Qualitative Research and Applications in Colorectal Surgery

Abstract

Traditionally employed in medical anthropologic and sociologic literature, qualitative methods are emerging as an essential component of clinical research as surgeons and researchers strive to optimize care informed by patient perspectives. Qualitative methods in health care–related research may be used to understand subjective experiences, beliefs, and concepts that are not captured using quantitative analyses and to gain in-depth knowledge of a specific context or culture. A qualitative approach may also be employed to explore under-researched problems and generate new ideas. Here, we provide an overview of aspects to consider when designing and conducting a qualitative research study.

Keywords

qualitative research - mixed methods - patient experience

Publication History

Article published online:
15 March 2023

• References

• 1 Institute of Medicine (US) Committee on Quality of Health Care in America. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academies Press; 2001
• 2 Epstein RM, Street Jr RL. The values and value of patient-centered care. Ann Fam Med 2011; 9 (02) 100-103
• 3 Lussiez A, Vitous CA, De Roo AC. et al. A multi-modal study examining long-term bowel, urinary, and sexual function after rectal cancer surgery. Am J Surg 2022; 224 (1 Pt B): 562-568
• 4 Rivard SJ, Vitous CA, Bamdad MC. et al. It's not fine: a photo-elicitation study of rectal cancer survivors' emotions and coping strategies. Surgery 2022; 171 (06) 1480-1485
• 5 Vu JVT, Matusko N, Hendren S, Regenbogen SE, Hardiman KM. Patient-reported unmet needs in colorectal cancer survivors after treatment for curative intent. Dis Colon Rectum 2019; 62 (07) 815-822
• 6 Rivard S, Vitous CA, Bamdad M. et al. “I wish there had been resources.” A photo-elicitation study of rectal cancer survivorship care needs. Ann Surg Oncol 2022; (e-pub ahead of print)
• 7 Mertens DM. Research and Evaluation in Education and Psychology: Integrating Diversity with Quantitative, Qualitative, and Mixed Methods. Thousand Oaks, CA: Sage; 2005
• 8 Bogdan R, Biklen SK. Qualitative Research for Education: An Introduction to Theories and Methods. Boston, MA: Allyn and Bacon; 1998
• 9 Creswell JW, Poth CN. Qualitative Inquiry & Research Design: Choosing among Five Approaches. 4th ed.. Thousand Oaks, CA: Sage; 2018
• 10 Polidano K, Chew-Graham CA, Farmer AD, Saunders B. Access to psychological support for young people following stoma surgery: exploring patients' and clinicians' perspectives. Qual Health Res 2021; 31 (03) 535-549
• 11 Li M, Yeh YL, Sun H, Chang B, Chen LS. Community-based participatory research: a family health history-based colorectal cancer prevention program among Chinese Americans. J Cancer Educ 2020; 35 (03) 485-492
• 12 Coronado GD, Schneider JL, Petrik A, Rivelli J, Taplin S, Green BB. Implementation successes and challenges in participating in a pragmatic study to improve colon cancer screening: perspectives of health center leaders. Transl Behav Med 2017; 7 (03) 557-566
• 13 Lau J, Lim TZ, Jianlin Wong G, Tan KK. The health belief model and colorectal cancer screening in the general population: a systematic review. Prev Med Rep 2020; 20: 101223
• 14 Buck C, Pini S, Lally P, Beeken RJ, Fisher A. The impact of the COVID-19 pandemic on the health behaviours of people living with and beyond breast, prostate, and colorectal cancer-a qualitative study. J Cancer Surviv 2022; (e-pub ahead of print)
• 15 Byrnes ME, Varlamos CJ, Rivard SJ. et al. “You're used to being the one that can fix things…”: a qualitative snapshot of colorectal surgeons during COVID-19. Dis Colon Rectum 2020; 63 (12) 1575-1578
• 16 Rivard SJ, Vitous CA, Cocroft S. et al. Colorectal surgery patient perspectives on healthcare during the CoVID-19 pandemic. Am J Surg 2021; 222 (04) 759-765
• 17 Al-Ghunaim TA, Johnson J, Biyani CS, O'Connor D. Psychological and occupational impact of the COVID-19 pandemic on UK surgeons: a qualitative investigation. BMJ Open 2021; 11 (04) e045699
• 18 Thorne S. Interpretive Description: Qualitative Research for Applied Practice. 2nd ed.. New York, NY: Routledge; 2016
• 19 Johnson M, Long T, White A. Arguments for ‘British Pluralism’ in qualitative health research. J Adv Nurs 2001; 33 (02) 243-249
• 20 Kahlke RM. Generic qualitative approaches: pitfalls and benefits of methodological mixology. Int J Qual Methods 2014; 13 (01) 37-52
• 21 Thompson Burdine J, Thorne S, Sandhu G. Interpretive description: a flexible qualitative methodology for medical education research. Med Educ 2021; 55 (03) 336-343
• 22 Merriam SB. Qualitative Research in Education: A User's Guide. 2nd ed.. Oxford: Oxford University Press; 2002
• 23 Caelli K, Ray L, Mill J. ‘Clear as mud’: toward greater clarity in generic qualitative research. Int J Qual Methods 2003; 2 (02) 1-13
• 24 Neergaard MA, Olesen F, Andersen RS, Sondergaard J. Qualitative description - the poor cousin of health research?. BMC Med Res Methodol 2009; 9 (01) 52
• 25 Hunt MR. Strengths and challenges in the use of interpretive description: reflections arising from a study of the moral experience of health professionals in humanitarian work. Qual Health Res 2009; 19 (09) 1284-1292
• 26 Creswell JW, Miller DL. Determining validity in qualitative inquiry. Theory Pract 2000; 39 (03) 124-130
• 27 Barbour RS. Checklists for improving rigour in qualitative research: a case of the tail wagging the dog?. BMJ 2001; 322 (7294): 1115-1117
• 28 Tracy SJ. Qualitative quality: eight “big-tent” criteria for excellent qualitative research. Qual Inq 2010; 16 (10) 837-851
• 29 Glaser BG. The constant comparative method of qualitative analysis. Soc Probl 1965; 12 (04) 436-445
• 30 Russell CK, Gregory DM. Evaluation of qualitative research studies. Evid Based Nurs 2003; 6 (02) 36-40
• 31 Busetto L, Wick W, Gumbinger C. How to use and assess qualitative research methods. Neurol Res Pract 2020; 2 (01) 14
• 32 Bernard HR. Research Methods in Anthropology: Qualitative and Quantitative Approaches. 5th ed.. Lanham, MD: AltaMira Press; 2011
• 33 Creswell JW, Klassen AC, Clark VLP, Smith KC. Best Practices for Mixed Methods Research in the Health Sciences. 2011
• 34 Kemper EA, Stringfield S, Teddlie C. Mixed methods sampling strategies in social science research. In: Tashakkori A, Teddlie C. eds. Handbook of Mixed Methods in Social and Behavioral Research. Thousand Oaks, CA: Sage; 2003: 273-296
• 35 Miles M, Huberman AM. Qualitative Data Analysis: An Expanded Sourcebook. 2nd ed.. Thousand Oaks, CA: Sage; 1994
• 36 Spradley JP. The Ethnographic Interview. New York, NY: Holt, Rinehart and Winston; 1979
• 37 Malterud K, Siersma VD, Guassora AD. Sample size in qualitative interview studies: guided by information power. Qual Health Res 2016; 26 (13) 1753-1760
• 38 Saunders B, Sim J, Kingstone T. et al. Saturation in qualitative research: exploring its conceptualization and operationalization. Qual Quant 2018; 52 (04) 1893-1907
• 39 Glaser B, Strauss A. The Discovery of Grounded Theory: Strategies for Qualitative Research. New York, NY: Routledge; 1967
• 40 Bradley EH, Curry LA, Devers KJ. Qualitative data analysis for health services research: developing taxonomy, themes, and theory. Health Serv Res 2007; 42 (04) 1758-1772
• 41 Elfenbein DM, Schwarze ML. Qualitative research methods. In: Dimick J, Lubitz C. eds. Health Services Research. Success in Academic Surgery. Cham: Springer; 2020: 249-260
• 42 Miles MB, Huberman AM. Early steps in analysis. In: Qualitative Data Analysis. Thousand Oaks, CA: Sage; 1994: 50-89
• 43 Averill JB. Matrix analysis as a complementary analytic strategy in qualitative inquiry. Qual Health Res 2002; 12 (06) 855-866
• 44 Vitous CA, Ivatury SJ, Suwanabol PA. Value of qualitative research in colorectal surgery. Dis Colon Rectum 2021; 64 (12) 1444-1446
• 45 Eakin JM, Mykhalovskiy E. Reframing the evaluation of qualitative health research: reflections on a review of appraisal guidelines in the health sciences. J Eval Clin Pract 2003; 9 (02) 187-194
• 46 Schwandt TA, Halpern ES. Linking Auditing and Metaevaluation: Enhancing Quality in Applied Research. Thousand Oaks, CA: Sage; 1988
• 47 Hammersley M, Atkinson P. Ethnography: Principles in Practice. 2nd ed.. New York, NY: Routledge; 1983
• 48 Sinclair LG. Young adults with permanent ileostomies: experiences during the first 4 years after surgery. J Wound Ostomy Continence Nurs 2009; 36 (03) 306-316
• 49 Brown D, McCormack B. Determining factors that have an impact upon effective evidence-based pain management with older people, following colorectal surgery: an ethnographic study. J Clin Nurs 2006; 15 (10) 1287-1298
• 50 Moene M, Bergbom I, Skott C. Patients' existential situation prior to colorectal surgery. J Adv Nurs 2006; 54 (02) 199-207
• 51 Rogers CR, Matthews P, Brooks E. et al. Barriers to and facilitators of recruitment of adult African American men for colorectal cancer research: an instrumental exploratory case study. JCO Oncol Pract 2021; 17 (05) e686-e694
• 52 Beech N, Arber A, Faithfull S. Restoring a sense of wellness following colorectal cancer: a grounded theory. J Adv Nurs 2012; 68 (05) 1134-1144
• 53 McMullan C, Pinkney TD, Jones LL. et al. Adapting to ulcerative colitis to try to live a ‘normal’ life: a qualitative study of patients' experiences in the Midlands region of England. BMJ Open 2017; 7 (08) e017544