, Romeo, Alex C. Lange, and Antonio Duran. 2021. “A Whitened Rainbow: The In/Visibility of Race and Racism in LGBTQ Higher Education Scholarship.” Journal Committed to Social Change on Race and Ethnicity (JCSCORE) 7(2):174–206.* Using a “critical summative content analysis” approach, examines research published on LGBTQ people between 2009 and 2019.

Krippendorff, Klaus. 2018. Content Analysis: An Introduction to Its Methodology . 4th ed. Thousand Oaks, CA: SAGE. A very comprehensive textbook on both quantitative and qualitative forms of content analysis.

Mayring, Philipp. 2022. Qualitative Content Analysis: A Step-by-Step Guide . Thousand Oaks, CA: SAGE. Formulates an eight-step approach to QCA.

Messinger, Adam M. 2012. “Teaching Content Analysis through ‘Harry Potter.’” Teaching Sociology 40(4):360–367. This is a fun example of a relatively brief foray into content analysis using the music found in Harry Potter films.

Neuendorft, Kimberly A. 2002. The Content Analysis Guidebook . Thousand Oaks, CA: SAGE. Although a helpful guide to content analysis in general, be warned that this textbook definitely favors quantitative over qualitative approaches to content analysis.

Schrier, Margrit. 2012. Qualitative Content Analysis in Practice . Thousand Okas, CA: SAGE. Arguably the most accessible guidebook for QCA, written by a professor based in Germany.

Weber, Matthew A., Shannon Caplan, Paul Ringold, and Karen Blocksom. 2017. “Rivers and Streams in the Media: A Content Analysis of Ecosystem Services.” Ecology and Society 22(3).* Examines the content of a blog hosted by National Geographic and articles published in The New York Times and the Wall Street Journal for stories on rivers and streams (e.g., water-quality flooding).

  • There are ways of handling content analysis quantitatively, however. Some practitioners therefore specify qualitative content analysis (QCA). In this chapter, all content analysis is QCA unless otherwise noted. ↵
  • Note that some qualitative software allows you to upload whole films or film clips for coding. You will still have to get access to the film, of course. ↵
  • See chapter 20 for more on the final presentation of research. ↵
  • . Actually, ATLAS.ti is an annual license, while NVivo is a perpetual license, but both are going to cost you at least $500 to use. Student rates may be lower. And don’t forget to ask your institution or program if they already have a software license you can use. ↵

A method of both data collection and data analysis in which a given content (textual, visual, graphic) is examined systematically and rigorously to identify meanings, themes, patterns and assumptions.  Qualitative content analysis (QCA) is concerned with gathering and interpreting an existing body of material.    

Introduction to Qualitative Research Methods Copyright © 2023 by Allison Hurst is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License , except where otherwise noted.

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Qualitative case study data analysis: an example from practice

Affiliation.

  • 1 School of Nursing and Midwifery, National University of Ireland, Galway, Republic of Ireland.
  • PMID: 25976531
  • DOI: 10.7748/nr.22.5.8.e1307

Aim: To illustrate an approach to data analysis in qualitative case study methodology.

Background: There is often little detail in case study research about how data were analysed. However, it is important that comprehensive analysis procedures are used because there are often large sets of data from multiple sources of evidence. Furthermore, the ability to describe in detail how the analysis was conducted ensures rigour in reporting qualitative research.

Data sources: The research example used is a multiple case study that explored the role of the clinical skills laboratory in preparing students for the real world of practice. Data analysis was conducted using a framework guided by the four stages of analysis outlined by Morse ( 1994 ): comprehending, synthesising, theorising and recontextualising. The specific strategies for analysis in these stages centred on the work of Miles and Huberman ( 1994 ), which has been successfully used in case study research. The data were managed using NVivo software.

Review methods: Literature examining qualitative data analysis was reviewed and strategies illustrated by the case study example provided. Discussion Each stage of the analysis framework is described with illustration from the research example for the purpose of highlighting the benefits of a systematic approach to handling large data sets from multiple sources.

Conclusion: By providing an example of how each stage of the analysis was conducted, it is hoped that researchers will be able to consider the benefits of such an approach to their own case study analysis.

Implications for research/practice: This paper illustrates specific strategies that can be employed when conducting data analysis in case study research and other qualitative research designs.

Keywords: Case study data analysis; case study research methodology; clinical skills research; qualitative case study methodology; qualitative data analysis; qualitative research.

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Methodology or method? A critical review of qualitative case study reports

Despite on-going debate about credibility, and reported limitations in comparison to other approaches, case study is an increasingly popular approach among qualitative researchers. We critically analysed the methodological descriptions of published case studies. Three high-impact qualitative methods journals were searched to locate case studies published in the past 5 years; 34 were selected for analysis. Articles were categorized as health and health services ( n= 12), social sciences and anthropology ( n= 7), or methods ( n= 15) case studies. The articles were reviewed using an adapted version of established criteria to determine whether adequate methodological justification was present, and if study aims, methods, and reported findings were consistent with a qualitative case study approach. Findings were grouped into five themes outlining key methodological issues: case study methodology or method, case of something particular and case selection, contextually bound case study, researcher and case interactions and triangulation, and study design inconsistent with methodology reported. Improved reporting of case studies by qualitative researchers will advance the methodology for the benefit of researchers and practitioners.

Case study research is an increasingly popular approach among qualitative researchers (Thomas, 2011 ). Several prominent authors have contributed to methodological developments, which has increased the popularity of case study approaches across disciplines (Creswell, 2013b ; Denzin & Lincoln, 2011b ; Merriam, 2009 ; Ragin & Becker, 1992 ; Stake, 1995 ; Yin, 2009 ). Current qualitative case study approaches are shaped by paradigm, study design, and selection of methods, and, as a result, case studies in the published literature vary. Differences between published case studies can make it difficult for researchers to define and understand case study as a methodology.

Experienced qualitative researchers have identified case study research as a stand-alone qualitative approach (Denzin & Lincoln, 2011b ). Case study research has a level of flexibility that is not readily offered by other qualitative approaches such as grounded theory or phenomenology. Case studies are designed to suit the case and research question and published case studies demonstrate wide diversity in study design. There are two popular case study approaches in qualitative research. The first, proposed by Stake ( 1995 ) and Merriam ( 2009 ), is situated in a social constructivist paradigm, whereas the second, by Yin ( 2012 ), Flyvbjerg ( 2011 ), and Eisenhardt ( 1989 ), approaches case study from a post-positivist viewpoint. Scholarship from both schools of inquiry has contributed to the popularity of case study and development of theoretical frameworks and principles that characterize the methodology.

The diversity of case studies reported in the published literature, and on-going debates about credibility and the use of case study in qualitative research practice, suggests that differences in perspectives on case study methodology may prevent researchers from developing a mutual understanding of practice and rigour. In addition, discussion about case study limitations has led some authors to query whether case study is indeed a methodology (Luck, Jackson, & Usher, 2006 ; Meyer, 2001 ; Thomas, 2010 ; Tight, 2010 ). Methodological discussion of qualitative case study research is timely, and a review is required to analyse and understand how this methodology is applied in the qualitative research literature. The aims of this study were to review methodological descriptions of published qualitative case studies, to review how the case study methodological approach was applied, and to identify issues that need to be addressed by researchers, editors, and reviewers. An outline of the current definitions of case study and an overview of the issues proposed in the qualitative methodological literature are provided to set the scene for the review.

Definitions of qualitative case study research

Case study research is an investigation and analysis of a single or collective case, intended to capture the complexity of the object of study (Stake, 1995 ). Qualitative case study research, as described by Stake ( 1995 ), draws together “naturalistic, holistic, ethnographic, phenomenological, and biographic research methods” in a bricoleur design, or in his words, “a palette of methods” (Stake, 1995 , pp. xi–xii). Case study methodology maintains deep connections to core values and intentions and is “particularistic, descriptive and heuristic” (Merriam, 2009 , p. 46).

As a study design, case study is defined by interest in individual cases rather than the methods of inquiry used. The selection of methods is informed by researcher and case intuition and makes use of naturally occurring sources of knowledge, such as people or observations of interactions that occur in the physical space (Stake, 1998 ). Thomas ( 2011 ) suggested that “analytical eclecticism” is a defining factor (p. 512). Multiple data collection and analysis methods are adopted to further develop and understand the case, shaped by context and emergent data (Stake, 1995 ). This qualitative approach “explores a real-life, contemporary bounded system (a case ) or multiple bounded systems (cases) over time, through detailed, in-depth data collection involving multiple sources of information … and reports a case description and case themes ” (Creswell, 2013b , p. 97). Case study research has been defined by the unit of analysis, the process of study, and the outcome or end product, all essentially the case (Merriam, 2009 ).

The case is an object to be studied for an identified reason that is peculiar or particular. Classification of the case and case selection procedures informs development of the study design and clarifies the research question. Stake ( 1995 ) proposed three types of cases and study design frameworks. These include the intrinsic case, the instrumental case, and the collective instrumental case. The intrinsic case is used to understand the particulars of a single case, rather than what it represents. An instrumental case study provides insight on an issue or is used to refine theory. The case is selected to advance understanding of the object of interest. A collective refers to an instrumental case which is studied as multiple, nested cases, observed in unison, parallel, or sequential order. More than one case can be simultaneously studied; however, each case study is a concentrated, single inquiry, studied holistically in its own entirety (Stake, 1995 , 1998 ).

Researchers who use case study are urged to seek out what is common and what is particular about the case. This involves careful and in-depth consideration of the nature of the case, historical background, physical setting, and other institutional and political contextual factors (Stake, 1998 ). An interpretive or social constructivist approach to qualitative case study research supports a transactional method of inquiry, where the researcher has a personal interaction with the case. The case is developed in a relationship between the researcher and informants, and presented to engage the reader, inviting them to join in this interaction and in case discovery (Stake, 1995 ). A postpositivist approach to case study involves developing a clear case study protocol with careful consideration of validity and potential bias, which might involve an exploratory or pilot phase, and ensures that all elements of the case are measured and adequately described (Yin, 2009 , 2012 ).

Current methodological issues in qualitative case study research

The future of qualitative research will be influenced and constructed by the way research is conducted, and by what is reviewed and published in academic journals (Morse, 2011 ). If case study research is to further develop as a principal qualitative methodological approach, and make a valued contribution to the field of qualitative inquiry, issues related to methodological credibility must be considered. Researchers are required to demonstrate rigour through adequate descriptions of methodological foundations. Case studies published without sufficient detail for the reader to understand the study design, and without rationale for key methodological decisions, may lead to research being interpreted as lacking in quality or credibility (Hallberg, 2013 ; Morse, 2011 ).

There is a level of artistic license that is embraced by qualitative researchers and distinguishes practice, which nurtures creativity, innovation, and reflexivity (Denzin & Lincoln, 2011b ; Morse, 2009 ). Qualitative research is “inherently multimethod” (Denzin & Lincoln, 2011a , p. 5); however, with this creative freedom, it is important for researchers to provide adequate description for methodological justification (Meyer, 2001 ). This includes paradigm and theoretical perspectives that have influenced study design. Without adequate description, study design might not be understood by the reader, and can appear to be dishonest or inaccurate. Reviewers and readers might be confused by the inconsistent or inappropriate terms used to describe case study research approach and methods, and be distracted from important study findings (Sandelowski, 2000 ). This issue extends beyond case study research, and others have noted inconsistencies in reporting of methodology and method by qualitative researchers. Sandelowski ( 2000 , 2010 ) argued for accurate identification of qualitative description as a research approach. She recommended that the selected methodology should be harmonious with the study design, and be reflected in methods and analysis techniques. Similarly, Webb and Kevern ( 2000 ) uncovered inconsistencies in qualitative nursing research with focus group methods, recommending that methodological procedures must cite seminal authors and be applied with respect to the selected theoretical framework. Incorrect labelling using case study might stem from the flexibility in case study design and non-directional character relative to other approaches (Rosenberg & Yates, 2007 ). Methodological integrity is required in design of qualitative studies, including case study, to ensure study rigour and to enhance credibility of the field (Morse, 2011 ).

Case study has been unnecessarily devalued by comparisons with statistical methods (Eisenhardt, 1989 ; Flyvbjerg, 2006 , 2011 ; Jensen & Rodgers, 2001 ; Piekkari, Welch, & Paavilainen, 2009 ; Tight, 2010 ; Yin, 1999 ). It is reputed to be the “the weak sibling” in comparison to other, more rigorous, approaches (Yin, 2009 , p. xiii). Case study is not an inherently comparative approach to research. The objective is not statistical research, and the aim is not to produce outcomes that are generalizable to all populations (Thomas, 2011 ). Comparisons between case study and statistical research do little to advance this qualitative approach, and fail to recognize its inherent value, which can be better understood from the interpretive or social constructionist viewpoint of other authors (Merriam, 2009 ; Stake, 1995 ). Building on discussions relating to “fuzzy” (Bassey, 2001 ), or naturalistic generalizations (Stake, 1978 ), or transference of concepts and theories (Ayres, Kavanaugh, & Knafl, 2003 ; Morse et al., 2011 ) would have more relevance.

Case study research has been used as a catch-all design to justify or add weight to fundamental qualitative descriptive studies that do not fit with other traditional frameworks (Merriam, 2009 ). A case study has been a “convenient label for our research—when we ‘can't think of anything ‘better”—in an attempt to give it [qualitative methodology] some added respectability” (Tight, 2010 , p. 337). Qualitative case study research is a pliable approach (Merriam, 2009 ; Meyer, 2001 ; Stake, 1995 ), and has been likened to a “curious methodological limbo” (Gerring, 2004 , p. 341) or “paradigmatic bridge” (Luck et al., 2006 , p. 104), that is on the borderline between postpositivist and constructionist interpretations. This has resulted in inconsistency in application, which indicates that flexibility comes with limitations (Meyer, 2001 ), and the open nature of case study research might be off-putting to novice researchers (Thomas, 2011 ). The development of a well-(in)formed theoretical framework to guide a case study should improve consistency, rigour, and trust in studies published in qualitative research journals (Meyer, 2001 ).

Assessment of rigour

The purpose of this study was to analyse the methodological descriptions of case studies published in qualitative methods journals. To do this we needed to develop a suitable framework, which used existing, established criteria for appraising qualitative case study research rigour (Creswell, 2013b ; Merriam, 2009 ; Stake, 1995 ). A number of qualitative authors have developed concepts and criteria that are used to determine whether a study is rigorous (Denzin & Lincoln, 2011b ; Lincoln, 1995 ; Sandelowski & Barroso, 2002 ). The criteria proposed by Stake ( 1995 ) provide a framework for readers and reviewers to make judgements regarding case study quality, and identify key characteristics essential for good methodological rigour. Although each of the factors listed in Stake's criteria could enhance the quality of a qualitative research report, in Table I we present an adapted criteria used in this study, which integrates more recent work by Merriam ( 2009 ) and Creswell ( 2013b ). Stake's ( 1995 ) original criteria were separated into two categories. The first list of general criteria is “relevant for all qualitative research.” The second list, “high relevance to qualitative case study research,” was the criteria that we decided had higher relevance to case study research. This second list was the main criteria used to assess the methodological descriptions of the case studies reviewed. The complete table has been preserved so that the reader can determine how the original criteria were adapted.

Framework for assessing quality in qualitative case study research.

Checklist for assessing the quality of a case study report
Relevant for all qualitative research
1. Is this report easy to read?
2. Does it fit together, each sentence contributing to the whole?
3. Does this report have a conceptual structure (i.e., themes or issues)?
4. Are its issues developed in a series and scholarly way?
5. Have quotations been used effectively?
6. Has the writer made sound assertions, neither over- or under-interpreting?
7. Are headings, figures, artefacts, appendices, indexes effectively used?
8. Was it edited well, then again with a last minute polish?
9. Were sufficient raw data presented?
10. Is the nature of the intended audience apparent?
11. Does it appear that individuals were put at risk?
High relevance to qualitative case study research
12. Is the case adequately defined?
13. Is there a sense of story to the presentation?
14. Is the reader provided some vicarious experience?
15. Has adequate attention been paid to various contexts?
16. Were data sources well-chosen and in sufficient number?
17. Do observations and interpretations appear to have been triangulated?
18. Is the role and point of view of the researcher nicely apparent?
19. Is empathy shown for all sides?
20. Are personal intentions examined?
Added from Merriam ( )
21. Is the case study particular?
22. Is the case study descriptive?
23. Is the case study heuristic?
Added from Creswell ( )
24. Was study design appropriate to methodology?

Adapted from Stake ( 1995 , p. 131).

Study design

The critical review method described by Grant and Booth ( 2009 ) was used, which is appropriate for the assessment of research quality, and is used for literature analysis to inform research and practice. This type of review goes beyond the mapping and description of scoping or rapid reviews, to include “analysis and conceptual innovation” (Grant & Booth, 2009 , p. 93). A critical review is used to develop existing, or produce new, hypotheses or models. This is different to systematic reviews that answer clinical questions. It is used to evaluate existing research and competing ideas, to provide a “launch pad” for conceptual development and “subsequent testing” (Grant & Booth, 2009 , p. 93).

Qualitative methods journals were located by a search of the 2011 ISI Journal Citation Reports in Social Science, via the database Web of Knowledge (see m.webofknowledge.com). No “qualitative research methods” category existed in the citation reports; therefore, a search of all categories was performed using the term “qualitative.” In Table II , we present the qualitative methods journals located, ranked by impact factor. The highest ranked journals were selected for searching. We acknowledge that the impact factor ranking system might not be the best measure of journal quality (Cheek, Garnham, & Quan, 2006 ); however, this was the most appropriate and accessible method available.

International Journal of Qualitative Studies on Health and Well-being.

Journal title2011 impact factor5-year impact factor
2.1882.432
1.426N/A
0.8391.850
0.780N/A
0.612N/A

Search strategy

In March 2013, searches of the journals, Qualitative Health Research , Qualitative Research , and Qualitative Inquiry were completed to retrieve studies with “case study” in the abstract field. The search was limited to the past 5 years (1 January 2008 to 1 March 2013). The objective was to locate published qualitative case studies suitable for assessment using the adapted criterion. Viewpoints, commentaries, and other article types were excluded from review. Title and abstracts of the 45 retrieved articles were read by the first author, who identified 34 empirical case studies for review. All authors reviewed the 34 studies to confirm selection and categorization. In Table III , we present the 34 case studies grouped by journal, and categorized by research topic, including health sciences, social sciences and anthropology, and methods research. There was a discrepancy in categorization of one article on pedagogy and a new teaching method published in Qualitative Inquiry (Jorrín-Abellán, Rubia-Avi, Anguita-Martínez, Gómez-Sánchez, & Martínez-Mones, 2008 ). Consensus was to allocate to the methods category.

Outcomes of search of qualitative methods journals.

Journal titleDate of searchNumber of studies locatedNumber of full text studies extractedHealth sciencesSocial sciences and anthropologyMethods
4 Mar 20131816 Barone ( ); Bronken et al. ( ); Colón-Emeric et al. ( ); Fourie and Theron ( ); Gallagher et al. ( ); Gillard et al. ( ); Hooghe et al. ( ); Jackson et al. ( ); Ledderer ( ); Mawn et al. ( ); Roscigno et al. ( ); Rytterström et al. ( ) Nil Austin, Park, and Goble ( ); Broyles, Rodriguez, Price, Bayliss, and Sevick ( ); De Haene et al. ( ); Fincham et al. ( )
7 Mar 2013117Nil Adamson and Holloway ( ); Coltart and Henwood ( ) Buckley and Waring ( ); Cunsolo Willox et al. ( ); Edwards and Weller ( ); Gratton and O'Donnell ( ); Sumsion ( )
4 Mar 20131611Nil Buzzanell and D’Enbeau ( ); D'Enbeau et al. ( ); Nagar-Ron and Motzafi-Haller ( ); Snyder-Young ( ); Yeh ( ) Ajodhia-Andrews and Berman ( ); Alexander et al. ( ); Jorrín-Abellán et al. ( ); Nairn and Panelli ( ); Nespor ( ); Wimpenny and Savin-Baden ( )
Total453412715

In Table III , the number of studies located, and final numbers selected for review have been reported. Qualitative Health Research published the most empirical case studies ( n= 16). In the health category, there were 12 case studies of health conditions, health services, and health policy issues, all published in Qualitative Health Research . Seven case studies were categorized as social sciences and anthropology research, which combined case study with biography and ethnography methodologies. All three journals published case studies on methods research to illustrate a data collection or analysis technique, methodological procedure, or related issue.

The methodological descriptions of 34 case studies were critically reviewed using the adapted criteria. All articles reviewed contained a description of study methods; however, the length, amount of detail, and position of the description in the article varied. Few studies provided an accurate description and rationale for using a qualitative case study approach. In the 34 case studies reviewed, three described a theoretical framework informed by Stake ( 1995 ), two by Yin ( 2009 ), and three provided a mixed framework informed by various authors, which might have included both Yin and Stake. Few studies described their case study design, or included a rationale that explained why they excluded or added further procedures, and whether this was to enhance the study design, or to better suit the research question. In 26 of the studies no reference was provided to principal case study authors. From reviewing the description of methods, few authors provided a description or justification of case study methodology that demonstrated how their study was informed by the methodological literature that exists on this approach.

The methodological descriptions of each study were reviewed using the adapted criteria, and the following issues were identified: case study methodology or method; case of something particular and case selection; contextually bound case study; researcher and case interactions and triangulation; and, study design inconsistent with methodology. An outline of how the issues were developed from the critical review is provided, followed by a discussion of how these relate to the current methodological literature.

Case study methodology or method

A third of the case studies reviewed appeared to use a case report method, not case study methodology as described by principal authors (Creswell, 2013b ; Merriam, 2009 ; Stake, 1995 ; Yin, 2009 ). Case studies were identified as a case report because of missing methodological detail and by review of the study aims and purpose. These reports presented data for small samples of no more than three people, places or phenomenon. Four studies, or “case reports” were single cases selected retrospectively from larger studies (Bronken, Kirkevold, Martinsen, & Kvigne, 2012 ; Coltart & Henwood, 2012 ; Hooghe, Neimeyer, & Rober, 2012 ; Roscigno et al., 2012 ). Case reports were not a case of something, instead were a case demonstration or an example presented in a report. These reports presented outcomes, and reported on how the case could be generalized. Descriptions focussed on the phenomena, rather than the case itself, and did not appear to study the case in its entirety.

Case reports had minimal in-text references to case study methodology, and were informed by other qualitative traditions or secondary sources (Adamson & Holloway, 2012 ; Buzzanell & D'Enbeau, 2009 ; Nagar-Ron & Motzafi-Haller, 2011 ). This does not suggest that case study methodology cannot be multimethod, however, methodology should be consistent in design, be clearly described (Meyer, 2001 ; Stake, 1995 ), and maintain focus on the case (Creswell, 2013b ).

To demonstrate how case reports were identified, three examples are provided. The first, Yeh ( 2013 ) described their study as, “the examination of the emergence of vegetarianism in Victorian England serves as a case study to reveal the relationships between boundaries and entities” (p. 306). The findings were a historical case report, which resulted from an ethnographic study of vegetarianism. Cunsolo Willox, Harper, Edge, ‘My Word’: Storytelling and Digital Media Lab, and Rigolet Inuit Community Government (2013) used “a case study that illustrates the usage of digital storytelling within an Inuit community” (p. 130). This case study reported how digital storytelling can be used with indigenous communities as a participatory method to illuminate the benefits of this method for other studies. This “case study was conducted in the Inuit community” but did not include the Inuit community in case analysis (Cunsolo Willox et al., 2013 , p. 130). Bronken et al. ( 2012 ) provided a single case report to demonstrate issues observed in a larger clinical study of aphasia and stroke, without adequate case description or analysis.

Case study of something particular and case selection

Case selection is a precursor to case analysis, which needs to be presented as a convincing argument (Merriam, 2009 ). Descriptions of the case were often not adequate to ascertain why the case was selected, or whether it was a particular exemplar or outlier (Thomas, 2011 ). In a number of case studies in the health and social science categories, it was not explicit whether the case was of something particular, or peculiar to their discipline or field (Adamson & Holloway, 2012 ; Bronken et al., 2012 ; Colón-Emeric et al., 2010 ; Jackson, Botelho, Welch, Joseph, & Tennstedt, 2012 ; Mawn et al., 2010 ; Snyder-Young, 2011 ). There were exceptions in the methods category ( Table III ), where cases were selected by researchers to report on a new or innovative method. The cases emerged through heuristic study, and were reported to be particular, relative to the existing methods literature (Ajodhia-Andrews & Berman, 2009 ; Buckley & Waring, 2013 ; Cunsolo Willox et al., 2013 ; De Haene, Grietens, & Verschueren, 2010 ; Gratton & O'Donnell, 2011 ; Sumsion, 2013 ; Wimpenny & Savin-Baden, 2012 ).

Case selection processes were sometimes insufficient to understand why the case was selected from the global population of cases, or what study of this case would contribute to knowledge as compared with other possible cases (Adamson & Holloway, 2012 ; Bronken et al., 2012 ; Colón-Emeric et al., 2010 ; Jackson et al., 2012 ; Mawn et al., 2010 ). In two studies, local cases were selected (Barone, 2010 ; Fourie & Theron, 2012 ) because the researcher was familiar with and had access to the case. Possible limitations of a convenience sample were not acknowledged. Purposeful sampling was used to recruit participants within the case of one study, but not of the case itself (Gallagher et al., 2013 ). Random sampling was completed for case selection in two studies (Colón-Emeric et al., 2010 ; Jackson et al., 2012 ), which has limited meaning in interpretive qualitative research.

To demonstrate how researchers provided a good justification for the selection of case study approaches, four examples are provided. The first, cases of residential care homes, were selected because of reported occurrences of mistreatment, which included residents being locked in rooms at night (Rytterström, Unosson, & Arman, 2013 ). Roscigno et al. ( 2012 ) selected cases of parents who were admitted for early hospitalization in neonatal intensive care with a threatened preterm delivery before 26 weeks. Hooghe et al. ( 2012 ) used random sampling to select 20 couples that had experienced the death of a child; however, the case study was of one couple and a particular metaphor described only by them. The final example, Coltart and Henwood ( 2012 ), provided a detailed account of how they selected two cases from a sample of 46 fathers based on personal characteristics and beliefs. They described how the analysis of the two cases would contribute to their larger study on first time fathers and parenting.

Contextually bound case study

The limits or boundaries of the case are a defining factor of case study methodology (Merriam, 2009 ; Ragin & Becker, 1992 ; Stake, 1995 ; Yin, 2009 ). Adequate contextual description is required to understand the setting or context in which the case is revealed. In the health category, case studies were used to illustrate a clinical phenomenon or issue such as compliance and health behaviour (Colón-Emeric et al., 2010 ; D'Enbeau, Buzzanell, & Duckworth, 2010 ; Gallagher et al., 2013 ; Hooghe et al., 2012 ; Jackson et al., 2012 ; Roscigno et al., 2012 ). In these case studies, contextual boundaries, such as physical and institutional descriptions, were not sufficient to understand the case as a holistic system, for example, the general practitioner (GP) clinic in Gallagher et al. ( 2013 ), or the nursing home in Colón-Emeric et al. ( 2010 ). Similarly, in the social science and methods categories, attention was paid to some components of the case context, but not others, missing important information required to understand the case as a holistic system (Alexander, Moreira, & Kumar, 2012 ; Buzzanell & D'Enbeau, 2009 ; Nairn & Panelli, 2009 ; Wimpenny & Savin-Baden, 2012 ).

In two studies, vicarious experience or vignettes (Nairn & Panelli, 2009 ) and images (Jorrín-Abellán et al., 2008 ) were effective to support description of context, and might have been a useful addition for other case studies. Missing contextual boundaries suggests that the case might not be adequately defined. Additional information, such as the physical, institutional, political, and community context, would improve understanding of the case (Stake, 1998 ). In Boxes 1 and 2 , we present brief synopses of two studies that were reviewed, which demonstrated a well bounded case. In Box 1 , Ledderer ( 2011 ) used a qualitative case study design informed by Stake's tradition. In Box 2 , Gillard, Witt, and Watts ( 2011 ) were informed by Yin's tradition. By providing a brief outline of the case studies in Boxes 1 and 2 , we demonstrate how effective case boundaries can be constructed and reported, which may be of particular interest to prospective case study researchers.

Article synopsis of case study research using Stake's tradition

Ledderer ( 2011 ) used a qualitative case study research design, informed by modern ethnography. The study is bounded to 10 general practice clinics in Denmark, who had received federal funding to implement preventative care services based on a Motivational Interviewing intervention. The researcher question focussed on “why is it so difficult to create change in medical practice?” (Ledderer, 2011 , p. 27). The study context was adequately described, providing detail on the general practitioner (GP) clinics and relevant political and economic influences. Methodological decisions are described in first person narrative, providing insight on researcher perspectives and interaction with the case. Forty-four interviews were conducted, which focussed on how GPs conducted consultations, and the form, nature and content, rather than asking their opinion or experience (Ledderer, 2011 , p. 30). The duration and intensity of researcher immersion in the case enhanced depth of description and trustworthiness of study findings. Analysis was consistent with Stake's tradition, and the researcher provided examples of inquiry techniques used to challenge assumptions about emerging themes. Several other seminal qualitative works were cited. The themes and typology constructed are rich in narrative data and storytelling by clinic staff, demonstrating individual clinic experiences as well as shared meanings and understandings about changing from a biomedical to psychological approach to preventative health intervention. Conclusions make note of social and cultural meanings and lessons learned, which might not have been uncovered using a different methodology.

Article synopsis of case study research using Yin's tradition

Gillard et al. ( 2011 ) study of camps for adolescents living with HIV/AIDs provided a good example of Yin's interpretive case study approach. The context of the case is bounded by the three summer camps of which the researchers had prior professional involvement. A case study protocol was developed that used multiple methods to gather information at three data collection points coinciding with three youth camps (Teen Forum, Discover Camp, and Camp Strong). Gillard and colleagues followed Yin's ( 2009 ) principles, using a consistent data protocol that enhanced cross-case analysis. Data described the young people, the camp physical environment, camp schedule, objectives and outcomes, and the staff of three youth camps. The findings provided a detailed description of the context, with less detail of individual participants, including insight into researcher's interpretations and methodological decisions throughout the data collection and analysis process. Findings provided the reader with a sense of “being there,” and are discovered through constant comparison of the case with the research issues; the case is the unit of analysis. There is evidence of researcher immersion in the case, and Gillard reports spending significant time in the field in a naturalistic and integrated youth mentor role.

This case study is not intended to have a significant impact on broader health policy, although does have implications for health professionals working with adolescents. Study conclusions will inform future camps for young people with chronic disease, and practitioners are able to compare similarities between this case and their own practice (for knowledge translation). No limitations of this article were reported. Limitations related to publication of this case study were that it was 20 pages long and used three tables to provide sufficient description of the camp and program components, and relationships with the research issue.

Researcher and case interactions and triangulation

Researcher and case interactions and transactions are a defining feature of case study methodology (Stake, 1995 ). Narrative stories, vignettes, and thick description are used to provoke vicarious experience and a sense of being there with the researcher in their interaction with the case. Few of the case studies reviewed provided details of the researcher's relationship with the case, researcher–case interactions, and how these influenced the development of the case study (Buzzanell & D'Enbeau, 2009 ; D'Enbeau et al., 2010 ; Gallagher et al., 2013 ; Gillard et al., 2011 ; Ledderer, 2011 ; Nagar-Ron & Motzafi-Haller, 2011 ). The role and position of the researcher needed to be self-examined and understood by readers, to understand how this influenced interactions with participants, and to determine what triangulation is needed (Merriam, 2009 ; Stake, 1995 ).

Gillard et al. ( 2011 ) provided a good example of triangulation, comparing data sources in a table (p. 1513). Triangulation of sources was used to reveal as much depth as possible in the study by Nagar-Ron and Motzafi-Haller ( 2011 ), while also enhancing confirmation validity. There were several case studies that would have benefited from improved range and use of data sources, and descriptions of researcher–case interactions (Ajodhia-Andrews & Berman, 2009 ; Bronken et al., 2012 ; Fincham, Scourfield, & Langer, 2008 ; Fourie & Theron, 2012 ; Hooghe et al., 2012 ; Snyder-Young, 2011 ; Yeh, 2013 ).

Study design inconsistent with methodology

Good, rigorous case studies require a strong methodological justification (Meyer, 2001 ) and a logical and coherent argument that defines paradigm, methodological position, and selection of study methods (Denzin & Lincoln, 2011b ). Methodological justification was insufficient in several of the studies reviewed (Barone, 2010 ; Bronken et al., 2012 ; Hooghe et al., 2012 ; Mawn et al., 2010 ; Roscigno et al., 2012 ; Yeh, 2013 ). This was judged by the absence, or inadequate or inconsistent reference to case study methodology in-text.

In six studies, the methodological justification provided did not relate to case study. There were common issues identified. Secondary sources were used as primary methodological references indicating that study design might not have been theoretically sound (Colón-Emeric et al., 2010 ; Coltart & Henwood, 2012 ; Roscigno et al., 2012 ; Snyder-Young, 2011 ). Authors and sources cited in methodological descriptions were inconsistent with the actual study design and practices used (Fourie & Theron, 2012 ; Hooghe et al., 2012 ; Jorrín-Abellán et al., 2008 ; Mawn et al., 2010 ; Rytterström et al., 2013 ; Wimpenny & Savin-Baden, 2012 ). This occurred when researchers cited Stake or Yin, or both (Mawn et al., 2010 ; Rytterström et al., 2013 ), although did not follow their paradigmatic or methodological approach. In 26 studies there were no citations for a case study methodological approach.

The findings of this study have highlighted a number of issues for researchers. A considerable number of case studies reviewed were missing key elements that define qualitative case study methodology and the tradition cited. A significant number of studies did not provide a clear methodological description or justification relevant to case study. Case studies in health and social sciences did not provide sufficient information for the reader to understand case selection, and why this case was chosen above others. The context of the cases were not described in adequate detail to understand all relevant elements of the case context, which indicated that cases may have not been contextually bounded. There were inconsistencies between reported methodology, study design, and paradigmatic approach in case studies reviewed, which made it difficult to understand the study methodology and theoretical foundations. These issues have implications for methodological integrity and honesty when reporting study design, which are values of the qualitative research tradition and are ethical requirements (Wager & Kleinert, 2010a ). Poorly described methodological descriptions may lead the reader to misinterpret or discredit study findings, which limits the impact of the study, and, as a collective, hinders advancements in the broader qualitative research field.

The issues highlighted in our review build on current debates in the case study literature, and queries about the value of this methodology. Case study research can be situated within different paradigms or designed with an array of methods. In order to maintain the creativity and flexibility that is valued in this methodology, clearer descriptions of paradigm and theoretical position and methods should be provided so that study findings are not undervalued or discredited. Case study research is an interdisciplinary practice, which means that clear methodological descriptions might be more important for this approach than other methodologies that are predominantly driven by fewer disciplines (Creswell, 2013b ).

Authors frequently omit elements of methodologies and include others to strengthen study design, and we do not propose a rigid or purist ideology in this paper. On the contrary, we encourage new ideas about using case study, together with adequate reporting, which will advance the value and practice of case study. The implications of unclear methodological descriptions in the studies reviewed were that study design appeared to be inconsistent with reported methodology, and key elements required for making judgements of rigour were missing. It was not clear whether the deviations from methodological tradition were made by researchers to strengthen the study design, or because of misinterpretations. Morse ( 2011 ) recommended that innovations and deviations from practice are best made by experienced researchers, and that a novice might be unaware of the issues involved with making these changes. To perpetuate the tradition of case study research, applications in the published literature should have consistencies with traditional methodological constructions, and deviations should be described with a rationale that is inherent in study conduct and findings. Providing methodological descriptions that demonstrate a strong theoretical foundation and coherent study design will add credibility to the study, while ensuring the intrinsic meaning of case study is maintained.

The value of this review is that it contributes to discussion of whether case study is a methodology or method. We propose possible reasons why researchers might make this misinterpretation. Researchers may interchange the terms methods and methodology, and conduct research without adequate attention to epistemology and historical tradition (Carter & Little, 2007 ; Sandelowski, 2010 ). If the rich meaning that naming a qualitative methodology brings to the study is not recognized, a case study might appear to be inconsistent with the traditional approaches described by principal authors (Creswell, 2013a ; Merriam, 2009 ; Stake, 1995 ; Yin, 2009 ). If case studies are not methodologically and theoretically situated, then they might appear to be a case report.

Case reports are promoted by university and medical journals as a method of reporting on medical or scientific cases; guidelines for case reports are publicly available on websites ( http://www.hopkinsmedicine.org/institutional_review_board/guidelines_policies/guidelines/case_report.html ). The various case report guidelines provide a general criteria for case reports, which describes that this form of report does not meet the criteria of research, is used for retrospective analysis of up to three clinical cases, and is primarily illustrative and for educational purposes. Case reports can be published in academic journals, but do not require approval from a human research ethics committee. Traditionally, case reports describe a single case, to explain how and what occurred in a selected setting, for example, to illustrate a new phenomenon that has emerged from a larger study. A case report is not necessarily particular or the study of a case in its entirety, and the larger study would usually be guided by a different research methodology.

This description of a case report is similar to what was provided in some studies reviewed. This form of report lacks methodological grounding and qualities of research rigour. The case report has publication value in demonstrating an example and for dissemination of knowledge (Flanagan, 1999 ). However, case reports have different meaning and purpose to case study, which needs to be distinguished. Findings of our review suggest that the medical understanding of a case report has been confused with qualitative case study approaches.

In this review, a number of case studies did not have methodological descriptions that included key characteristics of case study listed in the adapted criteria, and several issues have been discussed. There have been calls for improvements in publication quality of qualitative research (Morse, 2011 ), and for improvements in peer review of submitted manuscripts (Carter & Little, 2007 ; Jasper, Vaismoradi, Bondas, & Turunen, 2013 ). The challenging nature of editor and reviewers responsibilities are acknowledged in the literature (Hames, 2013 ; Wager & Kleinert, 2010b ); however, review of case study methodology should be prioritized because of disputes on methodological value.

Authors using case study approaches are recommended to describe their theoretical framework and methods clearly, and to seek and follow specialist methodological advice when needed (Wager & Kleinert, 2010a ). Adequate page space for case study description would contribute to better publications (Gillard et al., 2011 ). Capitalizing on the ability to publish complementary resources should be considered.

Limitations of the review

There is a level of subjectivity involved in this type of review and this should be considered when interpreting study findings. Qualitative methods journals were selected because the aims and scope of these journals are to publish studies that contribute to methodological discussion and development of qualitative research. Generalist health and social science journals were excluded that might have contained good quality case studies. Journals in business or education were also excluded, although a review of case studies in international business journals has been published elsewhere (Piekkari et al., 2009 ).

The criteria used to assess the quality of the case studies were a set of qualitative indicators. A numerical or ranking system might have resulted in different results. Stake's ( 1995 ) criteria have been referenced elsewhere, and was deemed the best available (Creswell, 2013b ; Crowe et al., 2011 ). Not all qualitative studies are reported in a consistent way and some authors choose to report findings in a narrative form in comparison to a typical biomedical report style (Sandelowski & Barroso, 2002 ), if misinterpretations were made this may have affected the review.

Case study research is an increasingly popular approach among qualitative researchers, which provides methodological flexibility through the incorporation of different paradigmatic positions, study designs, and methods. However, whereas flexibility can be an advantage, a myriad of different interpretations has resulted in critics questioning the use of case study as a methodology. Using an adaptation of established criteria, we aimed to identify and assess the methodological descriptions of case studies in high impact, qualitative methods journals. Few articles were identified that applied qualitative case study approaches as described by experts in case study design. There were inconsistencies in methodology and study design, which indicated that researchers were confused whether case study was a methodology or a method. Commonly, there appeared to be confusion between case studies and case reports. Without clear understanding and application of the principles and key elements of case study methodology, there is a risk that the flexibility of the approach will result in haphazard reporting, and will limit its global application as a valuable, theoretically supported methodology that can be rigorously applied across disciplines and fields.

Conflict of interest and funding

The authors have not received any funding or benefits from industry or elsewhere to conduct this study.

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The Oxford Handbook of Qualitative Research

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The Oxford Handbook of Qualitative Research

22 Case Study Research: In-Depth Understanding in Context

Helen Simons, School of Education, University of Southampton

  • Published: 01 July 2014
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This chapter explores case study as a major approach to research and evaluation. After first noting various contexts in which case studies are commonly used, the chapter focuses on case study research directly Strengths and potential problematic issues are outlined and then key phases of the process. The chapter emphasizes how important it is to design the case, to collect and interpret data in ways that highlight the qualitative, to have an ethical practice that values multiple perspectives and political interests, and to report creatively to facilitate use in policy making and practice. Finally, it explores how to generalize from the single case. Concluding questions center on the need to think more imaginatively about design and the range of methods and forms of reporting requiredto persuade audiences to value qualitative ways of knowing in case study research.

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Research Design Review

A discussion of qualitative & quantitative research design, analyzability & a qualitative content analysis case study.

The following is a modified excerpt from Applied Qualitative Research Design: A Total Quality Framework Approach (Roller & Lavrakas, 2015, pp. 284-285).

Gender & Society

Purpose & Scope The primary purpose of this primary qualitative content analysis study was to extend the existing literature on the portrayal of women’s roles in print media by examining the imagery and themes depicted of heterosexual college-educated women who leave the workforce to devote themselves to being stay-at-home mothers (a phenomenon referred to as “opting out”) across a wide, diverse range of print publications. More specifically, this research set out to investigate two areas of media coverage: the content (e.g., the women who are portrayed in the media and how they are described) and the context (e.g., the types of media and articles).

This study examined a 16-year period from 1988 to 2003. This 16-year period was chosen because 1988 was the earliest date on which the researchers had access to a searchable database for sampling, and 2003 was the year that the term “opting out” (referring to women leaving the workforce to become full-time mothers) became popular. The researchers identified 51 articles from 30 publications that represented a wide diversity of large-circulation print media. The researchers acknowledged that the sample “underrepresents articles appearing in small-town outlets” (p. 502).

Analyzability There are two aspects of the TQF Analyzability component — processing and verification. In terms of processing, the content data obtained by Kuperberg and Stone from coding revealed three primary patterns or themes in the depiction of women who opt out: “family first, child-centric”; “the mommy elite”; and “making choices.” The researchers discuss these themes at some length and support their findings by way of research literature and other references. In some instances, they report that their findings were in contrast to the literature (which presented an opportunity for future research in this area). Their final interpretation of the data includes their overall assertion that print media depict “traditional images of heterosexual women” (p. 510).

Important to the integrity of the analysis process, the researchers absorbed themselves in the sampled articles and, in doing so, identified inconsistencies in the research outcomes. For example, a careful reading of the articles revealed that many of the women depicted as stay-at-home mothers were actually employed in some form of paid work from home. The researchers also enriched the discussion of their findings by giving the reader some context relevant to the publications and articles. For example, they revealed that 45 of the 51 articles were from general interest newspapers or magazines, a fact that supports their research objective of analyzing print media that reach large, diverse audiences.

In terms of verification, the researchers performed a version of deviant case analysis in which they investigated contrary evidence to the assertion made by many articles that there is a growing trend in the proportion of women opting out. Citing research studies from the literature as well as actual trend data, the researchers stated that the articles’ claim that women were increasingly opting out had weak support.

Kuperberg, A., & Stone, P. (2008). The media depiction of women who opt out. Gender & Society , 22 (4), 497–517.

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5 Qualitative Data Analysis Methods + When To Use Each

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Qualitative data analysis is the work of organizing and interpreting descriptive data. Interview recordings, open-ended survey responses, and focus group observations all yield descriptive—qualitative—information. This is the opposite of quantitative data, which is all about numbers and statistics. 

Qualitative data can’t easily be cleaned, sliced, and diced like its numerical sister. So researchers use specific qualitative data analysis methods to understand the information they collect. 

The field of research recognizes five qualitative data analysis methods. We’ll quickly define each one. Then we’ll break down how to use them, when, and why.

#1. Content Analysis

Content analysis is when researchers categorize and organize words, concepts, patterns, and themes in their data. 

When You Should Use Content Analysis

Content analysis is useful for identifying trends and patterns in research. 

The trends could be literally anything. Market researchers could look at a large sample of contemporary ad campaigns to spot trends in how businesses use emotions to appeal to their customers.

Social researchers could study mommy blog posts and Instagram momfluencers from 2010 to 2020 to identify patterns about how motherhood changed in the span of a decade.

You get the idea. 

Content analysis hasis flexible, and to better understand it, get to know the two subtypes of content analysis: conceptual analysis and relational analysis. 

First, let’s look at conceptual analysis. 

When people talk about content analysis, they often mean conceptual analysis. This method involves picking a concept and then counting how often it appears in your data. The basic goal is to see how frequently certain terms come up. In general, conceptual analysis requires you to do three things: 

  • Identify your question: Figure out what you want to learn from your research and choose your samples accordingly.
  • Determine your level of analysis: Decide whether you want to analyze words, phrases, sentences, or themes.
  • Code the text: Break the text down into manageable categories. In other words, figure out which specific words or patterns are relevant to your research question, and quantify them. This process, called coding, is made much easier with qualitative research software like QDA Miner and ATLAS.ti .

Relational analysis takes conceptual analysis a step further. It involves identifying patterns and focusing on the relationships between them, rather than studying the existence of the patterns themselves. 

There are three subtypes of relational analysis: 

  • Affect extraction: Identifying and analyzing the emotions expressed within your qualitative data.
  • Proximity analysis: Looking at how often and where words, phrases, or ideas appear close to each other in a text.
  • Cognitive mapping: Using charts, graphs, or other visualization tools to explore the relationships between specific themes and trends. 

When To Use Content Analysis 

How do you know when to use cognitive vs. relational concept analysis?

It’s simple. 

  • Use conceptual analysis when you want to quantify the presence and frequency of a specific concept. 
  • Use relational analysis when you want to explore the relationships between concepts in a set of qualitative data. 

Say you run a survey to ask a group of dog owners whether they let their furry friends sleep in their beds with them. Conceptual content analysis can reveal how many times certain words are used, like “always,” “never,” “cuddle,” and “scratch.” It can also show you trends in the attitudes pup parents have about bedsharing (or not) with their furbabies. 

Relational analysis can help you explore themes among people who responded “yes” and people who said “no.” This, in turn, can help you understand the reasons behind the answers. 

#2. Narrative Analysis

Narrative analysis involves collecting stories or accounts and looking for underlying themes.  

When You Should Use Narrative Analysis

Use narrative analysis when you need to understand the stories behind client or customer experiences.

If your goal is to improve your customer journey, for instance, narrative analysis can reveal what your customers think about the journey as it is right now. What they love about it—and what they don’t.

The content you need for narrative analysis might already be out there. Do your customers or clients give reviews? Those count as narratives that can be analyzed.

But you can also be intentional and methodical about collecting the qualitative data you need for these reviews. Consider hosting one-on-one interviews with a small group of customers. Or running a focus group. Even surveys with space for long-form responses provide narratives you can dig through.

An Example of Narrative Analysis

Imagine a mid-sized retail company, Fashion ABC, is facing a decline in repeat customers. This is despite offering high-quality products—and even getting top influencers to be brand ambassadors. For some reason, though, Fashion ABC just can’t hang onto as many customers as they’d like to.

To get to the bottom of this, they decide to use narrative analysis on customer feedback collected over the past year.

Here’s how Fashion ABC runs the process, step by step.

  • Gather stories : Fashion ABC collects customer stories from reviews, social media comments, and customer service call transcripts.
  • Find the narratives : The team looks for personal stories within the data. They note the positive stories but focus more intensely on any narrative with a negative emotion, like anger or frustration.
  • Identify themes : Next, Fashion ABC categorizes these stories to spot common themes, like “return process,” “customer service,” “product quality,” and “shopping experience.”
  • Analyze patterns : In the “return process” category, the Fashion ABC team notices a trend: many customers are unhappy with the confusing return policies and especially the slow refunds.
  • Draw insights : It becomes clear that although customers love the products, the complicated return process is a major pain point. Even returning something as simple as a too-big shirt or pair of pants is a major hassle. This issue shows up consistently across different feedback sources.
  • Take action : Fashion ABC decides to simplify their return policy. They make it clearer and look to other companies, like Target and Costco, to figure out how to quickly refund customers. They roll out the new, easy-to-understand return policy on their website and streamline the return process.
  • Check results : The narrative analysis isn’t done yet. After a few months, the Fashion ABC team gathers new customer feedback. Their goal? To see if the changes have made a positive impact on customer satisfaction and loyalty.

If the changes work, the team knows that the inefficient return process really was the culprit. If not, they can go back to square one and keep digging. 

#3. Discourse Analysis

Discourse analysis looks at how people structure and express language within a cultural context.

When You Should Use Discourse Analysis 

Discourse analysis is a great tool to use when you want to understand how language shapes and reflects us. It’s ideal for examining how different groups or institutions communicate—and helps measure the impact of language choices. 

Take political speeches, for example. Politicians hire speechwriters for a reason. They’re looking for people who can carefully use words to influence public opinion and persuade people to a specific point of view. (Hot tip: If you’ve never done discourse analysis before, these speeches are a great place to do some practice analysis.)

Like any type of concept analysis, though, discourse analysis is helpful in just about every field. 

In education, it can highlight how the language teachers use affects learning. In healthcare, it can help researchers understand how language between doctors and patients impacts the quality of care. 

It’s also really useful in media studies. You can use it to look at how news outlets frame specific stories, which can reveal hidden biases. All it takes is looking at one news story from the point of view of five different publications to see how the language used in each one might influence the reader to a specific viewpoint.

In short, discourse analysis doesn’t just help you understand what is being said. It also helps you understand why it’s being said the way it is. 

An Example of Discourse Analysis

Let’s pretend we’re analyzing an ad for a new herbal tea. Here’s the general process we’d take for discourse analysis.

First, we’d choose a specific ad promoting a brand of herbal tea.

Then we’d look for recurring themes within the images. Does the ad emphasize relaxation? Health benefits? Luxury? All three?

Let’s look at the image below, which shows a billboard for Pukka tea. Specifically, for a tea that’s meant to help people get ready for a good night’s sleep. 

case study research qualitative content analysis

Let’s look at what words and phrases the company uses to communicate these themes. 

There’s not a lot on the billboard, but what’s there is powerful: “Unwind with Nature.” Pukka’s signature twisty vines and flowers bookend the corners of the billboard, and the purple hues and steam rising from the cup help complete the ad. 

The language here is telling us that with Pukka tea, we can relax and look forward to a good night’s sleep. It also suggests that by drinking Pukka tea, we’re connected to nature—even in the middle of a city.

#4. Thematic Analysis

Thematic analysis involves looking at a set of qualitative data, like interview transcripts or survey responses, and extracting meanings and themes from it. 

When To Use Thematic Analysis

Thematic analysis is helpful for finding ideas—aka themes—in qualitative data. You can use it to analyze things like interview transcripts, open-ended survey responses, focus group discussions, and just about any type of qualitative data you collect or source from elsewhere.

And with today’s AI-powered tools like NVivo and ATLAS.ti , thematic analysis is easier than ever. (More on how to use AI for content analysis in a moment.)

Thematic analysis is especially useful early on in your research, especially when you’re trying to generate new ideas. Or when you’re exploring a topic without any specific hypotheses in mind.

For example, if you’re in healthcare research, you might use thematic analysis to understand how patients feel about a new treatment. In education, it can help you explore what teachers think about a new curriculum. In the business world, it’s useful for analyzing customer feedback to spot common complaints.

An Example of Thematic Analysis

Let’s say we’ve decided to use thematic analysis to analyze customer feedback for our new coffee shop. To begin, we collect and read through 50 customer reviews. Our goal is to look for recurring words or phrases that point to specific ideas—things like “friendly staff,” “cozy atmosphere,” and “long wait times.”

Next, we’ll group these elements into broader themes. “Friendly staff” and “cozy atmosphere” go in a “Positive Experiences” category. Points like “pricey menu” and “long wait times” go under a “Needs Work” category.

From there, we can summarize our findings and use them to make improvements to our new coffee shop. 

#5. Grounded Theory 

Grounded theory is a way of trying to understand the meanings of peoples’ actions—based on their own interpretations of those actions. 

When You Should Use Grounded Theory

You should use grounded theory when you’re trying to use your data to develop a theory, rather than the other way around. Grounded theory is particularly useful when existing theories about something don’t really fit, and you’re looking for a different angle or answer.

For instance, let’s say you’re studying how people adapt to remote work in a field like telehealth. With grounded theory, you can use participants’ actual experiences and interactions to generate theories and better understand the topic of your research. 

So why is it called grounded theory, anyway? 

The answer lies in this definition of grounded theory, which comes to us from a 2021 article titled, “Grounded theory: what makes a grounded theory study?” in the European Journal of Cardiovascular Nursing : “The focus of [grounded theory] is to generate theory that is grounded in data and shaped by the views of participants.”

In other words, it’s a qualitative research method that invites theory to originate from the ground up, instead of the other way around. 

An Example of Grounded Theory 

Imagine you want to develop software to help digital nomads keep track of their working hours and block distractions. (For reference, digital nomads are people who work remotely using technology and travel as they work.)

There’s not much existing research on how these folks manage their work-life balance or connect with other people. It must be hard, since they’re always on the go. How do they do it? What does it mean for their work-life balance? You want to use grounded theory to learn more about this growing segment of people so your product can support their needs.

To collect data, you start by surveying a variety of self-proclaimed digital nomads. You also spend time observing online forums like Reddit to get more of an insider perspective.

case study research qualitative content analysis

As you dig into the survey responses and your observation notes, you start the coding process. To do this, you identify concepts like “flexible work hours,” “isolation,” “community support,” and “travel logistics.”

Next, you connect these concepts into broader categories. For instance, “flexible work hours” and “travel logistics” might merge into a category called “lifestyle management,” while “isolation” and “community support” could come together under “social dynamics.”

Finally, you refine these categories into a new, core theory. You might come up with the idea that digital nomads thrive by balancing autonomy and flexible scheduling with community support. This theory highlights how digital nomads create routines that help them manage work and travel. At the same time, they rely on online and physical communities to fill their social cup. 

Your grounded theory suggests that the sustainability of the digital nomad lifestyle hinges on balancing personal freedom, structured but flexible work hours, and social connectedness.

At the end of this journey, you’ve decided to build software that provides digital nomads with a one-stop shop for logging work hours, blocking distractions, and connecting with other nomads. 

How to Use AI With Qualitative Data Analysis

AI is a hot-button topic, but there’s no question it can help with qualitative analysis. It can’t—and shouldn’t—do all the work for you, though. 

Here’s a quick round-up of Do’s and Don’ts when it comes to using AI in qualitative analysis.

  • Use AI for data cleaning : AI tools can do the mindless tasks humans take forever to do, like transcribing interviews, removing duplicates, and organizing qualitative data.
  • Use AI for initial coding : AI can also do a great job helping you with the coding process. How? By identifying frequent terms in the text. Some tools can help you organize those terms into broader theme groups, too.
  • Use AI for visualizing data: AI can help you create graphs and other visual representations of data, which makes it easier to digest and study.

Don’t:

  • Use AI for anything else. No, really. AI is not human, and it can’t make interpretations, draw conclusions, or basically do any of the heavy thinking necessary in qualitative analysis. It’s great for eliminating busywork, but you’ve got to use your own brain and experience as a human to do all the rest. 

Tools like ATLAS.ti, Nvivo, and Tableau can help you with the AI-friendly parts of qualitative research. Trust your experience as a human being to help you with the rest.

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From: http://www.emeraldgrouppublishing.com/products/case_studies/index.htm

What is a case study?

  • Attempts to shed light on a phenomena by studying a single case example.
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  • Stark, R. (1995). The  art of case study research, Thousand Oaks: Sage.
  • Yin, R.K. (2009) Case study research: Design and methods. Los Angeles: Sage.
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  • Volume 14, Issue 8
  • Community pharmacists’ roles during the closure stage of the COVID-19 pandemic in Newfoundland and Labrador, Canada: a qualitative case study
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  • Sylvia Farooq 1 ,
  • http://orcid.org/0000-0002-2908-0804 Jennifer R Donnan 1 ,
  • Julia Lukewich 2 ,
  • Maria Mathews 3 ,
  • http://orcid.org/0000-0001-5207-2186 Tiffany A Lee 1
  • 1 Pharmacy , Memorial University of Newfoundland , St. John's , Newfoundland and Labrador , Canada
  • 2 Faculty of Nursing , Memorial University of Newfoundland , St. John's , Newfoundland and Labrador , Canada
  • 3 Department of Family Medicine , University of Western Ontario , London , Ontario , Canada
  • Correspondence to Dr Tiffany A Lee; tiffany.lee{at}mun.ca

Objectives To explore the experiences and perspectives of community pharmacists regarding their roles during the closure stage (ie, March to May 2020) of the COVID-19 pandemic in Newfoundland and Labrador (NL), Canada.

Design This qualitative case study included a document analysis and semistructured interviews with community pharmacists who provided direct patient care during the COVID-19 pandemic. The document analysis was used to develop a chronology that informed the interviews. Themes from qualitative interviews were developed through iterative cycles of data review and analysis using applied thematic analysis. Findings are presented specifically for the time period between March and May 2020, defined as the ‘Closure Stage’.

Setting Community pharmacies in NL, Canada.

Results 12 community pharmacists participated in the interviews. Four themes were developed including (1) pharmacists’ leadership in continuity of care, (2) pharmacists as medication stewards, (3) pharmacists as a source of COVID-19 health information and (4) the impact of COVID-19 on pharmacists’ mental health and well-being. The first three themes described the key roles played by community pharmacists during the early days of the COVID-19 pandemic, including coordinating care, prescribing for common ailments, delivering medications and supplies, providing information on COVID-19 symptoms and their management, renewing chronic medications and protecting the medication supply. Unclear guidance on scope of practice, limited scope of practice, inadequate staffing and limited support from government bodies were identified as barriers to these roles. Facilitators included access to a delivery service, swift regulatory changes, reimbursement and support from colleagues and other healthcare professionals. The fourth theme is presented independently, emphasising the impact of working within the primary healthcare (PHC) system during the COVID-19 pandemic on pharmacists’ mental health and well-being.

Conclusion Pharmacists played a critical role in the delivery of PHC services during the closure stage of the COVID-19 pandemic. The findings of this research highlight the essential elements of a strong PHC pandemic preparedness plan that is inclusive of community pharmacists, including improved communication strategies, mental health support and access to resources.

  • Primary Health Care
  • Pharmacists
  • QUALITATIVE RESEARCH

Data availability statement

No data are available. We did not obtain approval to share data related to this work from our Health Research Ethics Board.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:  http://creativecommons.org/licenses/by-nc/4.0/ .

https://doi.org/10.1136/bmjopen-2024-085338

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Strengths and limitations of this study

The roles of community pharmacists during the closure stage of COVID-19 were explored in an in-depth manner using qualitative case study research methods.

Data may predominantly reflect certain regions of the province of Newfoundland and Labrador, Canada and may not be transferrable to other jurisdictions.

The perceived burden of COVID-19 at the time of the interview may have influenced the reflections provided by the community pharmacists.

Introduction

The global outbreak of COVID-19 led to unprecedented closures of community health centres as well as non-essential services (eg, restaurants, hair salons, gyms) to reduce the transmission of the novel coronavirus and pressure on the healthcare system. 1–3 Unlike acute care centres, which have well-established pandemic preparedness plans, primary healthcare (PHC) providers (eg, family physicians, nurse practitioners, pharmacists) faced tremendous uncertainty about how to sustain the delivery of PHC services in the early days of the COVID-19 pandemic. Historically, pandemic preparedness plans have concentrated on acute care and creating surge capacity in hospitals, tailored for geographically specific or time-limited events. 4 5 However, these plans fail to account for the need to support and maintain PHC services, which became particularly evident given the essential role of PHC services in ensuring continuity of care. Continuity of care has been defined as the relationship between a provider and patient that exists beyond a specific episode of illness, involving coordination and communication to facilitate patient care. 6 It is rooted in providing high-quality care over time for individual patients by one or more healthcare professionals. 6

PHC in the province of Newfoundland and Labrador (NL) is delivered by a multidisciplinary group of providers working in various settings, including primary care clinics, community health clinics, public health clinics and community pharmacies. 7 Primary care clinics in the province include those that are funded by the Provincial Health Authority (PHA) (ie, the publicly funded health service provider in the province of NL) and privately run practices by family physicians and nurse practitioners (NP). 7 Clinics run by the PHA are typically colocated with other PHC services, including public health (ie, health initiatives focused on the health of the entire population) and community health (ie, health initiatives focused on the health needs and concerns of particular communities or groups) 8 ; these clinics are primarily physician-led except for some rural and remote areas of the province, which are predominately staffed by registered nurses (RNs) with support from visiting locum physicians. 7 Whereas, privately owned primary care physician (PCP) clinics operate independently and are funded under a fee-for-service model via claim submission through the provincial medical care plan. 7 On the other hand, community pharmacies and NP clinics operate entirely as private businesses, 7 with few services funded by the government. The majority of residents of NL have access to primary care services; however, the number of those without access to a PCP is growing. 9 Residents who do not have access to a PCP or NP often rely on emergency departments that operate low-acuity Fast Track Clinics, 10 the provincial health line (ie, 811) or community pharmacies for non-urgent care (eg, prescription refills, chronic disease management, management of cold or influenza symptoms).

In NL, community pharmacies provide a range of pharmacist-delivered PHC services, including pharmaceutical care and medication dispensing, immunisation, acute management of common ailments, drug information, and screening and monitoring for chronic disease. 11 In regions lacking access to emergency medical facilities or where PCP or NP waiting times are significant, patients frequently seek non-urgent healthcare services from local community pharmacies. This is particularly common in rural areas of the province that are not regularly staffed with a PCP. 11 As such, community pharmacists play a pivotal role in sustaining continuity of care, frequently serving as the primary or sole healthcare provider in some areas of the province. 11

At the beginning of the COVID-19 pandemic, there was a scarcity of published studies examining the roles of community pharmacists in pandemic response efforts. Like other primary care providers, pharmacists lacked guidance on their roles and responsibilities during a global pandemic. There were no provincial guidance documents or pandemic preparedness plans available to community pharmacists. The only document available in the early days of COVID-19 was a guideline published by the International Pharmaceutical Federation (FIP) titled, ‘COVID-19: Guidelines for pharmacists and the pharmacy workforce’ which provided guidance on measures to reduce infection, patient isolation and referral, diagnostic testing and immediate roles pharmacists could play to support public and patient safety during COVID-19. 12 At the time, there was limited understanding of the extent to which the FIP guidelines could be implemented in NL. Therefore, it should come as no surprise that in the absence of clear guidance and pandemic preparedness plans, specifically tailored to the role of community pharmacists in sustaining continuity of care and supporting the PHC system during a pandemic, community pharmacists were left to figure out how to adapt their roles to help support their patients during the pandemic. This knowledge gap was important to address and served as the motive behind our study, which aimed to describe pharmacists’ roles during the COVID-19 pandemic in NL and to identify the supports and barriers that facilitate or hinder pharmacists’ performance in these roles.

In this paper, we explored the experiences of community pharmacists during the closure stage of the COVID-19 pandemic in the Canadian province of NL. More specifically, we aimed to (i) describe the roles of community pharmacists in delivering PHC services and (ii) describe the facilitators and barriers to enacting these roles. This study is part of a larger programme of research that aims to understand the proposed, actual and potential roles of primary care providers (PCPs, NPs, RNs and pharmacists) in NL and to integrate findings into a pandemic preparedness plan for PHC delivery in the province.

Study design

Situated within the paradigm of pragmatism 13 and drawing on the case study methodology described by Yin 14 and Merriam, 15 we used a single embedded case study design that included a document analysis, semistructured interviews and reflexivity. The document analysis facilitated the development of a chronology document (see online supplemental appendix A ). The chronology document described key milestones during the COVID-19 pandemic, regulatory changes to pharmacy practice during the same time period and proposed roles for pharmacists during each pandemic stage, as described in government, health system and pharmacy professional bodies documents. Semistructured interviews provided an in-depth understanding of the experiences of community pharmacists during the COVID-19 pandemic, including any new roles they undertook during the closure stage of the COVID-19 pandemic and barriers and facilitators to these roles. Researcher reflexivity was used to enhance the study’s rigour and enable a comprehensive exploration of the case. By embracing reflexivity, we acknowledged and documented the researchers’ subjectivity, providing understanding into its impact on study decisions (see researchers and positionality in online supplemental appendix B ).

Supplemental material

Study period.

This paper is specifically focused on the period of the COVID-19 pandemic from 18 March to 15 May 2020, which we have defined as the ‘Closure Stage’ in accordance with the COVID-19 chronology proposed by Mathews and colleagues. 16 The closure stage is defined as the time period when many public services, including some healthcare services, were closed to the public. During this time, the provincial Chief Medical Officer of Health (CMOH) deemed all retail services that provide food and medicines essential services. As such, community pharmacies, due to their pivotal role in providing access to essential health products (eg, medicines, devices), remained operational and were open to the public with appropriate social distancing measures in place. However, PCP and NP clinics were advised to cease non-urgent or emergent services and operate using virtual modes of care.

Sampling and recruitment

Pharmacists were eligible to take part in this study if they were licensed to practice pharmacy in NL and worked in a community pharmacy setting during the COVID-19 pandemic. A variety of purposive sampling techniques, including maximum variation sampling and snowball sampling, were used. Maximum variation sampling was used to capture a variety of perspectives and ensure diversity 17 across a broad range of characteristics, including age, gender, years of practice, location of practice and type of pharmacy. Given the small number of community pharmacists practising in NL (ie, approximately 600), 18 snowball sampling helped to facilitate the identification of participants with some of these specific characteristics. Multiple strategies were used to recruit participants, such as social media (ie, private Facebook groups), email and telephone; interested pharmacists were asked to reach out to researchers via email. Following each interview, participants were asked to suggest other community pharmacists who could provide valuable perspectives. Recruitment continued until community pharmacists’ perspectives were well represented and data saturation 14 was achieved. Data saturation was determined when no new themes, categories or insights emerged from the data. 14 Participants were offered a $75 Amazon gift card as an honorarium for their participation in a research interview.

Patient and public involvement

Patients and/or the public were not involved in the design or conduct of this research.

Data collection

Semistructured interviews with community pharmacists occurred between February and August 2022. Designated team members (SF, TAL and JRD) completed interviews virtually in pairs on Zoom (ie, virtual conference or call-in). Prior to the interview, participants were provided with a copy of the chronology document (see online supplemental appendix A ) to help with the recall of major events during the COVID-19 pandemic. As per the interview guide ( online supplemental appendix C ), interviewers asked participants for some key demographic information and provided participants with a brief description of the pandemic stage. Participants were then asked to describe their roles, and the facilitators and barriers that may have impacted their ability to enact these roles during each stage.

The interviews lasted 60 to 120 min (averaging 86 min) and were audiorecorded and then transcribed verbatim using NVivo V.12 by the first author (SF). All transcripts were reviewed for accuracy and in accordance with Jeffersonian transcribing conventions. 19 After each interview, the interviewers engaged in reflective writing and later reconvened to debrief and discuss the interview and their reflections. Additionally, the first author (SF) maintained a reflexive journal throughout the study. Using these reflections, researchers were able to adapt the interview guide, avoid leading questions and improve rapport with participants.

Data analysis

For data analysis, we used the applied thematic analysis approach described by Guest and colleagues. 20 Recurring ideas and codes were identified by SF, TAL and JRD inductively and independently. The research team collectively verified the coding through debriefing meetings and discussion. Data grouped under the same code were organised into categories, which were subsequently reviewed and condensed into potential themes. 20 21 Themes were then developed collaboratively and finalised by the research team. 20

We conducted interviews with 12 participants, including five men and seven women. Our participants had been practising for an average of 15.6 years, with four pharmacists practising in rural communities. Other demographic characteristics are outlined in table 1 .

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Participant demographic characteristics (n=12)

Four themes were developed: (1) pharmacists’ leadership in continuity of care, (2) pharmacists as medication stewards, (3) pharmacists as a source of COVID-19 health information and (4) the impact of COVID-19 on pharmacists’ mental health and well-being. The first three themes described the key roles played by community pharmacists during the closure stage (eg, March to May 2020). The fourth theme highlighted the significant impact of working in the PHC setting during the early days of the COVID-19 pandemic on pharmacists’ mental health and well-being. Barriers and facilitators were discussed in relation to each theme. Illustrative quotes are provided in-text and have been edited for clarity. Table 2 provides a summary of themes, roles, barriers and facilitators.

Pharmacists’ roles during the closure stage of the COVID-19 pandemic and associated barriers and facilitators

Pharmacists’ leadership in continuity of care

The pandemic influenced access to healthcare services, which our participants described as having an important impact on the sheer number of patients who sought healthcare services more routinely from pharmacists. As such, pharmacists played a key leadership role in continuity of care. Participants described having to adapt their roles and priorities to meet the needs of their patients and a strained healthcare system. They supported and fostered continuity of care through two key elements: (i) access and coordination, and (ii) collaboration with patients and other healthcare providers. The necessary transition in pharmacy services was accompanied by unique barriers and facilitators, described below.

Access and coordination

During the closure stage, PCPs and NPs were advised by the CMOH to restrict in-person clinic visits to urgent or emergent cases and to offer virtual care where possible. As these healthcare providers shifted their practice to virtual care during the closure stage, our pharmacists described experiencing an increase in demand for pharmacist care, as a notable portion of the population turned to them for healthcare services. Likewise, individuals who lacked a PCP or NP, who had previously relied on the Fast Track Clinic within provincial emergency departments for chronic disease management, increasingly relied on community pharmacists to address their healthcare needs.

Participants in our study reported an increased demand for pharmacist-delivered chronic disease management (eg, assessment, monitoring), prescription renewals, and prescribing and care for common ailments. As noted by one pharmacist: “I did the most prescribing I've ever done in my life, extending prescriptions and all that.” – P6. In addition, due to the inaccessibility of PHA-run clinics, which are most commonly located in community hospitals, and low-acuity emergency room services for many people, our participants had felt a greater need to coordinate care for their patients: “So, the hospital wouldn't take any patients, they wouldn't see any patients. And if the patient needed refills, it got sent to me to figure out.” – P1. Participants also described numerous changes to their provision of care for patients requiring opioid agonist maintenance therapy (OAMT), where they engaged in providing prescription delivery and at-home witnessed dosing of OAMT for patients unable to visit the pharmacy in person.

Common barriers emerged from the pharmacists’ stories. For example, barriers included lack of financial compensation for the extra roles played during COVID-19, the delay in care caused by regulatory paperwork and lack of adequate staff. For example, there was a lag between the implementation of new pharmacist-delivered services for patients isolating due to COVID-19, such as delivery and witnessed dosing of OAMT, and government funding/reimbursement for these services:

But you know, at the beginning stages, there was no talk about reimbursement for all these extra services that were going to be required because of [self-isolation for patients experiencing symptoms of COVID-19]. – P3

Other barriers included the increase in paperwork. For example, participants described the many steps involved in the approval process for OAMT delivery and witnessed dosing—a new government-funded service introduced during the closure stage of the pandemic. The pharmacy service fee and approval process for patients to access the service did not account for the time-sensitive nature of OAMT or the urgency of approval when a patient receiving OAMT was suspected to have COVID-19. As a result, some pharmacists described providing the service without reimbursement:

(The service fee) is $50 […]but you used to have to get approval (from public health) … So, I delivered a lot of OAMT (Opioid Agonist Maintenance Treatment) and never was paid for it because I just didn't have time to call public health and wait for (approval). (OAMT) is time-sensitive stuff. – P2

Additional barriers included lack of access to personal protective equipment (PPE) and lack of adequate staff. Pharmacists felt there was no proactive consideration of pharmacists’ patient care roles during the closure phase, which often excluded pharmacists from important resources, such as PPE and resulted in some pharmacists making their own forms of PPE (eg, masks). As one participant noted, “We weren't included in [PPE rollout,] and we really had to fight to have access to PPE […]. The government had a store of it, but they wouldn't release it to us even to purchase.” – P2

Despite the reported barriers, facilitators were also described by some participants. These included physician support and cooperation, their scope of practice, access to delivery services and reimbursement for delivery and witness dosing of OAMT. Company-specific policies designed to prevent the spread of COVID-19, such as the stratification of pharmacy personnel into designated teams, were also reported as supportive measures. This facilitated the safe operation of community pharmacies and allowed pharmacists to remain accessible to their patients and communities during the pandemic:

I think, (it) was a company-wide decision, at least in the province, that stores were going to kind of split their staff up into two teams. The overall goal was to prevent total closure of places in case team members did contract COVID. So that was a fairly big shift, because we wound up then kind of working days on days off in sort of like a half-half of the team sort of a situation. – P4

Collaboration

Pharmacists also discussed their crucial role in collaborating with other healthcare providers to help maintain continuity of care. During the closure stage of COVID-19, the majority of family physicians’ offices were closed with few virtual care options, creating challenges for patients to access their family doctor for prescription renewals and clinical assessments. To fill the gap in communication between patients and physicians, pharmacists facilitated connecting patients with their PCP when necessary. Some physicians provided pharmacists with their personal phone numbers. When needed, pharmacists would allow patients to use their offices and connect with the physician to facilitate virtual assessments and verbal prescriptions while maintaining the privacy of the physician’s personal contact information.

Barriers to communicating and collaborating with other providers to achieve continuity of care were described. Information on which providers worked remotely from home during the closure stage was not readily available. Pharmacists described feeling left in the dark and without necessary contact information for their primary care colleagues. Essentially, they had to wait for the other provider to reach out to them with alternate contact information. Some participants felt that the professional associations (ie, the pharmacy association and the medical association) should have taken a greater leadership role in coordinating resources to aid in delivering primary care. As one participant noted, “It would have been great if the (medical association) had compiled a list of alternate contact information for (physician) prescribers (who were) managing patients from home.”– P3

In terms of supports, when contact information was available for a PCP or NP, the pharmacist was then able to facilitate care between the patient and the physician or NP. Pharmacists viewed having this information as a key facilitator to collaboration and continuity of care. For example, one pharmacist discussed connecting with the other providers at the medical clinic next door to the pharmacy who were regularly working from home during the closure stage, “I would take a picture of his arm or whatever was happening […]and text it to their family doctor.”– P5. The use of technology in this case helped to facilitate communication and collaboration between the pharmacist, the patient and other healthcare providers.

Pharmacists as medication stewards

At the risk of depleting the drug supply and its potential negative impact on public health, the pharmacist’s traditional role as a medication steward re-emerged as a necessity. The roles of pharmacists as medication stewards were discussed extensively during the interviews, which included limiting the sales of over-the-counter medication and devices, following the 30-day medication supply limit and ensuring a consistent supply of medications to long-term care homes.

The public fear of pandemic-associated supply chain restrictions led to the hoarding of over-the-counter (OTC) medications and devices, and requests for larger quantities of prescription medications in many areas of the province. To combat this problem and prevent drug shortages, pharmacies were directed by their regulatory board—the Newfoundland and Labrador Pharmacy Board—to limit medication dispensing to a 30-day supply. One participant described the situation as follows, “The shelves became bare in every pharmacy…all analgesics and cough and cold products and things like that, they all got (bought) out across the country.” – P5. As such, pharmacists played a key role in protecting the drug supply, including limiting the sale of OTC medications and devices. Pharmacists working in pharmacies that serviced long-term care homes also described being especially diligent about their medication stewardship role; they took steps to ensure that their affiliated long-term care homes (ie, residential facilities that provide long-term care services that are associated with a specific pharmacy) had an adequate and consistent supply of medication. However, this came at a cost, as participants described time, medication shortages, access to PPE and access to the facility as notable barriers to maintaining medication supply at long-term care homes.

Instead of just bringing the drugs through the front door of the long-term care home. (Access was via) a back door, which is not designed for receiving inventory due to it being the furthest place from the residents. Not a lot of long-term care homes are designed for pandemics. – P11

Having to limit the dispensing of medications to a 30-day supply created many challenges. It increased the workload associated with dispensing and increased fees/costs for patients. Furthermore, there was considerable miscommunication about the necessity of the 30-day supply, with the provincial Minister of Health proclaiming that it was not absolutely necessary or supported by the government. This created a media frenzy, and as a result, pharmacists described feeling villainised in their role as medication stewards: “We were definitely the villains as pharmacists for [30-day supply] at that time.” – P6

Pharmacists as a source of COVID-19 health information

Early in the pandemic, there was limited information on COVID-19 available to the public. Our participants described a general lack of patient-friendly resources regarding COVID-19, which led patients to seek information from pharmacists on many topics, such as COVID-19 symptoms, symptom management and other related clinical questions: “At that point there was no treatment options or recommended recommendations on what to give. So (we suggested medications) if there was something that we could give them over-the-counter to treat symptoms.” – P7

Barriers included the lack of evidence-based information, the sheer volume of information about COVID-19 from public health authorities and conflicting public health information. Our study participants reported feeling an increased responsibility to stay informed about various aspects of COVID-19, which came with its own challenges. One pharmacist described the sheer exhaustion that came as a result: “I remember it was just like so stressful every day trying to go in and figure everything (out) […]. Everything was changing, like every other hour.” – P6

Pharmacists working in independent pharmacies seemed to experience greater challenges acquiring up-to-date information on COVID-19 recommendations and policies. These pharmacists did not have access to the different levels of support that come with working within a larger organisation, like a pharmacy chain: “I'm an independent pharmacy, so I don't have anybody relaying information down to me. […] So just day by day, (I had) to figure it out and then communicate (it) to everybody.” – P6. Facilitators supporting their informational roles included support from other pharmacists and healthcare workers, as well as their company/pharmacy chain.

The impact of COVID-19 on community pharmacists’ mental health and well-being

The COVID-19 pandemic impacted all aspects of pharmacists’ lives, including their mental health and well-being. Pharmacists in our study expressed that they felt feelings of fear, guilt and isolation. As one participant stated, “A simple word to describe it was, you know, working hell […] You know, so you're half afraid to go to work then half afraid to come home to your family at times.” – P1. Many spoke about the fear of catching COVID-19 and spreading it to their family, friends and patients, which often led them to isolate themselves from their partners, children, parents, friends and pets. This was illustrated by the following quote:

You know, I couldn't even go near any of them, couldn't see my dog (inaudible), couldn't go to a store. I couldn't go to visit anyone. I couldn't, you know, they talk about your steady 20 and you're tight 10 in that kind of thing. I didn't even (have) that. I had myself. That’s all I had. Just because of that fear of contracting and having to shut down. – P1

The topic of the limited availability of mental health support and childcare support was also frequently discussed. One pharmacist mentioned that they often felt like an essential mental health support for the community but there was limited support available to them as a pharmacist, which led to feelings of burnout. The participant stated, “I felt like I was a support for everyone else, which was an additional level of burnout for me.” – P2. Another pharmacist expressed concern about the lack of available and affordable childcare services:

My husband goes to work, and I go to work, and we've relied on family members essentially for almost 2 years. Increasing the daycare availability to working parents at an affordable rate to $15 or $10 a day is a great idea. But there is no point if there is a 2 to 3 year wait list. – P8

Pharmacists working in independently owned pharmacies felt the added stress of completing management duties simultaneously with their patient care tasks. They did not have access to the additional supports that are often available through larger corporations. As a result, they described struggling to keep up and balance all their responsibilities. Whereas, within chain pharmacies, head offices were often able to acquire PPE and cleaning supplies and offered suggestions on best practices to minimise the spread of COVID-19 between staff members (ie, rotating shift work to minimise interactions).

A grassroots initiative that emerged during the COVID-19 pandemic—developed by pharmacists in NL—that seemed to support pharmacists’ well-being and professional responsibilities was a social media community group. The majority of participants described how the private NL Pharmacists Facebook page created a support network among practising pharmacists. The information sharing and collaboration that occurred through this network strengthened participants’ sense of community and belonging and helped to build resilience: “That Facebook group was very helpful as well, seeing that a lot of people were going through the same stuff and feeling the same feelings and that type of thing.” – P2

This paper described the roles community pharmacists played in the delivery of PHC during the closure stage of the COVID-19 pandemic and explored the barriers and facilitators to these roles. Our findings draw attention to community pharmacists’ critical role in maintaining continuity of care, protecting the drug supply and disseminating COVID-19 health information during the closure stage. Community pharmacists engaged in coordinating care, prescribing for common ailments, delivering medications and supplies, providing information on COVID-19 symptoms and their management, renewing chronic medications and limiting the sale of OTC and prescription medications and devices. Many barriers and facilitators influenced the roles of many participants in our study; serving as the most accessible healthcare provider during the closure stage significantly impacted their mental health and well-being.

Our study highlighted how the pandemic necessitated that community pharmacists’ practice to full scope (eg, prescribing, monitoring drug therapy, managing chronic diseases), whether or not they were prepared or not. Pharmacists practised to their full scope and took on new roles to ensure continuity of care for their patients and communities. Similar results were reported in a cross-sectional survey of Canadian pharmacist roles during the pandemic, which identified that 70.4% of pharmacists were renewing and extending prescriptions, 67.4% of pharmacists were educating the public on reducing the spread of the COVID-19 infection, 19.9% were independent prescribing and 23.7% were collaborating with other healthcare providers on COVID-19 infection treatments. 22

Roles associated with the theme of ‘pharmacist leadership in continuity of care’ during the closure stage of COVID-19 were prominent findings in our study. Reports and publications from other regions in Canada and beyond supported this finding. For example, Lee and colleagues found that pharmacists from 10 Canadian provinces and one territory demonstrated leadership by adapting their practices to meet the needs of society (eg, provided emergency supply refills, established remote pharmacy services and provided patients with psychological first aid). 23 Other forms of pharmacist leadership in PHC have also been described in the literature. In Alberta, Watson and colleagues described how pharmacists demonstrated leadership through visible and invisible roles, regardless of whether they were in a management position. 24 Pharmacists recognised the importance of establishing a precedent for their staff, colleagues, patients and community by enforcing and practising public health measures and policies. 23 Community pharmacists also demonstrated leadership within the pharmacy by focusing on the team dynamic by outlining their responsibilities to protect and take into consideration the mental health and well-being of their pharmacy staff and colleagues. 23 This contrasted our findings, which highlighted the barriers in accessing supports to improve the well-being and mental health of community pharmacists in NL.

Amidst the challenges during the COVID-19 pandemic, community pharmacists’ role as medication stewards was brought to the forefront with the need to protect the drug supply and minimise potential drug shortages. Specifically, pharmacists were required to dispense medication in 30-day increments rather than a 90-day supply often provided for chronic medications. 24 Other studies have also shown that pharmacists played a key role in protecting the drug supply. 25 26 For example, pharmacists in different countries used pre-existing mobile applications to help guide patients on where to purchase their medications or arrange a medication delivery. 25 Additionally, pharmacists provided patients with a therapeutic substitution to reduce the strain on the supply chain. 26

The participants in our study also served as a source of COVID-19 health information. They provided patients with information on COVID-19 prevention, symptoms, symptom management and how COVID-19 may impact an individual’s other health conditions. Similar experiences were reported globally. For example, in Egypt, pharmacists contributed to patient education regarding infection control, disease management, hygiene practices, counteracting falsified claims and serving as a point of reference in their community. 27 A study in France reported that pharmacists provided education on hygiene practices and social distancing to mitigate the spread of COVID-19. 28 In Jordan, pharmacists provided patient education regarding COVID-19 symptom management, practices related to decreasing the spread of COVID-19 and medication counselling. 29 In contrast to the experiences reported by participants in our study, particularly those employed in independent pharmacies, who highlighted the limited accessibility of reliable sources of COVID-19 information, Hoti and colleagues 30 described numerous helpful sources of COVID-19-related information available for community pharmacists during the closure stage practising in Kosovo. These included pharmacy professional bodies, the internet, television, social media and scientific articles, which acted as facilitators in supporting pharmacists in their COVID-19 health information role. 30

New PHC roles (eg, educating patients on symptoms associated with COVID-19, providing advice on supportive measures to reduce COVID-19 symptoms) that emerged as a result of COVID-19 caused an increase in pharmacist workload, especially in light of patients having limited access to other healthcare providers. In our study, participants described having spent considerable amounts of time facilitating patient care with other providers. The same observation was made by Isenor and colleagues 31 in Nova Scotia, who found that the workload of community pharmacists increased during the COVID-19 pandemic due to the accessibility of pharmacies and the closure of many other healthcare centres, which prompted pharmacists to adapt their roles to meet the needs of their patients. 31 However, pharmacists were not compensated for time spent coordinating care with other healthcare providers. For example, consulting with physicians to facilitate assessments and diagnoses for patients is not routinely part of their daily roles.

Gaps in access to mental health and childcare services can considerably strain pharmacists’ well-being and impede their ability to carry out their roles effectively. Commentary published by the Canadian Pharmacists Association described an increase in pharmacists’ levels of stress, burden and frustration during the early days of the pandemic, which impacted their mental health. 32 In our study, participants gave examples of instances where they experienced high levels of stress and isolation in their role as a provider of primary care. Yet, there was also evidence of resilience and determination. This coexistence of symptoms of burnout and resilience among pharmacy professionals is not unique to our study, as other researchers have reported similar findings. 33 34

Strength and limitations

To enhance the rigour, reliability and credibility of this study through triangulation, our results drew on evidence gathered through policy analysis, chronology and qualitative interviews. 35 Additionally, the participants represented a broad range of perspectives with respect to gender, years of experience and geographical location. The research team included individuals who practice as pharmacists and have had experience in qualitative methods, which contributed their knowledge in the development of the protocol and interpretation of the results. In addition, the incorporation of reflexivity (reflective journal and post-interview reflections) enhanced the study’s rigour by allowing researchers to acknowledge their assumptions and preconceptions that influenced the study’s design, data collection, analysis and interpretation (ie, adapted the interview guide, avoided leading questions and improved rapport with participants). 35 In terms of limitations, interviews took place 2 years after the beginning of the pandemic between February and August of 2022, which could have affected the perceived burden of the COVID-19 pandemic in the early stages of the pandemic and may have influenced participants’ ability to recall and recount past experiences accurately. This study took place in the province of NL and may not represent pharmacists’ experiences in other Canadian provinces or beyond.

The delivery of PHC services plays an important role in pandemic response. We identified key roles enacted by community pharmacists during the COVID-19 pandemic and identified facilitators and barriers that should be taken into account in future pandemic preparedness plans. These plans should acknowledge and support the roles of pharmacists in the continuity of care and medication stewardship and include appropriate compensation for any new roles that emerge as a result of the need for pharmacists to preserve the delivery of PHC. Appropriate levels of remuneration would allow for adequate staffing to match the increased demand and patient care responsibilities. Future pandemic preparedness plans should include the creation of an evidence-based information hub or online portal for healthcare professionals to use in educating their patients. Such a portal must be easy to navigate and provide real-time health information updates. Recognising the impact associated with being the most accessible front-line PHC provider during the closure stage of COVID-19, future pandemic preparedness plans should also prioritise the well-being of pharmacists by facilitating access to mental health and childcare services.

Ethics statements

Patient consent for publication.

Not applicable.

Ethics approval

This study involves human participants and was approved by Newfoundland & Labrador Health Research Ethics Board Reference No. 2020.251. Participants gave informed consent to participate in the study before taking part.

  • World Health Organization
  • Public Health Agency of Canada
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This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.

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Contributors All authors (SF, JRD, JL, MM and TAL) were involved in conceptualising the study. Designated team members (SF, TAL and JRD) engaged in data collection by completing interviews in pairs. SF, TAL and JRD also generated the first list of codes using the transcripts. All authors (SF, JRD, JL, MM and TAL) were involved in the development of themes. SF wrote the first draft of the manuscript in collaboration with TAL and JRD. Final edits to the manuscript were made by JL and MM. All authors have read and approved the final manuscript. TAL is responsible for the overall content as guarantor.

Funding This work was supported by Memorial University (Seed, Bridge, Multidisciplinary Fund).

Competing interests None declared.

Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

Provenance and peer review Not commissioned; externally peer reviewed.

Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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  • Volume 22, Issue 1
  • How to appraise qualitative research
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  • Calvin Moorley 1 ,
  • Xabi Cathala 2
  • 1 Nursing Research and Diversity in Care, School of Health and Social Care , London South Bank University , London , UK
  • 2 Institute of Vocational Learning , School of Health and Social Care, London South Bank University , London , UK
  • Correspondence to Dr Calvin Moorley, Nursing Research and Diversity in Care, School of Health and Social Care, London South Bank University, London SE1 0AA, UK; Moorleyc{at}lsbu.ac.uk

https://doi.org/10.1136/ebnurs-2018-103044

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Introduction

In order to make a decision about implementing evidence into practice, nurses need to be able to critically appraise research. Nurses also have a professional responsibility to maintain up-to-date practice. 1 This paper provides a guide on how to critically appraise a qualitative research paper.

What is qualitative research?

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Useful terms

Some of the qualitative approaches used in nursing research include grounded theory, phenomenology, ethnography, case study (can lend itself to mixed methods) and narrative analysis. The data collection methods used in qualitative research include in depth interviews, focus groups, observations and stories in the form of diaries or other documents. 3

Authenticity

Title, keywords, authors and abstract.

In a previous paper, we discussed how the title, keywords, authors’ positions and affiliations and abstract can influence the authenticity and readability of quantitative research papers, 4 the same applies to qualitative research. However, other areas such as the purpose of the study and the research question, theoretical and conceptual frameworks, sampling and methodology also need consideration when appraising a qualitative paper.

Purpose and question

The topic under investigation in the study should be guided by a clear research question or a statement of the problem or purpose. An example of a statement can be seen in table 2 . Unlike most quantitative studies, qualitative research does not seek to test a hypothesis. The research statement should be specific to the problem and should be reflected in the design. This will inform the reader of what will be studied and justify the purpose of the study. 5

Example of research question and problem statement

An appropriate literature review should have been conducted and summarised in the paper. It should be linked to the subject, using peer-reviewed primary research which is up to date. We suggest papers with a age limit of 5–8 years excluding original work. The literature review should give the reader a balanced view on what has been written on the subject. It is worth noting that for some qualitative approaches some literature reviews are conducted after the data collection to minimise bias, for example, in grounded theory studies. In phenomenological studies, the review sometimes occurs after the data analysis. If this is the case, the author(s) should make this clear.

Theoretical and conceptual frameworks

Most authors use the terms theoretical and conceptual frameworks interchangeably. Usually, a theoretical framework is used when research is underpinned by one theory that aims to help predict, explain and understand the topic investigated. A theoretical framework is the blueprint that can hold or scaffold a study’s theory. Conceptual frameworks are based on concepts from various theories and findings which help to guide the research. 6 It is the researcher’s understanding of how different variables are connected in the study, for example, the literature review and research question. Theoretical and conceptual frameworks connect the researcher to existing knowledge and these are used in a study to help to explain and understand what is being investigated. A framework is the design or map for a study. When you are appraising a qualitative paper, you should be able to see how the framework helped with (1) providing a rationale and (2) the development of research questions or statements. 7 You should be able to identify how the framework, research question, purpose and literature review all complement each other.

There remains an ongoing debate in relation to what an appropriate sample size should be for a qualitative study. We hold the view that qualitative research does not seek to power and a sample size can be as small as one (eg, a single case study) or any number above one (a grounded theory study) providing that it is appropriate and answers the research problem. Shorten and Moorley 8 explain that three main types of sampling exist in qualitative research: (1) convenience (2) judgement or (3) theoretical. In the paper , the sample size should be stated and a rationale for how it was decided should be clear.

Methodology

Qualitative research encompasses a variety of methods and designs. Based on the chosen method or design, the findings may be reported in a variety of different formats. Table 3 provides the main qualitative approaches used in nursing with a short description.

Different qualitative approaches

The authors should make it clear why they are using a qualitative methodology and the chosen theoretical approach or framework. The paper should provide details of participant inclusion and exclusion criteria as well as recruitment sites where the sample was drawn from, for example, urban, rural, hospital inpatient or community. Methods of data collection should be identified and be appropriate for the research statement/question.

Data collection

Overall there should be a clear trail of data collection. The paper should explain when and how the study was advertised, participants were recruited and consented. it should also state when and where the data collection took place. Data collection methods include interviews, this can be structured or unstructured and in depth one to one or group. 9 Group interviews are often referred to as focus group interviews these are often voice recorded and transcribed verbatim. It should be clear if these were conducted face to face, telephone or any other type of media used. Table 3 includes some data collection methods. Other collection methods not included in table 3 examples are observation, diaries, video recording, photographs, documents or objects (artefacts). The schedule of questions for interview or the protocol for non-interview data collection should be provided, available or discussed in the paper. Some authors may use the term ‘recruitment ended once data saturation was reached’. This simply mean that the researchers were not gaining any new information at subsequent interviews, so they stopped data collection.

The data collection section should include details of the ethical approval gained to carry out the study. For example, the strategies used to gain participants’ consent to take part in the study. The authors should make clear if any ethical issues arose and how these were resolved or managed.

The approach to data analysis (see ref  10 ) needs to be clearly articulated, for example, was there more than one person responsible for analysing the data? How were any discrepancies in findings resolved? An audit trail of how the data were analysed including its management should be documented. If member checking was used this should also be reported. This level of transparency contributes to the trustworthiness and credibility of qualitative research. Some researchers provide a diagram of how they approached data analysis to demonstrate the rigour applied ( figure 1 ).

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Example of data analysis diagram.

Validity and rigour

The study’s validity is reliant on the statement of the question/problem, theoretical/conceptual framework, design, method, sample and data analysis. When critiquing qualitative research, these elements will help you to determine the study’s reliability. Noble and Smith 11 explain that validity is the integrity of data methods applied and that findings should accurately reflect the data. Rigour should acknowledge the researcher’s role and involvement as well as any biases. Essentially it should focus on truth value, consistency and neutrality and applicability. 11 The authors should discuss if they used triangulation (see table 2 ) to develop the best possible understanding of the phenomena.

Themes and interpretations and implications for practice

In qualitative research no hypothesis is tested, therefore, there is no specific result. Instead, qualitative findings are often reported in themes based on the data analysed. The findings should be clearly linked to, and reflect, the data. This contributes to the soundness of the research. 11 The researchers should make it clear how they arrived at the interpretations of the findings. The theoretical or conceptual framework used should be discussed aiding the rigour of the study. The implications of the findings need to be made clear and where appropriate their applicability or transferability should be identified. 12

Discussions, recommendations and conclusions

The discussion should relate to the research findings as the authors seek to make connections with the literature reviewed earlier in the paper to contextualise their work. A strong discussion will connect the research aims and objectives to the findings and will be supported with literature if possible. A paper that seeks to influence nursing practice will have a recommendations section for clinical practice and research. A good conclusion will focus on the findings and discussion of the phenomena investigated.

Qualitative research has much to offer nursing and healthcare, in terms of understanding patients’ experience of illness, treatment and recovery, it can also help to understand better areas of healthcare practice. However, it must be done with rigour and this paper provides some guidance for appraising such research. To help you critique a qualitative research paper some guidance is provided in table 4 .

Some guidance for critiquing qualitative research

  • ↵ Nursing and Midwifery Council . The code: Standard of conduct, performance and ethics for nurses and midwives . 2015 https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/nmc-code.pdf ( accessed 21 Aug 18 ).
  • Barrett D ,
  • Cathala X ,
  • Shorten A ,

Patient consent for publication Not required.

Competing interests None declared.

Provenance and peer review Commissioned; internally peer reviewed.

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