The qualitative approach

4.3.1 Rationale for the qualitative approach

This study was designed to answer the second research question (Section 1.3), and, therefore, offer a conceptualisation of

attitudes toward older patients and their care in UK settings. Consequently, the goal of the present study was exploratory and concerned description and explanation rather than quantification. A qualitative approach was deemed appropriate because it can allow deeper understanding of social phenomena (Silverman, 2000). Additionally, the organisation of individual accounts of experience, characteristic of the qualitative approach, is considered useful for generating theory (Strauss & Corbin, 1990; Brown & Lilford, 2008).

Specifically, Strauss and Corbin (1990) argue that qualitative methods are ideal for the identification of variables that may later be measured

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patients held by medical students and doctors would benefit from qualitative data, because no matter how much data are collected, quantitative data represent a single dimension of knowledge (Mason, 2002). Mason has argued that qualitative inquiry represents an additional dimension to knowledge, and should be used in conjunction with quantitative methods so that investigation is multidimensional.

4.3.2 Limitations of the qualitative approach

Many of the criticisms of the qualitative approach relate to its incompatibility with the traditional positivist paradigm, due to the inherent subjectivity associated with many aspects of qualitative study design and analysis (Bryman, 2012). The researcher acts as the instrument of inquiry and, therefore, the objectivity of data collection and analysis is called into question (Lincoln & Guba, 1985), especially with regard to the validity, reliability and generalisability of data (Lincoln & Guba, 1985). Alternatives to traditional notions of quality have been offered by qualitative researchers to allow evaluation and confidence in qualitative findings. These criteria relate to the trustworthiness of data, such as the credibility and dependability of findings (Lincoln & Guba, 1985). In light of the current postpositivist theoretical position which considers scientific knowledge to be subject to human conjecture and bias, the goal of the qualitative researcher does not differ from the goal of the quantitative researcher. This goal is to reduce bias where possible, and accurately report the study settings and context to allow others to determine the generalisability or transferability of research findings to other settings (Lincoln & Guba, 1985). With these limitations in mind, a detailed account is provided of the decisions taken regarding the interview design, style, setting, participants, and analysis. This is in order to ensure that areas of potential bias are included in this account of the study and its

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4.3.3 Rationale for the selection of interviewing as a research tool

Interview style is typically described as unstructured, semistructured, or structured. Unstructured interviews may appear as a free-flowing

conversation between the interviewer and interviewee. At the other end of the spectrum, structured interviews consist of set questions, in a set order, and with little flexibility (Burgess, 1984). For this study, a semistructured interview style was chosen. Semistructured interviews typically have a set theme and predefined questions that serve as an interview guide (Patton, 1990). However, the order of questions and the precise terminology of the questions can vary between interviews to allow for a conversational feel to the interviews (Patton, 1990). One of the benefits of semistructured interviews is that the use of an interview guide with predefined questions allows the interviewer greater time and opportunity to focus on what is being said during the interview (Smith & Osborn, 2003). At the same time, the flexibility of a semistructured style allows the interviewer to pose questions that are not on the interview guide, if they are deemed relevant to the research aims (Patton, 1990). Therefore, semistructured interviews allow flexibility to explore new areas and new ideas during an interview. As a result, semistructured interviewing is particularly useful when there is a lack of previous research (Murphy & Dingwall, 2003), as was the case for this study. Any potential new ideas and themes raised by participants relating to the research aim were explored, as they may have been previously overlooked due to the limited depth of the prior research relating to the present topic. A semistructured style of interviewing was also selected because it was

considered important that some core questions on the topic were asked of all participants, and therefore an interview guide was needed.

4.3.4 Limitations of interviews and semistructured styles of interview

It should be highlighted that the use of a semistructured interview style means that interviews differ for each participant. Despite the use of an

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interview guide with core questions, some participants may be asked additional questions that others were not. This lack of standardisation in interviewing could be considered a limitation. Semistructured interviews have also been described as taking longer to conduct and the data being harder to analyse than structured interviews (Smith & Osborn, 2003). As a method of data collection, interviewing has been criticised on the grounds that it

depends greatly on the skill of the interviewer and suffers from the possibility of misinterpretation and inaccuracy at many stages of data collection and analysis (Becker & Geer, 1957). Nevertheless, Silverman (1985) posits that an approach or a data collection method is not inherently superior to another; what matters is the suitability of the approach and the data collection and analysis method to answer the research question.

It has also been argued that interviews take place in an unnatural

environment and, therefore, results are not likely to mirror the reality the interview data is attempting to reflect (Miller & Glassner, 1997). The postpositivist approach to interview research entails an awareness of the possibility of, and attempts to minimise, interviewer bias and the effect of social factors in the search for an approximate understanding of phenomena (Morris, 2006). The findings that emerge from research interviews are likely to be affected by a number of socially contingent factors relating to the background of the interviewer, interview setting, personality characteristics of the interviewee, and selection of participants (Silverman, 2000).The quality associated with qualitative studies tends to involve consideration of each of these factors. After a brief statement of the study objective, a detailed description of the study method is provided in order to make the

fullest possible details about the contexts in whic (Seale, 1999, p.177).

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