The strengths of qualitative method

Qualitative research has made a valuable contribution to improving health care practice and policy, and to understanding the experiences of health care among health consumers (Pope & Mays, 2013). Qualitative research that may include methods such as interviewing, focus groups and participant observation also assists to provide greater and in-depth understandings of the issues raised from

quantitative data. It is achieved by “establish[ing] an understanding of people’s lives, experiences and the subjective meanings” of a particular phenomena (Broom & Willis, 2007, p. 24). As such, it is a means to provide further insights to

consolidate quantitative analysis and to enrich findings with intricate meanings, which does not always occur within quantitative research (Bernard, 2000; Broom & Willis, 2007; Calnan, 2007; Davis & Scott, 2007). The trustworthiness of qualitative research is determined by principles that include rigour, credibility and reflexivity to ensure that high-quality data is produced (Patton, 1999). Each of these principles, in relation to the current research, is discussed below.

3.4.1 Rigour and credibility

Rigour is the systematic approach to the research study that follows a defined process while seeking to overcome and address issues and challenges such as selective interpretation and presentation of findings (Grbich, 1999). Rigour was addressed in this study through the use of preliminary data, and an explicit attention to developing relationships with key individuals, the use of snowball sampling, and a familiarity with many of the issues that participants may have encountered. Using this approach, the research provided a sense of ownership among key HCPs that allowed a greater access to women, and more in-depth information being provided during interviews. In addition, credibility is one method used by qualitative researchers to establish trustworthiness by examining the data, data analysis, and conclusions to identify whether the proposed findings are correct and accurate. For qualitative researchers, credibility includes taking on activities that increase probability so that there will be trustworthy findings (Saini & Shlonsky, 2012; Shenton, 2004).

3.4.2 Validity

Validity is established by how appropriate and meaningful the inferences are in terms of the quality and assertions made based on the data (McDermott & Sarvela, 1999). In this case, validity refers to whether the methodologies chosen allowed for the aims of the study to be interrogated (Malterud, 2001). Validity in qualitative research also lies in the reader being convinced that the researcher has accessed and accurately represented the social world under study (Grbich, 1999).

Access to the lived world of the women was achieved by building rapport with key HCPs, who accepted the research being conducted and the researcher who was conducting the research. This led to greater insights concerning the experiences and contact with women that the researcher may not have had otherwise. Access to the women’s social world was also realised by developing trust with each of the women that led to a greater level of openness and truth. It must be noted that validity is also established by presenting multiple quotes, reflexive notes, and addressing complex questions within the data analysis phase by seeking further clarification from participants through member checking, which occurred in this study.

Further, validity is concerned with using research methods that provide consistent, dependable and stable information and occurs when the participant’s views and meanings have been expressively accessed (Grbich, 1999; McDermott & Sarvela, 1999). It is the capacity to provide representations of good quality research that are believable from the participant’s, rather than the researcher’s, perspective

(Graneheim & Lundman, 2004; Shenton, 2004). Through validity, each participant’s voice becomes a more powerful vehicle within the research rather than being dominated by the researcher’s values, assumptions and suppositions (Denzin & Lincoln, 2000). To achieve this, tangible accounts of the women’s and HCP’s perspectives within the research are provided to authenticate the findings. The reader can analyse and judge for themselves the quality and authenticity of the data put forward (Liamputtong & Ezzy, 2005).

3.4.3 Transferability

Another measure of trustworthiness within qualitative research includes

transferability, where the findings can be transferred to other people and settings (Graneheim & Lundman, 2004; Hungler & Polit, 1999; Shenton, 2004). In most cases, qualitative research is unable to be generalised to other populations.

Transferability and generalisability are not aims of qualitative research as these are not its purposes. It is argued that these are standards of quantitative research that are applied to qualitative research, which is inappropriate (Marshall, 1996).

However, it has been argued that qualitative research may be in part transferable to other populations that are in similar situations, or help to understand similar cases (Malterud, 2001). In the case of this study, its thorough and descriptive findings related to the needs, desires and challenges encountered by women with PND and the HCPs locally can possibly provide some valuable insight into other situations nationally and internationally (Malterud, 2001).

3.4.4 Reflexivity

The trustworthiness of the research methods also requires reflexivity, which further strengthens the rigour and validity of qualitative research. Reflexivity acknowledges that the researcher is part of the setting, context and phenomenon they are seeking to analyse and comprehend (Liamputtong & Ezzy, 2005). Consequently, the

researcher needs to continually self-assess and identify their own subjectivity, preconceptions, motivation and theoretical foundations within the research process (Liamputtong & Ezzy, 2005; Malterud, 2001). To do this, the researcher must

consciously account for their own feelings, thoughts and location within the research to produce more robust and less biased findings (Pillow, 2003).