PHTY211 Lecture Notes - Lecture 9: Systematic Review, Pubmed, Upper Limb
Appraising evidence about experience
• Review qualitative research approaches
• Explain the reasons why the following are important when appraising evidence about
experiences
o Sampling strategy
o Method of data collection
o Description of the analytical path
• Evaluating qualitative research
• Qualitative research
o Qualitative research: "Focuses on understanding the complex world of lived experience
from the point of those who live it"
o Used to examine subjective human experience
o Quantitative research alone is insufficient to understand a patient's pain and disability
experiences
o Questions about experiences, attitudes and processes constitute a separate class of
clinical questions
▪ What are the experiences of children and parents attending asthma schools?
▪ In patients with chronic low back pain, do their beliefs and perceptions of pain
influence their recovery?
▪ Why do some patients not comply with a home exercise program?
o Qualitative research
▪ Differs from quantitative research in terms of
• Sampling techniques
• Data collection methods
• Data analysis
▪ Different criteria for appraisal
• Focus on elements and issues not numbers and graphs
o Design types
▪ Ethnography
• The discovery and description of a group people
• Culture is not limited to ethnic groups but can include organisations,
programs, groups of people e.g. smokers
• Example
o A qualitative ethnographic study was conducted to explore the
process and outcomes of a program of occupation for seniors with
dementia
o Data from observations, IVs with patients and staff and field notes
analysed to discover the barriers and opportunities to conducting an
occup program in a day hosp.
• The final ethnography (I.e. report) should provide a rich and holistic
description of the culture of the group under study
▪ Phenomenology
• The descriptive study of how individuals experience a phenomenon
• The researcher tries to gain access to individual's life-worlds, which is their
world of experience
• In-depth interviews is a common method for gaining access to an
individual's life-world
• Search for essences of their experiences
• Often search for commonalities across individuals
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o What are the essence's of peoples' experience of the death of a loved
one?
o What are the essences of peoples' experiences of an uncaring nurse?
o What are the lived experiences of student physios during their first
clinical placement
▪ Grounded theory
• Focuses on the task of theory construction and verification based on the
data collected
• It is bottom-up or inductive
o Does not start with a specific hypothesis and then set out to test it
o Data is collected and then a theory is developed or generated based
on the data
• Example:
o The grounded theory approach was used to explore enjoyment
experiences of people with schizophrenia.
o Interviews of participants focused on their descriptions of enjoyment
o The themes (thematic analysis) that emerged helped therapists gain a
better understanding of the issue and how best to manage people
with schizophrenia.
▪ Case study
• The detailed account and analysis of one or more cases
• A case is a bounded system I.e. a person, a group, an activity, a process
• Multiple methods are used to collect data
o Interviews, observation, documents, questionnaires, surveys
▪ Historical research
• Research about events that occurred in the past
• E.g. study how wound infection was managed in the 19th century
• How history can influence and form current practice in the 21st century
▪ Participatory action research
• Action Research used a great deal in education, instrument development
e.g. APP
• Process: identify an issue, evaluate, implement an intervention, evaluate
effectiveness
o Methods of data collection
▪ Observation
• Participant
o Participant observer uses observation to research culture or situation
from within
o Researcher spends an extended period of time within the setting to be
studied and records observations
o Is useful when the focus of interest is how activities and interactions
within a setting give meaning to beliefs or behaviours
• Direct
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o A direct observer doesn't typically try to become a participant in the
context
o Direct observation suggests a more detached perspective – the
researcher is watching rather than taking part
o The direct observer strikes to be as unobtrusive as possible so as not
to bias the observations
▪ Interview – structured and unstructured
• Participant provides researcher with information
• Non-verbal behaviours and the interview context become part of the data
• Emphasis is placed on listening
• A variety of open-ended questions are used to elicit the most information
possible
• Structured vs unstructured
▪ Questionnaires and surveys
• Closed questions
o Yes/no
o Very useful/not useful 5 poin scales
o Are you feeling any better today?
• Open-ended questions
o 3 things you liked
o 3 things to improve
o Comments/suggestions
o How do you feel today?
• Requires skill in design esp. Wording
• Don't use complex sentences
• Don't use jargon
• Don't assume everyone will know what you mean (keep Q unambiguous)
• Don't ask about more than one thing at a time
• Don't use double negatives
• Don’t ask leading uestions
• Types of rating scales
• Questionnaires data analysis
o Large amounts of data
o Frequencies (using SPSS) I.e. descriptive statistics
▪ Responses to closed questions
o Content analysis – key words
o Thematic analysis – the identification of themes or major ideas
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