importance of qualitative research in our daily lives

Importance of Qualitative Research

Qualitative research is a form of social investigation that primarily focuses on the different types of the way people make sense of their knowledge in the world they live in. It also involves the interpretation of their experiences in their daily life. We live in a world where the different races of human beings exist side by side without any problem. We might ask what are the attributes, differences or similarities to make this comparison. In this scenario, qualitative research plays a major role in answering all of our doubts.

Below are some of the real-life circumstances where qualitative research is often used. They are:

Any type of research be it qualitative or quantitative, both the approaches have pros and cons. In the case of qualitative research, its value is undeniably linked to the numbers of quantitative data. Thus we can conclude that qualitative research is far more focused, experimental and concentrated in capturing the views and feelings of the participants.

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• What Is Qualitative Research? | Methods & Examples

What Is Qualitative Research? | Methods & Examples

Published on June 19, 2020 by Pritha Bhandari . Revised on September 5, 2024.

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

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

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

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

Table of contents

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

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

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

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

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

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

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

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

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

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

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

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

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

• Flexibility

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

• Natural settings

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

• Meaningful insights

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

• Generation of new ideas

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

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

• Unreliability

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

• Subjectivity

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

• Limited generalizability

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

• Labor-intensive

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

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

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

Research bias

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

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

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

There are five common approaches to qualitative research :

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

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

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

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

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

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• > Qualitative research: its value and applicability

Article contents

What questions are best answered using qualitative research, countering some misconceptions, in conclusion, qualitative research: its value and applicability.

Published online by Cambridge University Press:  02 January 2018

Qualitative research has a rich tradition in the study of human social behaviour and cultures. Its general aim is to develop concepts which help us to understand social phenomena in, wherever possible, natural rather than experimental settings, to gain an understanding of the experiences, perceptions and/or behaviours of individuals, and the meanings attached to them. The effective application of qualitative methods to other disciplines, including clinical, health service and education research, has a rapidly expanding and robust evidence base. Qualitative approaches have particular potential in psychiatry research, singularly and in combination with quantitative methods. This article outlines the nature and potential application of qualitative research as well as attempting to counter a number of misconceptions.

Qualitative research has a rich tradition in the social sciences. Since the late 19th century, researchers interested in studying the social behaviour and cultures of humankind have perceived limitations in trying to explain the phenomena they encounter in purely quantifiable, measurable terms. Anthropology, in its social and cultural forms, was one of the foremost disciplines in developing what would later be termed a qualitative approach, founded as it was on ethnographic studies which sought an understanding of the culture of people from other societies, often hitherto unknown and far removed in geography. Reference Bernard 1 Early researchers would spend extended periods of time living in societies, observing, noting and photographing the minutia of daily life, with the most committed often learning the language of peoples they observed, in the hope of gaining greater acceptance by them and a more detailed understanding of the cultural norms at play. All academic disciplines concerned with human and social behaviour, including anthropology, sociology and psychology, now make extensive use of qualitative research methods whose systematic application was first developed by these colonial-era social scientists.

Their methods, involving observation, participation and discussion of the individuals and groups being studied, as well as reading related textual and visual media and artefacts, form the bedrock of all qualitative social scientific inquiry. The general aim of qualitative research is thus to develop concepts which help us to understand social phenomena in, wherever possible, natural rather than experimental settings, to gain an understanding of the experiences, perceptions and/or behaviours of those studied, and the meanings attached to them. Reference Bryman 2 Researchers interested in finding out why people behave the way they do; how people are affected by events, how attitudes and opinions are formed; how and why cultures and practices have developed in the way they have, might well consider qualitative methods to answer their questions.

It is fair to say that clinical and health-related research is still dominated by quantitative methods, of which the randomised controlled trial, focused on hypothesis-testing through experiment controlled by randomisation, is perhaps the quintessential method. Qualitative approaches may seem obscure to the uninitiated when directly compared with the experimental, quantitative methods used in clinical research. There is increasing recognition among researchers in these fields, however, that qualitative methods such as observation, in-depth interviews, focus groups, consensus methods, case studies and the interpretation of texts can be more effective than quantitative approaches in exploring complex phenomena and as such are valuable additions to the methodological armoury available to them. Reference Denzin and Lincoln 3

In considering what kind of research questions are best answered using a qualitative approach, it is important to remember that, first and foremost, unlike quantitative research, inquiry conducted in the qualitative tradition seeks to answer the question ‘What?’ as opposed to ‘How often?’. Qualitative methods are designed to reveal what is going on by describing and interpreting phenomena; they do not attempt to measure how often an event or association occurs. Research conducted using qualitative methods is normally done with an intent to preserve the inherent complexities of human behaviour as opposed to assuming a reductive view of the subject in order to count and measure the occurrence of phenomena. Qualitative research normally takes an inductive approach, moving from observation to hypothesis rather than hypothesis-testing or deduction, although the latter is perfectly possible.

When conducting research in this tradition, the researcher should, if possible, avoid separating the stages of study design, data collection and analysis, but instead weave backwards and forwards between the raw data and the process of conceptualisation, thereby making sense of the data throughout the period of data collection. Although there are inevitable tensions among methodologists concerned with qualitative practice, there is broad consensus that a priori categories and concepts reflecting a researcher's own preconceptions should not be imposed on the process of data collection and analysis. The emphasis should be on capturing and interpreting research participants' true perceptions and/or behaviours.

Using combined approaches

The polarity between qualitative and quantitative research has been largely assuaged, to the benefit of all disciplines which now recognise the value, and compatibility, of both approaches. Indeed, there can be particular value in using quantitative methods in combination with qualitative methods. Reference Barbour 4 In the exploratory stages of a research project, qualitative methodology can be used to clarify or refine the research question, to aid conceptualisation and to generate a hypothesis. It can also help to identify the correct variables to be measured, as researchers have been known to measure before they fully understand the underlying issues pertaining to a study and, as a consequence, may not always target the most appropriate factors. Qualitative work can be valuable in the interpretation, qualification or illumination of quantitative research findings. This is particularly helpful when focusing on anomalous results, as they test the main hypothesis formulated. Qualitative methods can also be used in combination with quantitative methods to triangulate findings and support the validation process, for example, where three or more methods are used and the results compared for similarity (e.g. a survey, interviews and a period of observation in situ ).

‘There is little value in qualitative research findings because we cannot generalise from them’

Generalisability refers to the extent that the account can be applied to other people, times and settings other than those actually studied. A common criticism of qualitative research is that the results of a study are rarely, if ever, generalisable to a larger population because the sample groups are small and the participants are not chosen randomly. Such criticism fails to recognise the distinctiveness of qualitative research where sampling is concerned. In quantitative research, the intent is to secure a large random sample that is representative of the general population, with the purpose of eliminating individual variations, focusing on generalisations and thereby allowing for statistical inference of results that are applicable across an entire population. In qualitative research, generalisability is based on the assumption that it is valuable to begin to understand similar situations or people, rather than being representative of the target population. Qualitative research is rarely based on the use of random samples, so the kinds of reference to wider populations made on the basis of surveys cannot be used in qualitative analysis.

Qualitative researchers utilise purposive sampling, whereby research participants are selected deliberately to test a particular theoretical premise. The purpose of sampling here is not to identify a random subgroup of the general population from which statistically significant results can be extrapolated, but rather to identify, in a systematic way, individuals that possess relevant characteristics for the question being considered. Reference Strauss and Corbin 5 The researchers must instead ensure that any reference to people and settings beyond those in the study are justified, which is normally achieved by defining, in detail, the type of settings and people to whom the explanation or theory applies based on the identification of similar settings and people in the study. The intent is to permit a detailed examination of the phenomenon, resulting in a text-rich interpretation that can deepen our understanding and produce a plausible explanation of the phenomenon under study. The results are not intended to be statistically generalisable, although any theory they generate might well be.

‘Qualitative research cannot really claim reliability or validity’

In quantitative research, reliability is the extent to which different observers, or the same observers on different occasions, make the same observations or collect the same data about the same object of study. The changing nature of social phenomena scrutinised by qualitative researchers inevitably makes the possibility of the same kind of reliability problematic in their work. A number of alternative concepts to reliability have been developed by qualitative methodologists, however, known collectively as forms of trustworthiness. Reference Guba 6

One way to demonstrate trustworthiness is to present detailed evidence in the form of quotations from interviews and field notes, along with thick textual descriptions of episodes, events and settings. To be trustworthy, qualitative analysis should also be auditable, making it possible to retrace the steps leading to a certain interpretation or theory to check that no alternatives were left unexamined and that no researcher biases had any avoidable influence on the results. Usually, this involves the recording of information about who did what with the data and in what order so that the origin of interpretations can be retraced.

In general, within the research traditions of the natural sciences, findings are validated by their repeated replication, and if a second investigator cannot replicate the findings when they repeat the experiment then the original results are questioned. If no one else can replicate the original results then they are rejected as fatally flawed and therefore invalid. Natural scientists have developed a broad spectrum of procedures and study designs to ensure that experiments are dependable and that replication is possible. In the social sciences, particularly when using qualitative research methods, replication is rarely possible given that, when observed or questioned again, respondents will almost never say or do precisely the same things. Whether results have been successfully replicated is always a matter of interpretation. There are, however, procedures that, if followed, can significantly reduce the possibility of producing analyses that are partial or biased. Reference Altheide, Johnson, Denzin and Lincoln 7

Triangulation is one way of doing this. It essentially means combining multiple views, approaches or methods in an investigation to obtain a more accurate interpretation of the phenomena, thereby creating an analysis of greater depth and richness. As the process of analysing qualitative data normally involves some form of coding, whereby data are broken down into units of analysis, constant comparison can also be used. Constant comparison involves checking the consistency and accuracy of interpretations and especially the application of codes by constantly comparing one interpretation or code with others both of a similar sort and in other cases and settings. This in effect is a form of interrater reliability, involving multiple researchers or teams in the coding process so that it is possible to compare how they have coded the same passages and where there are areas of agreement and disagreement so that consensus can be reached about a code's definition, improving consistency and rigour. It is also good practice in qualitative analysis to look constantly for outliers – results that are out of line with your main findings or any which directly contradict what your explanations might predict, re-examining the data to try to find a way of explaining the atypical finding to produce a modified and more complex theory and explanation.

Qualitative research has been established for many decades in the social sciences and encompasses a valuable set of methodological tools for data collection, analysis and interpretation. Their effective application to other disciplines, including clinical, health service and education research, has a rapidly expanding and robust evidence base. The use of qualitative approaches to research in psychiatry has particular potential, singularly and in combination with quantitative methods. Reference Crabb and Chur-Hansen 8 When devising research questions in the specialty, careful thought should always be given to the most appropriate methodology, and consideration given to the great depth and richness of empirical evidence which a robust qualitative approach is able to provide.

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• Volume 37, Issue 6
• Steven J. Agius (a1)
• DOI: https://doi.org/10.1192/pb.bp.113.042770

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Market Research

Qualitative Research: Understanding the Goal and Benefits for Effective Analysis

As market trends evolve at lightning speed in the age of digital transformation, having an intimate understanding of consumer desires and motivations is more critical than ever. Enter qualitative research – the knight in shining armor of deep-dive data analysis. In this blog post, we’ll be exploring the profound purpose and impressive benefits behind qualitative research, unveiling how it anchors effective market analysis and strategy development. Brace yourselves for a mesmerizing journey into the realm of potent insights that power consequential decisions and breed groundbreaking innovation.

The primary goal of qualitative research is to obtain insights into participants’ experiences and understanding of the world. This type of research provides rich descriptions and explanations of processes in identifiable local contexts. Qualitative research has several benefits including providing an in-depth understanding, being flexible and adaptable, and generating descriptive data that can be used to create new theories using the inductive method. 

Qualitative Study’s Importance

Qualitative research holds a significant place in the realm of social science research and is integral for understanding the complexities of human behavior, experiences, and social interactions. Unlike quantitative research which focuses on numerical data and statistical analysis, qualitative research collects non-numerical data and emphasizes interpreting meaning from social contexts.

The importance of qualitative research lies in its ability to provide rich descriptions and explanations of processes in identifiable local contexts. It allows researchers to gain insights into participants’ experiences and understand the world as another person experiences it. This deeper understanding paves the way for more comprehensive analyses and the development of theories that accurately represent the intricacies of human life.

For instance, imagine a sociologist interested in studying how individuals cope with unemployment during economic downturns. By conducting qualitative research , these sociologists can immerse themselves in the lives of unemployed individuals, observe their daily routines, conduct in-depth interviews, and analyze their personal narratives. This approach goes beyond simply quantifying unemployment rates; it provides an intimate understanding of how people navigate through difficult situations and sheds light on the emotional, psychological, and societal impacts.

In addition to providing rich insight into human experiences, qualitative research offers numerous other benefits that contribute to effective analysis.

• Qualitative research is essential in social science research as it allows for a deeper understanding of human behavior and social interactions. Its focus on non-numerical data collection and interpretation of meaning helps researchers gain insights into participants’ experiences and contextual factors. Qualitative research also provides rich descriptions and explanations of processes in identifiable local contexts, leading to the development of comprehensive analysis and accurate theories. Overall, qualitative research offers numerous benefits that contribute to effective analysis in social science research.

Goals & Benefits Driving Research

The goals of qualitative research are multifaceted. One primary objective is to investigate the meanings people attribute to their behavior and interactions within specific social contexts. This focus on subjective interpretations helps uncover individual perspectives that may be overlooked by quantitative methods alone. Additionally, qualitative research aims to explore social phenomena that are not easily measurable or quantifiable.

Qualitative research also generates descriptive data that requires rigorous methods of analysis. Researchers employ various techniques such as thematic analysis or grounded theory to identify patterns, themes, and categories within their data. These analytical approaches ensure systematic interpretation while maintaining the integrity of participants’ lived experiences.

Beyond these goals, qualitative research offers several benefits that aid in reliable analysis. Firstly, it provides an in-depth understanding of complex social issues by capturing the nuances and subtleties of human behavior. This depth allows researchers to generate rich descriptions and explanations that facilitate a comprehensive comprehension of social phenomena.

For example, consider a study exploring the experience of minority students in predominantly white institutions. Through qualitative research methods like interviews and focus groups, researchers can delve into the students’ lived experiences, their perceptions of inclusion or exclusion, and their strategies for navigating through institutional challenges. This level of detail paints a holistic picture that goes beyond quantitative statistics such as enrollment numbers.

Another advantage of qualitative research is its flexibility and adaptability. Researchers can modify their data collection methods to account for new insights or unexpected findings during the research process. This responsiveness allows for deeper exploration and ensures that no valuable information is left unexamined.

However, it is essential to acknowledge that qualitative research also has its limitations. These include the limited scope and generalizability of findings due to the smaller sample sizes typically used in qualitative studies. Additionally, there is a potential for researcher bias since the individuals collecting and analyzing the data play an active role in shaping the research process.

Nonetheless, while objectivity may be seen as a myth in qualitative research, researchers should be honest and transparent about their own biases and assumptions. Reflexivity, which involves acknowledging and critically examining one’s subjectivity throughout the research process, is integral to ensuring integrity and minimizing undue influence.

• According to a report from the Journal of Social Issues, as of 2022, around 45% of psychological studies used qualitative methods, signaling strong recognition in the field for its unique insights into human behavior.
• A study conducted by the Market Research Society confirmed that out of all market research carried out worldwide, approximately 20% utilize qualitative methodologies. This highlights its crucial role in understanding customer behaviors and motivations.
• The National Center for Biotechnology Information (NCBI) indicated that nearly 70% of health research incorporates some elements of qualitative research, underscoring its importance in contributing to our understanding of complex health issues and interventions.

Comprehensive Approaches

When conducting qualitative research , adopting comprehensive approaches is essential for capturing the richness and depth of data required for effective analysis. These approaches involve a holistic perspective that considers multiple dimensions and contexts. One commonly used comprehensive approach is triangulation , which involves using multiple data sources, methods, or perspectives to cross-verify findings. By triangulating data, researchers can enhance the reliability and validity of their analysis.

Another important approach is thick description , which focuses on providing detailed and vivid accounts of participants’ experiences and contexts. This technique enables researchers to capture the nuances and complexities of social phenomena, ensuring a comprehensive understanding of the research topic. Thick descriptions typically include vivid narratives, dialogue excerpts, and detailed observations, providing readers with a rich portrayal of the study’s context.

Researchers may also adopt an iterative process in their analysis, where data collection and analysis occur simultaneously. This approach allows for constant refinement and adjustment of research questions and methods based on emerging findings. Through iteration, researchers can dive deeper into the topic, uncover unexpected insights, and explore various angles that contribute to a more comprehensive analysis.

It’s worth noting that comprehensive approaches in qualitative research require flexibility and openness to embracing emergent themes and unexpected directions. As researchers immerse themselves in the data, they should be willing to adapt their strategies accordingly.

Participant Engagement & Topic Exploration

Participant engagement plays a crucial role in qualitative research as it fosters a deeper understanding of participants’ perspectives and experiences. Effective engagement encourages open dialogue and trust between the researcher and participants, allowing for richer data collection. One way to promote participant engagement is through active listening . By attentively listening to participants’ stories, concerns, and viewpoints, researchers can demonstrate empathy and create a safe space for open expression.

Another aspect that greatly enhances participant engagement is establishing rapport . Building rapport involves creating a comfortable environment where participants feel at ease to share their thoughts and experiences. This can be achieved through transparent communication, respect for participants’ autonomy, and genuine interest in their stories. Researchers should establish a positive and respectful relationship with participants, positioning themselves as partners rather than authoritative figures.

In qualitative research, topic exploration is a dynamic and iterative process that allows researchers to uncover new insights and dimensions of the phenomenon under study. This involves probing deeper into participants’ responses, asking follow-up questions, and exploring unexpected avenues that emerge during data collection. By being open to revisiting research questions and digging deeper into topics, researchers can uncover valuable insights and gain a more comprehensive understanding of the subject matter.

It’s important to note that participant engagement and topic exploration go hand in hand. Engaged participants are more likely to provide rich and detailed responses, leading to enhanced exploration of the research topic. Conversely, skillful topic exploration can foster deeper engagement from participants by demonstrating genuine interest and curiosity in their perspectives.

Effective Data Accumulation Methods

In qualitative research, the collection of rich and meaningful data is a crucial step toward understanding the complexities of human experiences. To ensure effective analysis, researchers need to employ appropriate data accumulation methods that capture the depth of participants’ perspectives and insights. Let’s explore some strategies that can facilitate this process.

One common method used in qualitative research is participant observation. This involves immersing oneself in the research setting, actively observing, and taking detailed notes on behaviors, interactions, and cultural nuances. By being present in the natural context, researchers gain a deeper understanding of the social dynamics and can document valuable data that may go unnoticed otherwise.

For instance, imagine a researcher interested in studying the experiences of healthcare workers in a hospital. Through participant observation, they can shadow these workers, witness their daily routines, the challenges they face, and even engage in conversations during breaks. This method provides an intimate look into their lives and generates valuable insights.

Another effective technique is in-depth interviews. These interviews allow researchers to establish a personal connection with participants and delve into their thoughts, feelings, and motivations regarding the research topic. It’s crucial to create an open and comfortable environment where participants feel safe sharing their views openly.

Additionally, focus groups are utilized as a powerful data accumulation method. Bringing together a small group of individuals who share similar characteristics or experiences allows for stimulating discussions that uncover diverse perspectives. Participants can build upon each other’s ideas and provide deeper insights collectively.

Having explored effective data accumulation methods like participant observation, in-depth interviews, and focus groups, let’s now dive into another important aspect of qualitative research – harnessing sensory inputs & eliciting verbal responses.

Harnessing Sensory Inputs and Eliciting Verbal Responses

Qualitative research aims to understand phenomena from the perspective of individuals involved. One way to achieve this is by harnessing sensory inputs and eliciting verbal responses, allowing participants to express themselves fully. This approach taps into a range of human senses and encourages participants to describe their experiences vividly.

For instance, researchers might utilize photovoice techniques, where participants capture images related to the research topic using cameras or smartphones. These visual representations allow participants to share their perspectives in a unique and powerful way.

Imagine a study exploring the impact of urbanization on community well-being. Participants could be asked to take pictures of spaces they feel contribute positively or negatively to their quality of life. These images can then be used as stimuli for further discussion, sparking conversations about the emotional and sensory aspects of the built environment.

In addition to visuals, researchers can also engage participants’ sense of hearing through audio recordings. By recording interviews, focus group discussions, or even ambient sounds in a particular environment, researchers can capture subtle nuances that may not be conveyed through written transcripts alone.

By harnessing sensory inputs and giving participants the space for verbal expression, qualitative researchers foster an environment where rich and nuanced data can be collected. This multi-sensory approach enables a deeper understanding of individuals’ experiences and allows us to gain insights beyond mere words.

Parsing and Conclusion Derivation from Data

In qualitative research, one of the primary goals is to parse and derive meaningful conclusions from the collected data. Unlike quantitative research which relies on statistical analysis, qualitative research involves obtaining rich descriptions of participants’ experiences and understanding the world as another person experiences it. The process of parsing and deriving conclusions from qualitative data requires a meticulous examination of the data, identification of patterns, themes, and connections, and an inductive approach to theory development.

Qualitative researchers immerse themselves in the data collected through methods such as interviews, observations, and focus groups. They carefully analyze transcripts, field notes, or documents to identify recurring themes or significant incidents that shed light on the research question. Through this process of coding and categorizing, researchers start to make sense of the data and identify key findings that can be used to develop theories or inform specific contexts.

For example, imagine a researcher conducting an ethnographic study exploring the experiences of undocumented immigrants in their journey toward citizenship. Through interviews and participant observation, they gather compelling stories and narratives about the challenges faced by these individuals. By carefully analyzing these stories for common themes such as navigating legal systems or facing social stigma, the researcher can derive conclusions about the complex processes involved in seeking legal status.

“Analyzing qualitative data is like piecing together a puzzle. Each interview or observation provides a unique piece that contributes to the overall picture.”

However, it is important to note that deriving conclusions from qualitative data is not a simple linear process. It requires reflexivity on the part of the researcher to acknowledge their own biases and assumptions that may influence their interpretation of the data. Reflexivity encourages researchers to critically reflect on how their own subjectivity affects their analysis and conclusions.

Advantages & Drawbacks of This Research Type

Qualitative research offers several advantages that contribute to its effectiveness in providing rich insights into social phenomena. First and foremost, it allows researchers to gain an in-depth understanding of the experiences, perspectives, and meanings that individuals attribute to their behavior and interactions. This depth of understanding is often difficult to achieve through quantitative research methods alone.

Moreover, qualitative research is known for its flexibility and adaptability. Researchers can modify their research design or data collection methods as they delve deeper into the field, responding to emerging themes or new areas of investigation. The open-ended nature of qualitative research also enables participants to express themselves freely and provide nuanced responses, offering a more comprehensive view of complex social phenomena.

On the other hand, there are some drawbacks to consider when conducting qualitative research. One challenge is the limited scope and generalizability of findings. Due to the small sample sizes typically involved in qualitative studies, it can be challenging to extrapolate findings to broader populations or contexts. Additionally, there is potential for researcher bias as interpretations of qualitative data are subjective and influenced by researchers’ perspectives and assumptions.

Despite these limitations, the benefits of qualitative research outweigh its drawbacks in many cases. By providing detailed insights into participants’ experiences, qualitative research contributes valuable knowledge that can inform policy decisions, improve interventions, and enhance our understanding of social phenomena.

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An Overview of Qualitative Research Methods

Direct Observation, Interviews, Participation, Immersion, Focus Groups

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Qualitative research is a type of social science research that collects and works with non-numerical data and that seeks to interpret meaning from these data that help understand social life through the study of targeted populations or places.

People often frame it in opposition to quantitative research , which uses numerical data to identify large-scale trends and employs statistical operations to determine causal and correlative relationships between variables.

Within sociology, qualitative research is typically focused on the micro-level of social interaction that composes everyday life, whereas quantitative research typically focuses on macro-level trends and phenomena.

Key Takeaways

Methods of qualitative research include:

• observation and immersion
• open-ended surveys
• focus groups
• content analysis of visual and textual materials
• oral history

Qualitative research has a long history in sociology and has been used within it for as long as the field has existed.

This type of research has long appealed to social scientists because it allows the researchers to investigate the meanings people attribute to their behavior, actions, and interactions with others.

While quantitative research is useful for identifying relationships between variables, like, for example, the connection between poverty and racial hate, it is qualitative research that can illuminate why this connection exists by going directly to the source—the people themselves.

Qualitative research is designed to reveal the meaning that informs the action or outcomes that are typically measured by quantitative research. So qualitative researchers investigate meanings, interpretations, symbols, and the processes and relations of social life.

What this type of research produces is descriptive data that the researcher must then interpret using rigorous and systematic methods of transcribing, coding, and analysis of trends and themes.

Because its focus is everyday life and people's experiences, qualitative research lends itself well to creating new theories using the inductive method , which can then be tested with further research.

Qualitative researchers use their own eyes, ears, and intelligence to collect in-depth perceptions and descriptions of targeted populations, places, and events.

Their findings are collected through a variety of methods, and often a researcher will use at least two or several of the following while conducting a qualitative study:

• Direct observation : With direct observation, a researcher studies people as they go about their daily lives without participating or interfering. This type of research is often unknown to those under study, and as such, must be conducted in public settings where people do not have a reasonable expectation of privacy. For example, a researcher might observe the ways in which strangers interact in public as they gather to watch a street performer.
• Open-ended surveys : While many surveys are designed to generate quantitative data, many are also designed with open-ended questions that allow for the generation and analysis of qualitative data. For example, a survey might be used to investigate not just which political candidates voters chose, but why they chose them, in their own words.
• Focus group : In a focus group, a researcher engages a small group of participants in a conversation designed to generate data relevant to the research question. Focus groups can contain anywhere from 5 to 15 participants. Social scientists often use them in studies that examine an event or trend that occurs within a specific community. They are common in market research, too.
• In-depth interviews : Researchers conduct in-depth interviews by speaking with participants in a one-on-one setting. Sometimes a researcher approaches the interview with a predetermined list of questions or topics for discussion but allows the conversation to evolve based on how the participant responds. Other times, the researcher has identified certain topics of interest but does not have a formal guide for the conversation, but allows the participant to guide it.
• Oral history : The oral history method is used to create a historical account of an event, group, or community, and typically involves a series of in-depth interviews conducted with one or multiple participants over an extended period.
• Participant observation : This method is similar to observation, however with this one, the researcher also participates in the action or events to not only observe others but to gain the first-hand experience in the setting.
• Ethnographic observation : Ethnographic observation is the most intensive and in-depth observational method. Originating in anthropology, with this method, a researcher fully immerses themselves into the research setting and lives among the participants as one of them for anywhere from months to years. By doing this, the researcher attempts to experience day-to-day existence from the viewpoints of those studied to develop in-depth and long-term accounts of the community, events, or trends under observation.
• Content analysis : This method is used by sociologists to analyze social life by interpreting words and images from documents, film, art, music, and other cultural products and media. The researchers look at how the words and images are used, and the context in which they are used to draw inferences about the underlying culture. Content analysis of digital material, especially that generated by social media users, has become a popular technique within the social sciences.

While much of the data generated by qualitative research is coded and analyzed using just the researcher's eyes and brain, the use of computer software to do these processes is increasingly popular within the social sciences.

Such software analysis works well when the data is too large for humans to handle, though the lack of a human interpreter is a common criticism of the use of computer software.

Pros and Cons

Qualitative research has both benefits and drawbacks.

On the plus side, it creates an in-depth understanding of the attitudes, behaviors, interactions, events, and social processes that comprise everyday life. In doing so, it helps social scientists understand how everyday life is influenced by society-wide things like social structure , social order , and all kinds of social forces.

This set of methods also has the benefit of being flexible and easily adaptable to changes in the research environment and can be conducted with minimal cost in many cases.

Among the downsides of qualitative research is that its scope is fairly limited so its findings are not always widely able to be generalized.

Researchers also have to use caution with these methods to ensure that they do not influence the data in ways that significantly change it and that they do not bring undue personal bias to their interpretation of the findings.

Fortunately, qualitative researchers receive rigorous training designed to eliminate or reduce these types of research bias.

• How to Conduct a Sociology Research Interview
• What Is Participant Observation Research?
• Immersion Definition: Cultural, Language, and Virtual
• Definition and Overview of Grounded Theory
• The Differences Between Indexes and Scales
• Pros and Cons of Secondary Data Analysis
• Social Surveys: Questionnaires, Interviews, and Telephone Polls
• The Different Types of Sampling Designs in Sociology
• Principal Components and Factor Analysis
• Sociology Explains Why Some People Cheat on Their Spouses
• Deductive Versus Inductive Reasoning
• How to Construct an Index for Research
• Data Sources For Sociological Research
• A Review of Software Tools for Quantitative Data Analysis
• Constructing a Deductive Theory
• Scales Used in Social Science Research

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Qualitative Research: Getting Started

Introduction.

As scientifically trained clinicians, pharmacists may be more familiar and comfortable with the concept of quantitative rather than qualitative research. Quantitative research can be defined as “the means for testing objective theories by examining the relationship among variables which in turn can be measured so that numbered data can be analyzed using statistical procedures”. 1 Pharmacists may have used such methods to carry out audits or surveys within their own practice settings; if so, they may have had a sense of “something missing” from their data. What is missing from quantitative research methods is the voice of the participant. In a quantitative study, large amounts of data can be collected about the number of people who hold certain attitudes toward their health and health care, but what qualitative study tells us is why people have thoughts and feelings that might affect the way they respond to that care and how it is given (in this way, qualitative and quantitative data are frequently complementary). Possibly the most important point about qualitative research is that its practitioners do not seek to generalize their findings to a wider population. Rather, they attempt to find examples of behaviour, to clarify the thoughts and feelings of study participants, and to interpret participants’ experiences of the phenomena of interest, in order to find explanations for human behaviour in a given context.

WHAT IS QUALITATIVE RESEARCH?

Much of the work of clinicians (including pharmacists) takes place within a social, clinical, or interpersonal context where statistical procedures and numeric data may be insufficient to capture how patients and health care professionals feel about patients’ care. Qualitative research involves asking participants about their experiences of things that happen in their lives. It enables researchers to obtain insights into what it feels like to be another person and to understand the world as another experiences it.

Qualitative research was historically employed in fields such as sociology, history, and anthropology. 2 Miles and Huberman 2 said that qualitative data “are a source of well-grounded, rich descriptions and explanations of processes in identifiable local contexts. With qualitative data one can preserve chronological flow, see precisely which events lead to which consequences, and derive fruitful explanations.” Qualitative methods are concerned with how human behaviour can be explained, within the framework of the social structures in which that behaviour takes place. 3 So, in the context of health care, and hospital pharmacy in particular, researchers can, for example, explore how patients feel about their care, about their medicines, or indeed about “being a patient”.

THE IMPORTANCE OF METHODOLOGY

Smith 4 has described methodology as the “explanation of the approach, methods and procedures with some justification for their selection.” It is essential that researchers have robust theories that underpin the way they conduct their research—this is called “methodology”. It is also important for researchers to have a thorough understanding of various methodologies, to ensure alignment between their own positionality (i.e., bias or stance), research questions, and objectives. Clinicians may express reservations about the value or impact of qualitative research, given their perceptions that it is inherently subjective or biased, that it does not seek to be reproducible across different contexts, and that it does not produce generalizable findings. Other clinicians may express nervousness or hesitation about using qualitative methods, claiming that their previous “scientific” training and experience have not prepared them for the ambiguity and interpretative nature of qualitative data analysis. In both cases, these clinicians are depriving themselves of opportunities to understand complex or ambiguous situations, phenomena, or processes in a different way.

Qualitative researchers generally begin their work by recognizing that the position (or world view) of the researcher exerts an enormous influence on the entire research enterprise. Whether explicitly understood and acknowledged or not, this world view shapes the way in which research questions are raised and framed, methods selected, data collected and analyzed, and results reported. 5 A broad range of different methods and methodologies are available within the qualitative tradition, and no single review paper can adequately capture the depth and nuance of these diverse options. Here, given space constraints, we highlight certain options for illustrative purposes only, emphasizing that they are only a sample of what may be available to you as a prospective qualitative researcher. We encourage you to continue your own study of this area to identify methods and methodologies suitable to your questions and needs, beyond those highlighted here.

The following are some of the methodologies commonly used in qualitative research:

• Ethnography generally involves researchers directly observing participants in their natural environments over time. A key feature of ethnography is the fact that natural settings, unadapted for the researchers’ interests, are used. In ethnography, the natural setting or environment is as important as the participants, and such methods have the advantage of explicitly acknowledging that, in the real world, environmental constraints and context influence behaviours and outcomes. 6 An example of ethnographic research in pharmacy might involve observations to determine how pharmacists integrate into family health teams. Such a study would also include collection of documents about participants’ lives from the participants themselves and field notes from the researcher. 7
• Grounded theory, first described by Glaser and Strauss in 1967, 8 is a framework for qualitative research that suggests that theory must derive from data, unlike other forms of research, which suggest that data should be used to test theory. Grounded theory may be particularly valuable when little or nothing is known or understood about a problem, situation, or context, and any attempt to start with a hypothesis or theory would be conjecture at best. 9 An example of the use of grounded theory in hospital pharmacy might be to determine potential roles for pharmacists in a new or underserviced clinical area. As with other qualitative methodologies, grounded theory provides researchers with a process that can be followed to facilitate the conduct of such research. As an example, Thurston and others 10 used constructivist grounded theory to explore the availability of arthritis care among indigenous people of Canada and were able to identify a number of influences on health care for this population.
• Phenomenology attempts to understand problems, ideas, and situations from the perspective of common understanding and experience rather than differences. 10 Phenomenology is about understanding how human beings experience their world. It gives researchers a powerful tool with which to understand subjective experience. In other words, 2 people may have the same diagnosis, with the same treatment prescribed, but the ways in which they experience that diagnosis and treatment will be different, even though they may have some experiences in common. Phenomenology helps researchers to explore those experiences, thoughts, and feelings and helps to elicit the meaning underlying how people behave. As an example, Hancock and others 11 used a phenomenological approach to explore health care professionals’ views of the diagnosis and management of heart failure since publication of an earlier study in 2003. Their findings revealed that barriers to effective treatment for heart failure had not changed in 10 years and provided a new understanding of why this was the case.

ROLE OF THE RESEARCHER

For any researcher, the starting point for research must be articulation of his or her research world view. This core feature of qualitative work is increasingly seen in quantitative research too: the explicit acknowledgement of one’s position, biases, and assumptions, so that readers can better understand the particular researcher. Reflexivity describes the processes whereby the act of engaging in research actually affects the process being studied, calling into question the notion of “detached objectivity”. Here, the researcher’s own subjectivity is as critical to the research process and output as any other variable. Applications of reflexivity may include participant-observer research, where the researcher is actually one of the participants in the process or situation being researched and must then examine it from these divergent perspectives. 12 Some researchers believe that objectivity is a myth and that attempts at impartiality will fail because human beings who happen to be researchers cannot isolate their own backgrounds and interests from the conduct of a study. 5 Rather than aspire to an unachievable goal of “objectivity”, it is better to simply be honest and transparent about one’s own subjectivities, allowing readers to draw their own conclusions about the interpretations that are presented through the research itself. For new (and experienced) qualitative researchers, an important first step is to step back and articulate your own underlying biases and assumptions. The following questions can help to begin this reflection process:

• Why am I interested in this topic? To answer this question, try to identify what is driving your enthusiasm, energy, and interest in researching this subject.
• What do I really think the answer is? Asking this question helps to identify any biases you may have through honest reflection on what you expect to find. You can then “bracket” those assumptions to enable the participants’ voices to be heard.
• What am I getting out of this? In many cases, pressures to publish or “do” research make research nothing more than an employment requirement. How does this affect your interest in the question or its outcomes, or the depth to which you are willing to go to find information?
• What do others in my professional community think of this work—and of me? As a researcher, you will not be operating in a vacuum; you will be part of a complex social and interpersonal world. These external influences will shape your views and expectations of yourself and your work. Acknowledging this influence and its potential effects on personal behaviour will facilitate greater self-scrutiny throughout the research process.

FROM FRAMEWORKS TO METHODS

Qualitative research methodology is not a single method, but instead offers a variety of different choices to researchers, according to specific parameters of topic, research question, participants, and settings. The method is the way you carry out your research within the paradigm of quantitative or qualitative research.

Qualitative research is concerned with participants’ own experiences of a life event, and the aim is to interpret what participants have said in order to explain why they have said it. Thus, methods should be chosen that enable participants to express themselves openly and without constraint. The framework selected by the researcher to conduct the research may direct the project toward specific methods. From among the numerous methods used by qualitative researchers, we outline below the three most frequently encountered.

DATA COLLECTION

Patton 12 has described an interview as “open-ended questions and probes yielding in-depth responses about people’s experiences, perceptions, opinions, feelings, and knowledge. Data consists of verbatim quotations and sufficient content/context to be interpretable”. Researchers may use a structured or unstructured interview approach. Structured interviews rely upon a predetermined list of questions framed algorithmically to guide the interviewer. This approach resists improvisation and following up on hunches, but has the advantage of facilitating consistency between participants. In contrast, unstructured or semistructured interviews may begin with some defined questions, but the interviewer has considerable latitude to adapt questions to the specific direction of responses, in an effort to allow for more intuitive and natural conversations between researchers and participants. Generally, you should continue to interview additional participants until you have saturated your field of interest, i.e., until you are not hearing anything new. The number of participants is therefore dependent on the richness of the data, though Miles and Huberman 2 suggested that more than 15 cases can make analysis complicated and “unwieldy”.

Focus Groups

Patton 12 has described the focus group as a primary means of collecting qualitative data. In essence, focus groups are unstructured interviews with multiple participants, which allow participants and a facilitator to interact freely with one another and to build on ideas and conversation. This method allows for the collection of group-generated data, which can be a challenging experience.

Observations

Patton 12 described observation as a useful tool in both quantitative and qualitative research: “[it involves] descriptions of activities, behaviours, actions, conversations, interpersonal interactions, organization or community processes or any other aspect of observable human experience”. Observation is critical in both interviews and focus groups, as nonalignment between verbal and nonverbal data frequently can be the result of sarcasm, irony, or other conversational techniques that may be confusing or open to interpretation. Observation can also be used as a stand-alone tool for exploring participants’ experiences, whether or not the researcher is a participant in the process.

Selecting the most appropriate and practical method is an important decision and must be taken carefully. Those unfamiliar with qualitative research may assume that “anyone” can interview, observe, or facilitate a focus group; however, it is important to recognize that the quality of data collected through qualitative methods is a direct reflection of the skills and competencies of the researcher. 13 The hardest thing to do during an interview is to sit back and listen to participants. They should be doing most of the talking—it is their perception of their own life-world that the researcher is trying to understand. Sophisticated interpersonal skills are required, in particular the ability to accurately interpret and respond to the nuanced behaviour of participants in various settings. More information about the collection of qualitative data may be found in the “Further Reading” section of this paper.

It is essential that data gathered during interviews, focus groups, and observation sessions are stored in a retrievable format. The most accurate way to do this is by audio-recording (with the participants’ permission). Video-recording may be a useful tool for focus groups, because the body language of group members and how they interact can be missed with audio-recording alone. Recordings should be transcribed verbatim and checked for accuracy against the audio- or video-recording, and all personally identifiable information should be removed from the transcript. You are then ready to start your analysis.

DATA ANALYSIS

Regardless of the research method used, the researcher must try to analyze or make sense of the participants’ narratives. This analysis can be done by coding sections of text, by writing down your thoughts in the margins of transcripts, or by making separate notes about the data collection. Coding is the process by which raw data (e.g., transcripts from interviews and focus groups or field notes from observations) are gradually converted into usable data through the identification of themes, concepts, or ideas that have some connection with each other. It may be that certain words or phrases are used by different participants, and these can be drawn together to allow the researcher an opportunity to focus findings in a more meaningful manner. The researcher will then give the words, phrases, or pieces of text meaningful names that exemplify what the participants are saying. This process is referred to as “theming”. Generating themes in an orderly fashion out of the chaos of transcripts or field notes can be a daunting task, particularly since it may involve many pages of raw data. Fortunately, sophisticated software programs such as NVivo (QSR International Pty Ltd) now exist to support researchers in converting data into themes; familiarization with such software supports is of considerable benefit to researchers and is strongly recommended. Manual coding is possible with small and straightforward data sets, but the management of qualitative data is a complexity unto itself, one that is best addressed through technological and software support.

There is both an art and a science to coding, and the second checking of themes from data is well advised (where feasible) to enhance the face validity of the work and to demonstrate reliability. Further reliability-enhancing mechanisms include “member checking”, where participants are given an opportunity to actually learn about and respond to the researchers’ preliminary analysis and coding of data. Careful documentation of various iterations of “coding trees” is important. These structures allow readers to understand how and why raw data were converted into a theme and what rules the researcher is using to govern inclusion or exclusion of specific data within or from a theme. Coding trees may be produced iteratively: after each interview, the researcher may immediately code and categorize data into themes to facilitate subsequent interviews and allow for probing with subsequent participants as necessary. At the end of the theming process, you will be in a position to tell the participants’ stories illustrated by quotations from your transcripts. For more information on different ways to manage qualitative data, see the “Further Reading” section at the end of this paper.

ETHICAL ISSUES

In most circumstances, qualitative research involves human beings or the things that human beings produce (documents, notes, etc.). As a result, it is essential that such research be undertaken in a manner that places the safety, security, and needs of participants at the forefront. Although interviews, focus groups, and questionnaires may seem innocuous and “less dangerous” than taking blood samples, it is important to recognize that the way participants are represented in research can be significantly damaging. Try to put yourself in the shoes of the potential participants when designing your research and ask yourself these questions:

• Are the requests you are making of potential participants reasonable?
• Are you putting them at unnecessary risk or inconvenience?
• Have you identified and addressed the specific needs of particular groups?

Where possible, attempting anonymization of data is strongly recommended, bearing in mind that true anonymization may be difficult, as participants can sometimes be recognized from their stories. Balancing the responsibility to report findings accurately and honestly with the potential harm to the participants involved can be challenging. Advice on the ethical considerations of research is generally available from research ethics boards and should be actively sought in these challenging situations.

GETTING STARTED

Pharmacists may be hesitant to embark on research involving qualitative methods because of a perceived lack of skills or confidence. Overcoming this barrier is the most important first step, as pharmacists can benefit from inclusion of qualitative methods in their research repertoire. Partnering with others who are more experienced and who can provide mentorship can be a valuable strategy. Reading reports of research studies that have utilized qualitative methods can provide insights and ideas for personal use; such papers are routinely included in traditional databases accessed by pharmacists. Engaging in dialogue with members of a research ethics board who have qualitative expertise can also provide useful assistance, as well as saving time during the ethics review process itself. The references at the end of this paper may provide some additional support to allow you to begin incorporating qualitative methods into your research.

CONCLUSIONS

Qualitative research offers unique opportunities for understanding complex, nuanced situations where interpersonal ambiguity and multiple interpretations exist. Qualitative research may not provide definitive answers to such complex questions, but it can yield a better understanding and a springboard for further focused work. There are multiple frameworks, methods, and considerations involved in shaping effective qualitative research. In most cases, these begin with self-reflection and articulation of positionality by the researcher. For some, qualitative research may appear commonsensical and easy; for others, it may appear daunting, given its high reliance on direct participant– researcher interactions. For yet others, qualitative research may appear subjective, unscientific, and consequently unreliable. All these perspectives reflect a lack of understanding of how effective qualitative research actually occurs. When undertaken in a rigorous manner, qualitative research provides unique opportunities for expanding our understanding of the social and clinical world that we inhabit.

Further Reading

• Breakwell GM, Hammond S, Fife-Schaw C, editors. Research methods in psychology. Thousand Oaks (CA): Sage Publications Ltd; 1995. [ Google Scholar ]
• Strauss A, Corbin J. Basics of qualitative research. Thousand Oaks (CA): Sage Publications Ltd; 1998. [ Google Scholar ]
• Willig C. Introducing qualitative research in psychology. Buckingham (UK): Open University Press; 2001. [ Google Scholar ]
• Guest G, Namey EE, Mitchel ML. Collecting qualitative data: a field manual for applied research. Thousand Oaks (CA): Sage Publications Ltd; 2013. [ Google Scholar ]
• Ogden R. Bias. In: Given LM, editor. The Sage encyclopedia of qualitative research methods. Thousand Oaks (CA): Sage Publications Inc; 2008. pp. 61–2. [ Google Scholar ]

This article is the seventh in the CJHP Research Primer Series, an initiative of the CJHP Editorial Board and the CSHP Research Committee. The planned 2-year series is intended to appeal to relatively inexperienced researchers, with the goal of building research capacity among practising pharmacists. The articles, presenting simple but rigorous guidance to encourage and support novice researchers, are being solicited from authors with appropriate expertise.

Previous article in this series:

Bond CM. The research jigsaw: how to get started. Can J Hosp Pharm . 2014;67(1):28–30.

Tully MP. Research: articulating questions, generating hypotheses, and choosing study designs. Can J Hosp Pharm . 2014;67(1):31–4.

Loewen P. Ethical issues in pharmacy practice research: an introductory guide. Can J Hosp Pharm. 2014;67(2):133–7.

Tsuyuki RT. Designing pharmacy practice research trials. Can J Hosp Pharm . 2014;67(3):226–9.

Bresee LC. An introduction to developing surveys for pharmacy practice research. Can J Hosp Pharm . 2014;67(4):286–91.

Gamble JM. An introduction to the fundamentals of cohort and case–control studies. Can J Hosp Pharm . 2014;67(5):366–72.

Competing interests: None declared.

Practical Research 1 Module: Qualitative Research and Its Importance in Daily Life

This Senior High School Practical Research 1 Self-Learning Module (SLM) is prepared so that you, our dear learners, can continue your studies and learn while at home. Activities, questions, directions, exercises, and discussions are carefully stated for you to understand each lesson.

Conducting qualitative research is as significant as the necessities of human existence. It paves way to understanding the current issues and natural phenomena that greatly contribute to the lives of the people.

As a researcher, it is imperative to realize the importance of qualitative research in everyday life for this will serve as sustenance to finish the course of the study. Further, this will truly inspire anyone to pursue the fulfillment of research in the context of providing answers to questions and set a trend to the rest of the researchers.

This lesson will brace you with knowledge on kinds, characteristics, uses, strengths, and weaknesses of qualitative research. These topics are necessary as you get closer to choosing the field of research you will focus on.

Every day of our lives is a challenge. We face so many questions that sometimes cannot be answered by merely asking our neighbors or even the experts we know. As a result, we attempt to investigate about these problems ourselves. In this scenario, our knowledge in research is very important.

Among the steps we take is asking ourselves, “Why do I need to pursue the answers to these questions? Well, for that matter, you must realize that research plays a big role in the lives of the people-your family, friends, and neighbors.

TABLE OF CONTENTS

Learning Objectives:

After studying this module, you are expected to:

• describe the characteristics, strengths and weaknesses of qualitative research (CS_RS11-IIIb-1) ;
• identify the kinds of qualitative research (CS_RS11-IIIb-1) ;
• familiarize the qualitative research in different fields (CS_RS11-IIIb-2) ; and
• determine the importance of qualitative research in different fields (CS_RS11-IIIb 2) .

Senior High School Quarter 1 Self-Learning Module Practical Research 2 – Qualitative Research and Its Importance in Daily Life

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Speak for yourself: usability and acceptability of audio diaries to explore physical activity, sedentary and sleep behaviours of those living with severe mental illness

• Open access
• Published: 11 September 2024
• Volume 3 , article number  21 , ( 2024 )

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• Ilaria Pina 1 ,
• Philip Hodgson 2 , 3 ,
• Kirstie Anderson 1 , 4 &
• Emily J. Oliver 1  

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People living with severe mental illness (SMI) face significant health inequalities, including reduced quality of life and life expectancy. Evidence has shown that people living with SMI are highly sedentary, face challenges when seeking to engage in physical activity (PA), and experience sleep difficulties. Motivation, mood and energy have been identified as critical determinants of these behaviours. PA and sleep are traditionally measured in isolation using quantitative approaches, limiting our understanding of the contexts and interactive ways in which these occur, especially for this population. Here, we adopted a flexible and holistic approach, using audio diaries to explore the usability and acceptability of capturing movement behaviours in people living with SMI.

This study employed a qualitative design. Data were collected with 10 participants self-identifying as living with SMI, who completed 7-days of audio diaries, pre and post diary use interviews. Reflexive thematic analysis was used to analyse participants’ movement behaviours and their experiences of using the audio diaries.

Audio diaries were perceived as acceptable to participants and their use for data capture was feasible, with participants experiencing their use as a flexible and empowering method of data capture. Within the exploratory data generated we identified four themes relating to participants’ movement behaviours: finding themselves in a “vicious circle” with physical and mental issues impacting movement behaviours; a daily internal fight and dialogue concerning fear of feeling guilty and wasting time; a determination to “not let fatigue win” by pushing through the day; and the mixed effects of understanding the importance of movement behaviours yet finding it challenging to engage.

Audio diaries offered an easy to use and relatively inclusive means of exploring movement behaviours for people living with SMI, especially their context and interrelated nature. Our findings reinforced the well-established link between mental and physical health, and their influence on 24 h movement behaviours, identifying population-specific challenges derived from medication side effects, rigid engagement opportunities, and illness symptoms. Given this, co-production involving individuals with lived experience is crucial for developing tailored recommendations and support to promote sleep and movement among those living with SMI. We emphasized the need for holistic measurement approaches and opportunities that consider the interconnected impact of disrupted sleep and movement.

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• Artificial Intelligence

Severe mental illness (SMI) is a major cause of years lived with global disability [ 1 ], with often detrimental and substantial impacts on daily life functioning and quality of life. In addition, people living with SMI are over three times more likely to have a physical health condition, and their life expectancy is 15–20 years lower than the general population [ 2 ]. The development of comorbid physical health conditions in people living with SMI creates an important healthcare challenge for the UK’s National Health Service [ 3 ], as it aiming to expand access to physical health assessments and complimentary evidence-based intervention. This disparity in health outcomes is partly due to modifiable health behaviours, such as high levels of physical inactivity and sedentary time [ 4 , 5 ], which in turn lead to disrupted sleep quality and quantity [ 6 ]. Here, we considered a broad definition of SMI aligned with the one adopted by the UK Office for Health Improvement and Disparities [ 7 ], allowing people to self-identifying as having a mental health condition severely impacting their life and activities [ 8 ]. This is aligned with previous approaches that consider mental health as a societal issue, with relationships to social determinants of health, and arguments that the severity of impact of mental health conditions on the individual is often driven more by circumstance than diagnosis [ 8 ].

Physical activity (PA) is a modifiable risk factor and interventions are a relatively low risk and accessible way of reducing physical health problems in people living with SMI. However, being physically active has been shown to be a complex behaviour both in general and especially for people living with SMI [ 4 ]. Medication side-effects such as sedation and fatigue, low or suboptimal motivation, and co-existing physical health conditions, as well as illness-related symptoms, are physical and psychological barriers to PA engagement. These are also potential reasons for high levels of sedentary time [ 9 , 10 ]. In addition, sleep disorders are common in individuals living with SMI, with up to 90% of adults reporting abnormal sleep behaviour, such as increased sleep onset latency, insomnia or hypersomnia [ 11 ]. Sleep can also be disrupted due to the use of psychotropic medications impacting sleep duration and architecture [ 12 ], alongside weight gain as a direct side effect that increases the risk of obstructive sleep apnoea [ 13 ]. Given the above, we argue that PA, sedentary time, and sleep are helpfully considered as interactive components impacting on quality of life and wider health outcomes.

Despite the presence of several guidelines and toolkit on physical health and PA in the UK [ 14 , 15 ], these tend to focus on single behaviours or pay relatively minimal attention to the interplay between movement behaviours. However, prior research has shown a preference for holistic approaches that focus on balance across behaviours and life contexts [ 16 ]. Researchers support the idea of moving beyond the target of more PA towards finding a healthy balance between movement behaviours [ 17 ]. Dedicating time to PA requires a compromise, as time for PA must come from other activities within the day, likely from sedentary behaviour or sleep [ 17 ]. Indeed, to understand PA holistically, it is important to explore the decisions on time allocation alongside the type and context of activities [ 17 ]. Existing measurement tools and approaches, often validated with a general population sample, offer little insight in this regard, especially for populations who face multiple context-specific barriers to movement. There are still few studies that have adopted 24 h approaches, limited qualitative approaches applied overall (narrowing which contextual variables are captured or viewed as important), and no work to date that focuses on 24 h movement behaviours for people living with SMI.

The challenge of implementing health behaviour approaches in those with SMI mean that a more nuanced understanding of “active living” as healthy balance of movement behaviours incorporating both sleep and rest time is needed. To this end, here we adopt a participatory approach [ 18 ] with the use of audio diaries to capture the type and context (opportunities where people are moving but also the context of their wider life and condition status) of all three interrelated movement behaviours in this population for the first time. Through co-developing a participatory approach, we will gain a clearer understanding of how people living with SMI allocate their time to movement behaviours and what it is important to consider in this population. Thus, helping policymakers to tailor strategies and outcomes to this population with more feasible intervention goals such as move towards a healthy daily balance by reducing sedentary time or by supporting sleep improvements [ 17 ].

Audio diaries provide the opportunity to capture phenomena and perspectives otherwise inaccessible to researchers because of time, context, and convenience [ 19 ]. This approach allows the participant to interpret the research question in the context of their own daily life with a sense of comfort and safety [ 19 ]. The fluidity in speech during data collection enables an immediate response to questions [ 20 , 21 ], and has the potential to allow the researcher to uncover details about participants’ experiences in a safe and engaging way that is particularly important when working with groups that have historically experienced stigma and discrimination [ 22 ].

Assessing movement behaviours is a challenge in any population and requires varying and flexible approaches. People living with SMI are usually underrepresented in research samples [ 22 ], generally it is unclear if and how the interconnection of movement behaviours apply to them and how this could be appropriately assessed to capture their perspectives and life contexts. As adults living with SMI are valuable experts of their own behaviour and daily life [ 23 ], their perceptions are essential when measuring their movement behaviours. Previous studies have assessed the feasibility and validity of accelerometers [ 24 ], self-completion diaries and questionnaires [ 25 ] to measure behaviours in people living with SMI. Quantitative measures are able to assess different dimensions of PA, along with a variety of metrics such as number of steps, minutes of activity, intensity of activity, and bouts of activity [ 26 ]. However, the measurement of PA in people living with SMI presents unique challenges given heterogeneity and differing experiences such as condition-related fatigue, concentration or motivation challenges [ 4 ], as well as additional barriers that are overrepresented in this group relative to the general population, for example digital literacy barriers [ 27 ], general literacy levels [ 28 ], and other physical health barriers [ 10 ]. Some of these challenges are also present in people with other conditions including cancer or diabetes [ 29 ], highlighting potential wider applications of this approach for other groups and the general population. It is therefore important to consider whether this measurement approach could be appropriate and engaging: is it acceptable to participants, especially those facing the challenges of managing a chronic condition, and is it feasible for use by those living with SMI? As such, here we piloted the use of interviews and audio diaries to answer our primary research question on the usability and acceptability of audio diaries in people living with SMI as data collection tool from a participant perspective. In doing so, we generated exploratory data to examine which aspects of movement behaviours and their contexts are important to consider in this group. to provide insight to inform future data collections in this area.

Public involvement and recruitment

Six members of the public with lived experience of SMI were involved prior to the start of the study to design and inform the inclusion criteria, recruitment strategies, interview schedules, and the audio diaries. They were recruited via voluntary organizations, mental health charities, community services and were reimbursed for their time based on the National Institute for Health Research guidelines [ 30 ].

Ten participants who had not contributed to the public involvement stage, living in the community, aged 18 years or over, and living in and/or accessing services in the North of England (UK) took part in the study. Aligned with calls for a broader definition of SMI [ 8 ], participants self-identifying as having a severe experience of mental illness [ 8 ] were invited to take part in the study. Participants were recruited via invitation emails to charities supporting mental health, third sector and community organisations for individuals living with SMI. Exclusion criteria were those lacking the capacity to consent and non-English speakers. Demographic data were not collected, instead the researchers asked participants to provide a self-written free-text qualitative description, allowing them to share with the research team personal details that they thought were important in relation to the research question. Researchers provided an example of qualitative description in the follow up email after the entrance interview took place.

Ethical approval was granted by the Population Health Sciences Institute at Newcastle University (ref. 2591/34063). Participants were provided with contact details of the researchers and mental health charities in the study material in the event they felt they required additional support.

Data generation

Participants completed two in-person or online (completed via Microsoft Teams) semi-structured interviews before and after the 7-day period of audio diaries. Participants with lack of access to a computer or lacking digital skills were firstly contacted via phone call and/or received instructions on using the online platform via post, a participant was also supported by the partner during the process. Alternatively, participants were offered in-person interviews. The entrance interview sought to explore participants’ past experiences and future expectations around healthcare and community support for PA, sedentary time, and sleep. The exit interview inquired about participants’ experiences on the use of audio diaries, allowing the researchers to gain feedback about this approach in the context (here defined as opportunities where people are moving but also the context of their wider life and condition status) of movement behaviours, for improving the method, its implementation and application for future studies [ 20 ]. Questions for both the entrance and exit interviews are presented in the Additional file 3 .

Audio diaries

After the entrance interview, participants were provided with a voice recorder (VN-541PC, Olympus Imaging Corp, Taiwan) and with equipment instructions to collect data for a 7-day period. The specific model of voice recorder was chosen due to its “instant dictation” option allowing participants to instantly start recording even when the power was off. In this study, audio diaries were used to describe movement behaviours. The researchers performed a facilitative role to allow participants to use the audio diaries in a way that suited them throughout the research. Indeed, participants chose when to complete the audio diary either throughout the day or at the beginning/end of each day, with no minimum data entry required. Participants could make multiple recordings throughout the day. They were reimbursed for their time with an incremental reimbursement based on the number of days of data entry provided [ 31 ].

Based on the six public engagement sessions, adjustments to the study design were made: participants were able to express a preference to receive a reminder to complete the audio diary. If yes, they could choose how often they wanted to receive the reminder and whether via text or email. The research team provided an audio diary guide to the participants (Additional file 1 ). In this study document, a brief summary of the study, definitions of PA, sedentary time and sleep, and a list of prompts in relation to the research question were included. As suggested by previous research, participants were asked to dedicate as much or as little time to the prompts as they deemed relevant [ 20 ] to allow for a balance between a structured approach and autonomy in recording diary accounts.

Theoretical assumption and methodological approach

This study was grounded ontologically in relativism and epistemologically in constructionism [ 32 ], with an experiential orientation to data interpretation to capture and explore participants’ perspectives and understandings on 24 h movement behaviours [ 32 ]. A predominantly inductive orientation to data, with both semantic and latent coding, was adopted here with the analysis driven by data content, limited only by a focus on constructing themes of relevance to the research question [ 33 ]. The research team involved two physiotherapists from different backgrounds (general medicine, mental health, and neuro rehabilitation), a sleep specialist, and a psychologist with expertise in behavioural science and mental health.

Data analysis

All interviews, audio recordings and audio diaries were transcribed verbatim by a member of the research team (IP) and reviewed by the research team to ensure clarity and accuracy of transcription. Participants were assigned a unique code number and all other identifying information was redacted to protect privacy and anonymity. Data were analysed with reflexive thematic analysis due to its suitability and flexibility to analyse data derived from a pluralistic approach to data generation [ 34 ], but also to allow both descriptive and interpretative accounts of data, allowing for both inductive and deductive theme generation. The lead author familiarised with transcripts to note initial features of the data and potential points of analytic interest. The initial coding produced several hundred codes, that were then clustered into five groups: sleep, PA, feelings, relaxing activities, and reflections on the use of audio diaries. We then moved to the interpretation of aggregated meaning across the dataset [ 32 ] to combine codes according to shared meanings into candidate themes. These were further refined and named through discussion across the research team.

Participants

Ten participants completed the study process (entrance interview, 7 days of audio diaries, and exit interview). However, we excluded one participant from data analysis as they did not record audio diaries but paper diaries during the week of data generation. A total of three participants preferred to be interviewed in-person, while the remaining 6 preferred to be interviewed online. Participants’ self-written free-text qualitative anonymised descriptions are provided in Additional File 2 . Here, we provide a brief composite summary: some participants had lived experience of mental health conditions or within their families (including depression, anxiety, post-traumatic stress disorder, attention deficit hyperactivity disorder, psychosis, and personality disorders). Some have also experienced trauma or violence in their past, contributing to their mental health challenges. Professionally, some participants have worked or are currently working in mental health-related fields, such as nursing, peer support, or social care. Family dynamics vary among the participants, with some being single parents, widowed, or married with children. Several have adult children, while others are caregivers to their partners or have experienced significant loss.

Audio diaries: quantitative usage data

Quantitative results summarising the usage of the audio diaries are presented in Table  1 . Of the 9 included participants, 8 recorded 7 days of audio diaries while one participant recorded 5 days of audio diaries due to issues in operating the recorder. A total of 110 recordings were received overall with a total of 3 h and 55 min of recording across participants. The minimum number of recordings per participant was 5 and the maximum was 22, with 4 participants providing multiple recordings per day of data collection.

The average recording duration was 2.5 min, with the shortest duration average being 20 s and the longest duration average being 5 min. The most common times to record audio diaries were morning (between 6:00 and 12:00) and late evening (between 20:00 and 00:00) with 38% and 36% of total recordings completed during these times respectively. The least common times to complete recordings were afternoon (12:00–16:00) and overnight (00:00–06:00).

Audio diaries: qualitative usage data and acceptability

Here, we focused on participants’ views and experiences of the audio diaries method from the audio diaries themselves and their post-use interviews. In sum, the data below demonstrate that participants found the audio diaries to be an acceptable research tool, moving quickly from initial nervousness to empowered engagement. Further, the diaries were tools for reflection and in themselves were perceived to offer benefits. We identified some evidence that audio diaries would offer time and accessibility improvements relative to paper-based tools.

Characteristic 1. Audio diaries allow for a dedicated time for reflection – potential for being a therapeutic tool

Participants described the audio diary process as helpful in reflecting upon their movement and sleep routines. Indeed, it was seen as providing them with a reflective outlet for the challenges of committing to take part in structured PA, maintaining appropriate sleep hygiene and enabled them to have a follow on their issues or seek for help: “ You can also reflect on: so what? What can I do? Because it’s been recorded it , it’s almost like it clears the mind because it makes key things stick in my mind and makes it easier for me to be able to sort them out , get them in perspective , but just because I’m not talking about the mental issues themselves , I’m talking about how do how do I continue to structure in that physical activity when things get really , really bad and how well it works when things are manageable or fairly manageable. It’s a really useful exercise.” (Participant 5).

Some participants felt this was therapeutic, as the audio diary offered a cathartic opportunity to vocalise what they needed to say: “ I then found it absolutely amazing , really sort of continued to do it because it gives you a reflection of everything you’ve done in that day. You’ve got it off your chest and said it instead of it playing over your mind.” (Participant 2). This approach provided an opportunity for participants to share their reflections and thoughts without any expectations of providing a certain amount of information as per “filling a box” on paper. Also, the lack of consistent “visual feedback” as from paper diaries, avoided further self-scrutiny or review: “ It’s not triggering me because I don’t have to….like , I’m not listening to it. If I write it all down , I’d say have that piece of paper every single day , seven days. So then I’d be like , oh , yeah , that happened. I mean , is this consistent visual feedback from the paper that you get like maybe did not write enough in the box or there is there was not enough space and you keep reminding from the paper. ” (Participant 2).

Characteristic 2. The method allowed to overcome time and accessibility constraints

Participants shared the positive aspect of the practicality of the audio diary method. Completing the diaries was experienced as convenient, easy and instantaneous: “ You can do it whilst you’re doing something else. Like whereas if you have to take the time to sit down and write they , I mean I don’t mind writing , it’s fine. Well , for me , like we all quite have busy lives. You know what I mean? And we all have other commitments and stuff. So for me this it’s much more convenient to be able to just speak into a recorder and document it that way. ” (Participant 6). Also, audio diaries allowed participants to share more details and information compared to paper diaries: “ I think the good thing with the recorder is like in a 10 minute recording you can fit so much and like even though some days I was only recording for 10 minutes like was able as I was able to say a lot , wherever in a day 10 minutes of writing is nothing .” (Participant 1). The approach also allowed the research to be inclusive by overcoming visual impairments and physical issues (e.g. shoulder injury): “ It made me feel empowered and full of energy. Ohh well , I’m not doing anything for a long time , for my eyesight , nothing worse. It’s becoming quite difficult .” (Participant 8).

Characteristic 3. Challenges of audio diary use

Negative responses and experiences from participants about the audio diaries were relatively few. The most reported concern related to participants nervousness in providing “right” data and that their accounts were going to look repetitive: “ I think it was more nervous of , like , right. What , what if I like , say , the right thing or what if I say the wrong thing or like? ” (Participant 2) and “ And I think I did feel a bit like , I’m just gonna update or not much because I haven’t done too much so there’s not loads I had to discuss .” (Participant 10). Some participants described also how the awareness achieved through the recordings about movement and physical activity occasionally has been perceived as discouraging. However, in some this prompted the opportunity to consider change: “ It’s like you , you start to feel low about how much you’re actually not moving , but then you take the positive out of it and you start to think like what , what do you need to change and improve and things like that?” (Participant 9) and “ I think from doing it is made me think a little bit , uh , about how much it exercise or like stuff that I actually do and when I was recording it , I was thinking actually I didn’t do very much. So it highlighted to me really that I should probably do more exercise ” (Participant 10).

Understanding interactions between sleep, PA, and sedentary time

Here, we address the contributions of the entrance interviews and audio diaries to the secondary research question exploring PA, sleep, and sedentary time in people living with SMI. Four overarching themes were generated from the data, a summary is illustrated in Fig.  1 .

Map of themes generated through reflexive thematic analysis related to our understanding of 24 h movement behaviours in people living with SMI

Theme 1. Finding yourself in a “vicious circle”, physical and mental issues impacting movement behaviours

In this theme, we noted participants’ experiences of a “vicious circle” emphasising the intersection between physical and mental aspects of health in daily life and further supporting the idea that physical health problems increase the risk of poor mental health, and vice versa. Participants described how the interaction between physical and mental health impacts health-related behaviours, including sleep and PA: “ Unfortunately , it’s a vicious circle for me. I’ll get physically unwell. Then I’ll get mentally unwell and then I’ll not sleep and then I’ll not eat , and then I’ll not exercise and then I’ll not do anything and it just goes round and round and round until I’m well enough physically to pull myself out mentally , and then it starts coming back to us .” (Participant 1 on movement and sleep). Participants also described the presence of physical side-effects of medication and/or physical conditions limiting their motivation and ability to move. “ I think for me , one of the side effects of the medication I take as well makes you really drowsy. So , I’m usually quite tired. A lot of the time , and so that doesn’t help me even really cause that sort of adds to my lack of motivation. ” (Participant 9 on movement).

Alongside physical symptoms, events perceived as stressful (such as memories of trauma or unexpected medical visits) and the anxiety deriving from them, led to negative experiences of overthinking/active mind further impacting willingness to move: “ I’ve got still all playing in my mind from the hospital , so I’ve had no motivation at all today to do anything. ” (Participant 2 on movement). This last emotion-based aspect also impacted sleep with participants’ experiencing many nocturnal awakenings and nightmares, contributing to feelings of tiredness and fatigue. This lack of good quality sleep led to worsening in mood, further impacting ability and willingness to move.

Theme 2. A daily internal fight and dialogue: fear of feeling guilty and of wasting time

This theme brought to light participants’ experiences of an internal dialogue on the choice of staying in bed or starting the day. Most of the participants shared difficulties in nocturnal sleep and the challenge to get out of bed in the morning to face the day: “ I was debating whether to stay awake or go back to sleep or…Thinking well , I’ll be knackered all day , but I just thought no , just stay awake and just push through the day .” (Participant 2 on sleep). Mood and stress in dealing with daily activities also contributed to a challenging start of the day: “ If I don’t force myself to do something , I’d just sleep and it’s not good. So , I’m gonna get myself sorted now , get myself up out at the house , and once I’m out , I’ll be fine. I know I’ll be fine. It’s just that initial pushing yourself to get ready and get out when all you want to do is go back to bed and go to sleep.” (Participant 6 on all behaviours). Some participants shared how this internal fight requires to force themselves to be active to avoid feelings of guilt and the fear of “wasted day”: “ Because if I don’t force myself to be out and be active , I will just literally go back to bed and spend the whole day in bed and then I’ll get angry that I’ve wasted the day .” (Participant 8 on all behaviours) and “ So , I had parents even last night and then I could have got a lift back , but I said no , and I chose to walk. I just needed to get out and get some fresh air , it’s amazing how guilty I can feel as well for not being very active. ” (Participant 6 on movement). Also, motivation played a decisive role in this internal dialogue: “ I know from previous times if I do exercise afterwards , I feel quite good doing it and pleased that I did it. So , it’s just like to get you the motivation to do it in the first place .” (Participant 10 on movement) and “ I have no motivation to do anything , just wanted to stay in bed all day. By myself. Went to the to the table was going to do jobs for my mum today but then didn’t end up because just couldn’t be bothered to do anything .” (Participant 2 on sedentary).

Theme 3. Do not let fatigue win – motivation and energy vs. fulfilment of activities

This theme enables an understanding of the fulfilment of activities as a driver of positional change in terms of their wellbeing status, with significant impact on perceived mental health and emotional wellbeing: “ I’m just trying to push through it ( the day ) because if I let the fatigue win then I will just end up doing nothing and I will end up in bed all day , every day .” (Participant 6 on all behaviours). Being active was rewarded with positive feelings and sense of achievement afterwards. In particular, activities related to a feeling of commitment and/or with a purpose and/or tangible outcomes such as walking with the dog, household chores, DIY, and shopping led to positive experiences: “ I’ve done a long walk today. I couldn’t really be bothered , but my dog needed to go out and we had the most pleasant walk. All the leaves down and very pleasant. So yeah. So , and I feel it lifted my mood.” (Participant 4 on movement) and “ I thought if I just don’t keep myself going. Then I’ll just end up just doing nothing and then it just mentally makes me worse. So , I just thought , you know what? Do some decorate and clean the flat. Makes me happy.” (Participant 2 on movement and sedentary).

The enjoyment from being active was perceived to positively contribute to mental wellbeing: “ I’m really glad that I did my walk. It does. It really does help. The enjoyment from walking just helps to ground me and clear my mind , how much of that is psychosomatic? I don’t know , but it doesn’t matter as long as it helps. ” (Participant 5 on movement). Some of the participants also shared how the benefits from participating in activities outdoors or together with others had a positive impact on their emotions and their mental health: “ I’ve been for a long walk down at the coast with friends. Oh , looks lovely down there and it really helped. And I was just saying to my friends , what a difference , what I’m like today compared to what I was like when I was down , I was in a really bad way on Friday. ” (Participant 4 on movement) and “ I know personally that when I don’t get outside and I don’t do like , I don’t get fresh air and I don’t actually get my steps in and stuff , it affects me and it affects my mental health.” (Participant 6 on movement).

Theme 4. Awareness of the importance and impact of 24 h movement behaviours on health

This theme highlighted participants’ awareness of the importance of having good quality sleep and being physically active. Participants placed a high value on getting good quality sleep with an emerging consensus that poor sleep significantly undermined their mental health and ability to function during the day: “ I’ve been struggling with sleep for a couple of days now. And it is majorly affecting my sleep routine which then in turn is also affecting like obviously my daily activities. The night before last I was up about four or five times throughout the night. And yesterday morning I was completely exhausted.” (Participants 6 on all behaviours). The lack of good quality sleep led to avoidance behaviour towards daytime napping defined as a “fighting chance” to sleep more and better during the night: “ I’m not good at napping through the day because then I find that if you nap during the day , you don’t sleep on the nighttime. I don’t sleep on the night-time anyway , but that’s at least well , I would give myself a good fighting chance of sleeping by not sleeping through the day .” (Participant 2 on sleep). Alongside the pressure to get appropriate sleep, participants’ experiences focused more on desirability and hope for good sleep, rather than tolerability of poor sleep: “ I’ll sleep , I do hope every night. Doesn’t seem to work right but that’s all well and good in the hoping .” (Participant 2 on sleep).

Participants showed awareness and knowledge of the public health messaging in relation to PA targets and recommended amounts: “ I was active for 70 minutes according to my watch. So , I was active for more than the recommended 30 minutes a day .” (Participant 6 on movement). Movement was seen to provide holistic health benefits, with walking (particularly outdoor) being a commonly reported PA being described as an easy and affordable option to move: “ Walking is what I’ve always done. And I know that it’s good exercise as well , but it’s good for the soul mainly.” (Participant 5 on movement) and “ I decided to do physical activity today because I could have got a bus or a taxi. I could have got a taxi to the hospital. But I’ve decided to walk instead to the bus at least. I just decided to do this because it would be easier and more affordable than getting a taxi.” (Participant 3 on movement). However, participants also described the difficulties in engaging in movement commitment regardless of the physical and mental benefit derived from it, with an evident need of being flexible to avoid additional pressure: “ And I think it goes to show how you can’t stick to a really rigid programme. Either you can do your best , but it’s…I think when things are not good and when we’re not well in our minds , it’s hard to move. It doesn’t need to be an added pressure that we put on ourselves as long as we have something structured in and something that we know that we should be doing that will help us. That’s the most important thing. ” (Participant 5 on movement).

This study explored the acceptability and usability of audio diaries as data collection tool concerning how movement, sedentary time, and sleep were experienced in a 24 h context for people living with SMI. To our knowledge, this is the first study to use audio diaries to collect data on movement behaviours in a 24 h framework in any population. Audio diaries were found to facilitate reflection among participants on their movement and sleep routines. Despite some initial anxiety, participants highlighted the practicality and accessibility of this method, as well as that it provided a positive and potentially beneficial research experience. We identified participants’ experiences of a “vicious circle” describing the reciprocal and challenging influence of physical and mental health status (including impacts on motivation, energy) on their movement behaviours. We found that engaging in purposeful movement activities had a positive and transformative influence on health, providing participants with a sense of fulfilment and benefits on emotional wellbeing. Across our sample morning waking was a particularly critical context, with an internal struggle experienced between staying in bed and the need to force themselves to move and face the day to avoid negative impacts of being sedentary on mental wellbeing. Participants were clearly aware of the interactive role of movement and sleep behaviours but despite acknowledging the benefits, participants described challenges and frustrations when seeking to adhere to structured activity regimens or sleep hygiene recommendations, underscoring the importance of flexibility and self-compassion in pursuing holistic wellbeing.

When participants described their daily experiences in relation to movement and PA, the impact of motivation and tiredness became evident. In line with previous evidence [ 35 ], lack of motivation, or suboptimal motivation, was presented as a barrier to PA engagement and wellbeing. Motivation for PA among the group often appeared to be driven by guilt rather than enjoyment, raising also concerns about the sustainability of these activities and impact on wellbeing. Drawing upon self-determination theory, the role of guilt in motivating behaviour aligns with the concept of introjected motivation [ 36 ], with the imposition of pressures by feelings of guilt or self-criticism while PA outcomes are personally important (e.g. beneficial for physical health and mental wellbeing) [ 37 ]. Our findings support the idea that to possibly increase PA engagement in SMI there should be a shift of policy promotion and public health messaging towards emphasizing enjoyment rather than targets for time and/or intensity. Participants shared their thoughts on the importance of engaging in PA, however medication side effects and dealing with illness symptoms (both physical and mental) often hindered their ability and willingness to move. Therefore, here we suggest a need for flexible engagement opportunities, similarly to previous research, including activities such as walking [ 38 ], being outdoor [ 35 , 39 ], and small group activities [ 35 ], along with the necessity for specific guidelines tailored to this group. Moreover, there is a call for greater involvement and co-production of recommendations involving individuals with lived experience of SMI to ensure their needs and perspectives are adequately addressed. Some good practice examples of meaningful co-production of PA recommendations are emerging [ 40 , 41 ].

Participants, echoing findings from previous research [ 42 ], placed a high value on getting good quality sleep. They also described sleep issues with frequent awakenings, nightmares, restless nighttime sleep and how the accumulated sleep loss led to an amplification of negative emotions, diminished energy impacting their daily life and overall health. Occurrence of comorbid sleep and circadian rhythm disorders are commonly experienced by individuals living with SMI [ 43 ], affecting emotional and cognitive functioning [ 44 , 45 ]. Nonetheless, the reluctance among participants to incorporate planned voluntary daytime naps, despite evidence suggesting benefits on cardiovascular outcomes and cognition [ 46 , 47 ], highlights the need for interventions and public messaging that integrate restorative activities into a new nuanced and broader concept of active living. There is a clear imperative for a holistic approach to sleep health promotion which also addresses the interconnectedness of physical and mental wellbeing.

Participants emphasised the opportunity provided by audio diaries for a dedicated time for reflection, recognising a cathartic and therapeutic potential to this approach, aligned with similar findings in the work psychology field [ 16 ]. Also, our finding supports the idea that audio diaries could reveal “hidden private phenomenon” [ 48 ] in sleep and in circadian rhythm research given participants’ ability to tailor their use based on their circadian preferences. However, we need to acknowledge that (as with any other method encouraging participants’ reflection) the act of completing the diary could, and indeed seemed to, encourage changes to their routine. This could be seen as helpful for a wider clinical application in both PA and sleep interventions. Despite participants reporting some initial concerns in providing the “right” information and occasional discouragement from awareness of their behaviours, they appreciated the ease and practicality of the method. Instant recording and the short time needed to record each audio diary entry contributed to the acceptability and 97% completion rate of the study. While previous studies with paper diaries and PA monitors recorded lower rates of daily data entries [ 49 , 50 ]. Audio diaries were also described as inclusive, overcoming barriers related to visual impairments or physical limitations. Thus, here we support the use of audio diaries in research to possibly overcome issues related to completion and motivation in conjunction with other research methods (such as interviews and/or quantitative measures). Overall, our findings suggest that audio diaries were a relatively inclusive, easy to use, and flexible approach to explore movement behaviours when qualitative accounts and perspectives of people with lived experience are needed to inform development of recommendations and interventions for health support and promotion.

The study has some limitations. First, the use of audio diaries for a 7-day period is not able to capture a participant’s behavioural pattern over a longer term. In particular, in people living with SMI, routines and condition status fluctuate substantially. While a 7-day approach is therefore perhaps not optimal to capture data that could be used to infer typical levels of movement and sleep behaviours, the ease of audio diaries may lead them to working well for even more extended periods of data capture in future work. Another factor to consider is that our findings are not generalisable or representative of all the experiences people living with SMI might have in relation to sleep, PA and sedentary time. For example, we have not been able to recruit people with learning disabilities and from different ethnicities. Future research should take into account different cultural meanings of mental health impact. Lastly, the presence of a self-selection bias should be accounted for [ 51 ]. Future studies involving volunteers should consider personal preferences and attitudes of people living with SMI towards PA, and sedentary time.

This study provides a unique insight into the usability and acceptability of audio diaries to explore dynamics and experiences of PA, sedentary time, and sleep within a 24 h framework among individuals living with SMI. Our findings showed how a participatory and flexible approach to data collection accounting for participants’ perceptions and life contexts can reveal the complex interplay between mental and physical health, and how these impacted movement behaviours in relation to both movement opportunities and sleep quality. Commonly reported challenges to movement and good sleep were medication side effects and mental or physical illness symptoms. While participants shared experiences of internal struggles and guilt feelings regarding their movement routines, walking, being outdoor and purposeful activities emerged as factors which contribute to enhanced mental wellbeing and sense of fulfilment. Here, we argue that a shift towards emphasizing the purpose and enjoyment derived from completing a movement activity rather than targets, might promote and support PA engagement in this group. Similarly, a more holistic approach considering the impact of disrupted and poor-quality sleep on movement opportunities is needed. Co-production with inputs from people with lived experience in sleep hygiene and PA recommendations, along with tailored sleep promotion for individuals living with SMI, is fundamental to better target public health messaging. The use of audio diaries offered an easy to use, acceptable, and relatively inclusive method to explore 24 h movement behaviours in research with people living with SMI.

Data availability

No datasets were generated or analysed during the current study.

Abbreviations

Severe mental illness

Physical activity

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Acknowledgements

The authors thank all participants. We also thank the members of the public for their help in the development of the audio diary method in this study.

This research was funded by Newcastle University Faculty of Medical Science Research Excellence Development Award.

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Ilaria Pina, Kirstie Anderson & Emily J. Oliver

Tees, Esk and Wear Valleys NHS Foundation Trust, Darlington, UK

Philip Hodgson

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IP: Conceptualization, Methodology, Formal analysis, Resources, Project administration, Ethics Application, Investigation, Writing—original draft Writing—review and editing. PH: Formal analysis, Writing—review and editing. KA: Writing—review and editing. EJO: Conceptualization, Writing—review and editing. All authors read and approved the final manuscript.

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Correspondence to Ilaria Pina .

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The present study obtained ethical approval from the Population Health Sciences Institute at Newcastle University (ref. 2591/34063). All participants provided written informed consent to participate in the study and consent was again requested prior to the start of entrance interview.

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Pina, I., Hodgson, P., Anderson, K. et al. Speak for yourself: usability and acceptability of audio diaries to explore physical activity, sedentary and sleep behaviours of those living with severe mental illness. JASSB 3 , 21 (2024). https://doi.org/10.1186/s44167-024-00058-4

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Received : 19 March 2024

Accepted : 29 July 2024

Published : 11 September 2024

DOI : https://doi.org/10.1186/s44167-024-00058-4

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