respondents for qualitative research

• Research article
• Open access
• Published: 21 November 2018

Characterising and justifying sample size sufficiency in interview-based studies: systematic analysis of qualitative health research over a 15-year period

• Konstantina Vasileiou   ORCID: orcid.org/0000-0001-5047-3920 1 ,
• Julie Barnett 1 ,
• Susan Thorpe 2 &
• Terry Young 3  

BMC Medical Research Methodology volume  18 , Article number:  148 ( 2018 ) Cite this article

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Choosing a suitable sample size in qualitative research is an area of conceptual debate and practical uncertainty. That sample size principles, guidelines and tools have been developed to enable researchers to set, and justify the acceptability of, their sample size is an indication that the issue constitutes an important marker of the quality of qualitative research. Nevertheless, research shows that sample size sufficiency reporting is often poor, if not absent, across a range of disciplinary fields.

A systematic analysis of single-interview-per-participant designs within three health-related journals from the disciplines of psychology, sociology and medicine, over a 15-year period, was conducted to examine whether and how sample sizes were justified and how sample size was characterised and discussed by authors. Data pertinent to sample size were extracted and analysed using qualitative and quantitative analytic techniques.

Our findings demonstrate that provision of sample size justifications in qualitative health research is limited; is not contingent on the number of interviews; and relates to the journal of publication. Defence of sample size was most frequently supported across all three journals with reference to the principle of saturation and to pragmatic considerations. Qualitative sample sizes were predominantly – and often without justification – characterised as insufficient (i.e., ‘small’) and discussed in the context of study limitations. Sample size insufficiency was seen to threaten the validity and generalizability of studies’ results, with the latter being frequently conceived in nomothetic terms.

Conclusions

We recommend, firstly, that qualitative health researchers be more transparent about evaluations of their sample size sufficiency, situating these within broader and more encompassing assessments of data adequacy . Secondly, we invite researchers critically to consider how saturation parameters found in prior methodological studies and sample size community norms might best inform, and apply to, their own project and encourage that data adequacy is best appraised with reference to features that are intrinsic to the study at hand. Finally, those reviewing papers have a vital role in supporting and encouraging transparent study-specific reporting.

Peer Review reports

Sample adequacy in qualitative inquiry pertains to the appropriateness of the sample composition and size . It is an important consideration in evaluations of the quality and trustworthiness of much qualitative research [ 1 ] and is implicated – particularly for research that is situated within a post-positivist tradition and retains a degree of commitment to realist ontological premises – in appraisals of validity and generalizability [ 2 , 3 , 4 , 5 ].

Samples in qualitative research tend to be small in order to support the depth of case-oriented analysis that is fundamental to this mode of inquiry [ 5 ]. Additionally, qualitative samples are purposive, that is, selected by virtue of their capacity to provide richly-textured information, relevant to the phenomenon under investigation. As a result, purposive sampling [ 6 , 7 ] – as opposed to probability sampling employed in quantitative research – selects ‘information-rich’ cases [ 8 ]. Indeed, recent research demonstrates the greater efficiency of purposive sampling compared to random sampling in qualitative studies [ 9 ], supporting related assertions long put forward by qualitative methodologists.

Sample size in qualitative research has been the subject of enduring discussions [ 4 , 10 , 11 ]. Whilst the quantitative research community has established relatively straightforward statistics-based rules to set sample sizes precisely, the intricacies of qualitative sample size determination and assessment arise from the methodological, theoretical, epistemological, and ideological pluralism that characterises qualitative inquiry (for a discussion focused on the discipline of psychology see [ 12 ]). This mitigates against clear-cut guidelines, invariably applied. Despite these challenges, various conceptual developments have sought to address this issue, with guidance and principles [ 4 , 10 , 11 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ], and more recently, an evidence-based approach to sample size determination seeks to ground the discussion empirically [ 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ].

Focusing on single-interview-per-participant qualitative designs, the present study aims to further contribute to the dialogue of sample size in qualitative research by offering empirical evidence around justification practices associated with sample size. We next review the existing conceptual and empirical literature on sample size determination.

Sample size in qualitative research: Conceptual developments and empirical investigations

Qualitative research experts argue that there is no straightforward answer to the question of ‘how many’ and that sample size is contingent on a number of factors relating to epistemological, methodological and practical issues [ 36 ]. Sandelowski [ 4 ] recommends that qualitative sample sizes are large enough to allow the unfolding of a ‘new and richly textured understanding’ of the phenomenon under study, but small enough so that the ‘deep, case-oriented analysis’ (p. 183) of qualitative data is not precluded. Morse [ 11 ] posits that the more useable data are collected from each person, the fewer participants are needed. She invites researchers to take into account parameters, such as the scope of study, the nature of topic (i.e. complexity, accessibility), the quality of data, and the study design. Indeed, the level of structure of questions in qualitative interviewing has been found to influence the richness of data generated [ 37 ], and so, requires attention; empirical research shows that open questions, which are asked later on in the interview, tend to produce richer data [ 37 ].

Beyond such guidance, specific numerical recommendations have also been proffered, often based on experts’ experience of qualitative research. For example, Green and Thorogood [ 38 ] maintain that the experience of most qualitative researchers conducting an interview-based study with a fairly specific research question is that little new information is generated after interviewing 20 people or so belonging to one analytically relevant participant ‘category’ (pp. 102–104). Ritchie et al. [ 39 ] suggest that studies employing individual interviews conduct no more than 50 interviews so that researchers are able to manage the complexity of the analytic task. Similarly, Britten [ 40 ] notes that large interview studies will often comprise of 50 to 60 people. Experts have also offered numerical guidelines tailored to different theoretical and methodological traditions and specific research approaches, e.g. grounded theory, phenomenology [ 11 , 41 ]. More recently, a quantitative tool was proposed [ 42 ] to support a priori sample size determination based on estimates of the prevalence of themes in the population. Nevertheless, this more formulaic approach raised criticisms relating to assumptions about the conceptual [ 43 ] and ontological status of ‘themes’ [ 44 ] and the linearity ascribed to the processes of sampling, data collection and data analysis [ 45 ].

In terms of principles, Lincoln and Guba [ 17 ] proposed that sample size determination be guided by the criterion of informational redundancy , that is, sampling can be terminated when no new information is elicited by sampling more units. Following the logic of informational comprehensiveness Malterud et al. [ 18 ] introduced the concept of information power as a pragmatic guiding principle, suggesting that the more information power the sample provides, the smaller the sample size needs to be, and vice versa.

Undoubtedly, the most widely used principle for determining sample size and evaluating its sufficiency is that of saturation . The notion of saturation originates in grounded theory [ 15 ] – a qualitative methodological approach explicitly concerned with empirically-derived theory development – and is inextricably linked to theoretical sampling. Theoretical sampling describes an iterative process of data collection, data analysis and theory development whereby data collection is governed by emerging theory rather than predefined characteristics of the population. Grounded theory saturation (often called theoretical saturation) concerns the theoretical categories – as opposed to data – that are being developed and becomes evident when ‘gathering fresh data no longer sparks new theoretical insights, nor reveals new properties of your core theoretical categories’ [ 46 p. 113]. Saturation in grounded theory, therefore, does not equate to the more common focus on data repetition and moves beyond a singular focus on sample size as the justification of sampling adequacy [ 46 , 47 ]. Sample size in grounded theory cannot be determined a priori as it is contingent on the evolving theoretical categories.

Saturation – often under the terms of ‘data’ or ‘thematic’ saturation – has diffused into several qualitative communities beyond its origins in grounded theory. Alongside the expansion of its meaning, being variously equated with ‘no new data’, ‘no new themes’, and ‘no new codes’, saturation has emerged as the ‘gold standard’ in qualitative inquiry [ 2 , 26 ]. Nevertheless, and as Morse [ 48 ] asserts, whilst saturation is the most frequently invoked ‘guarantee of qualitative rigor’, ‘it is the one we know least about’ (p. 587). Certainly researchers caution that saturation is less applicable to, or appropriate for, particular types of qualitative research (e.g. conversation analysis, [ 49 ]; phenomenological research, [ 50 ]) whilst others reject the concept altogether [ 19 , 51 ].

Methodological studies in this area aim to provide guidance about saturation and develop a practical application of processes that ‘operationalise’ and evidence saturation. Guest, Bunce, and Johnson [ 26 ] analysed 60 interviews and found that saturation of themes was reached by the twelfth interview. They noted that their sample was relatively homogeneous, their research aims focused, so studies of more heterogeneous samples and with a broader scope would be likely to need a larger size to achieve saturation. Extending the enquiry to multi-site, cross-cultural research, Hagaman and Wutich [ 28 ] showed that sample sizes of 20 to 40 interviews were required to achieve data saturation of meta-themes that cut across research sites. In a theory-driven content analysis, Francis et al. [ 25 ] reached data saturation at the 17th interview for all their pre-determined theoretical constructs. The authors further proposed two main principles upon which specification of saturation be based: (a) researchers should a priori specify an initial analysis sample (e.g. 10 interviews) which will be used for the first round of analysis and (b) a stopping criterion , that is, a number of interviews (e.g. 3) that needs to be further conducted, the analysis of which will not yield any new themes or ideas. For greater transparency, Francis et al. [ 25 ] recommend that researchers present cumulative frequency graphs supporting their judgment that saturation was achieved. A comparative method for themes saturation (CoMeTS) has also been suggested [ 23 ] whereby the findings of each new interview are compared with those that have already emerged and if it does not yield any new theme, the ‘saturated terrain’ is assumed to have been established. Because the order in which interviews are analysed can influence saturation thresholds depending on the richness of the data, Constantinou et al. [ 23 ] recommend reordering and re-analysing interviews to confirm saturation. Hennink, Kaiser and Marconi’s [ 29 ] methodological study sheds further light on the problem of specifying and demonstrating saturation. Their analysis of interview data showed that code saturation (i.e. the point at which no additional issues are identified) was achieved at 9 interviews, but meaning saturation (i.e. the point at which no further dimensions, nuances, or insights of issues are identified) required 16–24 interviews. Although breadth can be achieved relatively soon, especially for high-prevalence and concrete codes, depth requires additional data, especially for codes of a more conceptual nature.

Critiquing the concept of saturation, Nelson [ 19 ] proposes five conceptual depth criteria in grounded theory projects to assess the robustness of the developing theory: (a) theoretical concepts should be supported by a wide range of evidence drawn from the data; (b) be demonstrably part of a network of inter-connected concepts; (c) demonstrate subtlety; (d) resonate with existing literature; and (e) can be successfully submitted to tests of external validity.

Other work has sought to examine practices of sample size reporting and sufficiency assessment across a range of disciplinary fields and research domains, from nutrition [ 34 ] and health education [ 32 ], to education and the health sciences [ 22 , 27 ], information systems [ 30 ], organisation and workplace studies [ 33 ], human computer interaction [ 21 ], and accounting studies [ 24 ]. Others investigated PhD qualitative studies [ 31 ] and grounded theory studies [ 35 ]. Incomplete and imprecise sample size reporting is commonly pinpointed by these investigations whilst assessment and justifications of sample size sufficiency are even more sporadic.

Sobal [ 34 ] examined the sample size of qualitative studies published in the Journal of Nutrition Education over a period of 30 years. Studies that employed individual interviews ( n  = 30) had an average sample size of 45 individuals and none of these explicitly reported whether their sample size sought and/or attained saturation. A minority of articles discussed how sample-related limitations (with the latter most often concerning the type of sample, rather than the size) limited generalizability. A further systematic analysis [ 32 ] of health education research over 20 years demonstrated that interview-based studies averaged 104 participants (range 2 to 720 interviewees). However, 40% did not report the number of participants. An examination of 83 qualitative interview studies in leading information systems journals [ 30 ] indicated little defence of sample sizes on the basis of recommendations by qualitative methodologists, prior relevant work, or the criterion of saturation. Rather, sample size seemed to correlate with factors such as the journal of publication or the region of study (US vs Europe vs Asia). These results led the authors to call for more rigor in determining and reporting sample size in qualitative information systems research and to recommend optimal sample size ranges for grounded theory (i.e. 20–30 interviews) and single case (i.e. 15–30 interviews) projects.

Similarly, fewer than 10% of articles in organisation and workplace studies provided a sample size justification relating to existing recommendations by methodologists, prior relevant work, or saturation [ 33 ], whilst only 17% of focus groups studies in health-related journals provided an explanation of sample size (i.e. number of focus groups), with saturation being the most frequently invoked argument, followed by published sample size recommendations and practical reasons [ 22 ]. The notion of saturation was also invoked by 11 out of the 51 most highly cited studies that Guetterman [ 27 ] reviewed in the fields of education and health sciences, of which six were grounded theory studies, four phenomenological and one a narrative inquiry. Finally, analysing 641 interview-based articles in accounting, Dai et al. [ 24 ] called for more rigor since a significant minority of studies did not report precise sample size.

Despite increasing attention to rigor in qualitative research (e.g. [ 52 ]) and more extensive methodological and analytical disclosures that seek to validate qualitative work [ 24 ], sample size reporting and sufficiency assessment remain inconsistent and partial, if not absent, across a range of research domains.

Objectives of the present study

The present study sought to enrich existing systematic analyses of the customs and practices of sample size reporting and justification by focusing on qualitative research relating to health. Additionally, this study attempted to expand previous empirical investigations by examining how qualitative sample sizes are characterised and discussed in academic narratives. Qualitative health research is an inter-disciplinary field that due to its affiliation with medical sciences, often faces views and positions reflective of a quantitative ethos. Thus qualitative health research constitutes an emblematic case that may help to unfold underlying philosophical and methodological differences across the scientific community that are crystallised in considerations of sample size. The present research, therefore, incorporates a comparative element on the basis of three different disciplines engaging with qualitative health research: medicine, psychology, and sociology. We chose to focus our analysis on single-per-participant-interview designs as this not only presents a popular and widespread methodological choice in qualitative health research, but also as the method where consideration of sample size – defined as the number of interviewees – is particularly salient.

Study design

A structured search for articles reporting cross-sectional, interview-based qualitative studies was carried out and eligible reports were systematically reviewed and analysed employing both quantitative and qualitative analytic techniques.

We selected journals which (a) follow a peer review process, (b) are considered high quality and influential in their field as reflected in journal metrics, and (c) are receptive to, and publish, qualitative research (Additional File  1 presents the journals’ editorial positions in relation to qualitative research and sample considerations where available). Three health-related journals were chosen, each representing a different disciplinary field; the British Medical Journal (BMJ) representing medicine, the British Journal of Health Psychology (BJHP) representing psychology, and the Sociology of Health & Illness (SHI) representing sociology.

Search strategy to identify studies

Employing the search function of each individual journal, we used the terms ‘interview*’ AND ‘qualitative’ and limited the results to articles published between 1 January 2003 and 22 September 2017 (i.e. a 15-year review period).

Eligibility criteria

To be eligible for inclusion in the review, the article had to report a cross-sectional study design. Longitudinal studies were thus excluded whilst studies conducted within a broader research programme (e.g. interview studies nested in a trial, as part of a broader ethnography, as part of a longitudinal research) were included if they reported only single-time qualitative interviews. The method of data collection had to be individual, synchronous qualitative interviews (i.e. group interviews, structured interviews and e-mail interviews over a period of time were excluded), and the data had to be analysed qualitatively (i.e. studies that quantified their qualitative data were excluded). Mixed method studies and articles reporting more than one qualitative method of data collection (e.g. individual interviews and focus groups) were excluded. Figure  1 , a PRISMA flow diagram [ 53 ], shows the number of: articles obtained from the searches and screened; papers assessed for eligibility; and articles included in the review (Additional File  2 provides the full list of articles included in the review and their unique identifying code – e.g. BMJ01, BJHP02, SHI03). One review author (KV) assessed the eligibility of all papers identified from the searches. When in doubt, discussions about retaining or excluding articles were held between KV and JB in regular meetings, and decisions were jointly made.

PRISMA flow diagram

Data extraction and analysis

A data extraction form was developed (see Additional File  3 ) recording three areas of information: (a) information about the article (e.g. authors, title, journal, year of publication etc.); (b) information about the aims of the study, the sample size and any justification for this, the participant characteristics, the sampling technique and any sample-related observations or comments made by the authors; and (c) information about the method or technique(s) of data analysis, the number of researchers involved in the analysis, the potential use of software, and any discussion around epistemological considerations. The Abstract, Methods and Discussion (and/or Conclusion) sections of each article were examined by one author (KV) who extracted all the relevant information. This was directly copied from the articles and, when appropriate, comments, notes and initial thoughts were written down.

To examine the kinds of sample size justifications provided by articles, an inductive content analysis [ 54 ] was initially conducted. On the basis of this analysis, the categories that expressed qualitatively different sample size justifications were developed.

We also extracted or coded quantitative data regarding the following aspects:

Journal and year of publication

Number of interviews

Number of participants

Presence of sample size justification(s) (Yes/No)

Presence of a particular sample size justification category (Yes/No), and

Number of sample size justifications provided

Descriptive and inferential statistical analyses were used to explore these data.

A thematic analysis [ 55 ] was then performed on all scientific narratives that discussed or commented on the sample size of the study. These narratives were evident both in papers that justified their sample size and those that did not. To identify these narratives, in addition to the methods sections, the discussion sections of the reviewed articles were also examined and relevant data were extracted and analysed.

In total, 214 articles – 21 in the BMJ, 53 in the BJHP and 140 in the SHI – were eligible for inclusion in the review. Table  1 provides basic information about the sample sizes – measured in number of interviews – of the studies reviewed across the three journals. Figure  2 depicts the number of eligible articles published each year per journal.

The publication of qualitative studies in the BMJ was significantly reduced from 2012 onwards and this appears to coincide with the initiation of the BMJ Open to which qualitative studies were possibly directed.

Pairwise comparisons following a significant Kruskal-Wallis Footnote 2 test indicated that the studies published in the BJHP had significantly ( p  < .001) smaller samples sizes than those published either in the BMJ or the SHI. Sample sizes of BMJ and SHI articles did not differ significantly from each other.

Sample size justifications: Results from the quantitative and qualitative content analysis

Ten (47.6%) of the 21 BMJ studies, 26 (49.1%) of the 53 BJHP papers and 24 (17.1%) of the 140 SHI articles provided some sort of sample size justification. As shown in Table  2 , the majority of articles which justified their sample size provided one justification (70% of articles); fourteen studies (25%) provided two distinct justifications; one study (1.7%) gave three justifications and two studies (3.3%) expressed four distinct justifications.

There was no association between the number of interviews (i.e. sample size) conducted and the provision of a justification (rpb = .054, p  = .433). Within journals, Mann-Whitney tests indicated that sample sizes of ‘justifying’ and ‘non-justifying’ articles in the BMJ and SHI did not differ significantly from each other. In the BJHP, ‘justifying’ articles ( Mean rank  = 31.3) had significantly larger sample sizes than ‘non-justifying’ studies ( Mean rank  = 22.7; U = 237.000, p  < .05).

There was a significant association between the journal a paper was published in and the provision of a justification (χ 2 (2) = 23.83, p  < .001). BJHP studies provided a sample size justification significantly more often than would be expected ( z  = 2.9); SHI studies significantly less often ( z  = − 2.4). If an article was published in the BJHP, the odds of providing a justification were 4.8 times higher than if published in the SHI. Similarly if published in the BMJ, the odds of a study justifying its sample size were 4.5 times higher than in the SHI.

The qualitative content analysis of the scientific narratives identified eleven different sample size justifications. These are described below and illustrated with excerpts from relevant articles. By way of a summary, the frequency with which these were deployed across the three journals is indicated in Table  3 .

Saturation was the most commonly invoked principle (55.4% of all justifications) deployed by studies across all three journals to justify the sufficiency of their sample size. In the BMJ, two studies claimed that they achieved data saturation (BMJ17; BMJ18) and one article referred descriptively to achieving saturation without explicitly using the term (BMJ13). Interestingly, BMJ13 included data in the analysis beyond the point of saturation in search of ‘unusual/deviant observations’ and with a view to establishing findings consistency.

Thirty three women were approached to take part in the interview study. Twenty seven agreed and 21 (aged 21–64, median 40) were interviewed before data saturation was reached (one tape failure meant that 20 interviews were available for analysis). (BMJ17). No new topics were identified following analysis of approximately two thirds of the interviews; however, all interviews were coded in order to develop a better understanding of how characteristic the views and reported behaviours were, and also to collect further examples of unusual/deviant observations. (BMJ13).

Two articles reported pre-determining their sample size with a view to achieving data saturation (BMJ08 – see extract in section In line with existing research ; BMJ15 – see extract in section Pragmatic considerations ) without further specifying if this was achieved. One paper claimed theoretical saturation (BMJ06) conceived as being when “no further recurring themes emerging from the analysis” whilst another study argued that although the analytic categories were highly saturated, it was not possible to determine whether theoretical saturation had been achieved (BMJ04). One article (BMJ18) cited a reference to support its position on saturation.

In the BJHP, six articles claimed that they achieved data saturation (BJHP21; BJHP32; BJHP39; BJHP48; BJHP49; BJHP52) and one article stated that, given their sample size and the guidelines for achieving data saturation, it anticipated that saturation would be attained (BJHP50).

Recruitment continued until data saturation was reached, defined as the point at which no new themes emerged. (BJHP48). It has previously been recommended that qualitative studies require a minimum sample size of at least 12 to reach data saturation (Clarke & Braun, 2013; Fugard & Potts, 2014; Guest, Bunce, & Johnson, 2006) Therefore, a sample of 13 was deemed sufficient for the qualitative analysis and scale of this study. (BJHP50).

Two studies argued that they achieved thematic saturation (BJHP28 – see extract in section Sample size guidelines ; BJHP31) and one (BJHP30) article, explicitly concerned with theory development and deploying theoretical sampling, claimed both theoretical and data saturation.

The final sample size was determined by thematic saturation, the point at which new data appears to no longer contribute to the findings due to repetition of themes and comments by participants (Morse, 1995). At this point, data generation was terminated. (BJHP31).

Five studies argued that they achieved (BJHP05; BJHP33; BJHP40; BJHP13 – see extract in section Pragmatic considerations ) or anticipated (BJHP46) saturation without any further specification of the term. BJHP17 referred descriptively to a state of achieved saturation without specifically using the term. Saturation of coding , but not saturation of themes, was claimed to have been reached by one article (BJHP18). Two articles explicitly stated that they did not achieve saturation; instead claiming a level of theme completeness (BJHP27) or that themes being replicated (BJHP53) were arguments for sufficiency of their sample size.

Furthermore, data collection ceased on pragmatic grounds rather than at the point when saturation point was reached. Despite this, although nuances within sub-themes were still emerging towards the end of data analysis, the themes themselves were being replicated indicating a level of completeness. (BJHP27).

Finally, one article criticised and explicitly renounced the notion of data saturation claiming that, on the contrary, the criterion of theoretical sufficiency determined its sample size (BJHP16).

According to the original Grounded Theory texts, data collection should continue until there are no new discoveries ( i.e. , ‘data saturation’; Glaser & Strauss, 1967). However, recent revisions of this process have discussed how it is rare that data collection is an exhaustive process and researchers should rely on how well their data are able to create a sufficient theoretical account or ‘theoretical sufficiency’ (Dey, 1999). For this study, it was decided that theoretical sufficiency would guide recruitment, rather than looking for data saturation. (BJHP16).

Ten out of the 20 BJHP articles that employed the argument of saturation used one or more citations relating to this principle.

In the SHI, one article (SHI01) claimed that it achieved category saturation based on authors’ judgment.

This number was not fixed in advance, but was guided by the sampling strategy and the judgement, based on the analysis of the data, of the point at which ‘category saturation’ was achieved. (SHI01).

Three articles described a state of achieved saturation without using the term or specifying what sort of saturation they had achieved (i.e. data, theoretical, thematic saturation) (SHI04; SHI13; SHI30) whilst another four articles explicitly stated that they achieved saturation (SHI100; SHI125; SHI136; SHI137). Two papers stated that they achieved data saturation (SHI73 – see extract in section Sample size guidelines ; SHI113), two claimed theoretical saturation (SHI78; SHI115) and two referred to achieving thematic saturation (SHI87; SHI139) or to saturated themes (SHI29; SHI50).

Recruitment and analysis ceased once theoretical saturation was reached in the categories described below (Lincoln and Guba 1985). (SHI115). The respondents’ quotes drawn on below were chosen as representative, and illustrate saturated themes. (SHI50).

One article stated that thematic saturation was anticipated with its sample size (SHI94). Briefly referring to the difficulty in pinpointing achievement of theoretical saturation, SHI32 (see extract in section Richness and volume of data ) defended the sufficiency of its sample size on the basis of “the high degree of consensus [that] had begun to emerge among those interviewed”, suggesting that information from interviews was being replicated. Finally, SHI112 (see extract in section Further sampling to check findings consistency ) argued that it achieved saturation of discursive patterns . Seven of the 19 SHI articles cited references to support their position on saturation (see Additional File  4 for the full list of citations used by articles to support their position on saturation across the three journals).

Overall, it is clear that the concept of saturation encompassed a wide range of variants expressed in terms such as saturation, data saturation, thematic saturation, theoretical saturation, category saturation, saturation of coding, saturation of discursive themes, theme completeness. It is noteworthy, however, that although these various claims were sometimes supported with reference to the literature, they were not evidenced in relation to the study at hand.

Pragmatic considerations

The determination of sample size on the basis of pragmatic considerations was the second most frequently invoked argument (9.6% of all justifications) appearing in all three journals. In the BMJ, one article (BMJ15) appealed to pragmatic reasons, relating to time constraints and the difficulty to access certain study populations, to justify the determination of its sample size.

On the basis of the researchers’ previous experience and the literature, [30, 31] we estimated that recruitment of 15–20 patients at each site would achieve data saturation when data from each site were analysed separately. We set a target of seven to 10 caregivers per site because of time constraints and the anticipated difficulty of accessing caregivers at some home based care services. This gave a target sample of 75–100 patients and 35–50 caregivers overall. (BMJ15).

In the BJHP, four articles mentioned pragmatic considerations relating to time or financial constraints (BJHP27 – see extract in section Saturation ; BJHP53), the participant response rate (BJHP13), and the fixed (and thus limited) size of the participant pool from which interviewees were sampled (BJHP18).

We had aimed to continue interviewing until we had reached saturation, a point whereby further data collection would yield no further themes. In practice, the number of individuals volunteering to participate dictated when recruitment into the study ceased (15 young people, 15 parents). Nonetheless, by the last few interviews, significant repetition of concepts was occurring, suggesting ample sampling. (BJHP13).

Finally, three SHI articles explained their sample size with reference to practical aspects: time constraints and project manageability (SHI56), limited availability of respondents and project resources (SHI131), and time constraints (SHI113).

The size of the sample was largely determined by the availability of respondents and resources to complete the study. Its composition reflected, as far as practicable, our interest in how contextual factors (for example, gender relations and ethnicity) mediated the illness experience. (SHI131).

Qualities of the analysis

This sample size justification (8.4% of all justifications) was mainly employed by BJHP articles and referred to an intensive, idiographic and/or latently focused analysis, i.e. that moved beyond description. More specifically, six articles defended their sample size on the basis of an intensive analysis of transcripts and/or the idiographic focus of the study/analysis. Four of these papers (BJHP02; BJHP19; BJHP24; BJHP47) adopted an Interpretative Phenomenological Analysis (IPA) approach.

The current study employed a sample of 10 in keeping with the aim of exploring each participant’s account (Smith et al. , 1999). (BJHP19).

BJHP47 explicitly renounced the notion of saturation within an IPA approach. The other two BJHP articles conducted thematic analysis (BJHP34; BJHP38). The level of analysis – i.e. latent as opposed to a more superficial descriptive analysis – was also invoked as a justification by BJHP38 alongside the argument of an intensive analysis of individual transcripts

The resulting sample size was at the lower end of the range of sample sizes employed in thematic analysis (Braun & Clarke, 2013). This was in order to enable significant reflection, dialogue, and time on each transcript and was in line with the more latent level of analysis employed, to identify underlying ideas, rather than a more superficial descriptive analysis (Braun & Clarke, 2006). (BJHP38).

Finally, one BMJ paper (BMJ21) defended its sample size with reference to the complexity of the analytic task.

We stopped recruitment when we reached 30–35 interviews, owing to the depth and duration of interviews, richness of data, and complexity of the analytical task. (BMJ21).

Meet sampling requirements

Meeting sampling requirements (7.2% of all justifications) was another argument employed by two BMJ and four SHI articles to explain their sample size. Achieving maximum variation sampling in terms of specific interviewee characteristics determined and explained the sample size of two BMJ studies (BMJ02; BMJ16 – see extract in section Meet research design requirements ).

Recruitment continued until sampling frame requirements were met for diversity in age, sex, ethnicity, frequency of attendance, and health status. (BMJ02).

Regarding the SHI articles, two papers explained their numbers on the basis of their sampling strategy (SHI01- see extract in section Saturation ; SHI23) whilst sampling requirements that would help attain sample heterogeneity in terms of a particular characteristic of interest was cited by one paper (SHI127).

The combination of matching the recruitment sites for the quantitative research and the additional purposive criteria led to 104 phase 2 interviews (Internet (OLC): 21; Internet (FTF): 20); Gyms (FTF): 23; HIV testing (FTF): 20; HIV treatment (FTF): 20.) (SHI23). Of the fifty interviews conducted, thirty were translated from Spanish into English. These thirty, from which we draw our findings, were chosen for translation based on heterogeneity in depressive symptomology and educational attainment. (SHI127).

Finally, the pre-determination of sample size on the basis of sampling requirements was stated by one article though this was not used to justify the number of interviews (SHI10).

Sample size guidelines

Five BJHP articles (BJHP28; BJHP38 – see extract in section Qualities of the analysis ; BJHP46; BJHP47; BJHP50 – see extract in section Saturation ) and one SHI paper (SHI73) relied on citing existing sample size guidelines or norms within research traditions to determine and subsequently defend their sample size (7.2% of all justifications).

Sample size guidelines suggested a range between 20 and 30 interviews to be adequate (Creswell, 1998). Interviewer and note taker agreed that thematic saturation, the point at which no new concepts emerge from subsequent interviews (Patton, 2002), was achieved following completion of 20 interviews. (BJHP28). Interviewing continued until we deemed data saturation to have been reached (the point at which no new themes were emerging). Researchers have proposed 30 as an approximate or working number of interviews at which one could expect to be reaching theoretical saturation when using a semi-structured interview approach (Morse 2000), although this can vary depending on the heterogeneity of respondents interviewed and complexity of the issues explored. (SHI73).

In line with existing research

Sample sizes of published literature in the area of the subject matter under investigation (3.5% of all justifications) were used by 2 BMJ articles as guidance and a precedent for determining and defending their own sample size (BMJ08; BMJ15 – see extract in section Pragmatic considerations ).

We drew participants from a list of prisoners who were scheduled for release each week, sampling them until we reached the target of 35 cases, with a view to achieving data saturation within the scope of the study and sufficient follow-up interviews and in line with recent studies [8–10]. (BMJ08).

Similarly, BJHP38 (see extract in section Qualities of the analysis ) claimed that its sample size was within the range of sample sizes of published studies that use its analytic approach.

Richness and volume of data

BMJ21 (see extract in section Qualities of the analysis ) and SHI32 referred to the richness, detailed nature, and volume of data collected (2.3% of all justifications) to justify the sufficiency of their sample size.

Although there were more potential interviewees from those contacted by postcode selection, it was decided to stop recruitment after the 10th interview and focus on analysis of this sample. The material collected was considerable and, given the focused nature of the study, extremely detailed. Moreover, a high degree of consensus had begun to emerge among those interviewed, and while it is always difficult to judge at what point ‘theoretical saturation’ has been reached, or how many interviews would be required to uncover exception(s), it was felt the number was sufficient to satisfy the aims of this small in-depth investigation (Strauss and Corbin 1990). (SHI32).

Meet research design requirements

Determination of sample size so that it is in line with, and serves the requirements of, the research design (2.3% of all justifications) that the study adopted was another justification used by 2 BMJ papers (BMJ16; BMJ08 – see extract in section In line with existing research ).

We aimed for diverse, maximum variation samples [20] totalling 80 respondents from different social backgrounds and ethnic groups and those bereaved due to different types of suicide and traumatic death. We could have interviewed a smaller sample at different points in time (a qualitative longitudinal study) but chose instead to seek a broad range of experiences by interviewing those bereaved many years ago and others bereaved more recently; those bereaved in different circumstances and with different relations to the deceased; and people who lived in different parts of the UK; with different support systems and coroners’ procedures (see Tables 1 and 2 for more details). (BMJ16).

Researchers’ previous experience

The researchers’ previous experience (possibly referring to experience with qualitative research) was invoked by BMJ15 (see extract in section Pragmatic considerations ) as a justification for the determination of sample size.

Nature of study

One BJHP paper argued that the sample size was appropriate for the exploratory nature of the study (BJHP38).

A sample of eight participants was deemed appropriate because of the exploratory nature of this research and the focus on identifying underlying ideas about the topic. (BJHP38).

Further sampling to check findings consistency

Finally, SHI112 argued that once it had achieved saturation of discursive patterns, further sampling was decided and conducted to check for consistency of the findings.

Within each of the age-stratified groups, interviews were randomly sampled until saturation of discursive patterns was achieved. This resulted in a sample of 67 interviews. Once this sample had been analysed, one further interview from each age-stratified group was randomly chosen to check for consistency of the findings. Using this approach it was possible to more carefully explore children’s discourse about the ‘I’, agency, relationality and power in the thematic areas, revealing the subtle discursive variations described in this article. (SHI112).

Thematic analysis of passages discussing sample size

This analysis resulted in two overarching thematic areas; the first concerned the variation in the characterisation of sample size sufficiency, and the second related to the perceived threats deriving from sample size insufficiency.

Characterisations of sample size sufficiency

The analysis showed that there were three main characterisations of the sample size in the articles that provided relevant comments and discussion: (a) the vast majority of these qualitative studies ( n  = 42) considered their sample size as ‘small’ and this was seen and discussed as a limitation; only two articles viewed their small sample size as desirable and appropriate (b) a minority of articles ( n  = 4) proclaimed that their achieved sample size was ‘sufficient’; and (c) finally, a small group of studies ( n  = 5) characterised their sample size as ‘large’. Whilst achieving a ‘large’ sample size was sometimes viewed positively because it led to richer results, there were also occasions when a large sample size was problematic rather than desirable.

‘Small’ but why and for whom?

A number of articles which characterised their sample size as ‘small’ did so against an implicit or explicit quantitative framework of reference. Interestingly, three studies that claimed to have achieved data saturation or ‘theoretical sufficiency’ with their sample size, discussed or noted as a limitation in their discussion their ‘small’ sample size, raising the question of why, or for whom, the sample size was considered small given that the qualitative criterion of saturation had been satisfied.

The current study has a number of limitations. The sample size was small (n = 11) and, however, large enough for no new themes to emerge. (BJHP39). The study has two principal limitations. The first of these relates to the small number of respondents who took part in the study. (SHI73).

Other articles appeared to accept and acknowledge that their sample was flawed because of its small size (as well as other compositional ‘deficits’ e.g. non-representativeness, biases, self-selection) or anticipated that they might be criticized for their small sample size. It seemed that the imagined audience – perhaps reviewer or reader – was one inclined to hold the tenets of quantitative research, and certainly one to whom it was important to indicate the recognition that small samples were likely to be problematic. That one’s sample might be thought small was often construed as a limitation couched in a discourse of regret or apology.

Very occasionally, the articulation of the small size as a limitation was explicitly aligned against an espoused positivist framework and quantitative research.

This study has some limitations. Firstly, the 100 incidents sample represents a small number of the total number of serious incidents that occurs every year. 26 We sent out a nationwide invitation and do not know why more people did not volunteer for the study. Our lack of epidemiological knowledge about healthcare incidents, however, means that determining an appropriate sample size continues to be difficult. (BMJ20).

Indicative of an apparent oscillation of qualitative researchers between the different requirements and protocols demarcating the quantitative and qualitative worlds, there were a few instances of articles which briefly recognised their ‘small’ sample size as a limitation, but then defended their study on more qualitative grounds, such as their ability and success at capturing the complexity of experience and delving into the idiographic, and at generating particularly rich data.

This research, while limited in size, has sought to capture some of the complexity attached to men’s attitudes and experiences concerning incomes and material circumstances. (SHI35). Our numbers are small because negotiating access to social networks was slow and labour intensive, but our methods generated exceptionally rich data. (BMJ21). This study could be criticised for using a small and unrepresentative sample. Given that older adults have been ignored in the research concerning suntanning, fair-skinned older adults are the most likely to experience skin cancer, and women privilege appearance over health when it comes to sunbathing practices, our study offers depth and richness of data in a demographic group much in need of research attention. (SHI57).

‘Good enough’ sample sizes

Only four articles expressed some degree of confidence that their achieved sample size was sufficient. For example, SHI139, in line with the justification of thematic saturation that it offered, expressed trust in its sample size sufficiency despite the poor response rate. Similarly, BJHP04, which did not provide a sample size justification, argued that it targeted a larger sample size in order to eventually recruit a sufficient number of interviewees, due to anticipated low response rate.

Twenty-three people with type I diabetes from the target population of 133 ( i.e. 17.3%) consented to participate but four did not then respond to further contacts (total N = 19). The relatively low response rate was anticipated, due to the busy life-styles of young people in the age range, the geographical constraints, and the time required to participate in a semi-structured interview, so a larger target sample allowed a sufficient number of participants to be recruited. (BJHP04).

Two other articles (BJHP35; SHI32) linked the claimed sufficiency to the scope (i.e. ‘small, in-depth investigation’), aims and nature (i.e. ‘exploratory’) of their studies, thus anchoring their numbers to the particular context of their research. Nevertheless, claims of sample size sufficiency were sometimes undermined when they were juxtaposed with an acknowledgement that a larger sample size would be more scientifically productive.

Although our sample size was sufficient for this exploratory study, a more diverse sample including participants with lower socioeconomic status and more ethnic variation would be informative. A larger sample could also ensure inclusion of a more representative range of apps operating on a wider range of platforms. (BJHP35).

‘Large’ sample sizes - Promise or peril?

Three articles (BMJ13; BJHP05; BJHP48) which all provided the justification of saturation, characterised their sample size as ‘large’ and narrated this oversufficiency in positive terms as it allowed richer data and findings and enhanced the potential for generalisation. The type of generalisation aspired to (BJHP48) was not further specified however.

This study used rich data provided by a relatively large sample of expert informants on an important but under-researched topic. (BMJ13). Qualitative research provides a unique opportunity to understand a clinical problem from the patient’s perspective. This study had a large diverse sample, recruited through a range of locations and used in-depth interviews which enhance the richness and generalizability of the results. (BJHP48).

And whilst a ‘large’ sample size was endorsed and valued by some qualitative researchers, within the psychological tradition of IPA, a ‘large’ sample size was counter-normative and therefore needed to be justified. Four BJHP studies, all adopting IPA, expressed the appropriateness or desirability of ‘small’ sample sizes (BJHP41; BJHP45) or hastened to explain why they included a larger than typical sample size (BJHP32; BJHP47). For example, BJHP32 below provides a rationale for how an IPA study can accommodate a large sample size and how this was indeed suitable for the purposes of the particular research. To strengthen the explanation for choosing a non-normative sample size, previous IPA research citing a similar sample size approach is used as a precedent.

Small scale IPA studies allow in-depth analysis which would not be possible with larger samples (Smith et al. , 2009). (BJHP41). Although IPA generally involves intense scrutiny of a small number of transcripts, it was decided to recruit a larger diverse sample as this is the first qualitative study of this population in the United Kingdom (as far as we know) and we wanted to gain an overview. Indeed, Smith, Flowers, and Larkin (2009) agree that IPA is suitable for larger groups. However, the emphasis changes from an in-depth individualistic analysis to one in which common themes from shared experiences of a group of people can be elicited and used to understand the network of relationships between themes that emerge from the interviews. This large-scale format of IPA has been used by other researchers in the field of false-positive research. Baillie, Smith, Hewison, and Mason (2000) conducted an IPA study, with 24 participants, of ultrasound screening for chromosomal abnormality; they found that this larger number of participants enabled them to produce a more refined and cohesive account. (BJHP32).

The IPA articles found in the BJHP were the only instances where a ‘small’ sample size was advocated and a ‘large’ sample size problematized and defended. These IPA studies illustrate that the characterisation of sample size sufficiency can be a function of researchers’ theoretical and epistemological commitments rather than the result of an ‘objective’ sample size assessment.

Threats from sample size insufficiency

As shown above, the majority of articles that commented on their sample size, simultaneously characterized it as small and problematic. On those occasions that authors did not simply cite their ‘small’ sample size as a study limitation but rather continued and provided an account of how and why a small sample size was problematic, two important scientific qualities of the research seemed to be threatened: the generalizability and validity of results.

Generalizability

Those who characterised their sample as ‘small’ connected this to the limited potential for generalization of the results. Other features related to the sample – often some kind of compositional particularity – were also linked to limited potential for generalisation. Though not always explicitly articulated to what form of generalisation the articles referred to (see BJHP09), generalisation was mostly conceived in nomothetic terms, that is, it concerned the potential to draw inferences from the sample to the broader study population (‘representational generalisation’ – see BJHP31) and less often to other populations or cultures.

It must be noted that samples are small and whilst in both groups the majority of those women eligible participated, generalizability cannot be assumed. (BJHP09). The study’s limitations should be acknowledged: Data are presented from interviews with a relatively small group of participants, and thus, the views are not necessarily generalizable to all patients and clinicians. In particular, patients were only recruited from secondary care services where COFP diagnoses are typically confirmed. The sample therefore is unlikely to represent the full spectrum of patients, particularly those who are not referred to, or who have been discharged from dental services. (BJHP31).

Without explicitly using the term generalisation, two SHI articles noted how their ‘small’ sample size imposed limits on ‘the extent that we can extrapolate from these participants’ accounts’ (SHI114) or to the possibility ‘to draw far-reaching conclusions from the results’ (SHI124).

Interestingly, only a minority of articles alluded to, or invoked, a type of generalisation that is aligned with qualitative research, that is, idiographic generalisation (i.e. generalisation that can be made from and about cases [ 5 ]). These articles, all published in the discipline of sociology, defended their findings in terms of the possibility of drawing logical and conceptual inferences to other contexts and of generating understanding that has the potential to advance knowledge, despite their ‘small’ size. One article (SHI139) clearly contrasted nomothetic (statistical) generalisation to idiographic generalisation, arguing that the lack of statistical generalizability does not nullify the ability of qualitative research to still be relevant beyond the sample studied.

Further, these data do not need to be statistically generalisable for us to draw inferences that may advance medicalisation analyses (Charmaz 2014). These data may be seen as an opportunity to generate further hypotheses and are a unique application of the medicalisation framework. (SHI139). Although a small-scale qualitative study related to school counselling, this analysis can be usefully regarded as a case study of the successful utilisation of mental health-related resources by adolescents. As many of the issues explored are of relevance to mental health stigma more generally, it may also provide insights into adult engagement in services. It shows how a sociological analysis, which uses positioning theory to examine how people negotiate, partially accept and simultaneously resist stigmatisation in relation to mental health concerns, can contribute to an elucidation of the social processes and narrative constructions which may maintain as well as bridge the mental health service gap. (SHI103).

Only one article (SHI30) used the term transferability to argue for the potential of wider relevance of the results which was thought to be more the product of the composition of the sample (i.e. diverse sample), rather than the sample size.

The second major concern that arose from a ‘small’ sample size pertained to the internal validity of findings (i.e. here the term is used to denote the ‘truth’ or credibility of research findings). Authors expressed uncertainty about the degree of confidence in particular aspects or patterns of their results, primarily those that concerned some form of differentiation on the basis of relevant participant characteristics.

The information source preferred seemed to vary according to parents’ education; however, the sample size is too small to draw conclusions about such patterns. (SHI80). Although our numbers were too small to demonstrate gender differences with any certainty, it does seem that the biomedical and erotic scripts may be more common in the accounts of men and the relational script more common in the accounts of women. (SHI81).

In other instances, articles expressed uncertainty about whether their results accounted for the full spectrum and variation of the phenomenon under investigation. In other words, a ‘small’ sample size (alongside compositional ‘deficits’ such as a not statistically representative sample) was seen to threaten the ‘content validity’ of the results which in turn led to constructions of the study conclusions as tentative.

Data collection ceased on pragmatic grounds rather than when no new information appeared to be obtained ( i.e. , saturation point). As such, care should be taken not to overstate the findings. Whilst the themes from the initial interviews seemed to be replicated in the later interviews, further interviews may have identified additional themes or provided more nuanced explanations. (BJHP53). …it should be acknowledged that this study was based on a small sample of self-selected couples in enduring marriages who were not broadly representative of the population. Thus, participants may not be representative of couples that experience postnatal PTSD. It is therefore unlikely that all the key themes have been identified and explored. For example, couples who were excluded from the study because the male partner declined to participate may have been experiencing greater interpersonal difficulties. (BJHP03).

In other instances, articles attempted to preserve a degree of credibility of their results, despite the recognition that the sample size was ‘small’. Clarity and sharpness of emerging themes and alignment with previous relevant work were the arguments employed to warrant the validity of the results.

This study focused on British Chinese carers of patients with affective disorders, using a qualitative methodology to synthesise the sociocultural representations of illness within this community. Despite the small sample size, clear themes emerged from the narratives that were sufficient for this exploratory investigation. (SHI98).

The present study sought to examine how qualitative sample sizes in health-related research are characterised and justified. In line with previous studies [ 22 , 30 , 33 , 34 ] the findings demonstrate that reporting of sample size sufficiency is limited; just over 50% of articles in the BMJ and BJHP and 82% in the SHI did not provide any sample size justification. Providing a sample size justification was not related to the number of interviews conducted, but it was associated with the journal that the article was published in, indicating the influence of disciplinary or publishing norms, also reported in prior research [ 30 ]. This lack of transparency about sample size sufficiency is problematic given that most qualitative researchers would agree that it is an important marker of quality [ 56 , 57 ]. Moreover, and with the rise of qualitative research in social sciences, efforts to synthesise existing evidence and assess its quality are obstructed by poor reporting [ 58 , 59 ].

When authors justified their sample size, our findings indicate that sufficiency was mostly appraised with reference to features that were intrinsic to the study, in agreement with general advice on sample size determination [ 4 , 11 , 36 ]. The principle of saturation was the most commonly invoked argument [ 22 ] accounting for 55% of all justifications. A wide range of variants of saturation was evident corroborating the proliferation of the meaning of the term [ 49 ] and reflecting different underlying conceptualisations or models of saturation [ 20 ]. Nevertheless, claims of saturation were never substantiated in relation to procedures conducted in the study itself, endorsing similar observations in the literature [ 25 , 30 , 47 ]. Claims of saturation were sometimes supported with citations of other literature, suggesting a removal of the concept away from the characteristics of the study at hand. Pragmatic considerations, such as resource constraints or participant response rate and availability, was the second most frequently used argument accounting for approximately 10% of justifications and another 23% of justifications also represented intrinsic-to-the-study characteristics (i.e. qualities of the analysis, meeting sampling or research design requirements, richness and volume of the data obtained, nature of study, further sampling to check findings consistency).

Only, 12% of mentions of sample size justification pertained to arguments that were external to the study at hand, in the form of existing sample size guidelines and prior research that sets precedents. Whilst community norms and prior research can establish useful rules of thumb for estimating sample sizes [ 60 ] – and reveal what sizes are more likely to be acceptable within research communities – researchers should avoid adopting these norms uncritically, especially when such guidelines [e.g. 30 , 35 ], might be based on research that does not provide adequate evidence of sample size sufficiency. Similarly, whilst methodological research that seeks to demonstrate the achievement of saturation is invaluable since it explicates the parameters upon which saturation is contingent and indicates when a research project is likely to require a smaller or a larger sample [e.g. 29 ], specific numbers at which saturation was achieved within these projects cannot be routinely extrapolated for other projects. We concur with existing views [ 11 , 36 ] that the consideration of the characteristics of the study at hand, such as the epistemological and theoretical approach, the nature of the phenomenon under investigation, the aims and scope of the study, the quality and richness of data, or the researcher’s experience and skills of conducting qualitative research, should be the primary guide in determining sample size and assessing its sufficiency.

Moreover, although numbers in qualitative research are not unimportant [ 61 ], sample size should not be considered alone but be embedded in the more encompassing examination of data adequacy [ 56 , 57 ]. Erickson’s [ 62 ] dimensions of ‘evidentiary adequacy’ are useful here. He explains the concept in terms of adequate amounts of evidence, adequate variety in kinds of evidence, adequate interpretive status of evidence, adequate disconfirming evidence, and adequate discrepant case analysis. All dimensions might not be relevant across all qualitative research designs, but this illustrates the thickness of the concept of data adequacy, taking it beyond sample size.

The present research also demonstrated that sample sizes were commonly seen as ‘small’ and insufficient and discussed as limitation. Often unjustified (and in two cases incongruent with their own claims of saturation) these findings imply that sample size in qualitative health research is often adversely judged (or expected to be judged) against an implicit, yet omnipresent, quasi-quantitative standpoint. Indeed there were a few instances in our data where authors appeared, possibly in response to reviewers, to resist to some sort of quantification of their results. This implicit reference point became more apparent when authors discussed the threats deriving from an insufficient sample size. Whilst the concerns about internal validity might be legitimate to the extent that qualitative research projects, which are broadly related to realism, are set to examine phenomena in sufficient breadth and depth, the concerns around generalizability revealed a conceptualisation that is not compatible with purposive sampling. The limited potential for generalisation, as a result of a small sample size, was often discussed in nomothetic, statistical terms. Only occasionally was analytic or idiographic generalisation invoked to warrant the value of the study’s findings [ 5 , 17 ].

Strengths and limitations of the present study

We note, first, the limited number of health-related journals reviewed, so that only a ‘snapshot’ of qualitative health research has been captured. Examining additional disciplines (e.g. nursing sciences) as well as inter-disciplinary journals would add to the findings of this analysis. Nevertheless, our study is the first to provide some comparative insights on the basis of disciplines that are differently attached to the legacy of positivism and analysed literature published over a lengthy period of time (15 years). Guetterman [ 27 ] also examined health-related literature but this analysis was restricted to 26 most highly cited articles published over a period of five years whilst Carlsen and Glenton’s [ 22 ] study concentrated on focus groups health research. Moreover, although it was our intention to examine sample size justification in relation to the epistemological and theoretical positions of articles, this proved to be challenging largely due to absence of relevant information, or the difficulty into discerning clearly articles’ positions [ 63 ] and classifying them under specific approaches (e.g. studies often combined elements from different theoretical and epistemological traditions). We believe that such an analysis would yield useful insights as it links the methodological issue of sample size to the broader philosophical stance of the research. Despite these limitations, the analysis of the characterisation of sample size and of the threats seen to accrue from insufficient sample size, enriches our understanding of sample size (in)sufficiency argumentation by linking it to other features of the research. As the peer-review process becomes increasingly public, future research could usefully examine how reporting around sample size sufficiency and data adequacy might be influenced by the interactions between authors and reviewers.

The past decade has seen a growing appetite in qualitative research for an evidence-based approach to sample size determination and to evaluations of the sufficiency of sample size. Despite the conceptual and methodological developments in the area, the findings of the present study confirm previous studies in concluding that appraisals of sample size sufficiency are either absent or poorly substantiated. To ensure and maintain high quality research that will encourage greater appreciation of qualitative work in health-related sciences [ 64 ], we argue that qualitative researchers should be more transparent and thorough in their evaluation of sample size as part of their appraisal of data adequacy. We would encourage the practice of appraising sample size sufficiency with close reference to the study at hand and would thus caution against responding to the growing methodological research in this area with a decontextualised application of sample size numerical guidelines, norms and principles. Although researchers might find sample size community norms serve as useful rules of thumb, we recommend methodological knowledge is used to critically consider how saturation and other parameters that affect sample size sufficiency pertain to the specifics of the particular project. Those reviewing papers have a vital role in encouraging transparent study-specific reporting. The review process should support authors to exercise nuanced judgments in decisions about sample size determination in the context of the range of factors that influence sample size sufficiency and the specifics of a particular study. In light of the growing methodological evidence in the area, transparent presentation of such evidence-based judgement is crucial and in time should surely obviate the seemingly routine practice of citing the ‘small’ size of qualitative samples among the study limitations.

A non-parametric test of difference for independent samples was performed since the variable number of interviews violated assumptions of normality according to the standardized scores of skewness and kurtosis (BMJ: z skewness = 3.23, z kurtosis = 1.52; BJHP: z skewness = 4.73, z kurtosis = 4.85; SHI: z skewness = 12.04, z kurtosis = 21.72) and the Shapiro-Wilk test of normality ( p  < .001).

Abbreviations

British Journal of Health Psychology

British Medical Journal

Interpretative Phenomenological Analysis

Sociology of Health & Illness

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Acknowledgments

We would like to thank Dr. Paula Smith and Katharine Lee for their comments on a previous draft of this paper as well as Natalie Ann Mitchell and Meron Teferra for assisting us with data extraction.

This research was initially conceived of and partly conducted with financial support from the Multidisciplinary Assessment of Technology Centre for Healthcare (MATCH) programme (EP/F063822/1 and EP/G012393/1). The research continued and was completed independent of any support. The funding body did not have any role in the study design, the collection, analysis and interpretation of the data, in the writing of the paper, and in the decision to submit the manuscript for publication. The views expressed are those of the authors alone.

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JB and TY conceived the study; KV, JB, and TY designed the study; KV identified the articles and extracted the data; KV and JB assessed eligibility of articles; KV, JB, ST, and TY contributed to the analysis of the data, discussed the findings and early drafts of the paper; KV developed the final manuscript; KV, JB, ST, and TY read and approved the manuscript.

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Editorial positions on qualitative research and sample considerations (where available). (DOCX 12 kb)

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List of eligible articles included in the review ( N  = 214). (DOCX 38 kb)

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Citations used by articles to support their position on saturation. (DOCX 14 kb)

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Vasileiou, K., Barnett, J., Thorpe, S. et al. Characterising and justifying sample size sufficiency in interview-based studies: systematic analysis of qualitative health research over a 15-year period. BMC Med Res Methodol 18 , 148 (2018). https://doi.org/10.1186/s12874-018-0594-7

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What is Qualitative in Qualitative Research

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What is qualitative research? If we look for a precise definition of qualitative research, and specifically for one that addresses its distinctive feature of being “qualitative,” the literature is meager. In this article we systematically search, identify and analyze a sample of 89 sources using or attempting to define the term “qualitative.” Then, drawing on ideas we find scattered across existing work, and based on Becker’s classic study of marijuana consumption, we formulate and illustrate a definition that tries to capture its core elements. We define qualitative research as an iterative process in which improved understanding to the scientific community is achieved by making new significant distinctions resulting from getting closer to the phenomenon studied. This formulation is developed as a tool to help improve research designs while stressing that a qualitative dimension is present in quantitative work as well. Additionally, it can facilitate teaching, communication between researchers, diminish the gap between qualitative and quantitative researchers, help to address critiques of qualitative methods, and be used as a standard of evaluation of qualitative research.

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What is Qualitative in Research

Unsettling definitions of qualitative research, what is “qualitative” in qualitative research why the answer does not matter but the question is important.

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If we assume that there is something called qualitative research, what exactly is this qualitative feature? And how could we evaluate qualitative research as good or not? Is it fundamentally different from quantitative research? In practice, most active qualitative researchers working with empirical material intuitively know what is involved in doing qualitative research, yet perhaps surprisingly, a clear definition addressing its key feature is still missing.

To address the question of what is qualitative we turn to the accounts of “qualitative research” in textbooks and also in empirical work. In his classic, explorative, interview study of deviance Howard Becker ( 1963 ) asks ‘How does one become a marijuana user?’ In contrast to pre-dispositional and psychological-individualistic theories of deviant behavior, Becker’s inherently social explanation contends that becoming a user of this substance is the result of a three-phase sequential learning process. First, potential users need to learn how to smoke it properly to produce the “correct” effects. If not, they are likely to stop experimenting with it. Second, they need to discover the effects associated with it; in other words, to get “high,” individuals not only have to experience what the drug does, but also to become aware that those sensations are related to using it. Third, they require learning to savor the feelings related to its consumption – to develop an acquired taste. Becker, who played music himself, gets close to the phenomenon by observing, taking part, and by talking to people consuming the drug: “half of the fifty interviews were conducted with musicians, the other half covered a wide range of people, including laborers, machinists, and people in the professions” (Becker 1963 :56).

Another central aspect derived through the common-to-all-research interplay between induction and deduction (Becker 2017 ), is that during the course of his research Becker adds scientifically meaningful new distinctions in the form of three phases—distinctions, or findings if you will, that strongly affect the course of his research: its focus, the material that he collects, and which eventually impact his findings. Each phase typically unfolds through social interaction, and often with input from experienced users in “a sequence of social experiences during which the person acquires a conception of the meaning of the behavior, and perceptions and judgments of objects and situations, all of which make the activity possible and desirable” (Becker 1963 :235). In this study the increased understanding of smoking dope is a result of a combination of the meaning of the actors, and the conceptual distinctions that Becker introduces based on the views expressed by his respondents. Understanding is the result of research and is due to an iterative process in which data, concepts and evidence are connected with one another (Becker 2017 ).

Indeed, there are many definitions of qualitative research, but if we look for a definition that addresses its distinctive feature of being “qualitative,” the literature across the broad field of social science is meager. The main reason behind this article lies in the paradox, which, to put it bluntly, is that researchers act as if they know what it is, but they cannot formulate a coherent definition. Sociologists and others will of course continue to conduct good studies that show the relevance and value of qualitative research addressing scientific and practical problems in society. However, our paper is grounded in the idea that providing a clear definition will help us improve the work that we do. Among researchers who practice qualitative research there is clearly much knowledge. We suggest that a definition makes this knowledge more explicit. If the first rationale for writing this paper refers to the “internal” aim of improving qualitative research, the second refers to the increased “external” pressure that especially many qualitative researchers feel; pressure that comes both from society as well as from other scientific approaches. There is a strong core in qualitative research, and leading researchers tend to agree on what it is and how it is done. Our critique is not directed at the practice of qualitative research, but we do claim that the type of systematic work we do has not yet been done, and that it is useful to improve the field and its status in relation to quantitative research.

The literature on the “internal” aim of improving, or at least clarifying qualitative research is large, and we do not claim to be the first to notice the vagueness of the term “qualitative” (Strauss and Corbin 1998 ). Also, others have noted that there is no single definition of it (Long and Godfrey 2004 :182), that there are many different views on qualitative research (Denzin and Lincoln 2003 :11; Jovanović 2011 :3), and that more generally, we need to define its meaning (Best 2004 :54). Strauss and Corbin ( 1998 ), for example, as well as Nelson et al. (1992:2 cited in Denzin and Lincoln 2003 :11), and Flick ( 2007 :ix–x), have recognized that the term is problematic: “Actually, the term ‘qualitative research’ is confusing because it can mean different things to different people” (Strauss and Corbin 1998 :10–11). Hammersley has discussed the possibility of addressing the problem, but states that “the task of providing an account of the distinctive features of qualitative research is far from straightforward” ( 2013 :2). This confusion, as he has recently further argued (Hammersley 2018 ), is also salient in relation to ethnography where different philosophical and methodological approaches lead to a lack of agreement about what it means.

Others (e.g. Hammersley 2018 ; Fine and Hancock 2017 ) have also identified the treat to qualitative research that comes from external forces, seen from the point of view of “qualitative research.” This threat can be further divided into that which comes from inside academia, such as the critique voiced by “quantitative research” and outside of academia, including, for example, New Public Management. Hammersley ( 2018 ), zooming in on one type of qualitative research, ethnography, has argued that it is under treat. Similarly to Fine ( 2003 ), and before him Gans ( 1999 ), he writes that ethnography’ has acquired a range of meanings, and comes in many different versions, these often reflecting sharply divergent epistemological orientations. And already more than twenty years ago while reviewing Denzin and Lincoln’ s Handbook of Qualitative Methods Fine argued:

While this increasing centrality [of qualitative research] might lead one to believe that consensual standards have developed, this belief would be misleading. As the methodology becomes more widely accepted, querulous challengers have raised fundamental questions that collectively have undercut the traditional models of how qualitative research is to be fashioned and presented (1995:417).

According to Hammersley, there are today “serious treats to the practice of ethnographic work, on almost any definition” ( 2018 :1). He lists five external treats: (1) that social research must be accountable and able to show its impact on society; (2) the current emphasis on “big data” and the emphasis on quantitative data and evidence; (3) the labor market pressure in academia that leaves less time for fieldwork (see also Fine and Hancock 2017 ); (4) problems of access to fields; and (5) the increased ethical scrutiny of projects, to which ethnography is particularly exposed. Hammersley discusses some more or less insufficient existing definitions of ethnography.

The current situation, as Hammersley and others note—and in relation not only to ethnography but also qualitative research in general, and as our empirical study shows—is not just unsatisfactory, it may even be harmful for the entire field of qualitative research, and does not help social science at large. We suggest that the lack of clarity of qualitative research is a real problem that must be addressed.

Towards a Definition of Qualitative Research

Seen in an historical light, what is today called qualitative, or sometimes ethnographic, interpretative research – or a number of other terms – has more or less always existed. At the time the founders of sociology – Simmel, Weber, Durkheim and, before them, Marx – were writing, and during the era of the Methodenstreit (“dispute about methods”) in which the German historical school emphasized scientific methods (cf. Swedberg 1990 ), we can at least speak of qualitative forerunners.

Perhaps the most extended discussion of what later became known as qualitative methods in a classic work is Bronisław Malinowski’s ( 1922 ) Argonauts in the Western Pacific , although even this study does not explicitly address the meaning of “qualitative.” In Weber’s ([1921–-22] 1978) work we find a tension between scientific explanations that are based on observation and quantification and interpretative research (see also Lazarsfeld and Barton 1982 ).

If we look through major sociology journals like the American Sociological Review , American Journal of Sociology , or Social Forces we will not find the term qualitative sociology before the 1970s. And certainly before then much of what we consider qualitative classics in sociology, like Becker’ study ( 1963 ), had already been produced. Indeed, the Chicago School often combined qualitative and quantitative data within the same study (Fine 1995 ). Our point being that before a disciplinary self-awareness the term quantitative preceded qualitative, and the articulation of the former was a political move to claim scientific status (Denzin and Lincoln 2005 ). In the US the World War II seem to have sparked a critique of sociological work, including “qualitative work,” that did not follow the scientific canon (Rawls 2018 ), which was underpinned by a scientifically oriented and value free philosophy of science. As a result the attempts and practice of integrating qualitative and quantitative sociology at Chicago lost ground to sociology that was more oriented to surveys and quantitative work at Columbia under Merton-Lazarsfeld. The quantitative tradition was also able to present textbooks (Lundberg 1951 ) that facilitated the use this approach and its “methods.” The practices of the qualitative tradition, by and large, remained tacit or was part of the mentoring transferred from the renowned masters to their students.

This glimpse into history leads us back to the lack of a coherent account condensed in a definition of qualitative research. Many of the attempts to define the term do not meet the requirements of a proper definition: A definition should be clear, avoid tautology, demarcate its domain in relation to the environment, and ideally only use words in its definiens that themselves are not in need of definition (Hempel 1966 ). A definition can enhance precision and thus clarity by identifying the core of the phenomenon. Preferably, a definition should be short. The typical definition we have found, however, is an ostensive definition, which indicates what qualitative research is about without informing us about what it actually is :

Qualitative research is multimethod in focus, involving an interpretative, naturalistic approach to its subject matter. This means that qualitative researchers study things in their natural settings, attempting to make sense of, or interpret, phenomena in terms of the meanings people bring to them. Qualitative research involves the studied use and collection of a variety of empirical materials – case study, personal experience, introspective, life story, interview, observational, historical, interactional, and visual texts – that describe routine and problematic moments and meanings in individuals’ lives. (Denzin and Lincoln 2005 :2)

Flick claims that the label “qualitative research” is indeed used as an umbrella for a number of approaches ( 2007 :2–4; 2002 :6), and it is not difficult to identify research fitting this designation. Moreover, whatever it is, it has grown dramatically over the past five decades. In addition, courses have been developed, methods have flourished, arguments about its future have been advanced (for example, Denzin and Lincoln 1994) and criticized (for example, Snow and Morrill 1995 ), and dedicated journals and books have mushroomed. Most social scientists have a clear idea of research and how it differs from journalism, politics and other activities. But the question of what is qualitative in qualitative research is either eluded or eschewed.

We maintain that this lacuna hinders systematic knowledge production based on qualitative research. Paul Lazarsfeld noted the lack of “codification” as early as 1955 when he reviewed 100 qualitative studies in order to offer a codification of the practices (Lazarsfeld and Barton 1982 :239). Since then many texts on “qualitative research” and its methods have been published, including recent attempts (Goertz and Mahoney 2012 ) similar to Lazarsfeld’s. These studies have tried to extract what is qualitative by looking at the large number of empirical “qualitative” studies. Our novel strategy complements these endeavors by taking another approach and looking at the attempts to codify these practices in the form of a definition, as well as to a minor extent take Becker’s study as an exemplar of what qualitative researchers actually do, and what the characteristic of being ‘qualitative’ denotes and implies. We claim that qualitative researchers, if there is such a thing as “qualitative research,” should be able to codify their practices in a condensed, yet general way expressed in language.

Lingering problems of “generalizability” and “how many cases do I need” (Small 2009 ) are blocking advancement – in this line of work qualitative approaches are said to differ considerably from quantitative ones, while some of the former unsuccessfully mimic principles related to the latter (Small 2009 ). Additionally, quantitative researchers sometimes unfairly criticize the first based on their own quality criteria. Scholars like Goertz and Mahoney ( 2012 ) have successfully focused on the different norms and practices beyond what they argue are essentially two different cultures: those working with either qualitative or quantitative methods. Instead, similarly to Becker ( 2017 ) who has recently questioned the usefulness of the distinction between qualitative and quantitative research, we focus on similarities.

The current situation also impedes both students and researchers in focusing their studies and understanding each other’s work (Lazarsfeld and Barton 1982 :239). A third consequence is providing an opening for critiques by scholars operating within different traditions (Valsiner 2000 :101). A fourth issue is that the “implicit use of methods in qualitative research makes the field far less standardized than the quantitative paradigm” (Goertz and Mahoney 2012 :9). Relatedly, the National Science Foundation in the US organized two workshops in 2004 and 2005 to address the scientific foundations of qualitative research involving strategies to improve it and to develop standards of evaluation in qualitative research. However, a specific focus on its distinguishing feature of being “qualitative” while being implicitly acknowledged, was discussed only briefly (for example, Best 2004 ).

In 2014 a theme issue was published in this journal on “Methods, Materials, and Meanings: Designing Cultural Analysis,” discussing central issues in (cultural) qualitative research (Berezin 2014 ; Biernacki 2014 ; Glaeser 2014 ; Lamont and Swidler 2014 ; Spillman 2014). We agree with many of the arguments put forward, such as the risk of methodological tribalism, and that we should not waste energy on debating methods separated from research questions. Nonetheless, a clarification of the relation to what is called “quantitative research” is of outmost importance to avoid misunderstandings and misguided debates between “qualitative” and “quantitative” researchers. Our strategy means that researchers, “qualitative” or “quantitative” they may be, in their actual practice may combine qualitative work and quantitative work.

In this article we accomplish three tasks. First, we systematically survey the literature for meanings of qualitative research by looking at how researchers have defined it. Drawing upon existing knowledge we find that the different meanings and ideas of qualitative research are not yet coherently integrated into one satisfactory definition. Next, we advance our contribution by offering a definition of qualitative research and illustrate its meaning and use partially by expanding on the brief example introduced earlier related to Becker’s work ( 1963 ). We offer a systematic analysis of central themes of what researchers consider to be the core of “qualitative,” regardless of style of work. These themes – which we summarize in terms of four keywords: distinction, process, closeness, improved understanding – constitute part of our literature review, in which each one appears, sometimes with others, but never all in the same definition. They serve as the foundation of our contribution. Our categories are overlapping. Their use is primarily to organize the large amount of definitions we have identified and analyzed, and not necessarily to draw a clear distinction between them. Finally, we continue the elaboration discussed above on the advantages of a clear definition of qualitative research.

In a hermeneutic fashion we propose that there is something meaningful that deserves to be labelled “qualitative research” (Gadamer 1990 ). To approach the question “What is qualitative in qualitative research?” we have surveyed the literature. In conducting our survey we first traced the word’s etymology in dictionaries, encyclopedias, handbooks of the social sciences and of methods and textbooks, mainly in English, which is common to methodology courses. It should be noted that we have zoomed in on sociology and its literature. This discipline has been the site of the largest debate and development of methods that can be called “qualitative,” which suggests that this field should be examined in great detail.

In an ideal situation we should expect that one good definition, or at least some common ideas, would have emerged over the years. This common core of qualitative research should be so accepted that it would appear in at least some textbooks. Since this is not what we found, we decided to pursue an inductive approach to capture maximal variation in the field of qualitative research; we searched in a selection of handbooks, textbooks, book chapters, and books, to which we added the analysis of journal articles. Our sample comprises a total of 89 references.

In practice we focused on the discipline that has had a clear discussion of methods, namely sociology. We also conducted a broad search in the JSTOR database to identify scholarly sociology articles published between 1998 and 2017 in English with a focus on defining or explaining qualitative research. We specifically zoom in on this time frame because we would have expect that this more mature period would have produced clear discussions on the meaning of qualitative research. To find these articles we combined a number of keywords to search the content and/or the title: qualitative (which was always included), definition, empirical, research, methodology, studies, fieldwork, interview and observation .

As a second phase of our research we searched within nine major sociological journals ( American Journal of Sociology , Sociological Theory , American Sociological Review , Contemporary Sociology , Sociological Forum , Sociological Theory , Qualitative Research , Qualitative Sociology and Qualitative Sociology Review ) for articles also published during the past 19 years (1998–2017) that had the term “qualitative” in the title and attempted to define qualitative research.

Lastly we picked two additional journals, Qualitative Research and Qualitative Sociology , in which we could expect to find texts addressing the notion of “qualitative.” From Qualitative Research we chose Volume 14, Issue 6, December 2014, and from Qualitative Sociology we chose Volume 36, Issue 2, June 2017. Within each of these we selected the first article; then we picked the second article of three prior issues. Again we went back another three issues and investigated article number three. Finally we went back another three issues and perused article number four. This selection criteria was used to get a manageable sample for the analysis.

The coding process of the 89 references we gathered in our selected review began soon after the first round of material was gathered, and we reduced the complexity created by our maximum variation sampling (Snow and Anderson 1993 :22) to four different categories within which questions on the nature and properties of qualitative research were discussed. We call them: Qualitative and Quantitative Research, Qualitative Research, Fieldwork, and Grounded Theory. This – which may appear as an illogical grouping – merely reflects the “context” in which the matter of “qualitative” is discussed. If the selection process of the material – books and articles – was informed by pre-knowledge, we used an inductive strategy to code the material. When studying our material, we identified four central notions related to “qualitative” that appear in various combinations in the literature which indicate what is the core of qualitative research. We have labeled them: “distinctions”, “process,” “closeness,” and “improved understanding.” During the research process the categories and notions were improved, refined, changed, and reordered. The coding ended when a sense of saturation in the material arose. In the presentation below all quotations and references come from our empirical material of texts on qualitative research.

Analysis – What is Qualitative Research?

In this section we describe the four categories we identified in the coding, how they differently discuss qualitative research, as well as their overall content. Some salient quotations are selected to represent the type of text sorted under each of the four categories. What we present are examples from the literature.

Qualitative and Quantitative

This analytic category comprises quotations comparing qualitative and quantitative research, a distinction that is frequently used (Brown 2010 :231); in effect this is a conceptual pair that structures the discussion and that may be associated with opposing interests. While the general goal of quantitative and qualitative research is the same – to understand the world better – their methodologies and focus in certain respects differ substantially (Becker 1966 :55). Quantity refers to that property of something that can be determined by measurement. In a dictionary of Statistics and Methodology we find that “(a) When referring to *variables, ‘qualitative’ is another term for *categorical or *nominal. (b) When speaking of kinds of research, ‘qualitative’ refers to studies of subjects that are hard to quantify, such as art history. Qualitative research tends to be a residual category for almost any kind of non-quantitative research” (Stiles 1998:183). But it should be obvious that one could employ a quantitative approach when studying, for example, art history.

The same dictionary states that quantitative is “said of variables or research that can be handled numerically, usually (too sharply) contrasted with *qualitative variables and research” (Stiles 1998:184). From a qualitative perspective “quantitative research” is about numbers and counting, and from a quantitative perspective qualitative research is everything that is not about numbers. But this does not say much about what is “qualitative.” If we turn to encyclopedias we find that in the 1932 edition of the Encyclopedia of the Social Sciences there is no mention of “qualitative.” In the Encyclopedia from 1968 we can read:

Qualitative Analysis. For methods of obtaining, analyzing, and describing data, see [the various entries:] CONTENT ANALYSIS; COUNTED DATA; EVALUATION RESEARCH, FIELD WORK; GRAPHIC PRESENTATION; HISTORIOGRAPHY, especially the article on THE RHETORIC OF HISTORY; INTERVIEWING; OBSERVATION; PERSONALITY MEASUREMENT; PROJECTIVE METHODS; PSYCHOANALYSIS, article on EXPERIMENTAL METHODS; SURVEY ANALYSIS, TABULAR PRESENTATION; TYPOLOGIES. (Vol. 13:225)

Some, like Alford, divide researchers into methodologists or, in his words, “quantitative and qualitative specialists” (Alford 1998 :12). Qualitative research uses a variety of methods, such as intensive interviews or in-depth analysis of historical materials, and it is concerned with a comprehensive account of some event or unit (King et al. 1994 :4). Like quantitative research it can be utilized to study a variety of issues, but it tends to focus on meanings and motivations that underlie cultural symbols, personal experiences, phenomena and detailed understanding of processes in the social world. In short, qualitative research centers on understanding processes, experiences, and the meanings people assign to things (Kalof et al. 2008 :79).

Others simply say that qualitative methods are inherently unscientific (Jovanović 2011 :19). Hood, for instance, argues that words are intrinsically less precise than numbers, and that they are therefore more prone to subjective analysis, leading to biased results (Hood 2006 :219). Qualitative methodologies have raised concerns over the limitations of quantitative templates (Brady et al. 2004 :4). Scholars such as King et al. ( 1994 ), for instance, argue that non-statistical research can produce more reliable results if researchers pay attention to the rules of scientific inference commonly stated in quantitative research. Also, researchers such as Becker ( 1966 :59; 1970 :42–43) have asserted that, if conducted properly, qualitative research and in particular ethnographic field methods, can lead to more accurate results than quantitative studies, in particular, survey research and laboratory experiments.

Some researchers, such as Kalof, Dan, and Dietz ( 2008 :79) claim that the boundaries between the two approaches are becoming blurred, and Small ( 2009 ) argues that currently much qualitative research (especially in North America) tries unsuccessfully and unnecessarily to emulate quantitative standards. For others, qualitative research tends to be more humanistic and discursive (King et al. 1994 :4). Ragin ( 1994 ), and similarly also Becker, ( 1996 :53), Marchel and Owens ( 2007 :303) think that the main distinction between the two styles is overstated and does not rest on the simple dichotomy of “numbers versus words” (Ragin 1994 :xii). Some claim that quantitative data can be utilized to discover associations, but in order to unveil cause and effect a complex research design involving the use of qualitative approaches needs to be devised (Gilbert 2009 :35). Consequently, qualitative data are useful for understanding the nuances lying beyond those processes as they unfold (Gilbert 2009 :35). Others contend that qualitative research is particularly well suited both to identify causality and to uncover fine descriptive distinctions (Fine and Hallett 2014 ; Lichterman and Isaac Reed 2014 ; Katz 2015 ).

There are other ways to separate these two traditions, including normative statements about what qualitative research should be (that is, better or worse than quantitative approaches, concerned with scientific approaches to societal change or vice versa; Snow and Morrill 1995 ; Denzin and Lincoln 2005 ), or whether it should develop falsifiable statements; Best 2004 ).

We propose that quantitative research is largely concerned with pre-determined variables (Small 2008 ); the analysis concerns the relations between variables. These categories are primarily not questioned in the study, only their frequency or degree, or the correlations between them (cf. Franzosi 2016 ). If a researcher studies wage differences between women and men, he or she works with given categories: x number of men are compared with y number of women, with a certain wage attributed to each person. The idea is not to move beyond the given categories of wage, men and women; they are the starting point as well as the end point, and undergo no “qualitative change.” Qualitative research, in contrast, investigates relations between categories that are themselves subject to change in the research process. Returning to Becker’s study ( 1963 ), we see that he questioned pre-dispositional theories of deviant behavior working with pre-determined variables such as an individual’s combination of personal qualities or emotional problems. His take, in contrast, was to understand marijuana consumption by developing “variables” as part of the investigation. Thereby he presented new variables, or as we would say today, theoretical concepts, but which are grounded in the empirical material.

Qualitative Research

This category contains quotations that refer to descriptions of qualitative research without making comparisons with quantitative research. Researchers such as Denzin and Lincoln, who have written a series of influential handbooks on qualitative methods (1994; Denzin and Lincoln 2003 ; 2005 ), citing Nelson et al. (1992:4), argue that because qualitative research is “interdisciplinary, transdisciplinary, and sometimes counterdisciplinary” it is difficult to derive one single definition of it (Jovanović 2011 :3). According to them, in fact, “the field” is “many things at the same time,” involving contradictions, tensions over its focus, methods, and how to derive interpretations and findings ( 2003 : 11). Similarly, others, such as Flick ( 2007 :ix–x) contend that agreeing on an accepted definition has increasingly become problematic, and that qualitative research has possibly matured different identities. However, Best holds that “the proliferation of many sorts of activities under the label of qualitative sociology threatens to confuse our discussions” ( 2004 :54). Atkinson’s position is more definite: “the current state of qualitative research and research methods is confused” ( 2005 :3–4).

Qualitative research is about interpretation (Blumer 1969 ; Strauss and Corbin 1998 ; Denzin and Lincoln 2003 ), or Verstehen [understanding] (Frankfort-Nachmias and Nachmias 1996 ). It is “multi-method,” involving the collection and use of a variety of empirical materials (Denzin and Lincoln 1998; Silverman 2013 ) and approaches (Silverman 2005 ; Flick 2007 ). It focuses not only on the objective nature of behavior but also on its subjective meanings: individuals’ own accounts of their attitudes, motivations, behavior (McIntyre 2005 :127; Creswell 2009 ), events and situations (Bryman 1989) – what people say and do in specific places and institutions (Goodwin and Horowitz 2002 :35–36) in social and temporal contexts (Morrill and Fine 1997). For this reason, following Weber ([1921-22] 1978), it can be described as an interpretative science (McIntyre 2005 :127). But could quantitative research also be concerned with these questions? Also, as pointed out below, does all qualitative research focus on subjective meaning, as some scholars suggest?

Others also distinguish qualitative research by claiming that it collects data using a naturalistic approach (Denzin and Lincoln 2005 :2; Creswell 2009 ), focusing on the meaning actors ascribe to their actions. But again, does all qualitative research need to be collected in situ? And does qualitative research have to be inherently concerned with meaning? Flick ( 2007 ), referring to Denzin and Lincoln ( 2005 ), mentions conversation analysis as an example of qualitative research that is not concerned with the meanings people bring to a situation, but rather with the formal organization of talk. Still others, such as Ragin ( 1994 :85), note that qualitative research is often (especially early on in the project, we would add) less structured than other kinds of social research – a characteristic connected to its flexibility and that can lead both to potentially better, but also worse results. But is this not a feature of this type of research, rather than a defining description of its essence? Wouldn’t this comment also apply, albeit to varying degrees, to quantitative research?

In addition, Strauss ( 2003 ), along with others, such as Alvesson and Kärreman ( 2011 :10–76), argue that qualitative researchers struggle to capture and represent complex phenomena partially because they tend to collect a large amount of data. While his analysis is correct at some points – “It is necessary to do detailed, intensive, microscopic examination of the data in order to bring out the amazing complexity of what lies in, behind, and beyond those data” (Strauss 2003 :10) – much of his analysis concerns the supposed focus of qualitative research and its challenges, rather than exactly what it is about. But even in this instance we would make a weak case arguing that these are strictly the defining features of qualitative research. Some researchers seem to focus on the approach or the methods used, or even on the way material is analyzed. Several researchers stress the naturalistic assumption of investigating the world, suggesting that meaning and interpretation appear to be a core matter of qualitative research.

We can also see that in this category there is no consensus about specific qualitative methods nor about qualitative data. Many emphasize interpretation, but quantitative research, too, involves interpretation; the results of a regression analysis, for example, certainly have to be interpreted, and the form of meta-analysis that factor analysis provides indeed requires interpretation However, there is no interpretation of quantitative raw data, i.e., numbers in tables. One common thread is that qualitative researchers have to get to grips with their data in order to understand what is being studied in great detail, irrespective of the type of empirical material that is being analyzed. This observation is connected to the fact that qualitative researchers routinely make several adjustments of focus and research design as their studies progress, in many cases until the very end of the project (Kalof et al. 2008 ). If you, like Becker, do not start out with a detailed theory, adjustments such as the emergence and refinement of research questions will occur during the research process. We have thus found a number of useful reflections about qualitative research scattered across different sources, but none of them effectively describe the defining characteristics of this approach.

Although qualitative research does not appear to be defined in terms of a specific method, it is certainly common that fieldwork, i.e., research that entails that the researcher spends considerable time in the field that is studied and use the knowledge gained as data, is seen as emblematic of or even identical to qualitative research. But because we understand that fieldwork tends to focus primarily on the collection and analysis of qualitative data, we expected to find within it discussions on the meaning of “qualitative.” But, again, this was not the case.

Instead, we found material on the history of this approach (for example, Frankfort-Nachmias and Nachmias 1996 ; Atkinson et al. 2001), including how it has changed; for example, by adopting a more self-reflexive practice (Heyl 2001), as well as the different nomenclature that has been adopted, such as fieldwork, ethnography, qualitative research, naturalistic research, participant observation and so on (for example, Lofland et al. 2006 ; Gans 1999 ).

We retrieved definitions of ethnography, such as “the study of people acting in the natural courses of their daily lives,” involving a “resocialization of the researcher” (Emerson 1988 :1) through intense immersion in others’ social worlds (see also examples in Hammersley 2018 ). This may be accomplished by direct observation and also participation (Neuman 2007 :276), although others, such as Denzin ( 1970 :185), have long recognized other types of observation, including non-participant (“fly on the wall”). In this category we have also isolated claims and opposing views, arguing that this type of research is distinguished primarily by where it is conducted (natural settings) (Hughes 1971:496), and how it is carried out (a variety of methods are applied) or, for some most importantly, by involving an active, empathetic immersion in those being studied (Emerson 1988 :2). We also retrieved descriptions of the goals it attends in relation to how it is taught (understanding subjective meanings of the people studied, primarily develop theory, or contribute to social change) (see for example, Corte and Irwin 2017 ; Frankfort-Nachmias and Nachmias 1996 :281; Trier-Bieniek 2012 :639) by collecting the richest possible data (Lofland et al. 2006 ) to derive “thick descriptions” (Geertz 1973 ), and/or to aim at theoretical statements of general scope and applicability (for example, Emerson 1988 ; Fine 2003 ). We have identified guidelines on how to evaluate it (for example Becker 1996 ; Lamont 2004 ) and have retrieved instructions on how it should be conducted (for example, Lofland et al. 2006 ). For instance, analysis should take place while the data gathering unfolds (Emerson 1988 ; Hammersley and Atkinson 2007 ; Lofland et al. 2006 ), observations should be of long duration (Becker 1970 :54; Goffman 1989 ), and data should be of high quantity (Becker 1970 :52–53), as well as other questionable distinctions between fieldwork and other methods:

Field studies differ from other methods of research in that the researcher performs the task of selecting topics, decides what questions to ask, and forges interest in the course of the research itself . This is in sharp contrast to many ‘theory-driven’ and ‘hypothesis-testing’ methods. (Lofland and Lofland 1995 :5)

But could not, for example, a strictly interview-based study be carried out with the same amount of flexibility, such as sequential interviewing (for example, Small 2009 )? Once again, are quantitative approaches really as inflexible as some qualitative researchers think? Moreover, this category stresses the role of the actors’ meaning, which requires knowledge and close interaction with people, their practices and their lifeworld.

It is clear that field studies – which are seen by some as the “gold standard” of qualitative research – are nonetheless only one way of doing qualitative research. There are other methods, but it is not clear why some are more qualitative than others, or why they are better or worse. Fieldwork is characterized by interaction with the field (the material) and understanding of the phenomenon that is being studied. In Becker’s case, he had general experience from fields in which marihuana was used, based on which he did interviews with actual users in several fields.

Grounded Theory

Another major category we identified in our sample is Grounded Theory. We found descriptions of it most clearly in Glaser and Strauss’ ([1967] 2010 ) original articulation, Strauss and Corbin ( 1998 ) and Charmaz ( 2006 ), as well as many other accounts of what it is for: generating and testing theory (Strauss 2003 :xi). We identified explanations of how this task can be accomplished – such as through two main procedures: constant comparison and theoretical sampling (Emerson 1998:96), and how using it has helped researchers to “think differently” (for example, Strauss and Corbin 1998 :1). We also read descriptions of its main traits, what it entails and fosters – for instance, an exceptional flexibility, an inductive approach (Strauss and Corbin 1998 :31–33; 1990; Esterberg 2002 :7), an ability to step back and critically analyze situations, recognize tendencies towards bias, think abstractly and be open to criticism, enhance sensitivity towards the words and actions of respondents, and develop a sense of absorption and devotion to the research process (Strauss and Corbin 1998 :5–6). Accordingly, we identified discussions of the value of triangulating different methods (both using and not using grounded theory), including quantitative ones, and theories to achieve theoretical development (most comprehensively in Denzin 1970 ; Strauss and Corbin 1998 ; Timmermans and Tavory 2012 ). We have also located arguments about how its practice helps to systematize data collection, analysis and presentation of results (Glaser and Strauss [1967] 2010 :16).

Grounded theory offers a systematic approach which requires researchers to get close to the field; closeness is a requirement of identifying questions and developing new concepts or making further distinctions with regard to old concepts. In contrast to other qualitative approaches, grounded theory emphasizes the detailed coding process, and the numerous fine-tuned distinctions that the researcher makes during the process. Within this category, too, we could not find a satisfying discussion of the meaning of qualitative research.

Defining Qualitative Research

In sum, our analysis shows that some notions reappear in the discussion of qualitative research, such as understanding, interpretation, “getting close” and making distinctions. These notions capture aspects of what we think is “qualitative.” However, a comprehensive definition that is useful and that can further develop the field is lacking, and not even a clear picture of its essential elements appears. In other words no definition emerges from our data, and in our research process we have moved back and forth between our empirical data and the attempt to present a definition. Our concrete strategy, as stated above, is to relate qualitative and quantitative research, or more specifically, qualitative and quantitative work. We use an ideal-typical notion of quantitative research which relies on taken for granted and numbered variables. This means that the data consists of variables on different scales, such as ordinal, but frequently ratio and absolute scales, and the representation of the numbers to the variables, i.e. the justification of the assignment of numbers to object or phenomenon, are not questioned, though the validity may be questioned. In this section we return to the notion of quality and try to clarify it while presenting our contribution.

Broadly, research refers to the activity performed by people trained to obtain knowledge through systematic procedures. Notions such as “objectivity” and “reflexivity,” “systematic,” “theory,” “evidence” and “openness” are here taken for granted in any type of research. Next, building on our empirical analysis we explain the four notions that we have identified as central to qualitative work: distinctions, process, closeness, and improved understanding. In discussing them, ultimately in relation to one another, we make their meaning even more precise. Our idea, in short, is that only when these ideas that we present separately for analytic purposes are brought together can we speak of qualitative research.

Distinctions

We believe that the possibility of making new distinctions is one the defining characteristics of qualitative research. It clearly sets it apart from quantitative analysis which works with taken-for-granted variables, albeit as mentioned, meta-analyses, for example, factor analysis may result in new variables. “Quality” refers essentially to distinctions, as already pointed out by Aristotle. He discusses the term “qualitative” commenting: “By a quality I mean that in virtue of which things are said to be qualified somehow” (Aristotle 1984:14). Quality is about what something is or has, which means that the distinction from its environment is crucial. We see qualitative research as a process in which significant new distinctions are made to the scholarly community; to make distinctions is a key aspect of obtaining new knowledge; a point, as we will see, that also has implications for “quantitative research.” The notion of being “significant” is paramount. New distinctions by themselves are not enough; just adding concepts only increases complexity without furthering our knowledge. The significance of new distinctions is judged against the communal knowledge of the research community. To enable this discussion and judgements central elements of rational discussion are required (cf. Habermas [1981] 1987 ; Davidsson [ 1988 ] 2001) to identify what is new and relevant scientific knowledge. Relatedly, Ragin alludes to the idea of new and useful knowledge at a more concrete level: “Qualitative methods are appropriate for in-depth examination of cases because they aid the identification of key features of cases. Most qualitative methods enhance data” (1994:79). When Becker ( 1963 ) studied deviant behavior and investigated how people became marihuana smokers, he made distinctions between the ways in which people learned how to smoke. This is a classic example of how the strategy of “getting close” to the material, for example the text, people or pictures that are subject to analysis, may enable researchers to obtain deeper insight and new knowledge by making distinctions – in this instance on the initial notion of learning how to smoke. Others have stressed the making of distinctions in relation to coding or theorizing. Emerson et al. ( 1995 ), for example, hold that “qualitative coding is a way of opening up avenues of inquiry,” meaning that the researcher identifies and develops concepts and analytic insights through close examination of and reflection on data (Emerson et al. 1995 :151). Goodwin and Horowitz highlight making distinctions in relation to theory-building writing: “Close engagement with their cases typically requires qualitative researchers to adapt existing theories or to make new conceptual distinctions or theoretical arguments to accommodate new data” ( 2002 : 37). In the ideal-typical quantitative research only existing and so to speak, given, variables would be used. If this is the case no new distinction are made. But, would not also many “quantitative” researchers make new distinctions?

Process does not merely suggest that research takes time. It mainly implies that qualitative new knowledge results from a process that involves several phases, and above all iteration. Qualitative research is about oscillation between theory and evidence, analysis and generating material, between first- and second -order constructs (Schütz 1962 :59), between getting in contact with something, finding sources, becoming deeply familiar with a topic, and then distilling and communicating some of its essential features. The main point is that the categories that the researcher uses, and perhaps takes for granted at the beginning of the research process, usually undergo qualitative changes resulting from what is found. Becker describes how he tested hypotheses and let the jargon of the users develop into theoretical concepts. This happens over time while the study is being conducted, exemplifying what we mean by process.

In the research process, a pilot-study may be used to get a first glance of, for example, the field, how to approach it, and what methods can be used, after which the method and theory are chosen or refined before the main study begins. Thus, the empirical material is often central from the start of the project and frequently leads to adjustments by the researcher. Likewise, during the main study categories are not fixed; the empirical material is seen in light of the theory used, but it is also given the opportunity to kick back, thereby resisting attempts to apply theoretical straightjackets (Becker 1970 :43). In this process, coding and analysis are interwoven, and thus are often important steps for getting closer to the phenomenon and deciding what to focus on next. Becker began his research by interviewing musicians close to him, then asking them to refer him to other musicians, and later on doubling his original sample of about 25 to include individuals in other professions (Becker 1973:46). Additionally, he made use of some participant observation, documents, and interviews with opiate users made available to him by colleagues. As his inductive theory of deviance evolved, Becker expanded his sample in order to fine tune it, and test the accuracy and generality of his hypotheses. In addition, he introduced a negative case and discussed the null hypothesis ( 1963 :44). His phasic career model is thus based on a research design that embraces processual work. Typically, process means to move between “theory” and “material” but also to deal with negative cases, and Becker ( 1998 ) describes how discovering these negative cases impacted his research design and ultimately its findings.

Obviously, all research is process-oriented to some degree. The point is that the ideal-typical quantitative process does not imply change of the data, and iteration between data, evidence, hypotheses, empirical work, and theory. The data, quantified variables, are, in most cases fixed. Merging of data, which of course can be done in a quantitative research process, does not mean new data. New hypotheses are frequently tested, but the “raw data is often the “the same.” Obviously, over time new datasets are made available and put into use.

Another characteristic that is emphasized in our sample is that qualitative researchers – and in particular ethnographers – can, or as Goffman put it, ought to ( 1989 ), get closer to the phenomenon being studied and their data than quantitative researchers (for example, Silverman 2009 :85). Put differently, essentially because of their methods qualitative researchers get into direct close contact with those being investigated and/or the material, such as texts, being analyzed. Becker started out his interview study, as we noted, by talking to those he knew in the field of music to get closer to the phenomenon he was studying. By conducting interviews he got even closer. Had he done more observations, he would undoubtedly have got even closer to the field.

Additionally, ethnographers’ design enables researchers to follow the field over time, and the research they do is almost by definition longitudinal, though the time in the field is studied obviously differs between studies. The general characteristic of closeness over time maximizes the chances of unexpected events, new data (related, for example, to archival research as additional sources, and for ethnography for situations not necessarily previously thought of as instrumental – what Mannay and Morgan ( 2015 ) term the “waiting field”), serendipity (Merton and Barber 2004 ; Åkerström 2013 ), and possibly reactivity, as well as the opportunity to observe disrupted patterns that translate into exemplars of negative cases. Two classic examples of this are Becker’s finding of what medical students call “crocks” (Becker et al. 1961 :317), and Geertz’s ( 1973 ) study of “deep play” in Balinese society.

By getting and staying so close to their data – be it pictures, text or humans interacting (Becker was himself a musician) – for a long time, as the research progressively focuses, qualitative researchers are prompted to continually test their hunches, presuppositions and hypotheses. They test them against a reality that often (but certainly not always), and practically, as well as metaphorically, talks back, whether by validating them, or disqualifying their premises – correctly, as well as incorrectly (Fine 2003 ; Becker 1970 ). This testing nonetheless often leads to new directions for the research. Becker, for example, says that he was initially reading psychological theories, but when facing the data he develops a theory that looks at, you may say, everything but psychological dispositions to explain the use of marihuana. Especially researchers involved with ethnographic methods have a fairly unique opportunity to dig up and then test (in a circular, continuous and temporal way) new research questions and findings as the research progresses, and thereby to derive previously unimagined and uncharted distinctions by getting closer to the phenomenon under study.

Let us stress that getting close is by no means restricted to ethnography. The notion of hermeneutic circle and hermeneutics as a general way of understanding implies that we must get close to the details in order to get the big picture. This also means that qualitative researchers can literally also make use of details of pictures as evidence (cf. Harper 2002). Thus, researchers may get closer both when generating the material or when analyzing it.

Quantitative research, we maintain, in the ideal-typical representation cannot get closer to the data. The data is essentially numbers in tables making up the variables (Franzosi 2016 :138). The data may originally have been “qualitative,” but once reduced to numbers there can only be a type of “hermeneutics” about what the number may stand for. The numbers themselves, however, are non-ambiguous. Thus, in quantitative research, interpretation, if done, is not about the data itself—the numbers—but what the numbers stand for. It follows that the interpretation is essentially done in a more “speculative” mode without direct empirical evidence (cf. Becker 2017 ).

Improved Understanding

While distinction, process and getting closer refer to the qualitative work of the researcher, improved understanding refers to its conditions and outcome of this work. Understanding cuts deeper than explanation, which to some may mean a causally verified correlation between variables. The notion of explanation presupposes the notion of understanding since explanation does not include an idea of how knowledge is gained (Manicas 2006 : 15). Understanding, we argue, is the core concept of what we call the outcome of the process when research has made use of all the other elements that were integrated in the research. Understanding, then, has a special status in qualitative research since it refers both to the conditions of knowledge and the outcome of the process. Understanding can to some extent be seen as the condition of explanation and occurs in a process of interpretation, which naturally refers to meaning (Gadamer 1990 ). It is fundamentally connected to knowing, and to the knowing of how to do things (Heidegger [1927] 2001 ). Conceptually the term hermeneutics is used to account for this process. Heidegger ties hermeneutics to human being and not possible to separate from the understanding of being ( 1988 ). Here we use it in a broader sense, and more connected to method in general (cf. Seiffert 1992 ). The abovementioned aspects – for example, “objectivity” and “reflexivity” – of the approach are conditions of scientific understanding. Understanding is the result of a circular process and means that the parts are understood in light of the whole, and vice versa. Understanding presupposes pre-understanding, or in other words, some knowledge of the phenomenon studied. The pre-understanding, even in the form of prejudices, are in qualitative research process, which we see as iterative, questioned, which gradually or suddenly change due to the iteration of data, evidence and concepts. However, qualitative research generates understanding in the iterative process when the researcher gets closer to the data, e.g., by going back and forth between field and analysis in a process that generates new data that changes the evidence, and, ultimately, the findings. Questioning, to ask questions, and put what one assumes—prejudices and presumption—in question, is central to understand something (Heidegger [1927] 2001 ; Gadamer 1990 :368–384). We propose that this iterative process in which the process of understanding occurs is characteristic of qualitative research.

Improved understanding means that we obtain scientific knowledge of something that we as a scholarly community did not know before, or that we get to know something better. It means that we understand more about how parts are related to one another, and to other things we already understand (see also Fine and Hallett 2014 ). Understanding is an important condition for qualitative research. It is not enough to identify correlations, make distinctions, and work in a process in which one gets close to the field or phenomena. Understanding is accomplished when the elements are integrated in an iterative process.

It is, moreover, possible to understand many things, and researchers, just like children, may come to understand new things every day as they engage with the world. This subjective condition of understanding – namely, that a person gains a better understanding of something –is easily met. To be qualified as “scientific,” the understanding must be general and useful to many; it must be public. But even this generally accessible understanding is not enough in order to speak of “scientific understanding.” Though we as a collective can increase understanding of everything in virtually all potential directions as a result also of qualitative work, we refrain from this “objective” way of understanding, which has no means of discriminating between what we gain in understanding. Scientific understanding means that it is deemed relevant from the scientific horizon (compare Schütz 1962 : 35–38, 46, 63), and that it rests on the pre-understanding that the scientists have and must have in order to understand. In other words, the understanding gained must be deemed useful by other researchers, so that they can build on it. We thus see understanding from a pragmatic, rather than a subjective or objective perspective. Improved understanding is related to the question(s) at hand. Understanding, in order to represent an improvement, must be an improvement in relation to the existing body of knowledge of the scientific community (James [ 1907 ] 1955). Scientific understanding is, by definition, collective, as expressed in Weber’s famous note on objectivity, namely that scientific work aims at truths “which … can claim, even for a Chinese, the validity appropriate to an empirical analysis” ([1904] 1949 :59). By qualifying “improved understanding” we argue that it is a general defining characteristic of qualitative research. Becker‘s ( 1966 ) study and other research of deviant behavior increased our understanding of the social learning processes of how individuals start a behavior. And it also added new knowledge about the labeling of deviant behavior as a social process. Few studies, of course, make the same large contribution as Becker’s, but are nonetheless qualitative research.

Understanding in the phenomenological sense, which is a hallmark of qualitative research, we argue, requires meaning and this meaning is derived from the context, and above all the data being analyzed. The ideal-typical quantitative research operates with given variables with different numbers. This type of material is not enough to establish meaning at the level that truly justifies understanding. In other words, many social science explanations offer ideas about correlations or even causal relations, but this does not mean that the meaning at the level of the data analyzed, is understood. This leads us to say that there are indeed many explanations that meet the criteria of understanding, for example the explanation of how one becomes a marihuana smoker presented by Becker. However, we may also understand a phenomenon without explaining it, and we may have potential explanations, or better correlations, that are not really understood.

We may speak more generally of quantitative research and its data to clarify what we see as an important distinction. The “raw data” that quantitative research—as an idealtypical activity, refers to is not available for further analysis; the numbers, once created, are not to be questioned (Franzosi 2016 : 138). If the researcher is to do “more” or “change” something, this will be done by conjectures based on theoretical knowledge or based on the researcher’s lifeworld. Both qualitative and quantitative research is based on the lifeworld, and all researchers use prejudices and pre-understanding in the research process. This idea is present in the works of Heidegger ( 2001 ) and Heisenberg (cited in Franzosi 2010 :619). Qualitative research, as we argued, involves the interaction and questioning of concepts (theory), data, and evidence.

Ragin ( 2004 :22) points out that “a good definition of qualitative research should be inclusive and should emphasize its key strengths and features, not what it lacks (for example, the use of sophisticated quantitative techniques).” We define qualitative research as an iterative process in which improved understanding to the scientific community is achieved by making new significant distinctions resulting from getting closer to the phenomenon studied. Qualitative research, as defined here, is consequently a combination of two criteria: (i) how to do things –namely, generating and analyzing empirical material, in an iterative process in which one gets closer by making distinctions, and (ii) the outcome –improved understanding novel to the scholarly community. Is our definition applicable to our own study? In this study we have closely read the empirical material that we generated, and the novel distinction of the notion “qualitative research” is the outcome of an iterative process in which both deduction and induction were involved, in which we identified the categories that we analyzed. We thus claim to meet the first criteria, “how to do things.” The second criteria cannot be judged but in a partial way by us, namely that the “outcome” —in concrete form the definition-improves our understanding to others in the scientific community.

We have defined qualitative research, or qualitative scientific work, in relation to quantitative scientific work. Given this definition, qualitative research is about questioning the pre-given (taken for granted) variables, but it is thus also about making new distinctions of any type of phenomenon, for example, by coining new concepts, including the identification of new variables. This process, as we have discussed, is carried out in relation to empirical material, previous research, and thus in relation to theory. Theory and previous research cannot be escaped or bracketed. According to hermeneutic principles all scientific work is grounded in the lifeworld, and as social scientists we can thus never fully bracket our pre-understanding.

We have proposed that quantitative research, as an idealtype, is concerned with pre-determined variables (Small 2008 ). Variables are epistemically fixed, but can vary in terms of dimensions, such as frequency or number. Age is an example; as a variable it can take on different numbers. In relation to quantitative research, qualitative research does not reduce its material to number and variables. If this is done the process of comes to a halt, the researcher gets more distanced from her data, and it makes it no longer possible to make new distinctions that increase our understanding. We have above discussed the components of our definition in relation to quantitative research. Our conclusion is that in the research that is called quantitative there are frequent and necessary qualitative elements.

Further, comparative empirical research on researchers primarily working with ”quantitative” approaches and those working with ”qualitative” approaches, we propose, would perhaps show that there are many similarities in practices of these two approaches. This is not to deny dissimilarities, or the different epistemic and ontic presuppositions that may be more or less strongly associated with the two different strands (see Goertz and Mahoney 2012 ). Our point is nonetheless that prejudices and preconceptions about researchers are unproductive, and that as other researchers have argued, differences may be exaggerated (e.g., Becker 1996 : 53, 2017 ; Marchel and Owens 2007 :303; Ragin 1994 ), and that a qualitative dimension is present in both kinds of work.

Several things follow from our findings. The most important result is the relation to quantitative research. In our analysis we have separated qualitative research from quantitative research. The point is not to label individual researchers, methods, projects, or works as either “quantitative” or “qualitative.” By analyzing, i.e., taking apart, the notions of quantitative and qualitative, we hope to have shown the elements of qualitative research. Our definition captures the elements, and how they, when combined in practice, generate understanding. As many of the quotations we have used suggest, one conclusion of our study holds that qualitative approaches are not inherently connected with a specific method. Put differently, none of the methods that are frequently labelled “qualitative,” such as interviews or participant observation, are inherently “qualitative.” What matters, given our definition, is whether one works qualitatively or quantitatively in the research process, until the results are produced. Consequently, our analysis also suggests that those researchers working with what in the literature and in jargon is often called “quantitative research” are almost bound to make use of what we have identified as qualitative elements in any research project. Our findings also suggest that many” quantitative” researchers, at least to some extent, are engaged with qualitative work, such as when research questions are developed, variables are constructed and combined, and hypotheses are formulated. Furthermore, a research project may hover between “qualitative” and “quantitative” or start out as “qualitative” and later move into a “quantitative” (a distinct strategy that is not similar to “mixed methods” or just simply combining induction and deduction). More generally speaking, the categories of “qualitative” and “quantitative,” unfortunately, often cover up practices, and it may lead to “camps” of researchers opposing one another. For example, regardless of the researcher is primarily oriented to “quantitative” or “qualitative” research, the role of theory is neglected (cf. Swedberg 2017 ). Our results open up for an interaction not characterized by differences, but by different emphasis, and similarities.

Let us take two examples to briefly indicate how qualitative elements can fruitfully be combined with quantitative. Franzosi ( 2010 ) has discussed the relations between quantitative and qualitative approaches, and more specifically the relation between words and numbers. He analyzes texts and argues that scientific meaning cannot be reduced to numbers. Put differently, the meaning of the numbers is to be understood by what is taken for granted, and what is part of the lifeworld (Schütz 1962 ). Franzosi shows how one can go about using qualitative and quantitative methods and data to address scientific questions analyzing violence in Italy at the time when fascism was rising (1919–1922). Aspers ( 2006 ) studied the meaning of fashion photographers. He uses an empirical phenomenological approach, and establishes meaning at the level of actors. In a second step this meaning, and the different ideal-typical photographers constructed as a result of participant observation and interviews, are tested using quantitative data from a database; in the first phase to verify the different ideal-types, in the second phase to use these types to establish new knowledge about the types. In both of these cases—and more examples can be found—authors move from qualitative data and try to keep the meaning established when using the quantitative data.

A second main result of our study is that a definition, and we provided one, offers a way for research to clarify, and even evaluate, what is done. Hence, our definition can guide researchers and students, informing them on how to think about concrete research problems they face, and to show what it means to get closer in a process in which new distinctions are made. The definition can also be used to evaluate the results, given that it is a standard of evaluation (cf. Hammersley 2007 ), to see whether new distinctions are made and whether this improves our understanding of what is researched, in addition to the evaluation of how the research was conducted. By making what is qualitative research explicit it becomes easier to communicate findings, and it is thereby much harder to fly under the radar with substandard research since there are standards of evaluation which make it easier to separate “good” from “not so good” qualitative research.

To conclude, our analysis, which ends with a definition of qualitative research can thus both address the “internal” issues of what is qualitative research, and the “external” critiques that make it harder to do qualitative research, to which both pressure from quantitative methods and general changes in society contribute.

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Acknowledgements

Financial Support for this research is given by the European Research Council, CEV (263699). The authors are grateful to Susann Krieglsteiner for assistance in collecting the data. The paper has benefitted from the many useful comments by the three reviewers and the editor, comments by members of the Uppsala Laboratory of Economic Sociology, as well as Jukka Gronow, Sebastian Kohl, Marcin Serafin, Richard Swedberg, Anders Vassenden and Turid Rødne.

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Aspers, P., Corte, U. What is Qualitative in Qualitative Research. Qual Sociol 42 , 139–160 (2019). https://doi.org/10.1007/s11133-019-9413-7

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How many participants do I need for qualitative research?

For those new to the qualitative research space, there’s one question that’s usually pretty tough to figure out, and that’s the question of how many participants to include in a study. Regardless of whether it’s research as part of the discovery phase for a new product, or perhaps an in-depth canvas of the users of an existing service, researchers can often find it difficult to agree on the numbers. So is there an easy answer? Let’s find out.

Here, we’ll look into the right number of participants for qualitative research studies. If you want to know about participants for quantitative research, read Nielsen Norman Group’s article .

Getting the numbers right

So you need to run a series of user interviews or usability tests and aren’t sure exactly how many people you should reach out to. It can be a tricky situation – especially for those without much experience. Do you test a small selection of 1 or 2 people to make the recruitment process easier? Or, do you go big and test with a series of 10 people over the course of a month? The answer lies somewhere in between.

It’s often a good idea (for qualitative research methods like interviews and usability tests) to start with 5 participants and then scale up by a further 5 based on how complicated the subject matter is. You may also find it helpful to add additional participants if you’re new to user research or you’re working in a new area.

What you’re actually looking for here is what’s known as saturation.

Understanding saturation

Whether it’s qualitative research as part of a master’s thesis or as research for a new online dating app, saturation is the best metric you can use to identify when you’ve hit the right number of participants.

In a nutshell, saturation is when you’ve reached the point where adding further participants doesn’t give you any further insights. It’s true that you may still pick up on the occasional interesting detail, but all of your big revelations and learnings have come and gone. A good measure is to sit down after each session with a participant and analyze the number of new insights you’ve noted down.

Interestingly, in a paper titled How Many Interviews Are Enough? , authors Greg Guest, Arwen Bunce and Laura Johnson noted that saturation usually occurs with around 12 participants in homogeneous groups (meaning people in the same role at an organization, for example). However, carrying out ethnographic research on a larger domain with a diverse set of participants will almost certainly require a larger sample.

Ensuring you’ve hit the right number of participants

How do you know when you’ve reached saturation point? You have to keep conducting interviews or usability tests until you’re no longer uncovering new insights or concepts.

While this may seem to run counter to the idea of just gathering as much data from as many people as possible, there’s a strong case for focusing on a smaller group of participants. In The logic of small samples in interview-based , authors Mira Crouch and Heather McKenzie note that using fewer than 20 participants during a qualitative research study will result in better data. Why? With a smaller group, it’s easier for you (the researcher) to build strong close relationships with your participants, which in turn leads to more natural conversations and better data.

There's also a school of thought that you should interview 5 or so people per persona. For example, if you're working in a company that has well-defined personas, you might want to use those as a basis for your study, and then you would interview 5 people based on each persona. This maybe worth considering or particularly important when you have a product that has very distinct user groups (e.g. students and staff, teachers and parents etc).

How your domain affects sample size

The scope of the topic you’re researching will change the amount of information you’ll need to gather before you’ve hit the saturation point. Your topic is also commonly referred to as the domain.

If you’re working in quite a confined domain, for example, a single screen of a mobile app or a very specific scenario, you’ll likely find interviews with 5 participants to be perfectly fine. Moving into more complicated domains, like the entire checkout process for an online shopping app, will push up your sample size.

As Mitchel Seaman notes : “Exploring a big issue like young peoples’ opinions about healthcare coverage, a broad emotional issue like postmarital sexuality, or a poorly-understood domain for your team like mobile device use in another country can drastically increase the number of interviews you’ll want to conduct.”

In-person or remote

Does the location of your participants change the number you need for qualitative user research? Well, not really – but there are other factors to consider.

• Budget: If you choose to conduct remote interviews/usability tests, you’ll likely find you’ve got lower costs as you won’t need to travel to your participants or have them travel to you. This also affects…
• Participant access: Remote qualitative research can be a lifesaver when it comes to participant access. No longer are you confined to the people you have physical access to — instead you can reach out to anyone you’d like.
• Quality: On the other hand, remote research does have its downsides. For one, you’ll likely find you’re not able to build the same kinds of relationships over the internet or phone as those in person, which in turn means you never quite get the same level of insights.

Is there value in outsourcing recruitment?

Recruitment is understandably an intensive logistical exercise with many moving parts. If you’ve ever had to recruit people for a study before, you’ll understand the need for long lead times (to ensure you have enough participants for the project) and the countless long email chains as you discuss suitable times.

Outsourcing your participant recruitment is just one way to lighten the logistical load during your research. Instead of having to go out and look for participants, you have them essentially delivered to you in the right number and with the right attributes.

We’ve got one such service at Optimal Workshop, which means it’s the perfect accompaniment if you’re also using our platform of UX tools. Read more about that here .

So that’s really most of what there is to know about participant recruitment in a qualitative research context. As we said at the start, while it can appear quite tricky to figure out exactly how many people you need to recruit, it’s actually not all that difficult in reality.

Overall, the number of participants you need for your qualitative research can depend on your project among other factors. It’s important to keep saturation in mind, as well as the locale of participants. You also need to get the most you can out of what’s available to you. Remember: Some research is better than none!

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Qualitative Research Questions: Gain Powerful Insights + 25 Examples

We review the basics of qualitative research questions, including their key components, how to craft them effectively, & 25 example questions.

Einstein was many things—a physicist, a philosopher, and, undoubtedly, a mastermind. He also had an incredible way with words. His quote, "Everything that can be counted does not necessarily count; everything that counts cannot necessarily be counted," is particularly poignant when it comes to research. 

Some inquiries call for a quantitative approach, for counting and measuring data in order to arrive at general conclusions. Other investigations, like qualitative research, rely on deep exploration and understanding of individual cases in order to develop a greater understanding of the whole. That’s what we’re going to focus on today.

Qualitative research questions focus on the "how" and "why" of things, rather than the "what". They ask about people's experiences and perceptions , and can be used to explore a wide range of topics.

The following article will discuss the basics of qualitative research questions, including their key components, and how to craft them effectively. You'll also find 25 examples of effective qualitative research questions you can use as inspiration for your own studies.

Let’s get started!

What are qualitative research questions, and when are they used?

When researchers set out to conduct a study on a certain topic, their research is chiefly directed by an overarching question . This question provides focus for the study and helps determine what kind of data will be collected.

By starting with a question, we gain parameters and objectives for our line of research. What are we studying? For what purpose? How will we know when we’ve achieved our goals?

Of course, some of these questions can be described as quantitative in nature. When a research question is quantitative, it usually seeks to measure or calculate something in a systematic way.

For example:

• How many people in our town use the library?
• What is the average income of families in our city?
• How much does the average person weigh?

Other research questions, however—and the ones we will be focusing on in this article—are qualitative in nature. Qualitative research questions are open-ended and seek to explore a given topic in-depth.

According to the Australian & New Zealand Journal of Psychiatry , “Qualitative research aims to address questions concerned with developing an understanding of the meaning and experience dimensions of humans’ lives and social worlds.”

This type of research can be used to gain a better understanding of people’s thoughts, feelings and experiences by “addressing questions beyond ‘what works’, towards ‘what works for whom when, how and why, and focusing on intervention improvement rather than accreditation,” states one paper in Neurological Research and Practice .

Qualitative questions often produce rich data that can help researchers develop hypotheses for further quantitative study.

• What are people’s thoughts on the new library?
• How does it feel to be a first-generation student at our school?
• How do people feel about the changes taking place in our town?

As stated by a paper in Human Reproduction , “...‘qualitative’ methods are used to answer questions about experience, meaning, and perspective, most often from the standpoint of the participant. These data are usually not amenable to counting or measuring.”

Both quantitative and qualitative questions have their uses; in fact, they often complement each other. A well-designed research study will include a mix of both types of questions in order to gain a fuller understanding of the topic at hand.

If you would like to recruit unlimited participants for qualitative research for free and only pay for the interview you conduct, try using Respondent  today. 

Crafting qualitative research questions for powerful insights

Now that we have a basic understanding of what qualitative research questions are and when they are used, let’s take a look at how you can begin crafting your own.

According to a study in the International Journal of Qualitative Studies in Education, there is a certain process researchers should follow when crafting their questions, which we’ll explore in more depth.

1. Beginning the process 

Start with a point of interest or curiosity, and pose a draft question or ‘self-question’. What do you want to know about the topic at hand? What is your specific curiosity? You may find it helpful to begin by writing several questions.

For example, if you’re interested in understanding how your customer base feels about a recent change to your product, you might ask: 

• What made you decide to try the new product?
• How do you feel about the change?
• What do you think of the new design/functionality?
• What benefits do you see in the change?

2. Create one overarching, guiding question 

At this point, narrow down the draft questions into one specific question. “Sometimes, these broader research questions are not stated as questions, but rather as goals for the study.”

As an example of this, you might narrow down these three questions: 

into the following question: 

• What are our customers’ thoughts on the recent change to our product?

3. Theoretical framing 

As you read the relevant literature and apply theory to your research, the question should be altered to achieve better outcomes. Experts agree that pursuing a qualitative line of inquiry should open up the possibility for questioning your original theories and altering the conceptual framework with which the research began.

If we continue with the current example, it’s possible you may uncover new data that informs your research and changes your question. For instance, you may discover that customers’ feelings about the change are not just a reaction to the change itself, but also to how it was implemented. In this case, your question would need to reflect this new information: 

• How did customers react to the process of the change, as well as the change itself?

4. Ethical considerations 

A study in the International Journal of Qualitative Studies in Education stresses that ethics are “a central issue when a researcher proposes to study the lives of others, especially marginalized populations.” Consider how your question or inquiry will affect the people it relates to—their lives and their safety. Shape your question to avoid physical, emotional, or mental upset for the focus group.

In analyzing your question from this perspective, if you feel that it may cause harm, you should consider changing the question or ending your research project. Perhaps you’ve discovered that your question encourages harmful or invasive questioning, in which case you should reformulate it.

5. Writing the question 

The actual process of writing the question comes only after considering the above points. The purpose of crafting your research questions is to delve into what your study is specifically about” Remember that qualitative research questions are not trying to find the cause of an effect, but rather to explore the effect itself.

Your questions should be clear, concise, and understandable to those outside of your field. In addition, they should generate rich data. The questions you choose will also depend on the type of research you are conducting: 

• If you’re doing a phenomenological study, your questions might be open-ended, in order to allow participants to share their experiences in their own words.
• If you’re doing a grounded-theory study, your questions might be focused on generating a list of categories or themes.
• If you’re doing ethnography, your questions might be about understanding the culture you’re studying.

Whenyou have well-written questions, it is much easier to develop your research design and collect data that accurately reflects your inquiry.

In writing your questions, it may help you to refer to this simple flowchart process for constructing questions:

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25 examples of expertly crafted qualitative research questions

It's easy enough to cover the theory of writing a qualitative research question, but sometimes it's best if you can see the process in practice. In this section, we'll list 25 examples of B2B and B2C-related qualitative questions.

Let's begin with five questions. We'll show you the question, explain why it's considered qualitative, and then give you an example of how it can be used in research.

1. What is the customer's perception of our company's brand?

Qualitative research questions are often open-ended and invite respondents to share their thoughts and feelings on a subject. This question is qualitative because it seeks customer feedback on the company's brand. 

This question can be used in research to understand how customers feel about the company's branding, what they like and don't like about it, and whether they would recommend it to others.

2. Why do customers buy our product?

This question is also qualitative because it seeks to understand the customer's motivations for purchasing a product. It can be used in research to identify the reasons  customers buy a certain product, what needs or desires the product fulfills for them, and how they feel about the purchase after using the product.

3. How do our customers interact with our products?

Again, this question is qualitative because it seeks to understand customer behavior. In this case, it can be used in research to see how customers use the product, how they interact with it, and what emotions or thoughts the product evokes in them.

4. What are our customers' biggest frustrations with our products?

By seeking to understand customer frustrations, this question is qualitative and can provide valuable insights. It can be used in research to help identify areas in which the company needs to make improvements with its products.

5. How do our customers feel about our customer service?

Rather than asking why customers like or dislike something, this question asks how they feel. This qualitative question can provide insights into customer satisfaction or dissatisfaction with a company. 

This type of question can be used in research to understand what customers think of the company's customer service and whether they feel it meets their needs.

20 more examples to refer to when writing your question

Now that you’re aware of what makes certain questions qualitative, let's move into 20 more examples of qualitative research questions:

• How do your customers react when updates are made to your app interface?
• How do customers feel when they complete their purchase through your ecommerce site?
• What are your customers' main frustrations with your service?
• How do people feel about the quality of your products compared to those of your competitors?
• What motivates customers to refer their friends and family members to your product or service?
• What are the main benefits your customers receive from using your product or service?
• How do people feel when they finish a purchase on your website?
• What are the main motivations behind customer loyalty to your brand?
• How does your app make people feel emotionally?
• For younger generations using your app, how does it make them feel about themselves?
• What reputation do people associate with your brand?
• How inclusive do people find your app?
• In what ways are your customers' experiences unique to them?
• What are the main areas of improvement your customers would like to see in your product or service?
• How do people feel about their interactions with your tech team?
• What are the top five reasons people use your online marketplace?
• How does using your app make people feel in terms of connectedness?
• What emotions do people experience when they're using your product or service?
• Aside from the features of your product, what else about it attracts customers?
• How does your company culture make people feel?

As you can see, these kinds of questions are completely open-ended. In a way, they allow the research and discoveries made along the way to direct the research. The questions are merely a starting point from which to explore.

This video offers tips on how to write good qualitative research questions, produced by Qualitative Research Expert, Kimberly Baker.

Wrap-up: crafting your own qualitative research questions.

Over the course of this article, we've explored what qualitative research questions are, why they matter, and how they should be written. Hopefully you now have a clear understanding of how to craft your own.

Remember, qualitative research questions should always be designed to explore a certain experience or phenomena in-depth, in order to generate powerful insights. As you write your questions, be sure to keep the following in mind:

• Are you being inclusive of all relevant perspectives?
• Are your questions specific enough to generate clear answers?
• Will your questions allow for an in-depth exploration of the topic at hand?
• Do the questions reflect your research goals and objectives?

If you can answer "yes" to all of the questions above, and you've followed the tips for writing qualitative research questions we shared in this article, then you're well on your way to crafting powerful queries that will yield valuable insights.

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What is Qualitative Research? Methods, Types, Approaches and Examples

Qualitative research is a type of method that researchers use depending on their study requirements. Research can be conducted using several methods, but before starting the process, researchers should understand the different methods available to decide the best one for their study type. The type of research method needed depends on a few important criteria, such as the research question, study type, time, costs, data availability, and availability of respondents. The two main types of methods are qualitative research and quantitative research. Sometimes, researchers may find it difficult to decide which type of method is most suitable for their study. Keeping in mind a simple rule of thumb could help you make the correct decision. Quantitative research should be used to validate or test a theory or hypothesis and qualitative research should be used to understand a subject or event or identify reasons for observed patterns.  

Qualitative research methods are based on principles of social sciences from several disciplines like psychology, sociology, and anthropology. In this method, researchers try to understand the feelings and motivation of their respondents, which would have prompted them to select or give a particular response to a question. Here are two qualitative research examples :  

• Two brands (A & B) of the same medicine are available at a pharmacy. However, Brand A is more popular and has higher sales. In qualitative research , the interviewers would ideally visit a few stores in different areas and ask customers their reason for selecting either brand. Respondents may have different reasons that motivate them to select one brand over the other, such as brand loyalty, cost, feedback from friends, doctor’s suggestion, etc. Once the reasons are known, companies could then address challenges in that specific area to increase their product’s sales.  
• A company organizes a focus group meeting with a random sample of its product’s consumers to understand their opinion on a new product being launched.  

Table of Contents

What is qualitative research? 1

Qualitative research is the process of collecting, analyzing, and interpreting non-numerical data. The findings of qualitative research are expressed in words and help in understanding individuals’ subjective perceptions about an event, condition, or subject. This type of research is exploratory and is used to generate hypotheses or theories from data. Qualitative data are usually in the form of text, videos, photographs, and audio recordings. There are multiple qualitative research types , which will be discussed later.  

Qualitative research methods 2

Researchers can choose from several qualitative research methods depending on the study type, research question, the researcher’s role, data to be collected, etc.  

The following table lists the common qualitative research approaches with their purpose and examples, although there may be an overlap between some.  

Types of qualitative research 3,4

The data collection methods in qualitative research are designed to assess and understand the perceptions, motivations, and feelings of the respondents about the subject being studied. The different qualitative research types include the following:  

• In-depth or one-on-one interviews : This is one of the most common qualitative research methods and helps the interviewers understand a respondent’s subjective opinion and experience pertaining to a specific topic or event. These interviews are usually conversational and encourage the respondents to express their opinions freely. Semi-structured interviews, which have open-ended questions (where the respondents can answer more than just “yes” or “no”), are commonly used. Such interviews can be either face-to-face or telephonic, and the duration can vary depending on the subject or the interviewer. Asking the right questions is essential in this method so that the interview can be led in the suitable direction. Face-to-face interviews also help interviewers observe the respondents’ body language, which could help in confirming whether the responses match.  
• Document study/Literature review/Record keeping : Researchers’ review of already existing written materials such as archives, annual reports, research articles, guidelines, policy documents, etc.  
• Focus groups : Usually include a small sample of about 6-10 people and a moderator, to understand the participants’ opinion on a given topic. Focus groups ensure constructive discussions to understand the why, what, and, how about the topic. These group meetings need not always be in-person. In recent times, online meetings are also encouraged, and online surveys could also be administered with the option to “write” subjective answers as well. However, this method is expensive and is mostly used for new products and ideas.  
• Qualitative observation : In this method, researchers collect data using their five senses—sight, smell, touch, taste, and hearing. This method doesn’t include any measurements but only the subjective observation. For example, “The dessert served at the bakery was creamy with sweet buttercream frosting”; this observation is based on the taste perception.  

Qualitative research : Data collection and analysis

• Qualitative data collection is the process by which observations or measurements are gathered in research.  
• The data collected are usually non-numeric and subjective and could be recorded in various methods, for instance, in case of one-to-one interviews, the responses may be recorded using handwritten notes, and audio and video recordings, depending on the interviewer and the setting or duration.  
• Once the data are collected, they should be transcribed into meaningful or useful interpretations. An experienced researcher could take about 8-10 hours to transcribe an interview’s recordings. All such notes and recordings should be maintained properly for later reference.  
• Some interviewers make use of “field notes.” These are not exactly the respondents’ answers but rather some observations the interviewer may have made while asking questions and may include non-verbal cues or any information about the setting or the environment. These notes are usually informal and help verify respondents’ answers.  

2. Qualitative data analysis 

• This process involves analyzing all the data obtained from the qualitative research methods in the form of text (notes), audio-video recordings, and pictures.  
• Text analysis is a common form of qualitative data analysis in which researchers examine the social lives of the participants and analyze their words, actions, etc. in specific contexts. Social media platforms are now playing an important role in this method with researchers analyzing all information shared online.   

There are usually five steps in the qualitative data analysis process: 5

• Prepare and organize the data  
• Transcribe interviews  
• Collect and document field notes and other material  
• Review and explore the data  
• Examine the data for patterns or important observations  
• Develop a data coding system  
• Create codes to categorize and connect the data  
• Assign these codes to the data or responses  
• Review the codes  
• Identify recurring themes, opinions, patterns, etc.  
• Present the findings  
• Use the best possible method to present your observations  

The following table 6 lists some common qualitative data analysis methods used by companies to make important decisions, with examples and when to use each. The methods may be similar and can overlap.  

Characteristics of qualitative research methods 4

• Unstructured raw data : Qualitative research methods use unstructured, non-numerical data , which are analyzed to generate subjective conclusions about specific subjects, usually presented descriptively, instead of using statistical data.  
• Site-specific data collection : In qualitative research methods , data are collected at specific areas where the respondents or researchers are either facing a challenge or have a need to explore. The process is conducted in a real-world setting and participants do not need to leave their original geographical setting to be able to participate.  
• Researchers’ importance : Researchers play an instrumental role because, in qualitative research , communication with respondents is an essential part of data collection and analysis. In addition, researchers need to rely on their own observation and listening skills during an interaction and use and interpret that data appropriately.  
• Multiple methods : Researchers collect data through various methods, as listed earlier, instead of relying on a single source. Although there may be some overlap between the qualitative research methods , each method has its own significance.  
• Solving complex issues : These methods help in breaking down complex problems into more useful and interpretable inferences, which can be easily understood by everyone.  
• Unbiased responses : Qualitative research methods rely on open communication where the participants are allowed to freely express their views. In such cases, the participants trust the interviewer, resulting in unbiased and truthful responses.  
• Flexible : The qualitative research method can be changed at any stage of the research. The data analysis is not confined to being done at the end of the research but can be done in tandem with data collection. Consequently, based on preliminary analysis and new ideas, researchers have the liberty to change the method to suit their objective.  

When to use qualitative research   4

The following points will give you an idea about when to use qualitative research .  

• When the objective of a research study is to understand behaviors and patterns of respondents, then qualitative research is the most suitable method because it gives a clear insight into the reasons for the occurrence of an event.  
• A few use cases for qualitative research methods include:  
• New product development or idea generation  
• Strengthening a product’s marketing strategy  
• Conducting a SWOT analysis of product or services portfolios to help take important strategic decisions  
• Understanding purchasing behavior of consumers  
• Understanding reactions of target market to ad campaigns  
• Understanding market demographics and conducting competitor analysis  
• Understanding the effectiveness of a new treatment method in a particular section of society  

A qualitative research method case study to understand when to use qualitative research 7

Context : A high school in the US underwent a turnaround or conservatorship process and consequently experienced a below average teacher retention rate. Researchers conducted qualitative research to understand teachers’ experiences and perceptions of how the turnaround may have influenced the teachers’ morale and how this, in turn, would have affected teachers’ retention.  

Method : Purposive sampling was used to select eight teachers who were employed with the school before the conservatorship process and who were subsequently retained. One-on-one semi-structured interviews were conducted with these teachers. The questions addressed teachers’ perspectives of morale and their views on the conservatorship process.  

Results : The study generated six factors that may have been influencing teachers’ perspectives: powerlessness, excessive visitations, loss of confidence, ineffective instructional practices, stress and burnout, and ineffective professional development opportunities. Based on these factors, four recommendations were made to increase teacher retention by boosting their morale.  

Advantages of qualitative research 1

• Reflects real-world settings , and therefore allows for ambiguities in data, as well as the flexibility to change the method based on new developments.  
• Helps in understanding the feelings or beliefs of the respondents rather than relying only on quantitative data.  
• Uses a descriptive and narrative style of presentation, which may be easier to understand for people from all backgrounds.  
• Some topics involving sensitive or controversial content could be difficult to quantify and so qualitative research helps in analyzing such content.  
• The availability of multiple data sources and research methods helps give a holistic picture.  
• There’s more involvement of participants, which gives them an assurance that their opinion matters, possibly leading to unbiased responses.   

Disadvantages of qualitative research 1

• Large-scale data sets cannot be included because of time and cost constraints.  
• Ensuring validity and reliability may be a challenge because of the subjective nature of the data, so drawing definite conclusions could be difficult.  
• Replication by other researchers may be difficult for the same contexts or situations.  
• Generalization to a wider context or to other populations or settings is not possible.  
• Data collection and analysis may be time consuming.  
• Researcher’s interpretation may alter the results causing an unintended bias.  

Differences between qualitative research and quantitative research 1

Frequently asked questions on qualitative research  

Q: how do i know if qualitative research is appropriate for my study  .

A: Here’s a simple checklist you could use:  

• Not much is known about the subject being studied.  
• There is a need to understand or simplify a complex problem or situation.  
• Participants’ experiences/beliefs/feelings are required for analysis.  
• There’s no existing hypothesis to begin with, rather a theory would need to be created after analysis.  
• You need to gather in-depth understanding of an event or subject, which may not need to be supported by numeric data.  

Q: How do I ensure the reliability and validity of my qualitative research findings?  

A: To ensure the validity of your qualitative research findings you should explicitly state your objective and describe clearly why you have interpreted the data in a particular way. Another method could be to connect your data in different ways or from different perspectives to see if you reach a similar, unbiased conclusion.   

To ensure reliability, always create an audit trail of your qualitative research by describing your steps and reasons for every interpretation, so that if required, another researcher could trace your steps to corroborate your (or their own) findings. In addition, always look for patterns or consistencies in the data collected through different methods.  

Q: Are there any sampling strategies or techniques for qualitative research ?   

A: Yes, the following are few common sampling strategies used in qualitative research :  

1. Convenience sampling  

Selects participants who are most easily accessible to researchers due to geographical proximity, availability at a particular time, etc.  

2. Purposive sampling  

Participants are grouped according to predefined criteria based on a specific research question. Sample sizes are often determined based on theoretical saturation (when new data no longer provide additional insights).  

3. Snowball sampling  

Already selected participants use their social networks to refer the researcher to other potential participants.  

4. Quota sampling  

While designing the study, the researchers decide how many people with which characteristics to include as participants. The characteristics help in choosing people most likely to provide insights into the subject.  

Q: What ethical standards need to be followed with qualitative research ?  

A: The following ethical standards should be considered in qualitative research:  

• Anonymity : The participants should never be identified in the study and researchers should ensure that no identifying information is mentioned even indirectly.  
• Confidentiality : To protect participants’ confidentiality, ensure that all related documents, transcripts, notes are stored safely.  
• Informed consent : Researchers should clearly communicate the objective of the study and how the participants’ responses will be used prior to engaging with the participants.  

Q: How do I address bias in my qualitative research ?  

  A: You could use the following points to ensure an unbiased approach to your qualitative research :  

• Check your interpretations of the findings with others’ interpretations to identify consistencies.  
• If possible, you could ask your participants if your interpretations convey their beliefs to a significant extent.  
• Data triangulation is a way of using multiple data sources to see if all methods consistently support your interpretations.  
• Contemplate other possible explanations for your findings or interpretations and try ruling them out if possible.  
• Conduct a peer review of your findings to identify any gaps that may not have been visible to you.  
• Frame context-appropriate questions to ensure there is no researcher or participant bias.

We hope this article has given you answers to the question “ what is qualitative research ” and given you an in-depth understanding of the various aspects of qualitative research , including the definition, types, and approaches, when to use this method, and advantages and disadvantages, so that the next time you undertake a study you would know which type of research design to adopt.  

References:  

• McLeod, S. A. Qualitative vs. quantitative research. Simply Psychology [Accessed January 17, 2023]. www.simplypsychology.org/qualitative-quantitative.html    
• Omniconvert website [Accessed January 18, 2023]. https://www.omniconvert.com/blog/qualitative-research-definition-methodology-limitation-examples/  
• Busetto L., Wick W., Gumbinger C. How to use and assess qualitative research methods. Neurological Research and Practice [Accessed January 19, 2023] https://neurolrespract.biomedcentral.com/articles/10.1186/s42466-020-00059  
• QuestionPro website. Qualitative research methods: Types & examples [Accessed January 16, 2023]. https://www.questionpro.com/blog/qualitative-research-methods/  
• Campuslabs website. How to analyze qualitative data [Accessed January 18, 2023]. https://baselinesupport.campuslabs.com/hc/en-us/articles/204305675-How-to-analyze-qualitative-data  
• Thematic website. Qualitative data analysis: Step-by-guide [Accessed January 20, 2023]. https://getthematic.com/insights/qualitative-data-analysis/  
• Lane L. J., Jones D., Penny G. R. Qualitative case study of teachers’ morale in a turnaround school. Research in Higher Education Journal . https://files.eric.ed.gov/fulltext/EJ1233111.pdf  
• Meetingsnet website. 7 FAQs about qualitative research and CME [Accessed January 21, 2023]. https://www.meetingsnet.com/cme-design/7-faqs-about-qualitative-research-and-cme     
• Qualitative research methods: A data collector’s field guide. Khoury College of Computer Sciences. Northeastern University. https://course.ccs.neu.edu/is4800sp12/resources/qualmethods.pdf  

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Qualitative Research – Methods, Analysis Types and Guide

Table of Contents

Qualitative Research

Qualitative research is a type of research methodology that focuses on exploring and understanding people’s beliefs, attitudes, behaviors, and experiences through the collection and analysis of non-numerical data. It seeks to answer research questions through the examination of subjective data, such as interviews, focus groups, observations, and textual analysis.

Qualitative research aims to uncover the meaning and significance of social phenomena, and it typically involves a more flexible and iterative approach to data collection and analysis compared to quantitative research. Qualitative research is often used in fields such as sociology, anthropology, psychology, and education.

Qualitative Research Methods

Qualitative Research Methods are as follows:

One-to-One Interview

This method involves conducting an interview with a single participant to gain a detailed understanding of their experiences, attitudes, and beliefs. One-to-one interviews can be conducted in-person, over the phone, or through video conferencing. The interviewer typically uses open-ended questions to encourage the participant to share their thoughts and feelings. One-to-one interviews are useful for gaining detailed insights into individual experiences.

Focus Groups

This method involves bringing together a group of people to discuss a specific topic in a structured setting. The focus group is led by a moderator who guides the discussion and encourages participants to share their thoughts and opinions. Focus groups are useful for generating ideas and insights, exploring social norms and attitudes, and understanding group dynamics.

Ethnographic Studies

This method involves immersing oneself in a culture or community to gain a deep understanding of its norms, beliefs, and practices. Ethnographic studies typically involve long-term fieldwork and observation, as well as interviews and document analysis. Ethnographic studies are useful for understanding the cultural context of social phenomena and for gaining a holistic understanding of complex social processes.

Text Analysis

This method involves analyzing written or spoken language to identify patterns and themes. Text analysis can be quantitative or qualitative. Qualitative text analysis involves close reading and interpretation of texts to identify recurring themes, concepts, and patterns. Text analysis is useful for understanding media messages, public discourse, and cultural trends.

This method involves an in-depth examination of a single person, group, or event to gain an understanding of complex phenomena. Case studies typically involve a combination of data collection methods, such as interviews, observations, and document analysis, to provide a comprehensive understanding of the case. Case studies are useful for exploring unique or rare cases, and for generating hypotheses for further research.

Process of Observation

This method involves systematically observing and recording behaviors and interactions in natural settings. The observer may take notes, use audio or video recordings, or use other methods to document what they see. Process of observation is useful for understanding social interactions, cultural practices, and the context in which behaviors occur.

Record Keeping

This method involves keeping detailed records of observations, interviews, and other data collected during the research process. Record keeping is essential for ensuring the accuracy and reliability of the data, and for providing a basis for analysis and interpretation.

This method involves collecting data from a large sample of participants through a structured questionnaire. Surveys can be conducted in person, over the phone, through mail, or online. Surveys are useful for collecting data on attitudes, beliefs, and behaviors, and for identifying patterns and trends in a population.

Qualitative data analysis is a process of turning unstructured data into meaningful insights. It involves extracting and organizing information from sources like interviews, focus groups, and surveys. The goal is to understand people’s attitudes, behaviors, and motivations

Qualitative Research Analysis Methods

Qualitative Research analysis methods involve a systematic approach to interpreting and making sense of the data collected in qualitative research. Here are some common qualitative data analysis methods:

Thematic Analysis

This method involves identifying patterns or themes in the data that are relevant to the research question. The researcher reviews the data, identifies keywords or phrases, and groups them into categories or themes. Thematic analysis is useful for identifying patterns across multiple data sources and for generating new insights into the research topic.

Content Analysis

This method involves analyzing the content of written or spoken language to identify key themes or concepts. Content analysis can be quantitative or qualitative. Qualitative content analysis involves close reading and interpretation of texts to identify recurring themes, concepts, and patterns. Content analysis is useful for identifying patterns in media messages, public discourse, and cultural trends.

Discourse Analysis

This method involves analyzing language to understand how it constructs meaning and shapes social interactions. Discourse analysis can involve a variety of methods, such as conversation analysis, critical discourse analysis, and narrative analysis. Discourse analysis is useful for understanding how language shapes social interactions, cultural norms, and power relationships.

Grounded Theory Analysis

This method involves developing a theory or explanation based on the data collected. Grounded theory analysis starts with the data and uses an iterative process of coding and analysis to identify patterns and themes in the data. The theory or explanation that emerges is grounded in the data, rather than preconceived hypotheses. Grounded theory analysis is useful for understanding complex social phenomena and for generating new theoretical insights.

Narrative Analysis

This method involves analyzing the stories or narratives that participants share to gain insights into their experiences, attitudes, and beliefs. Narrative analysis can involve a variety of methods, such as structural analysis, thematic analysis, and discourse analysis. Narrative analysis is useful for understanding how individuals construct their identities, make sense of their experiences, and communicate their values and beliefs.

Phenomenological Analysis

This method involves analyzing how individuals make sense of their experiences and the meanings they attach to them. Phenomenological analysis typically involves in-depth interviews with participants to explore their experiences in detail. Phenomenological analysis is useful for understanding subjective experiences and for developing a rich understanding of human consciousness.

Comparative Analysis

This method involves comparing and contrasting data across different cases or groups to identify similarities and differences. Comparative analysis can be used to identify patterns or themes that are common across multiple cases, as well as to identify unique or distinctive features of individual cases. Comparative analysis is useful for understanding how social phenomena vary across different contexts and groups.

Applications of Qualitative Research

Qualitative research has many applications across different fields and industries. Here are some examples of how qualitative research is used:

• Market Research: Qualitative research is often used in market research to understand consumer attitudes, behaviors, and preferences. Researchers conduct focus groups and one-on-one interviews with consumers to gather insights into their experiences and perceptions of products and services.
• Health Care: Qualitative research is used in health care to explore patient experiences and perspectives on health and illness. Researchers conduct in-depth interviews with patients and their families to gather information on their experiences with different health care providers and treatments.
• Education: Qualitative research is used in education to understand student experiences and to develop effective teaching strategies. Researchers conduct classroom observations and interviews with students and teachers to gather insights into classroom dynamics and instructional practices.
• Social Work : Qualitative research is used in social work to explore social problems and to develop interventions to address them. Researchers conduct in-depth interviews with individuals and families to understand their experiences with poverty, discrimination, and other social problems.
• Anthropology : Qualitative research is used in anthropology to understand different cultures and societies. Researchers conduct ethnographic studies and observe and interview members of different cultural groups to gain insights into their beliefs, practices, and social structures.
• Psychology : Qualitative research is used in psychology to understand human behavior and mental processes. Researchers conduct in-depth interviews with individuals to explore their thoughts, feelings, and experiences.
• Public Policy : Qualitative research is used in public policy to explore public attitudes and to inform policy decisions. Researchers conduct focus groups and one-on-one interviews with members of the public to gather insights into their perspectives on different policy issues.

How to Conduct Qualitative Research

Here are some general steps for conducting qualitative research:

• Identify your research question: Qualitative research starts with a research question or set of questions that you want to explore. This question should be focused and specific, but also broad enough to allow for exploration and discovery.
• Select your research design: There are different types of qualitative research designs, including ethnography, case study, grounded theory, and phenomenology. You should select a design that aligns with your research question and that will allow you to gather the data you need to answer your research question.
• Recruit participants: Once you have your research question and design, you need to recruit participants. The number of participants you need will depend on your research design and the scope of your research. You can recruit participants through advertisements, social media, or through personal networks.
• Collect data: There are different methods for collecting qualitative data, including interviews, focus groups, observation, and document analysis. You should select the method or methods that align with your research design and that will allow you to gather the data you need to answer your research question.
• Analyze data: Once you have collected your data, you need to analyze it. This involves reviewing your data, identifying patterns and themes, and developing codes to organize your data. You can use different software programs to help you analyze your data, or you can do it manually.
• Interpret data: Once you have analyzed your data, you need to interpret it. This involves making sense of the patterns and themes you have identified, and developing insights and conclusions that answer your research question. You should be guided by your research question and use your data to support your conclusions.
• Communicate results: Once you have interpreted your data, you need to communicate your results. This can be done through academic papers, presentations, or reports. You should be clear and concise in your communication, and use examples and quotes from your data to support your findings.

Examples of Qualitative Research

Here are some real-time examples of qualitative research:

• Customer Feedback: A company may conduct qualitative research to understand the feedback and experiences of its customers. This may involve conducting focus groups or one-on-one interviews with customers to gather insights into their attitudes, behaviors, and preferences.
• Healthcare : A healthcare provider may conduct qualitative research to explore patient experiences and perspectives on health and illness. This may involve conducting in-depth interviews with patients and their families to gather information on their experiences with different health care providers and treatments.
• Education : An educational institution may conduct qualitative research to understand student experiences and to develop effective teaching strategies. This may involve conducting classroom observations and interviews with students and teachers to gather insights into classroom dynamics and instructional practices.
• Social Work: A social worker may conduct qualitative research to explore social problems and to develop interventions to address them. This may involve conducting in-depth interviews with individuals and families to understand their experiences with poverty, discrimination, and other social problems.
• Anthropology : An anthropologist may conduct qualitative research to understand different cultures and societies. This may involve conducting ethnographic studies and observing and interviewing members of different cultural groups to gain insights into their beliefs, practices, and social structures.
• Psychology : A psychologist may conduct qualitative research to understand human behavior and mental processes. This may involve conducting in-depth interviews with individuals to explore their thoughts, feelings, and experiences.
• Public Policy: A government agency or non-profit organization may conduct qualitative research to explore public attitudes and to inform policy decisions. This may involve conducting focus groups and one-on-one interviews with members of the public to gather insights into their perspectives on different policy issues.

Purpose of Qualitative Research

The purpose of qualitative research is to explore and understand the subjective experiences, behaviors, and perspectives of individuals or groups in a particular context. Unlike quantitative research, which focuses on numerical data and statistical analysis, qualitative research aims to provide in-depth, descriptive information that can help researchers develop insights and theories about complex social phenomena.

Qualitative research can serve multiple purposes, including:

• Exploring new or emerging phenomena : Qualitative research can be useful for exploring new or emerging phenomena, such as new technologies or social trends. This type of research can help researchers develop a deeper understanding of these phenomena and identify potential areas for further study.
• Understanding complex social phenomena : Qualitative research can be useful for exploring complex social phenomena, such as cultural beliefs, social norms, or political processes. This type of research can help researchers develop a more nuanced understanding of these phenomena and identify factors that may influence them.
• Generating new theories or hypotheses: Qualitative research can be useful for generating new theories or hypotheses about social phenomena. By gathering rich, detailed data about individuals’ experiences and perspectives, researchers can develop insights that may challenge existing theories or lead to new lines of inquiry.
• Providing context for quantitative data: Qualitative research can be useful for providing context for quantitative data. By gathering qualitative data alongside quantitative data, researchers can develop a more complete understanding of complex social phenomena and identify potential explanations for quantitative findings.

When to use Qualitative Research

Here are some situations where qualitative research may be appropriate:

• Exploring a new area: If little is known about a particular topic, qualitative research can help to identify key issues, generate hypotheses, and develop new theories.
• Understanding complex phenomena: Qualitative research can be used to investigate complex social, cultural, or organizational phenomena that are difficult to measure quantitatively.
• Investigating subjective experiences: Qualitative research is particularly useful for investigating the subjective experiences of individuals or groups, such as their attitudes, beliefs, values, or emotions.
• Conducting formative research: Qualitative research can be used in the early stages of a research project to develop research questions, identify potential research participants, and refine research methods.
• Evaluating interventions or programs: Qualitative research can be used to evaluate the effectiveness of interventions or programs by collecting data on participants’ experiences, attitudes, and behaviors.

Characteristics of Qualitative Research

Qualitative research is characterized by several key features, including:

• Focus on subjective experience: Qualitative research is concerned with understanding the subjective experiences, beliefs, and perspectives of individuals or groups in a particular context. Researchers aim to explore the meanings that people attach to their experiences and to understand the social and cultural factors that shape these meanings.
• Use of open-ended questions: Qualitative research relies on open-ended questions that allow participants to provide detailed, in-depth responses. Researchers seek to elicit rich, descriptive data that can provide insights into participants’ experiences and perspectives.
• Sampling-based on purpose and diversity: Qualitative research often involves purposive sampling, in which participants are selected based on specific criteria related to the research question. Researchers may also seek to include participants with diverse experiences and perspectives to capture a range of viewpoints.
• Data collection through multiple methods: Qualitative research typically involves the use of multiple data collection methods, such as in-depth interviews, focus groups, and observation. This allows researchers to gather rich, detailed data from multiple sources, which can provide a more complete picture of participants’ experiences and perspectives.
• Inductive data analysis: Qualitative research relies on inductive data analysis, in which researchers develop theories and insights based on the data rather than testing pre-existing hypotheses. Researchers use coding and thematic analysis to identify patterns and themes in the data and to develop theories and explanations based on these patterns.
• Emphasis on researcher reflexivity: Qualitative research recognizes the importance of the researcher’s role in shaping the research process and outcomes. Researchers are encouraged to reflect on their own biases and assumptions and to be transparent about their role in the research process.

Advantages of Qualitative Research

Qualitative research offers several advantages over other research methods, including:

• Depth and detail: Qualitative research allows researchers to gather rich, detailed data that provides a deeper understanding of complex social phenomena. Through in-depth interviews, focus groups, and observation, researchers can gather detailed information about participants’ experiences and perspectives that may be missed by other research methods.
• Flexibility : Qualitative research is a flexible approach that allows researchers to adapt their methods to the research question and context. Researchers can adjust their research methods in real-time to gather more information or explore unexpected findings.
• Contextual understanding: Qualitative research is well-suited to exploring the social and cultural context in which individuals or groups are situated. Researchers can gather information about cultural norms, social structures, and historical events that may influence participants’ experiences and perspectives.
• Participant perspective : Qualitative research prioritizes the perspective of participants, allowing researchers to explore subjective experiences and understand the meanings that participants attach to their experiences.
• Theory development: Qualitative research can contribute to the development of new theories and insights about complex social phenomena. By gathering rich, detailed data and using inductive data analysis, researchers can develop new theories and explanations that may challenge existing understandings.
• Validity : Qualitative research can offer high validity by using multiple data collection methods, purposive and diverse sampling, and researcher reflexivity. This can help ensure that findings are credible and trustworthy.

Limitations of Qualitative Research

Qualitative research also has some limitations, including:

• Subjectivity : Qualitative research relies on the subjective interpretation of researchers, which can introduce bias into the research process. The researcher’s perspective, beliefs, and experiences can influence the way data is collected, analyzed, and interpreted.
• Limited generalizability: Qualitative research typically involves small, purposive samples that may not be representative of larger populations. This limits the generalizability of findings to other contexts or populations.
• Time-consuming: Qualitative research can be a time-consuming process, requiring significant resources for data collection, analysis, and interpretation.
• Resource-intensive: Qualitative research may require more resources than other research methods, including specialized training for researchers, specialized software for data analysis, and transcription services.
• Limited reliability: Qualitative research may be less reliable than quantitative research, as it relies on the subjective interpretation of researchers. This can make it difficult to replicate findings or compare results across different studies.
• Ethics and confidentiality: Qualitative research involves collecting sensitive information from participants, which raises ethical concerns about confidentiality and informed consent. Researchers must take care to protect the privacy and confidentiality of participants and obtain informed consent.

Also see Research Methods

About the author

Muhammad Hassan

Researcher, Academic Writer, Web developer

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Research Design Review

A discussion of qualitative & quantitative research design, qualitative research “participants” are not “respondents” (& other misplaced concepts from quantitative research).

But to assume that there is a direct relationship between qualitative and quantitative research would be a grave mistake. As discussed in an article posted in 2013 – “10 Distinctive Qualities of Qualitative Research” – the design, implementation, analysis, and interpretation of qualitative research make it unique and uniquely suited to go beyond survey research to study the complexities and meaning of the human experience.

And yet, researchers – both qualitative and quantitative – regularly overextend the applicability of quantitative ideas to qualitative research design. Although survey research informs the researcher of the basic elements of “good research” – and draws the researcher’s attention to core criteria dealing with sampling, error, bias, and so on – many quantitative concepts and techniques cannot and should not be considered in qualitative research. Here are just three examples:

Generalization. It may seem obvious to most researchers that the limited and highly variable nature of qualitative research makes it a poor predictor of things to come; however, many researchers have advocated the “generalizability” of qualitative data. Whether to further a budding theory or make assertions about an entire population segment, the concept of generalization in the context of qualitative research comes up often. In referring to the case study method, for instance, Earl Babbie, in his seventh edition of The Basics of Social Research (2016), laments “the limited generalizability of what is observed in a single instance of some phenomenon,” stating further that “this risk is reduced, however, when more than one case is studied in depth” (p. 312).

Qualitative research does not need generalization to be valuable but it does need transferability – i.e., the ability to transfer the qualitative design and/or outcomes to other highly specific contexts. Transferability is discussed in several Research Design Review articles, including this one posted in 2013 .

Percentages & data graphs. Qualitative researchers have been known to use percentages to report various aspects of their findings (Smith, 2011). There is also a tendency to use graphs or charts of some sort to display the data. Illustrations can be useful to help visualize qualitative data but there is no reason why the researcher needs to fall back on bar graphs or pie charts. Even when no percentages are used – e.g., the histograms of tagged content made available by online discussion platforms – the appearance of a quantitative-like data display not only hints that the researcher believes the qualitative data are quantifiable but also serves to ignore the whole point of qualitative research – i.e., the analysis of context and personal meaning – by reducing the data to a graphical configuration.

“Respondent.” The survey respondent is appropriately referred to as a “respondent” because that is exactly the role they play in the research process. They are responding to the researcher’s questions which are typically structured and closed-ended in format. Similarly, the qualitative research participant is suitably labeled “participant” because their role goes beyond simply replying to a series of questions to encompass participation in the research on many levels. The participant elaborates on the interviewer’s/moderator’s questions, changes the topic if need be to convey an idea, takes part in a social relationship with the interviewer/moderator, engages with other participants in a focus group discussion, is willingly observed in an ethnographic study, and, in some instances, is asked to aid in the analysis. For all of these reasons (and more), it is research participants that provide qualitative data not respondents.

Babbie, E. R. (2016). The basics of social research (7th ed.). Cengage learning.

Smith, K. (2011). Anxiety, Knowledge and Help: A Model for How Black and White College Students Search for HIV/AIDS Information on the Internet. The Qualitative Report , 16 (1), 103-125. Retrieved from https://nsuworks.nova.edu/tqr/vol16/iss1/6

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Good write up

Neither qualitative nor quantitative participants should be called respondents! They are people.

I find the use of graphs and percentages can provide a mixed method contribution, which Bridges the two approaches along a continuum rather than perceiving them as black and white. I do appreciate many of the points you have raised and have shared your article with my network. Worthy of discourse for sure.

Agreed, that is the beauty of the social sciences!

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Qualitative vs. Quantitative Data: 7 Key Differences

Qualitative data is information you can describe with words rather than numbers. 

Quantitative data is information represented in a measurable way using numbers. 

One type of data isn’t better than the other. 

To conduct thorough research, you need both. But knowing the difference between them is important if you want to harness the full power of both qualitative and quantitative data. 

In this post, we’ll explore seven key differences between these two types of data. 

#1. The Type of Data

The single biggest difference between quantitative and qualitative data is that one deals with numbers, and the other deals with concepts and ideas. 

The words “qualitative” and “quantitative” are really similar, which can make it hard to keep track of which one is which. I like to think of them this way: 

• Quantitative = quantity = numbers-related data
• Qualitative = quality = descriptive data

Qualitative data—the descriptive one—usually involves written or spoken words, images, or even objects. It’s collected in all sorts of ways: video recordings, interviews, open-ended survey responses, and field notes, for example. 

I like how researcher James W. Crick defines qualitative research in a 2021 issue of the Journal of Strategic Marketing : “Qualitative research is designed to generate in-depth and subjective findings to build theory.”

In other words, qualitative research helps you learn more about a topic—usually from a primary, or firsthand, source—so you can form ideas about what it means. This type of data is often rich in detail, and its interpretation can vary depending on who’s analyzing it. 

Here’s what I mean: if you ask five different people to observe how 60 kittens behave when presented with a hamster wheel, you’ll get five different versions of the same event. 

Quantitative data, on the other hand, is all about numbers and statistics. There’s no wiggle room when it comes to interpretation. In our kitten scenario, quantitative data might show us that of the 60 kittens presented with a hamster wheel, 40 pawed at it, 5 jumped inside and started spinning, and 15 ignored it completely.

There’s no ifs, ands, or buts about the numbers. They just are. 

#2. When to Use Each Type of Data

You should use both quantitative and quantitative data to make decisions for your business. 

Quantitative data helps you get to the what . Qualitative data unearths the why .

Quantitative data collects surface information, like numbers. Qualitative data dives deep beneath these same numbers and fleshes out the nuances there. 

Research projects can often benefit from both types of data, which is why you’ll see the term “mixed-method” research in peer-reviewed journals. The term “mixed-method” refers to using both quantitative and qualitative methods in a study. 

So, maybe you’re diving into original research. Or maybe you’re looking at other peoples’ studies to make an important business decision. In either case, you can use both quantitative and qualitative data to guide you.

Imagine you want to start a company that makes hamster wheels for cats. You run that kitten experiment, only to learn that most kittens aren’t all that interested in the hamster wheel. That’s what your quantitative data seems to say. Of the 60 kittens who participated in the study, only 5 hopped into the wheel. 

But 40 of the kittens pawed at the wheel. According to your quantitative data, these 40 kittens touched the wheel but did not get inside. 

This is where your qualitative data comes into play. Why did these 40 kittens touch the wheel but stop exploring it? You turn to the researchers’ observations. Since there were five different researchers, you have five sets of detailed notes to study. 

From these observations, you learn that many of the kittens seemed frightened when the wheel moved after they pawed it. They grew suspicious of the structure, meowing and circling it, agitated.

One researcher noted that the kittens seemed desperate to enjoy the wheel, but they didn’t seem to feel it was safe. 

So your idea isn’t a flop, exactly. 

It just needs tweaking. 

According to your quantitative data, 75% of the kittens studied either touched or actively participated in the hamster wheel. Your qualitative data suggests more kittens would have jumped into the wheel if it hadn’t moved so easily when they pawed at it. 

You decide to make your kitten wheel sturdier and try the whole test again with a new set of kittens. Hopefully, this time a higher percentage of your feline participants will hop in and enjoy the fun. 

This is a very simplistic and fictional example of how a mixed-method approach can help you make important choices for your business. 

#3. Data You Have Access To

When you can swing it, you should look at both qualitative and quantitative data before you make any big decisions. 

But this is where we come to another big difference between quantitative vs. qualitative data: it’s a lot easier to source qualitative data than quantitative data. 

Why? Because it’s easy to run a survey, host a focus group, or conduct a round of interviews. All you have to do is hop on SurveyMonkey or Zoom and you’re on your way to gathering original qualitative data. 

And yes, you can get some quantitative data here. If you run a survey and 45 customers respond, you can collect demographic data and yes/no answers for that pool of 45 respondents.

But this is a relatively small sample size. (More on why this matters in a moment.) 

To tell you anything meaningful, quantitative data must achieve statistical significance. 

If it’s been a while since your college statistics class, here’s a refresh: statistical significance is a measuring stick. It tells you whether the results you get are due to a specific cause or if they can be attributed to random chance. 

To achieve statistical significance in a study, you have to be really careful to set the study up the right way and with a meaningful sample size.

This doesn’t mean it’s impossible to get quantitative data. But unless you have someone on your team who knows all about null hypotheses and p-values and statistical analysis, you might need to outsource quantitative research. 

Plenty of businesses do this, but it’s pricey. 

When you’re just starting out or you’re strapped for cash, qualitative data can get you valuable information—quickly and without gouging your wallet. 

#4. Big vs. Small Sample Size

Another reason qualitative data is more accessible? It requires a smaller sample size to achieve meaningful results. 

Even one person’s perspective brings value to a research project—ever heard of a case study?

The sweet spot depends on the purpose of the study, but for qualitative market research, somewhere between 10-40 respondents is a good number. 

Any more than that and you risk reaching saturation. That’s when you keep getting results that echo each other and add nothing new to the research.

Quantitative data needs enough respondents to reach statistical significance without veering into saturation territory. 

The ideal sample size number is usually higher than it is for qualitative data. But as with qualitative data, there’s no single, magic number. It all depends on statistical values like confidence level, population size, and margin of error.

Because it often requires a larger sample size, quantitative research can be more difficult for the average person to do on their own. 

#5. Methods of Analysis

Running a study is just the first part of conducting qualitative and quantitative research. 

After you’ve collected data, you have to study it. Find themes, patterns, consistencies, inconsistencies. Interpret and organize the numbers or survey responses or interview recordings. Tidy it all up into something you can draw conclusions from and apply to various situations. 

This is called data analysis, and it’s done in completely different ways for qualitative vs. quantitative data. 

For qualitative data, analysis includes: 

• Data prep: Make all your qualitative data easy to access and read. This could mean organizing survey results by date, or transcribing interviews, or putting photographs into a slideshow format. 
• Coding: No, not that kind. Think color coding, like you did for your notes in school. Assign colors or codes to specific attributes that make sense for your study—green for positive emotions, for instance, and red for angry emotions. Then code each of your responses. 
• Thematic analysis: Organize your codes into themes and sub-themes, looking for the meaning—and relationships—within each one. 
• Content analysis: Quantify the number of times certain words or concepts appear in your data. If this sounds suspiciously like quantitative research to you, it is. Sort of. It’s looking at qualitative data with a quantitative eye to identify any recurring themes or patterns. 
• Narrative analysis: Look for similar stories and experiences and group them together. Study them and draw inferences from what they say.
• Interpret and document: As you organize and analyze your qualitative data, decide what the findings mean for you and your project.

You can often do qualitative data analysis manually or with tools like NVivo and ATLAS.ti. These tools help you organize, code, and analyze your subjective qualitative data. 

Quantitative data analysis is a lot less subjective. Here’s how it generally goes: 

• Data cleaning: Remove all inconsistencies and inaccuracies from your data. Check for duplicates, incorrect formatting (mistakenly writing a 1.00 value as 10.1, for example), and incomplete numbers. 
• Summarize data with descriptive statistics: Use mean, median, mode, range, and standard deviation to summarize your data. 
• Interpret the data with inferential statistics: This is where it gets more complicated. Instead of simply summarizing stats, you’ll now use complicated mathematical and statistical formulas and tests—t-tests, chi-square tests, analysis of variance (ANOVA), and correlation, for starters—to assign meaning to your data. 

Researchers generally use sophisticated data analysis tools like RapidMiner and Tableau to help them do this work. 

#6. Flexibility 

Quantitative research tends to be less flexible than qualitative research. It relies on structured data collection methods, which researchers must set up well before the study begins.

This rigid structure is part of what makes quantitative data so reliable. But the downside here is that once you start the study, it’s hard to change anything without negatively affecting the results. If something unexpected comes up—or if new questions arise—researchers can’t easily change the scope of the study. 

Qualitative research is a lot more flexible. This is why qualitative data can go deeper than quantitative data. If you’re interviewing someone and an interesting, unexpected topic comes up, you can immediately explore it.

Other qualitative research methods offer flexibility, too. Most big survey software brands allow you to build flexible surveys using branching and skip logic. These features let you customize which questions respondents see based on the answers they give.  

This flexibility is unheard of in quantitative research. But even though it’s as flexible as an Olympic gymnast, qualitative data can be less reliable—and harder to validate. 

#7. Reliability and Validity

Quantitative data is more reliable than qualitative data. Numbers can’t be massaged to fit a certain bias. If you replicate the study—in other words, run the exact same quantitative study two or more times—you should get nearly identical results each time. The same goes if another set of researchers runs the same study using the same methods.

This is what gives quantitative data that reliability factor. 

There are a few key benefits here. First, reliable data means you can confidently make generalizations that apply to a larger population. It also means the data is valid and accurately measures whatever it is you’re trying to measure. 

And finally, reliable data is trustworthy. Big industries like healthcare, marketing, and education frequently use quantitative data to make life-or-death decisions. The more reliable and trustworthy the data, the more confident these decision-makers can be when it’s time to make critical choices. 

Unlike quantitative data, qualitative data isn’t overtly reliable. It’s not easy to replicate. If you send out the same qualitative survey on two separate occasions, you’ll get a new mix of responses. Your interpretations of the data might look different, too. 

There’s still incredible value in qualitative data, of course—and there are ways to make sure the data is valid. These include: 

• Member checking: Circling back with survey, interview, or focus group respondents to make sure you accurately summarized and interpreted their feedback. 
• Triangulation: Using multiple data sources, methods, or researchers to cross-check and corroborate findings.
• Peer debriefing: Showing the data to peers—other researchers—so they can review the research process and its findings and provide feedback on both. 

Whether you’re dealing with qualitative or quantitative data, transparency, accuracy, and validity are crucial. Focus on sourcing (or conducting) quantitative research that’s easy to replicate and qualitative research that’s been peer-reviewed.

With rock-solid data like this, you can make critical business decisions with confidence.

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Young, urban, African: research explores what it means to be a good citizen in Ghana, Uganda and Tanzania

Professor, Department of Politics, Sewanee: The University of the South

Professor, Department of Political Science, Whitworth University

Professor, Department of Politics and Economics, Calvin University

Disclosure statement

Amy S. Patterson received funding to complete research for this article from Global Religion Research Initiative, University of Notre Dame, USA and the Council for Christian Colleges and Universities, USA.

Megan J. Hershey received funding to complete research for this article from Global Religion Research Initiative, University of Notre Dame, USA and the Council for Christian Colleges and Universities, USA

Tracy Kuperus received funding to complete the research for this article from the Global Religion Research Initiative, University of Notre Dame, USA and the Council for Christian Colleges and Universities, USA.

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Young people between the ages of 18 and 35 make up two-thirds of Africa’s population. The number is expected to reach 75% by 2030 . They live in an environment of rapid urbanisation , high unemployment rates and poor state services. These are some of the factors that incline young people towards political involvement – as seen in Kenya and Uganda most recently.

As the Kenya example illustrates, youth can use protests, advocacy, or voting to express their citizenship. At its most basic, citizenship is a legal recognition by the state that gives individuals rights and obligations.

But it’s more than that. Citizenship is a multifaceted, malleable identity , one in which citizens are always transforming and becoming through actions that generate a sense of belonging.

We have a combined 90 years of research experience investigating democracy and civil society, health policy and advocacy, and religion and politics in Africa. Our recent book, Africa’s Urban Youth , uses research in Ghana, Uganda and Tanzania to answer this question: how do youth understand their citizenship amid challenges (like growing economic inequality and uneven democratic progress) and opportunities to shape the continent’s future?

Drawing from extensive fieldwork in Accra, Kampala and Dar es Salaam, this book investigates how Africa’s urban youth cultivate a sense of citizenship in this challenging environment, and what it means to them to be a “good citizen”.

In interviews and focus group discussions, African youth, activists and community leaders explained how income, religion and gender intertwined with their sense of citizenship and belonging. They crafted a citizenship identity that was rooted in their relationships and obligations to each other and the state.

We found that citizenship is a fluid identity that stretches beyond disappointment, protest, or voting. Despite being portrayed as either disillusioned, manipulated trouble-makers or idealistic agents , youth citizens exhibit a rich identity rooted in social practices. They are not waiting on elders to solve their problems . They look towards the future, while acting on obligations to improve the here and now.

What we found

We conducted 39 focus groups with people aged 18 to 35 in higher- and lower-income neighbourhoods in Accra, Dar es Salaam and Kampala. We also carried out 33 interviews with youth activists, 28 interviews with pastors who work with youth, and five case studies of youth organisations. We wondered: from the vantage point of African youth, what does it mean to be a good citizen? And, how does being a good citizen affect their actions in the local community and country? Do they view good citizenship to be different for men and women?

We paired this qualitative data with Afrobarometer results on youth community involvement and political participation. Our objective was to use the stories, impressions and experiences shared by young people to uncover the nuance and complexity of the patterns found in countrywide survey data.

We found overarching trends when we probed views of “good citizenship”. Although many began with legalistic replies — “a good citizen has an identification card” — most quickly moved to describing citizenship as daily actions within their own spheres of influence.

This citizenship crosses public-private boundaries, revealing itself in the household, market, workplace, classroom, worship space, street and voting booth.

The good citizen : Our respondents repeatedly described citizenship as active. The good citizen cares for a sick co-parishioner, lends a friend money, picks up trash in the community, patrols the neighbourhood at night to thwart thieves (for men) and raises children (for women). The good citizen also shares ideas at community meetings, prays for the nation (for churchgoers), gets an education, starts a business, and/or employs others.

For respondents, these actions helped to “build the nation”, an expression used predominantly by Tanzanian and Ghanaian respondents. This is perhaps due to its use by those countries’ independence leaders, Julius Nyerere and Kwame Nkrumah .

Our youth respondents imbued citizenship with a moral tenor. Many asserted that good citizens not only follow the law, but they also greet their neighbours, maintain peace in the community, and, for women, do not drink or stay out late. Tanzanians in particular emphasised these moral themes, as did mainline Christians (even more than Pentecostals). Youth were acutely aware that some elders urged this “future generation” to act appropriately and contribute to communal projects such as work days, while also denying youth status in public spaces.

Voting : Youth in our study spent little time describing good citizenship as voting, advocating or protesting. Ghanaians were slightly more talkative about these activities. Youth across the three countries viewed voting to be an expected, moral action with a social component . This echoed Afrobarometer findings that about 80% of youth do vote (a rate 5-8 percentage points below that of older adults).

They linked advocacy and protesting to their daily struggles and obligations. Protesting unfair economic practices reflected the need for money to help family or neighbours in need, an act of good citizenship. Advocating about domestic violence laws or mental health funding was rooted in personal experiences that pushed some youth to claim rights from the state.

Income: Income matters for how youth define their citizenship. Lower-income youth were more likely to stress community actions and obligations, while higher-income youth emphasised that others, particularly lower-income people, must obey the law.

Perhaps due to Ghana’s higher average income, its youth mentioned specific communal activities less than the broad notion that citizens build the nation. Regardless of income, youth – particularly men – asserted that entrepreneurship and hard work indicated good citizenship.

Coming of age with few state services and free market policies, they had absorbed neoliberal themes espoused by religious and political leaders. Neoliberalism, though, meant that good citizenship seemed unattainable to the unemployed youth who faced significant economic obstacles.

The bottom line

Three years of fieldwork in the three countries revealed that youth citizenship is distinct. Young people speak of specific challenges such as employment, obstacles to political leadership, and marriage expectations. But they are not despondent.

They also stress age-related contributions to building the nation, such as caring for children or doing physical work to improve their neighbourhood.

As youth continue to engage ever more boldly in politics, they will bring their citizenship understandings with them. Their productive and often visionary citizenship efforts reflect the value they place on both public and private actions, as well as their desire to see themselves represented as full citizens of their countries.

• Citizenship
• Neoliberalism
• Economic inequality
• Afrobarometer
• African cities
• Kwame Nkrumah
• Africa urbanisation
• Julius Nyerere
• African society
• KenyaTaxProtests

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Teaching public policy research skills to tomorrow’s leaders

When students learn the fundamentals of public policy research, they also acquire tools to evaluate how institutions operate and how those same tools can be used to solve problems in their communities. This blended learning approach can level up these skills

Christopher Kromphardt

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College students increasingly need to understand the role that data plays in public policy decisions as they seek to be engaged participants in civic life . As it turns out, most Americans agree with us that an awareness of how data-driven research affects policymaking can prepare young people for the future. Nearly 80 per cent of respondents within each generation – from the Silent Generation to Gen Z – agree that young people should be provided with “training to help them understand the political system or solve problems in their communities”, according to a January 2024 PRRI survey .

What do young people learn when they are trained in the fundamentals of public policy research ? First, they come to know the structure of the political system through its important public policymaking institutions. They also acquire policy research tools to evaluate how these institutions operate; later, these same tools can be used to solve problems in their communities.

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We combined our team’s expertise in public policy research and instructional design to facilitate a six-week fully online summer policy research institute (SPRI) at the University of Iowa from 2020 to 2022. The SPRI’s purpose was to train any university student, regardless of their experience or location, in how research supports public policy and about key mindsets and practices associated with public policy research.

A blended learning institute for training young people

The SPRI combined multiple learning methods, such as asynchronous online lessons combined with live sessions. The SPRI’s blend, described as “bi-chronous” online learning, involved asynchronous and synchronous online approaches . Participants were required to participate in two hours of synchronous/live classes and at least one hour of asynchronous learning per week. Students were encouraged to spend more time, but three hours was the minimum .

SPRI’s blend was informed by best practices in instructional design . First, we used backwards design to define learning objectives before developing learning experiences. The SPRI’s learning objectives and content align with the Entering Research (ER) conceptual framework, a popular approach for research trainees’ development . We tackled six core topics: research ethics , research communication , research team roles and responsibilities, research design, qualitative research methods, and quantitative research methods.

Second, we struck a balance between asynchronous and synchronous online learning experiences. Each week, students completed a custom-built asynchronous learning module – which consisted of curated readings, videos (original and from YouTube) and quizzes – followed by a synchronous active-learning session held over Zoom. For the live sessions, we adapted ER content and developed original content to be delivered by instructors and guest speakers associated with our university’s Public Policy Center, whose expertise ranged broadly across areas including health, education and criminal justice policy. One example of a training activity we facilitated was the “three-minute research story” ER activity to practise strategies for communication about technical subjects . In weekly synchronous “sharing sessions”, students delivered short presentations describing a policy research project of their choosing. Finally, several students published policy briefs they had coauthored with faculty mentors on the centre’s website.

This balance illustrates how our blend used scaffolded activities to support and enhance learning. After starting with fundamental understandings of core research and public policy concepts, we advanced to real-world applications. We devoted special attention to supporting learning transfer; we took students step by step towards how to apply information gleaned from the SPRI within directed research experiences.

Evaluating using a blended approach to teaching public policy research

Given the six-week timeline and the diversity of our participants’ backgrounds and experience levels, we sought evidence that showed the SPRI had achieved its learning objectives.

One metric of the SPRI’s success is its alignment with learning science principles. Our approach to integrating videos, readings and quizzes with structured live sessions drew on insights from the learning sciences. We worked to guide students as they formed connections with new information that expanded on their prior knowledge (building associations) to present content in both words and visuals (dual coding) and to organise information into manageable units (chunking). Also, we worked to stimulate deep mental processing, where meaningful learning took place through activities such as reflection , discussions, debates and receiving expert feedback . Here, it’s important to note that success in blended learning may require instructors to embrace student-centred, active learning designs, as opposed to an instructor-centred, content-driven approach.

We also used the ER learning assessment to evaluate how students perceived their learning gains. They reported consistent moderate or better gains across the ER learning objectives. Students reported greatest average gains in research ethics and equity and inclusion awareness and skills , followed by research comprehension and communication skills; researcher confidence and independence; practical research skills, and researcher identity. Our students also reported that, on average, they were very likely to recommend the SPRI to another student and were more likely to continue research after SPRI.

Overall, this evidence suggests that SPRI is a model that others can use to prepare students for the future. Through public policy research, young people develop the skills to understand the political system and solve problems in their communities.

Chris Kromphardt is assistant programme director and lecturer in data analytics and policy at Johns Hopkins University. He held previous positions in the Public Policy Center and department of educational policy and leadership studies at the University of Iowa.

Mark Anthoney is lead instructional designer in distance and online education, and Cassidy Branch is interim manager of research services in the Public Policy Center, both at the University of Iowa.

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• Open access
• Published: 03 August 2024

Workplace support for physicians during the COVID-19 Pandemic: Did it affect burnout?

• Joy Melnikow 1 ,
• Guibo Xing 2 ,
• Marykate E. Miller 2 ,
• Sabrina Loureiro 3 ,
• Andrew J. Padovani 4 ,
• Robin Whitney 5 &
• Richard L. Kravitz 6  

BMC Health Services Research volume  24 , Article number:  888 ( 2024 ) Cite this article

158 Accesses

Metrics details

A concern before 2020, physician burnout worsened during the COVID-19 pandemic. Little empirical data are available on pandemic workplace support interventions or their influence on burnout. We surveyed a national sample of frontline physicians on burnout and workplace support during the pandemic.

We surveyed a stratified random sample of 12,833 US physicians most likely to care for adult COVID-19 patients from the comprehensive AMA Physician Professional Data ™ file. The sample included 6722 primary care physicians (3331 family physicians, 3391 internists), 880 hospitalists, 1783 critical care physicians (894 critical care physicians, 889 pulmonary intensivists), 2548 emergency medicine physicians, and 900 infectious disease physicians. The emailed survey elicited physicians’ perceptions of organizational interventions to provide workplace support and/or to address burnout. Burnout was assessed with the Professional Fulfillment Index Burnout Composite scale (PFI-BC). Proportional specialty representation and response bias were addressed by survey weighting. Logistic regression assessed the association of physician characteristics and workplace interventions with burnout.

After weighting, respondents were representative of the total sample. Overall physician burnout was 45.4%, significantly higher than in our previous survey. Open-ended responses mentioned that staffing shortages (physician, nursing, and other staff) combined with the increased volume, complexity, and acuity of patients during the pandemic increased job demands. The most frequent workplace support interventions were direct pandemic control measures (increased access to personal protective equipment, 70.0%); improved telehealth functionality (43.4%); and individual resiliency tools (yoga, meditation, 30.7%). Respondents placed highest priority on workplace interventions to increase financial support and increase nursing and clinician staffing. Factors significantly associated with lower odds of burnout were practicing critical care (compared with emergency medicine) OR 0.33 (95% CI 0.12 – 0.93), improved telehealth functionality OR 0.47 (95% CI 0.23 – 0.97) and being in practice for 11 years or longer OR 0.44 (95% CI 0.19–0.99).

Conclusions

Burnout across frontline specialties increased during the pandemic. Physician respondents focused on inadequate staffing in the context of caring for more and sicker patients, combined with the lack of administrative efforts to mitigate problems. Burnout mitigation requires system-level interventions beyond individual-focused stress reduction programs to improve staffing, increase compensation, and build effective teams.

Peer Review reports

Introduction

Already a recognized concern before 2020 [ 1 ], physician burnout worsened during the COVID-19 pandemic [ 2 , 3 , 4 ]. Considered to result from excessive job demands combined with limited workplace resources and chronic emotional and interpersonal job stress, burnout is associated with chronic exhaustion, inefficacy, and cynicism [ 5 ].

The job demands-resources (JDR) model conceptualizes job resources as having a buffering effect on burnout resulting from excessive job demands [ 6 , 7 ]. In medicine, job demands include high work pressure and emotionally demanding interactions with patients and families, both notably increased during the pandemic [ 4 ]. Job resources include physical, psychological, social or organizational aspects of the job that are functional for achieving work goals, reducing job demands, or stimulating personal growth, learning and development. Interventions that effectively address burnout may impact not only professional satisfaction and fulfillment, but also patient safety [ 8 ]. The estimated system costs of physician burnout range from $2.6 billion to $6.3 billion each year [ 9 ].

The COVID-19 pandemic markedly increased job demands on physicians, initially in a setting of scarce resources such as personal protective equipment (PPE) and COVID testing. Infected colleagues and staff were sometimes unable to quarantine due to demands increased on those still working. Simultaneously, physicians experienced increased emotional stress due to lack of effective treatments for growing numbers of gravely ill patients and personal fears of contracting COVID-19 and infecting their families, potentially resulting in severe illness and death. Once vaccinations became widely available, frontline physicians continued to care for very ill patients who had declined vaccination. These unprecedented circumstances had high potential to increase physician burnout.

Hospital and health systems made efforts to attenuate physician stress and burnout. Healthcare workplace responses during the pandemic intended to support healthcare workers included implementing policies to reduce COVID-19 transmission by increasing access to PPE and COVID-19 testing; increasing staffing and providing more flexibility of staffing assignments; expanding telehealth; and increasing communication between administrators and physicians. Other supports focused on individual healthcare workers, including opportunities for counseling and peer support, providing other wellness resources such as meditation apps and yoga classes, access to childcare, and meals.

Little empirical data are available to document these interventions or to understand their influence on burnout. To better understand the physician perspective on how workplace support was implemented during the pandemic, in June 2022 we surveyed a national sample of frontline physicians, inquiring about the types of support implemented at their workplaces during the pandemic and evaluating their burnout levels. We examined the frequency of workplace support interventions and their association with physician burnout. We compared burnout scores in the current survey to scores from frontline physician surveys conducted earlier in the pandemic (May–June 2020 and December 2020-January 2021).

This study was considered low risk and exempt from written informed consent by the Institutional Review Board of the University of California, Davis.

The AMA Physician Professional Data™ includes essentially all practicing physicians (MDs and DOs) in the United States; hence random samples are nationally representative [ 10 ]. We leased a random sample of frontline physician emails from the AMA Physician Professional Data including internists, family physicians, infectious disease, hospitalists, critical care, pulmonary critical care, and emergency medicine. Physicians from smaller specialties (hospitalists, critical care physicians, infectious disease physicians and emergency medicine physicians) were intentionally oversampled to improve representation in survey responses. Responses from oversampled specialties were adjusted by weighting as described below.

The 2020 sample was expanded in 2021 from 10,000 to 15,000 emails before removal of invalid emails. After removal of invalid emails over 2 rounds of surveys in 2021 and 2022, 12,833 US physicians most likely to care for adult COVID-19 patients comprised the sample generated from the comprehensive AMA Physician Professional Data ™ file. The sample included: 6722 primary care physicians (3331 family physicians and 3391 internists), 880 hospitalists, 1783 critical care physicians (894 critical care and 889 pulmonary intensivists), 2548 emergency medicine physicians, and 900 infectious disease physicians.

The data provided included information on specialty, gender, years in practice, type of practice, and practice location for each physician in the sample. This survey, our third physician survey during the pandemic that included the Professional Fulfillment Index Burnout Composite scale (PFI-BC) [ 11 ], was conducted in June 2022. Previous surveys were conducted in June-July 2020 and December 2020 – Jan 2021. The sample for these earlier surveys has been previously described [ 2 ].

The survey was distributed in Qualtrics (Qualtrics © 2021 Provo, UT) via email three times over three weeks. To encourage response, emailed physicians were offered the opportunity to be entered in a gift card lottery. We assessed physician burnout and elicited physicians’ perceptions of organizational interventions instituted locally to provide workplace support and/or to address burnout. The survey was developed to inquire about respondents’ current work status and changes during the pandemic. It included both multiple choice questions with write-in options and narrative, open-ended questions. Burnout was assessed with the PFI-BC, a validated, open access measure of physician burnout. The PFI-BC averages the work exhaustion and interpersonal disengagement scales; respondents are asked to rate the items over the previous two weeks. Burnout was defined by a composite score of greater than 1.4 (calculated as the summed score of the 10 items comprising these two scales divided by 10) [ 12 ]. Multiple choice questions inquired about a range of options for workplace support that might have been implemented during the pandemic and which interventions at the time of the survey respondents felt should be continued or implemented. Options for interventions listed in the survey were based on prior literature [ 1 , 13 , 14 , 15 ], focus groups with frontline physicians conducted by our team early in the pandemic, informal discussions with colleagues, and the physician authors’ personal experience. A copy of the survey is available in the online appendix (Supplement attachment 1 ).

The analysis was designed to maximize sample representativeness and reduce bias. Random sampling from a comprehensive national sampling frame ensured that survey eligibility was free of selection bias. Weighting was applied to achieve representativeness and reduce non-response bias: sampling design weights adjusted the sample to be representative of the specialties in the sampling frame, and non-response weights addressed bias due to physician response self-selection. All data processing and analyses were performed with SAS 9.4 and Stata/MP 16™. After weighting, internal medicine and family medicine physicians were combined as a primary care category, and critical care and pulmonary critical care physicians were combined as critical care for analysis.

Sampling weights, based on AMA-supplied specialty categories, were calculated as the inverse of the probability of selection for each specialty. Non-response weights were constructed using entropy balancing [ 16 ], a nonparametric generalization of the propensity score weighting approach [ 17 ] to estimate the response probability of each physician in our sample based on observed characteristics: specialty, geography, years in practice, and type of practice. Considering that a physician's response probability is correlated with the observable characteristics in the sampling frame data, we adjusted our sample of respondents to be representative of all sampled physicians by including the response probability in the inverse probability weighting procedure. Entropy balancing, performed with the KMATCH module for Stata, constructed unit weights calibrated to match the mean, variance, and skewness of the full sample [ 18 ].

Weighted descriptive statistics were calculated; respondent characteristics were compared to the characteristics of the full sample. Logistic regression was used to analyze association of physician characteristics and workplace support interventions with burnout, adjusting for geographic variation in the COVID-19 case count and change in COVID-19 rates in the two weeks prior to survey completion for the respondent’s county, and adjusting by the respondent’s state to account for state COVID-19 policy variation. The analysis incorporated the survey data stratification, clustering, and unequal weighting among different specialties. Spearman’s correlations were used to examine correlations between types of workplace support.

Narrative responses to questions were tabulated, reviewed, and categorized by common themes.

344 responses were received. After weighting, respondents were representative of the total sample; the standard difference in means was 0, indicating perfect balance on measured characteristics. Characteristics of respondents and non-respondents are shown in Table  1 . Thirty six percent were women, 23.5% were emergency medicine physicians, 46% were primary care (internists and family physicians), 17.1% were critical care (critical care and pulmonary critical care physicians), 7.3% were hospitalists, and 6.1% were infectious disease physicians. Before weighting, a slightly higher percentage of respondents were women, practicing critical care and emergency medicine, and had been in practice for 10 years or less. Roughly 5% more respondents than non-respondents worked as hospital staff, and 6% fewer respondents were internists. Thirty one percent reported changing positions during the pandemic. Among all the respondents to the series of three surveys that included the burnout measure, 47 (6.7%) responded to all three surveys.

Overall burnout among frontline physicians, as defined by a score > 1.4 on the PFI, decreased from 37.5% in survey 1 (June 2020) to 33.6% in survey 2 (December 2020-January 2021), and then increased to 45.4% at the 3rd survey assessing burnout (June 2022). Overall, the proportion of physicians reporting burnout in the 3rd survey was significantly higher compared with the 2nd survey (odds ratio (OR) 1.67; 95% CI 1.03–2.73). Burnout scores were similar among physicians who had changed positions (mean scale score, 1.33) and those who did not (1.31).

Open-ended responses frequently mentioned that staffing shortages (physician, nursing, and other staff) combined with the increased volume, complexity, and acuity of patients during the pandemic were sources of extremely increased job demands. Respondents also noted their perceptions of increasing polarization and anger among patients. These stressors were felt across a range of specialties and settings, from large health systems to small group or individual practices. Table 2 shows illustrative physician responses related to these themes. Several respondents also noted the need for help with childcare, which had not been supported by their workplace. A few primary care respondents noted a sense of gratification from working in effective teams.

The frequencies of workplace support interventions reported by respondents are shown in Table  3 . Direct pandemic control interventions, such as increasing access to PPE, were the most common workplace support interventions, provided by 69.8% of respondents’ workplaces. Improved telehealth functionality, the next most frequent intervention, was cited by 43.4%. Individual level resiliency tools to support physicians (for example offering peer counseling, providing apps for meditation, or yoga classes) were next most frequent (30.7%), followed by workload management (26.5%). Financial bonuses, non-financial recognition and EHR improvements were least common. We found statistically significant, but low correlations ranging from 0.12 to 0.31 between the workplace support interventions (data not shown).

We solicited physicians’ opinions as to which interventions ought to be initiated or continued. The most frequent responses (ranked in the top three) were financial bonuses/salary increases (47.4%), adding physician staff (34.8%), and adding nonphysician staff (33.8%). Hospitalists (64.0%) and emergency medicine physicians (57.8%) most often cited financial incentives; critical care physicians (49.1%), infectious disease physicians (47.4%) and primary care physicians (39.2%) mentioned financial incentives less frequently (chi square for distribution p  = 0.04). Very few respondents prioritized individual level resiliency resources (3.20%) or nonfinancial recognition (3.20%).

Using multivariable logistic regression, we examined the association of burnout in this survey to specialty, years in practice, workplace support interventions, and the correspondence between what support interventions physicians said would help and what they reported that they received (Table  4 ). The analysis adjusted for geographic variation in COVID-19 current intensity and region. Most workplace support interventions were not associated with reduced odds of burnout. These included pandemic control interventions (which were relatively common), individual level resiliency tools (somewhat common), increased financial support, non-financial recognition, electronic health record improvements, or efforts to address workload management tools (all relatively uncommon). Factors significantly associated with lower odds of burnout were practicing critical care (compared with emergency medicine) OR 0.33 (95% CI 0.12 – 0.93), improved telehealth functionality OR 0.47 (95% CI 0.23 – 0.97) and being in practice for 11 years or longer OR 0.44 (95% CI 0.19–0.99). When a respondent’s reported workplace supports corresponded to what respondents ranked as their top 3 interventions that should be initiated or continued, burnout was lower but not statistically significant: OR 0.41 (95% CI 0.14 – 1.15).

In summary, we found that burnout across frontline specialties increased between early 2020 (near the onset of the Covid-19 pandemic) and June 2022. Frontline physicians reported exhaustion (the effects of which appeared to be cumulative), demoralization resulting from inadequate staffing, and perceived inadequacy of administrative efforts to mitigate problems. Another source of professional stress was patient anger fueled by polarization. System-level workplace support interventions outside of pandemic control interventions and improved telehealth functionality were relatively infrequent. Mitigating factors associated with lower odds of burnout included working in critical care, longer experience since residency and workplace provision of improved telehealth functionality. Respondents placed highest priority on workplace interventions to increase financial support and increased nursing and clinician staffing.

Our study is limited by the low response rate and the overall cross-sectional design. The random sample from a comprehensive sampling frame with known characteristics enabled us to adjust for nonresponse bias, but concern remains that responses were not fully representative of U.S. frontline physicians caring for adults. The inverse probability weighting and propensity score-based adjustments for nonresponse that we applied are standard, widely used methods to adjust samples to be representative of the target population and reduce bias [ 19 ]. The propensity-score based methods applied in our study accounted for non-response bias correlated with observed characteristics of responders and non-responders. We cannot rule out non-response bias correlated with characteristics we could not observe, however.

We obtained our physician sample early in the pandemic, before COVID-19 was known to impact substantial numbers of children and pregnant women, consequently pediatricians and obstetricians were not included in our sample and these important frontline physician perspectives are not included. Only 6.7% of respondents to the workplace support survey responded to all three surveys; hence the data are largely cross-sectional at three time points.

The COVID-19 pandemic challenged the American healthcare delivery system and degraded the health and wellbeing of U.S. physicians. Beyond the risk of death and severe illness attendant to working in healthcare settings, particularly before vaccines were available, high pandemic-related workloads and personal stressors have taken a continued toll on the emotional and psychological wellbeing of healthcare workers. Our findings of increased burnout among US frontline physicians are consistent with other research. A national survey of physicians in the United Kingdom (UK) found that 47% experienced a decline in mental health and 34% experienced a decline in physical health since the pandemic began [ 20 ]. A similar study of family medicine physicians in the United States and Canada found high levels of depersonalization (36%) and emotional exhaustion (67%) [ 21 ]. A national survey of emergency room physicians in Canada found that while 84% reported negative emotions, such as anxiety or fear, most did not seek mental health support [ 22 ]. These findings are especially concerning in light of the already high levels of burnout and emotional exhaustion among physicians that preceded the pandemic.

In the study by Linzer et al., U.S. physicians and advanced practice clinicians experienced increasing rates of burnout throughout the pandemic. [ 4 ] Consistent with the JDR model, lack of control over work and a fast-paced, chaotic environment were associated with more burnout, whereas mitigating factors such as feeling valued and experiencing good teamwork were associated with less. These findings are consistent with comments by some primary care physicians in our survey who described the benefits of belonging to strong teams with a sense of camaraderie.

There is concern that increasing burnout will result in early retirements, further contributing to the clinician workforce shortage [ 23 , 24 , 25 ], though data on physician retirement rates in the US during the pandemic are lacking. Our finding that longer experience in practice was associated with lower odds of burnout is consistent with a survey of family physician educators [ 21 ]. It suggests that workplace support interventions directed to the needs of younger physicians will be important to sustain the physician workforce.

The CDC, AMA, and Joint Commission on Accreditation of Hospitals (Joint Commission) among others made recommendations on supporting healthcare workers during the pandemic [ 26 , 27 , 28 ]. Our study directly solicited the priorities for workplace support from frontline physicians. It is clear from our respondents that system-level interventions are needed to improve staffing, increase compensation (which may add both material and symbolic value), and build effective teams. Workplace interventions directed at individual wellness may have benefits for some individuals but are perceived by other as attempts to transfer responsibility for system-level problems to individuals. Yoga classes, meditation apps, and peer counseling, commonly offered by health systems, are not perceived as solutions to the critical system-level challenges contributing to burnout.

In terms of the JDR model [ 7 ], interventions are needed to increase resources that are functional in achieving work goals, reducing job demands, or stimulating personal growth through work. It is striking that improved telehealth functionality, a system-level intervention that fits this resource definition, was associated with lower odds of burnout. One respondent commented on the need for strategic management of increased use of telehealth: “ We need more strategic thinking about managing the shift to greater virtual care. We've adapted to telehealth and portal messaging in the near term but haven't really thought about a proactive plan to manage and promote electronic care or how to rethink provider compensation, care team productivity, or future brick-and-mortar needs.” Interventions that provide an avenue for physicians to change burdensome aspects of the EMR or to suggest other workplace improvements have been piloted [ 29 ].

Intervention research is needed to evaluate the potential benefits of system-level changes . Cluster-randomized trials, regression-discontinuity designs, or step-wedge designs could evaluate the impact of interventions to build effective teams and innovative staffing models. Interventions that enable physicians to devote 20% of their medical practice to a part of their work that is especially meaningful to them have been suggested to be effective [ 30 ]. Policy changes, including nurse to patient ratios (which may impact physician workload) and work hour limits and/or workload limits for physicians also deserve further research [ 31 , 32 ].

Our results represent frontline physicians’ perspectives on what workplace support interventions were implemented and what is needed going forward. While health system administrators might tell a different story, the perspectives of the potential recipients of workplace support interventions are key.

Although some impacts of the pandemic on health systems and physicians may be attenuating as the high rates of hospitalization and death due to COVID-19 have decreased, physician burnout and effective workplace interventions to mitigate burnout remain important areas for research. A concern before the pandemic, physician burnout will remain a challenge going forward. Future pandemics and other serious challenges to the delivery of health care are likely, and implementation of what we learn through research about workplace interventions to support clinician wellbeing will enhance the resilience of both individuals and health care systems.

Availability of data and materials

Data are provided within the manuscript and supplemental file.

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Acknowledgements

The authors thank the physicians who contributed their valuable time to respond to our surveys during an unprecedented pandemic.

The study was funded through internal funds from the Center for Healthcare Policy and Research at the University of California, Davis.

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Joy Melnikow

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Guibo Xing & Marykate E. Miller

Center for Global Health, Weill Cornell Medicine, New York, NY, USA

Sabrina Loureiro

JBS International, Inc, San Mateo, CA, USA

Andrew J. Padovani

The Valley Foundation School of Nursing, San Jose State University, San Jose, CA, USA

Robin Whitney

Division of General Internal Medicine, University of California, Davis, Sacramento, CA, USA

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Contributions

JM and RLK conceived the research;  MM and SL conducted the survey, collected and cleaned the data; AJP designed the original weighting and analysis design; GX conducted the analysis; all authors (JM, MM, SL, GX, AJP, RW and RLK) participated in the interpretation of the findings; JM drafted the manuscript; and all authors reviewed, edited, and approved the final version of the manuscript.

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Correspondence to Joy Melnikow .

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This study was reviewed by the University of California Davis Institutional Review Board and determined to have methods in accordance with guidelines and regulations qualifying it as a low-risk study. As such, informed consent was obtained through the recipients’ review of the email and cover letter containing the link to the physician survey.

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Melnikow, J., Xing, G., Miller, M.E. et al. Workplace support for physicians during the COVID-19 Pandemic: Did it affect burnout?. BMC Health Serv Res 24 , 888 (2024). https://doi.org/10.1186/s12913-024-11366-5

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Received : 27 November 2023

Accepted : 26 July 2024

Published : 03 August 2024

DOI : https://doi.org/10.1186/s12913-024-11366-5

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ORIGINAL RESEARCH article

Prison healthcare service use and associated factors: a cross sectional study in northwestern ethiopia.

• 1 Department of Psychology, College of Social Sciences and Humanities, University of Gondar, Gondar, Ethiopia
• 2 Department of Social Anthropology, College of Social Sciences and Humanities, University of Gondar, Gondar, Ethiopia
• 3 Department of Criminology and Criminal Justice, College of Social Sciences and Humanities, University of Gondar, Gondar, Ethiopia
• 4 Department of Law, School of Law, University of Gondar, Gondar, Ethiopia

Introduction: Studies on inmates’ Health Care Service (HCS) utilization are scarce globally, infrequent in Ethiopia while findings about the factors associated with HCS utilization are inconsistent. The present study, therefore, examined inmates’ HCS utilization and associated socio-demographic and imprisonment related factors in Northwestern Ethiopia.

Methods: The study employed institution-based cross sectional research design and data was collected using questionnaire from 422 inmates in three prisons. The questionnaire collected data about prisoners’ demographic characters, imprisonment related information and HCS utilization. Descriptive statistical techniques as well as bi-variate and multiple logistic regressions were used to analyse the data.

Results and discussions: The study found that 72.5%, 66.1% and 13.3% of the inmates, respectively, used medical services, guidance and counseling services, and psychiatric services. Inmates with primary education, with secondary education, and who know the availability of the services were more likely to use medical services. Inmates with accused status were less likely to use medical services than inmates with convict status. Divorced marital status and knowledge of the service availability were associated with high guidance and counseling service use. An increase in the length of stay in the prison was associated with a decrease in psychiatry service use while knowledge of service availability was associated with higher odds of psychiatry service use. There are high medical care service utilization while low mental health care service utilization among inmates in Northwestern Ethiopia. Results of the study implied that there is a critical need for immediate health care service promotion and education measures. Besides, there are also needs for large scale, longitudinal and potentially cross-cultural studies to better understand additional factors that influence inmates’ HCS utilization.

1 Introduction

Globally, there are 11.5 million people in prison ( 1 ). The prison population is growing worldwide; in Africa this growth was 15% between 2000 and 2015 ( 2 ). By its very nature, incarceration can be deleterious to a prisoner’s mental and physical well-being. And the world health organization pinpointed that “Prisoners tend to have poorer physical, mental and social health than the population at large” ( 3 , 15). In fact incarcerated individuals have elevated rates of infectious diseases and mental health issues ( 4 ). As a result the health of inmates has become a public health issue that need to be properly addressed.

Therefore, prison administrators have initiated a variety of rehabilitation programs that would enhance the overall wellbeing of inmates. Technically, the mere presence of the service doesn’t guarantee participation ( 5 , 6 ). For example, in a Canadian research, 18.4% of the inmates who reported a recent history of mental illness or self-harm risk or distress did not get treatment ( 6 ). So, it is imperative to look into inmates’ actual participation in prison services.

Examining the participation of prisoners in Health Care Services (HCS) is important because participation has been linked to a lower recidivism rate. For instance, participation in rehabilitation treatment programs ( 7 ); psychological interventions ( 8 ); and psychiatric treatment at specialized forensic outpatient clinic ( 9 ) were associated with decreased recidivism rates.

Meanwhile, existing studies focused on the outcomes of participation ( 10 ), while studies on inmates’ participation rates in HCS and on why inmates do not participate are scarce ( 11 – 13 ). The available studies, mainly from the USA and Europe, reported different rates of participation. For instance in a study in Switzerland 82% the inmates utilized HCS from GPs, 90% of them utilized HCS from nurses and 43% of the inmates participate in psychiatric services ( 14 ). A study conducted in the USA found that 22% of the prisoners took part in mandated counseling sessions, while 31% of them participated in the voluntarily counseling service ( 15 ).

The HCS in prisons in Africa are poorly organized and are of poor quality. For example in a qualitative study in Ghana, there are no separate rooms designated for providing guidance and counseling services thereby difficult to maintain confidentiality. And professionals with insufficient experience offer guidance and counseling services ( 16 ). A scoping review of studies involving female prisoners in Sub-Saharan Africa (SSA) revealed that prison health facilities fall short of international standards. Plenty of barriers restrict inmates’ access to HCS outside of prisons ( 17 ). Similar review of studies among young inmates (aged 12 and 18) in SSA described the HCS as inadequate and alarmingly poor. Consequently, numerous obstacles impede prisoners’ access to healthcare both within and outside of prisons ( 18 ). This being the fact, there aren’t many studies on HCS utilization in African contexts. Such studies are particularly important in SSA where inmates “suffer more from inequitable access to healthcare services” ( 19 , 101).

Meanwhile, findings about the factors associated with HCS utilization are inconsistent ( 12 ). Socio-demographic and imprisonment related factors were examined as factors associated with HCS utilization but the exact effects of the variables remain unclear and contradictory findings are reported across many research. A good example from the socio-demographic variables is gender. In a study in Switzerland ( 20 ) it was depicted that females were more likely to use mental health services than their male counterparts. In another study in Switzerland ( 14 ) females were less likely to use psychiatric services. Contrary to these findings, two studies conducted in Norway ( 21 , 22 ) found no differences in HCS based on gender.

Likewise, length of stay is one of the imprisonment related factors associated with inmates’ HCS participation where contradictory findings are reported. In one of the studies in Switzerland ( 20 ) longer stay was associated with increased HCS use while in a longitudinal study in Portugal ( 12 ) it was associated with decreased HCS utilization. These all suggested that findings related to the factors associated with inmates’ participation in prison HCS are inconsistent thereby require additional investigations.

Furthermore, it was found that informational barriers were the main deterrents to participating in prison programs, particularly those related to education and vocational training (e.g. see 23 ). Likewise, in studies among university students in Ethiopia and elsewhere it was consistently found that lack of information about where to go is an important barrier to HCS use (e.g. ( 24 – 26 ). Meanwhile, giving information about the availability of HCS in prisons in African context is recommended ( 19 ). However, little research was done on these barriers in relation to prisoners’ use of HCS. It is, therefore, valuable to examine inmates’ knowledge of service availability or lack of knowledge thereof as a variable associated with inmates’ HCS utilizations.

In the Ethiopian context, the Ministry of Health (MoH) labeled prison inmates as “special vulnerable groups” that require special healthcare service ( 27 ). According to Article 28 of Federal Prison Proclamation No. 1174/2019, prison administrators are required to arrange HCS to prison inmates. The proclamation’s article 37 states that prisons medical services, including general health care, mental health care, and psychiatry services should be established and operated in prisons. As per the proclamation’s Article 42, prisons are required to offer psychological treatment to inmates as soon as they are accepted ( 28 ).

In actuality, many Ethiopian prisoners suffer from various physical and mental health conditions. In a meta-analysis and systematic review in Ethiopia 53.40% of inmates were found to have depressive symptoms ( 29 ). In another meta-analysis and systematic review, the prevalence of Tuberculosis (TB) among prison inmates in Ethiopia was found be high ( 30 ). Cognizant of this fact, a cross-sectional study depicted that 56.6% of inmates in Kality prion have depressive symptoms ( 31 ). Likewise, inmates in Northwestern Ethiopia were found to have higher rates of mental illnesses ( 32 ), suicidal ideation and attempt ( 33 ).

While these are the facts on the ground, studies on HCS in Ethiopian prison systems are infrequent. The few studies that are currently available looked at the delivery of HCS. For instance, a study conducted in Southern Ethiopia on the general rehabilitation program revealed that there are comparatively few prison treatment staff members compared to a large number of security personnel ( 34 ). In the Oromia National Regional State of Ethiopia, a research was carried out to look at the rights of inmates in the Ilu Abba Bor and Buno Bedelle Zones. According to the study, some prison centers had no medical services, while those who did (clinics per see) faced a variety of difficulties. It was also indicated that the clinics have lack budget, equipment, and transport services to nearby hospitals ( 35 ). These studies only examined the HCS provision and depicted that the HCS in prisons are inadequate.

The inadequate healthcare services in Ethiopian prisons alongside the high rate of mental and physical illness among prisoners deserve due attention. It is particularly important to understand how many prisoners are using the HCS and, if not, why they are not using the services. These types of studies are difficult to find in Ethiopia. The only exception here is a qualitative study in Southern Ethiopia that examined the standard healthcare utilization of inmates with HIV/AIDS. The study indicated that inmates HCS utilization is limited because of structural and social barriers such as insufficient support from HCS staff, uncooperative security system, lack of patient privacy, social stigma that prevents inmates from disclosing their status, and lack of food supplies ( 36 ). However, this study is delimited service utilization related to HIV/AIDS. The present study, therefore, attempted to fill the aforementioned research gaps by focusing on the HCS (Medical Service, Guidance and Counseling Service, and Psychiatric Service) utilization of inmates in Northwestern Ethiopia.

Based on research results that revealed poor HCS utilization in the general population (e.g. 37 , 38 ), we first hypothesized that there will be low HCS utilization among prisoners. It was also hypothesized that sociodemographic and imprisonment-related factors, including inmates’ knowledge of service availability, will influence inmates’ participation in HCSs.

The results of this study will help policy makers, prison administrators, and other stakeholders to develop customized interventions that may increase prisoners’ use of the available HCS. This would ultimately reduce recidivism in the nation by enabling prisoners to reap the advantages of improved health that come with participating in the programs. Additionally, our study’s findings will contribute to the global body of knowledge on inmates’ HCS use and associated socio-demographic and imprisonment related factors from a non-Western prison setting.

2 Materials and methods

2.1 research design.

The present study employed institution-based cross sectional research design where quantitative data collection technique is used. In terms of its methods of analysis, the study employed both descriptive and explanatory research designs. It is descriptive in that it summarized and described respondents’ characteristics, HCS utilizations and imprisonment related factors including their knowledge of the available services. It is explanatory because it tests the associations that existed between inmates’ HCS utilization and predictor variables.

2.2 Setting

Amhara National Regional State is home to 31 correctional facilities, 30 of which fall under regional administrative control and the remaining one facility (Shewarobit Rehabilitation and Correction Center) is under federal administrative control. There are two levels of correctional facilities in the region: higher level (12 in total), and medium and lower level (18 in total).

Of the 30 prisons in the region, 10 of them are found in the North-western part of the regional state. Simple random sampling technique was used to select three prisons: Gondar, Debretabor and Bahirdar prisons. While Debretabor Correction Center is under lower and medium level centers, Gondar and Bahirdar Prisons are higher level centers. During data collection there were 2417 inmates in Gondar prison, 2648 inmates in Bahirdar prison and 2099 inmates in Debretabor prison.

2.3 Healthcare services in the prisons

The Federal Prison Proclamation enforces prison administrations to provide health care services to inmates ( 28 ). Hence, there are clinics in the three prisons run by nurses and provide primary health care services. For complicated medical cases, the clinics have referral attachments with the nearby government hospitals in their respective cities. Besides, there are offices for guidance and counseling services inside the three prisons run by psychologists. The medical and counseling service provisions are initiated by the inmates and thus are voluntary. There are no psychiatric services per se in the three prions. Inmates receive psychiatric services in the nearby hospitals through referrals from the psychologists.

2.4 Sample size

For the purpose of determining the sample size of the study single proportion formula was used (n = [Z²a/2 X p(q)]/d²) with 95% confidence interval, a proportion of 50% (0.5) and e= + 0.05. Based on the computations using the formula the minimum sample size was 384. Assuming 10% non-response rate the final sample size was 422. During data collection there were 2,648 inmates at Bahirdar prison, 2,417 inmates at Gondar prison and 2,099 inmates at Debretabor prison. Quota sampling was used to include proportional number of inmates from the three prisons. Therefore, 142, 124 and 156 inmates from Gondar, Debretabor and Bahirdar prisons, respectively, participated as questionnaire respondents. Simple random sampling was used to select participants from each correction center.

2.5 Measures

In the present study data was collected using a structured and pretested questionnaire. The questionnaire has three sections. The first section collects data about inmates’ demographic characteristics while the second section collects imprisonment related data. Inmates’ HCS utilization measures are included in the third section of the questionnaire.

Inmates’ demographic factors: based on findings from earlier studies, age (measured in years); gender (male or female), educational status (the highest educational level attended); marital status (married, single/never married or divorced); and inmates’ employment status before they were incarcerated (categorized into unemployed, employed by others or self-employed) were included as demographic factors.

Imprisonment related factors: the length of stay (measured in years); frequency of imprisonment (first time or recidivist); convict status (pretrial detainees, accused or Sentenced); and type of offense the prisoner is serving (categorized as crime against person, crime against property and crime against state) were imprisonment related factors included in the present study. In addition, it is believed that an individual’s behavior (participation in our case) is dependent on his/her knowledge. We have included inmates’ knowledge of the three HCS as imprisonment related factor. Inmates were therefore asked to report whether they know the availability of the three HCS offered at the facility they are incarcerated. These were all dichotomous indicators of whether they had knowledge (1 = know, 0 = don’t know) of the three services offered at the facility.

Service Utilization: Inmates were asked to report whether they participated in the medical, guidance and counseling and psychiatry services offered in their respective facilities or not. These were all dichotomous indicators of whether they participated (1 = yes) or not (0 = no) in each types of services offered at their respective facilities.

2.6 Data collection procedures and ethical considerations

The questionnaire was prepared in English and translated to Amharic by experts in law, psychology, criminology and language. It was then back translated by public health, criminology and language experts who were not familiar with the purpose of the study. And minor differences in translations were resolved through a focus-group discussion. Formal letters directed to the selected facilities were written from the college of social science and humanities requesting permission to collect data at the respective facility. While delivering the letters, the purpose of the research was vividly communicated to prison administrators. At individual participant level, the participants were informed about the purpose of the study and measures were taken to maintain the respect, dignity and freedom of each individual participant and every inmate was assured about confidentiality. Participants were also ensured that they have full right to discontinue or refuse to participate in the study.

This study is part of a mega-project that examined the situation of prisons in Northwestern Ethiopia (The Prison Project). A representative from the regional prison administration office was with us while we develop the proposal. After the three prisons are selected, we have also included one prison staff from each prison as a focal person. The prison staffs in each prison helped the data collectors in selecting inmates. Data collection process was carried out by six trained M.A. holders (who were research team members and have prior experience in mixed-methods research data collection). Two data collectors on each facility contacted the inmates personally and assist them to complete the questionnaire. The data collectors handed the questionnaire to the inmates and the questionnaire was read for those who can’t read and write. And data collection was conducted either individually or in group meetings. Each questionnaire was immediately checked for completeness and if the questionnaire turned out to be incomplete, it was substituted with another questionnaire data from a different prisoner. Issues related with how crime types committed are categorized; the inclusion and exclusion criteria; and other data collection procedures are included elsewhere ( 32 ).

2.7 Methods of data analysis

Both descriptive and inferential statistics were used in the present study. Frequencies and percentages were computed to describe respondents’ demographic characteristics, imprisonment related factors, inmates’ knowledge of HCS available and HCS utilization among inmates. Moreover, mean standard deviation, maximum and minimum scores were computed to describe continuous variables (age and length of stay). Prison Healthcare service participation is dichotomous (participate or not participate) thereby logistic regression is performed. Preliminary tests were conducted to check for multicollinearity, outliers, and goodness of fit assumptions. Results showed that there were no major violations of these assumptions. So, the influence of demographic characteristics and imprisonment related factors on healthcare utilization was explored initially using bivariate analyses. Significant covariates of healthcare use were then added to the conditional models (multiple logistic regression models). A 95% confidence interval was used for the parameter estimates. All data analyses were carried out using SPSS version 23.

3.1 Description of the respondents

As can be seen from Table 1 respondents are aged between 16 and 67 years with a mean age of 31.91 years (SD= 11.083). The respondents stayed between 0 and 13 years in the prison where the mean stay of the respondents is 1.51 year (SD= 1.751). Majority of the respondents are males (92.2%), attend secondary education (39.3%), married (48.6%) and employed (42.7%). In terms of imprisonment related characteristics, majority of the respondents are imprisoned once (95.7%), have sentenced status (85.5%), and committed crimes against person (57.8%).

Table 1 Demographic and imprisonment related characteristics of the respondents (N=422).

3.2 Inmates’ knowledge and utilization of healthcare services

Table 2 depicted that 85.1% of the inmates know the presence of medical services while 72.5% of them use prison medical services. Likewise, 87.4% of the inmates know the availability of guidance and counseling services and 66.1% of the inmates use the services. With regard to psychiatry services, 29.4% of the inmates know the presence of the service while 13.3% of them utilize psychiatry services.

Table 2 Respondents’ knowledge and use of health care services.

3.3 Factors associated with inmates’ health care service utilization

3.3.1 factors associated with medical service use.

In the bivariate analysis education, convict status, types of crime committed and knowledge of medical service availability were significantly associated with medical service use (see Supplementary Material 1 for all variables). In the multiple logistic regression analysis all, except types of crimes committed, were significantly associated with medical service use. Specifically, Table 3 indicated that inmates with primary education (AOR=2.256, p<0.05, 95% CI= 1.155, 4.408) and inmates with secondary education (AOR= 1.955, p<0.05, 95% CI=1.012, 3.779) were two times more likely to use the medical services than inmates who didn’t get schooling. With regard to inmates convict status, inmates with accused status (AOR=.386, p<0.05, 95% CI= .183,.811) were less likely to use medical services than inmates with convict status. Inmates who know the availability of medical services (AOR=8.103, p<0.01, 95% CI= 4.405, 14.903) were 8 times more likely to use the services than inmates who don’t know the availability of the services.

Table 3 Factors associated with Medical service use.

3.3.2 Factors associated with guidance and counseling service use

As can be seen from Table 4 , education, marital status and knowledge of the availability of guidance and counseling services were significantly associated with service use in the bivariate analysis (detailed results can be found in Supplementary Material 2 ). In the multiple logistic regressions analysis, marital status and knowledge of the availability of guidance and counseling services remain significant. The odds of using the guidance and counseling services among inmates who are divorced were seven times higher than the odds of using the services among single inmates (AOR= 7.015, p<0.05, 95% CI=1.524, 32.290). Inmates who know the availability of guidance and counseling services were 4 times higher in using the services than inmates who don’t know the availability of the services (AOR= 4.169, p<0.01, 95% CI=2.224, 7.817).

Table 4 Factors associated with Guidance and Counseling service use.

3.3.3 Factors associated with psychiatry service use

Table 5 presents factors associated with psychiatry service use. In the bivariate analysis, length of stay in the prison and knowledge of psychiatry service availability were significantly associated with psychiatry service use (results about the remaining factors are included in Supplementary Material 3 ). These factors remain significant in the multiple logistic regression analyses. An increase in the length of stay in the prison is associated with a decrease in psychiatry service use (AOR= .455, p<0.01, 95% CI=.311,.665). Besides, inmates who know the availability of psychiatry services were found to have higher odds of psychiatry service use than inmates who didn’t know the availability of the service (AOR= 29.028, p<0.01, 95% CI= 12.363, 68.159).

Table 5 Factors associated with psychiatry service use.

4 Discussions

This study examined inmates’ HCS utilizations and associated factors in Northwestern Ethiopia. The study is the first of its kind to examine inmates’ HCS utilization in Ethiopia, at least to the knowledge of the present researchers. The study’s findings will also be important because it illustrates the significant impact that inmates’ knowledge of service accessibility plays in their use of HCS. This is because it is anticipated that the findings will spark scholarly discussion among experts in HCS use research.

In this study we first aimed to assess the knowledge inmates have about health care services available. While they are less aware of psychiatric services’ availability, inmates are well-informed about the availability of medical care services as well as guidance and counseling services. The low knowledge of psychiatric services among inmates could be attributed to the fact that the services are given in nearby hospitals. Likewise, the high knowledge of inmates on the medical care services and guidance and counseling services could be attributed to the facts that the services are given inside the prisons. The prison proclamation advocate for the provision of healthcare services as well as the delivery of health education activities by prison administrators ( 28 ). The fact that there are inmates who didn’t know the availability of the healthcare services reflects the problems in the health education activities in the prisons in Northwestern Ethiopia.

These findings implied that it is improper to believe that inmates will know the presence of the services as long as the services are available. Similar findings are reported in a study in Nigeria. In the study all the inmates reported that they have knowledge of rehabilitation services available in the prison but none of them stated health care services ( 39 ).

Second, we examined inmates’ participation levels in the three health care services and similar trends to their knowledge of the services are found. The medical health care utilization is said to be high. The medical service utilization in our sample is high compared to the reported 41.8% of health care utilization in a community based study in Dessie city, Amhara region ( 38 ). Likewise, a study in East Gojam, Amhara region, reported a rate of 41.5% HCS utilization ( 37 ) while another study in Achefer, Northwest Ethiopia, reported a rate of 39.9% ( 40 ) which implies that the rates of medical care utilization in our study is high. On the other hand, higher medical care utilization comparable to our study is reported among inmates in Switzerland ( 14 ) where 82% the inmates utilized health care services from GPs and 90% of them utilized health care services from nurses. The high medical care utilization rate in our study could be attributed to high rates of illnesses reported from other studies, e.g. high rates of TB among inmates ( 30 ).

With regard to guidance and counseling service use, it is found that 61.6% of the inmates utilize the service. Given the high number of inmates who are knowledgeable about the service availability (87.4%) the service utilization cannot be regarded as high. On the other hand, the guidance and counseling service utilization could also be considered as high when compared with the service utilization in other settings. For example, in a country where only 2% of university students in Amhara region are using guidance and counseling services ( 41 ) the participation rate found in our study is high. Coupled with this, the utilization rate could also be regarded as high when compared with findings from other studies. For instance, in a study in the USA it was revealed that 31% of the inmates voluntarily participated in the counseling service while 22% of them participated in mandated counseling services ( 15 ).

The psychiatry service utilization is low but it was expected. This is because the services are given in the nearby hospitals to individuals with severe illnesses; psychiatric services in Ethiopia are characterized low doctor-patient ratio, one psychiatrist serving 6 million individuals ( 42 ); and many Ethiopians prefer informal help for mental illness treatment ( 43 ).

Higher rates of psychiatric service utilization were reported from other studies. The study in Switzerland reported that 43% of the inmates participate in psychiatric services ( 14 ), a rate which is higher than the rate found in our study. Another study in Norway examined inmates’ participation in mental health consultation and reported a rate of 25%, which is still higher than what is found in our study. However, the study also found that it is only 3% of the inmates who received treatment for psychotic disorders ( 21 ). The difference could be attributed to the fact that psychiatric service to inmates in Ethiopia are delivered in the nearly hospitals while in both Switzerland and Norway the services are given inside the prisons. Coupled with this, the variations on what constitute psychiatric services could also be a factor for differences in findings. In our study we have assessed the psychiatric services inmates received in the nearby hospitals through referrals from counselors in the prisons. The study in Switzerland assessed psychiatric services rendered inside the prison only ( 14 ). On the other hand, the study in Norway assessed the services inmates received from psychologists, psychiatric nurses and psychiatrists in the prisons as well as the emergency psychiatric services the inmates received from private psychologists/psychiatrists and a deviant sexuality treatment clinic ( 21 ).

When we critically look into the overall mental health care utilizations (the guidance and counseling service utilization and psychiatry service utilization combined), there are low service utilization in the present study. This finding is similar with a research finding that depicted that there are low mental health care service utilizations in Ethiopia because of stigma and discrimination associated with mental illnesses ( 44 ).

In the present study factors associated with health care service utilization were also examined. Knowledge of service availability was consistently found to be associated with inmates’ health care service utilization. Inmates who have the knowledge of medical care services, guidance and counseling services and psychiatric services utilize the services more than the inmates who didn’t have the knowledge. In the global literature low health literacy is associated with high HCS utilization ( 45 , 46 ). Given the strong association between health literacy and health knowledge ( 47 ), one could argue that health knowledge and HCS utilization will have negative associations. Our findings are against this argument indicating that knowledge of service availability and utilization have positive associations. This implied that the role of knowledge of service availability on HCS utilization still needs further investigations. This is because knowledge of service availability may not entail general health knowledge.

Of the other variables included in the present study, education, marital status, convict status and length of stay were associated with the different health care service utilizations.

In the present study inmates who are sentenced were more likely to use medical services than inmates who were in accused status. Contrary to this finding, in the two studies in Switzerland inmates with pretrial detentions were found to use more nursing and GP health care services ( 14 , 20 ). However, the study in Norway that examined inmates’ participation in medical and mental health services found a similar result with our study where sentenced inmates were found to use more services than inmates in pretrial detention ( 22 ). The possible explanation for our finding is that inmates who are only accused might think of their release soon thereby delay their medical care use in the prison. Given the poor quality medical care in the prisons in Ethiopia ( 35 ) inmates who are accused might delay their service use while the only option for sentencedinmates is using the prison medical services.

Inmates’ educational status was associated with medical service use. Specifically inmates who attended primary and secondary education were more likely to participate in medical services than inmates with no schooling. Contrary to this finding, in the study in Norway education was not found to be associated with inmates’ participation in medical and mental health services ( 22 ). The small number of inmates with no schooling and with higher education status in our study could explain the variation in the findings. In the community based study in Achefer inmates with primary and above primary schooling were more likely to use medical health care service than inmates who can’t write and read ( 40 ). This finding substantiates the results from our study that depicted that inmates’ educational status is one of the significant factors in their medical care utilizations.

Inmates who are divorced were found to utilize more guidance and counseling services than inmates who are single. The study in Switzerland categorized inmates as married and unmarried where the former use less psychiatric services than the later ( 14 ). Differences in findings could be attributed to how the studies categorized inmates’ marital status. The negative effects of the divorce itself might have induced psychological problems and that in turn might have increased the odds of inmates in the present study to use the guidance and counseling services.

Length of stay is associated with psychiatric service utilizations where longer stay is associated with lower odds of psychiatric service utilizations. Similar to this finding, the study in Switzerland found an association between longer stay in prison with lower psychiatric service utilizations ( 14 ). From this findings it can be deduced that as inmates stay longer in prison they might adapt to the distresses because of the incarcerations thereby lower odds of using the psychiatric services. The fact that people with psychiatric disorder are difficult to find could also be a possible explanation here.

The cross-sectional nature of the study alongside with the fact that the study includes three prisons only could be considered as the limitations of the study. Moreover, the researchers acknowledged that the study would have been better had it included additional variables like having children, place of residence, presence of illnesses, etc. We also acknowledged that other important variables that could potentially influence prison HCS utilization are missing. For instance location of the service, such as whether it is offered inside or outside of a prison, may have an impact on the use of HCS. Similarly variables like treatment needs were not investigated. Future research need to include service location, treatment need and other important variables.

5 Conclusions and recommendations

There are high medical healthcare utilizations while there are low levels of mental health care service utilizations in the prisons in Northwestern Ethiopia. Significant numbers of inmates are unaware of the available HCS in their prisons. All of these suggested that there is much work to be done to enhance the way that prisoners use HCS, and consequently, their health. Mainly, health care service promotion and education measures need to be conducted by involving stakeholders including inmates, prison personnel, community representatives, health care professionals, police makers, etc. This is because knowledge of HCS availability was found to be the key factor influencing inmates’ usage of the HCS.

The factors associated with inmates’ use of medical services and the factors associated with their use of mental health services are different. Therefore, it is necessary to implement different approaches accordingly.

Above all, the results of this study can be used by policy makers, prison administrators, and other relevant organizations to create customized interventions that will increase inmates’ use of HCS, better their mental and physical health, and ultimately reduce recidivism in Ethiopia. Given the scope of the study is delimited to Northwestern Ethiopia; it is recommended that nationwide study, possibly a longitudinal one, need to be conducted. In the present study relatively high medical care utilization by inmates than the utilization rates reported from studies in the general public is found. Comparing the HCS utilization of inmates with the HCS utilizations by general public is, therefore, an important future research area in Ethiopia.

The current study assessed general participation in HCSs using a quantitative approach. Thus, extensive details regarding the involvement of prisoners are not investigated. It is possible to assess HCS use details using qualitative approaches. Future research therefore requires a mixed method research in order to mitigate the natural shortcomings of qualitative as well as quantitative methods.

Data availability statement

The original contributions presented in the study are included in the article/ Supplementary Material . Further inquiries can be directed to the corresponding author.

Ethics statement

The studies involving humans were approved by College of Social Science and Humanities Research Review Committee. The studies were conducted in accordance with the local legislation and institutional requirements. The participants provided their written informed consent to participate in this study.

Author contributions

YY: Conceptualization, Formal analysis, Methodology, Project administration, Supervision, Validation, Writing – original draft, Writing – review & editing. AB: Conceptualization, Formal analysis, Funding acquisition, Methodology, Project administration, Writing – original draft, Writing – review & editing. AB: Conceptualization, Formal analysis, Methodology, Project administration, Validation, Writing – original draft, Writing – review & editing. BA: Conceptualization, Formal analysis, Investigation, Methodology, Project administration, Validation, Writing – original draft, Writing – review & editing. AB: Conceptualization, Methodology, Project administration, Validation, Writing – original draft, Writing – review & editing. NA: Investigation, Methodology, Validation, Writing – original draft, Writing – review & editing.

The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.

Acknowledgments

The authors would like to thank the prison officials in the three facilities that helped us collect the data. We also wish to express our gratitude to the research participants who took the time to complete the questionnaire.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher’s note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

Supplementary material

The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fpsyt.2024.1426787/full#supplementary-material

Abbreviations

AOR, Adjusted Odds of Ratio; CI, Confidence Interval; HCS, Health Care Service; OR, Odds of ratio; TB, Tuberculosis.

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Keywords: healthcare service utilizations, medical service use, guidance and counseling service use, psychiatric service use, prisons, inmates, Northwestern Ethiopia

Citation: Yesuf YM, Birhan AA, Birara AG, Adimas BD, Bezabh AB and Agmase NG (2024) Prison healthcare service use and associated factors: a cross sectional study in Northwestern Ethiopia. Front. Psychiatry 15:1426787. doi: 10.3389/fpsyt.2024.1426787

Received: 02 May 2024; Accepted: 24 July 2024; Published: 06 August 2024.

Reviewed by:

Copyright © 2024 Yesuf, Birhan, Birara, Adimas, Bezabh and Agmase. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Yassin Mohammed Yesuf, [email protected]

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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What is Qualitative in Qualitative Research

Patrik aspers.

1 Department of Sociology, Uppsala University, Uppsala, Sweden

2 Seminar for Sociology, Universität St. Gallen, St. Gallen, Switzerland

3 Department of Media and Social Sciences, University of Stavanger, Stavanger, Norway

What is qualitative research? If we look for a precise definition of qualitative research, and specifically for one that addresses its distinctive feature of being “qualitative,” the literature is meager. In this article we systematically search, identify and analyze a sample of 89 sources using or attempting to define the term “qualitative.” Then, drawing on ideas we find scattered across existing work, and based on Becker’s classic study of marijuana consumption, we formulate and illustrate a definition that tries to capture its core elements. We define qualitative research as an iterative process in which improved understanding to the scientific community is achieved by making new significant distinctions resulting from getting closer to the phenomenon studied. This formulation is developed as a tool to help improve research designs while stressing that a qualitative dimension is present in quantitative work as well. Additionally, it can facilitate teaching, communication between researchers, diminish the gap between qualitative and quantitative researchers, help to address critiques of qualitative methods, and be used as a standard of evaluation of qualitative research.

If we assume that there is something called qualitative research, what exactly is this qualitative feature? And how could we evaluate qualitative research as good or not? Is it fundamentally different from quantitative research? In practice, most active qualitative researchers working with empirical material intuitively know what is involved in doing qualitative research, yet perhaps surprisingly, a clear definition addressing its key feature is still missing.

To address the question of what is qualitative we turn to the accounts of “qualitative research” in textbooks and also in empirical work. In his classic, explorative, interview study of deviance Howard Becker ( 1963 ) asks ‘How does one become a marijuana user?’ In contrast to pre-dispositional and psychological-individualistic theories of deviant behavior, Becker’s inherently social explanation contends that becoming a user of this substance is the result of a three-phase sequential learning process. First, potential users need to learn how to smoke it properly to produce the “correct” effects. If not, they are likely to stop experimenting with it. Second, they need to discover the effects associated with it; in other words, to get “high,” individuals not only have to experience what the drug does, but also to become aware that those sensations are related to using it. Third, they require learning to savor the feelings related to its consumption – to develop an acquired taste. Becker, who played music himself, gets close to the phenomenon by observing, taking part, and by talking to people consuming the drug: “half of the fifty interviews were conducted with musicians, the other half covered a wide range of people, including laborers, machinists, and people in the professions” (Becker 1963 :56).

Another central aspect derived through the common-to-all-research interplay between induction and deduction (Becker 2017 ), is that during the course of his research Becker adds scientifically meaningful new distinctions in the form of three phases—distinctions, or findings if you will, that strongly affect the course of his research: its focus, the material that he collects, and which eventually impact his findings. Each phase typically unfolds through social interaction, and often with input from experienced users in “a sequence of social experiences during which the person acquires a conception of the meaning of the behavior, and perceptions and judgments of objects and situations, all of which make the activity possible and desirable” (Becker 1963 :235). In this study the increased understanding of smoking dope is a result of a combination of the meaning of the actors, and the conceptual distinctions that Becker introduces based on the views expressed by his respondents. Understanding is the result of research and is due to an iterative process in which data, concepts and evidence are connected with one another (Becker 2017 ).

Indeed, there are many definitions of qualitative research, but if we look for a definition that addresses its distinctive feature of being “qualitative,” the literature across the broad field of social science is meager. The main reason behind this article lies in the paradox, which, to put it bluntly, is that researchers act as if they know what it is, but they cannot formulate a coherent definition. Sociologists and others will of course continue to conduct good studies that show the relevance and value of qualitative research addressing scientific and practical problems in society. However, our paper is grounded in the idea that providing a clear definition will help us improve the work that we do. Among researchers who practice qualitative research there is clearly much knowledge. We suggest that a definition makes this knowledge more explicit. If the first rationale for writing this paper refers to the “internal” aim of improving qualitative research, the second refers to the increased “external” pressure that especially many qualitative researchers feel; pressure that comes both from society as well as from other scientific approaches. There is a strong core in qualitative research, and leading researchers tend to agree on what it is and how it is done. Our critique is not directed at the practice of qualitative research, but we do claim that the type of systematic work we do has not yet been done, and that it is useful to improve the field and its status in relation to quantitative research.

The literature on the “internal” aim of improving, or at least clarifying qualitative research is large, and we do not claim to be the first to notice the vagueness of the term “qualitative” (Strauss and Corbin 1998 ). Also, others have noted that there is no single definition of it (Long and Godfrey 2004 :182), that there are many different views on qualitative research (Denzin and Lincoln 2003 :11; Jovanović 2011 :3), and that more generally, we need to define its meaning (Best 2004 :54). Strauss and Corbin ( 1998 ), for example, as well as Nelson et al. (1992:2 cited in Denzin and Lincoln 2003 :11), and Flick ( 2007 :ix–x), have recognized that the term is problematic: “Actually, the term ‘qualitative research’ is confusing because it can mean different things to different people” (Strauss and Corbin 1998 :10–11). Hammersley has discussed the possibility of addressing the problem, but states that “the task of providing an account of the distinctive features of qualitative research is far from straightforward” ( 2013 :2). This confusion, as he has recently further argued (Hammersley 2018 ), is also salient in relation to ethnography where different philosophical and methodological approaches lead to a lack of agreement about what it means.

Others (e.g. Hammersley 2018 ; Fine and Hancock 2017 ) have also identified the treat to qualitative research that comes from external forces, seen from the point of view of “qualitative research.” This threat can be further divided into that which comes from inside academia, such as the critique voiced by “quantitative research” and outside of academia, including, for example, New Public Management. Hammersley ( 2018 ), zooming in on one type of qualitative research, ethnography, has argued that it is under treat. Similarly to Fine ( 2003 ), and before him Gans ( 1999 ), he writes that ethnography’ has acquired a range of meanings, and comes in many different versions, these often reflecting sharply divergent epistemological orientations. And already more than twenty years ago while reviewing Denzin and Lincoln’ s Handbook of Qualitative Methods Fine argued:

While this increasing centrality [of qualitative research] might lead one to believe that consensual standards have developed, this belief would be misleading. As the methodology becomes more widely accepted, querulous challengers have raised fundamental questions that collectively have undercut the traditional models of how qualitative research is to be fashioned and presented (1995:417).

According to Hammersley, there are today “serious treats to the practice of ethnographic work, on almost any definition” ( 2018 :1). He lists five external treats: (1) that social research must be accountable and able to show its impact on society; (2) the current emphasis on “big data” and the emphasis on quantitative data and evidence; (3) the labor market pressure in academia that leaves less time for fieldwork (see also Fine and Hancock 2017 ); (4) problems of access to fields; and (5) the increased ethical scrutiny of projects, to which ethnography is particularly exposed. Hammersley discusses some more or less insufficient existing definitions of ethnography.

The current situation, as Hammersley and others note—and in relation not only to ethnography but also qualitative research in general, and as our empirical study shows—is not just unsatisfactory, it may even be harmful for the entire field of qualitative research, and does not help social science at large. We suggest that the lack of clarity of qualitative research is a real problem that must be addressed.

Towards a Definition of Qualitative Research

Seen in an historical light, what is today called qualitative, or sometimes ethnographic, interpretative research – or a number of other terms – has more or less always existed. At the time the founders of sociology – Simmel, Weber, Durkheim and, before them, Marx – were writing, and during the era of the Methodenstreit (“dispute about methods”) in which the German historical school emphasized scientific methods (cf. Swedberg 1990 ), we can at least speak of qualitative forerunners.

Perhaps the most extended discussion of what later became known as qualitative methods in a classic work is Bronisław Malinowski’s ( 1922 ) Argonauts in the Western Pacific , although even this study does not explicitly address the meaning of “qualitative.” In Weber’s ([1921–-22] 1978) work we find a tension between scientific explanations that are based on observation and quantification and interpretative research (see also Lazarsfeld and Barton 1982 ).

If we look through major sociology journals like the American Sociological Review , American Journal of Sociology , or Social Forces we will not find the term qualitative sociology before the 1970s. And certainly before then much of what we consider qualitative classics in sociology, like Becker’ study ( 1963 ), had already been produced. Indeed, the Chicago School often combined qualitative and quantitative data within the same study (Fine 1995 ). Our point being that before a disciplinary self-awareness the term quantitative preceded qualitative, and the articulation of the former was a political move to claim scientific status (Denzin and Lincoln 2005 ). In the US the World War II seem to have sparked a critique of sociological work, including “qualitative work,” that did not follow the scientific canon (Rawls 2018 ), which was underpinned by a scientifically oriented and value free philosophy of science. As a result the attempts and practice of integrating qualitative and quantitative sociology at Chicago lost ground to sociology that was more oriented to surveys and quantitative work at Columbia under Merton-Lazarsfeld. The quantitative tradition was also able to present textbooks (Lundberg 1951 ) that facilitated the use this approach and its “methods.” The practices of the qualitative tradition, by and large, remained tacit or was part of the mentoring transferred from the renowned masters to their students.

This glimpse into history leads us back to the lack of a coherent account condensed in a definition of qualitative research. Many of the attempts to define the term do not meet the requirements of a proper definition: A definition should be clear, avoid tautology, demarcate its domain in relation to the environment, and ideally only use words in its definiens that themselves are not in need of definition (Hempel 1966 ). A definition can enhance precision and thus clarity by identifying the core of the phenomenon. Preferably, a definition should be short. The typical definition we have found, however, is an ostensive definition, which indicates what qualitative research is about without informing us about what it actually is :

Qualitative research is multimethod in focus, involving an interpretative, naturalistic approach to its subject matter. This means that qualitative researchers study things in their natural settings, attempting to make sense of, or interpret, phenomena in terms of the meanings people bring to them. Qualitative research involves the studied use and collection of a variety of empirical materials – case study, personal experience, introspective, life story, interview, observational, historical, interactional, and visual texts – that describe routine and problematic moments and meanings in individuals’ lives. (Denzin and Lincoln 2005 :2)

Flick claims that the label “qualitative research” is indeed used as an umbrella for a number of approaches ( 2007 :2–4; 2002 :6), and it is not difficult to identify research fitting this designation. Moreover, whatever it is, it has grown dramatically over the past five decades. In addition, courses have been developed, methods have flourished, arguments about its future have been advanced (for example, Denzin and Lincoln 1994) and criticized (for example, Snow and Morrill 1995 ), and dedicated journals and books have mushroomed. Most social scientists have a clear idea of research and how it differs from journalism, politics and other activities. But the question of what is qualitative in qualitative research is either eluded or eschewed.

We maintain that this lacuna hinders systematic knowledge production based on qualitative research. Paul Lazarsfeld noted the lack of “codification” as early as 1955 when he reviewed 100 qualitative studies in order to offer a codification of the practices (Lazarsfeld and Barton 1982 :239). Since then many texts on “qualitative research” and its methods have been published, including recent attempts (Goertz and Mahoney 2012 ) similar to Lazarsfeld’s. These studies have tried to extract what is qualitative by looking at the large number of empirical “qualitative” studies. Our novel strategy complements these endeavors by taking another approach and looking at the attempts to codify these practices in the form of a definition, as well as to a minor extent take Becker’s study as an exemplar of what qualitative researchers actually do, and what the characteristic of being ‘qualitative’ denotes and implies. We claim that qualitative researchers, if there is such a thing as “qualitative research,” should be able to codify their practices in a condensed, yet general way expressed in language.

Lingering problems of “generalizability” and “how many cases do I need” (Small 2009 ) are blocking advancement – in this line of work qualitative approaches are said to differ considerably from quantitative ones, while some of the former unsuccessfully mimic principles related to the latter (Small 2009 ). Additionally, quantitative researchers sometimes unfairly criticize the first based on their own quality criteria. Scholars like Goertz and Mahoney ( 2012 ) have successfully focused on the different norms and practices beyond what they argue are essentially two different cultures: those working with either qualitative or quantitative methods. Instead, similarly to Becker ( 2017 ) who has recently questioned the usefulness of the distinction between qualitative and quantitative research, we focus on similarities.

The current situation also impedes both students and researchers in focusing their studies and understanding each other’s work (Lazarsfeld and Barton 1982 :239). A third consequence is providing an opening for critiques by scholars operating within different traditions (Valsiner 2000 :101). A fourth issue is that the “implicit use of methods in qualitative research makes the field far less standardized than the quantitative paradigm” (Goertz and Mahoney 2012 :9). Relatedly, the National Science Foundation in the US organized two workshops in 2004 and 2005 to address the scientific foundations of qualitative research involving strategies to improve it and to develop standards of evaluation in qualitative research. However, a specific focus on its distinguishing feature of being “qualitative” while being implicitly acknowledged, was discussed only briefly (for example, Best 2004 ).

In 2014 a theme issue was published in this journal on “Methods, Materials, and Meanings: Designing Cultural Analysis,” discussing central issues in (cultural) qualitative research (Berezin 2014 ; Biernacki 2014 ; Glaeser 2014 ; Lamont and Swidler 2014 ; Spillman 2014). We agree with many of the arguments put forward, such as the risk of methodological tribalism, and that we should not waste energy on debating methods separated from research questions. Nonetheless, a clarification of the relation to what is called “quantitative research” is of outmost importance to avoid misunderstandings and misguided debates between “qualitative” and “quantitative” researchers. Our strategy means that researchers, “qualitative” or “quantitative” they may be, in their actual practice may combine qualitative work and quantitative work.

In this article we accomplish three tasks. First, we systematically survey the literature for meanings of qualitative research by looking at how researchers have defined it. Drawing upon existing knowledge we find that the different meanings and ideas of qualitative research are not yet coherently integrated into one satisfactory definition. Next, we advance our contribution by offering a definition of qualitative research and illustrate its meaning and use partially by expanding on the brief example introduced earlier related to Becker’s work ( 1963 ). We offer a systematic analysis of central themes of what researchers consider to be the core of “qualitative,” regardless of style of work. These themes – which we summarize in terms of four keywords: distinction, process, closeness, improved understanding – constitute part of our literature review, in which each one appears, sometimes with others, but never all in the same definition. They serve as the foundation of our contribution. Our categories are overlapping. Their use is primarily to organize the large amount of definitions we have identified and analyzed, and not necessarily to draw a clear distinction between them. Finally, we continue the elaboration discussed above on the advantages of a clear definition of qualitative research.

In a hermeneutic fashion we propose that there is something meaningful that deserves to be labelled “qualitative research” (Gadamer 1990 ). To approach the question “What is qualitative in qualitative research?” we have surveyed the literature. In conducting our survey we first traced the word’s etymology in dictionaries, encyclopedias, handbooks of the social sciences and of methods and textbooks, mainly in English, which is common to methodology courses. It should be noted that we have zoomed in on sociology and its literature. This discipline has been the site of the largest debate and development of methods that can be called “qualitative,” which suggests that this field should be examined in great detail.

In an ideal situation we should expect that one good definition, or at least some common ideas, would have emerged over the years. This common core of qualitative research should be so accepted that it would appear in at least some textbooks. Since this is not what we found, we decided to pursue an inductive approach to capture maximal variation in the field of qualitative research; we searched in a selection of handbooks, textbooks, book chapters, and books, to which we added the analysis of journal articles. Our sample comprises a total of 89 references.

In practice we focused on the discipline that has had a clear discussion of methods, namely sociology. We also conducted a broad search in the JSTOR database to identify scholarly sociology articles published between 1998 and 2017 in English with a focus on defining or explaining qualitative research. We specifically zoom in on this time frame because we would have expect that this more mature period would have produced clear discussions on the meaning of qualitative research. To find these articles we combined a number of keywords to search the content and/or the title: qualitative (which was always included), definition, empirical, research, methodology, studies, fieldwork, interview and observation .

As a second phase of our research we searched within nine major sociological journals ( American Journal of Sociology , Sociological Theory , American Sociological Review , Contemporary Sociology , Sociological Forum , Sociological Theory , Qualitative Research , Qualitative Sociology and Qualitative Sociology Review ) for articles also published during the past 19 years (1998–2017) that had the term “qualitative” in the title and attempted to define qualitative research.

Lastly we picked two additional journals, Qualitative Research and Qualitative Sociology , in which we could expect to find texts addressing the notion of “qualitative.” From Qualitative Research we chose Volume 14, Issue 6, December 2014, and from Qualitative Sociology we chose Volume 36, Issue 2, June 2017. Within each of these we selected the first article; then we picked the second article of three prior issues. Again we went back another three issues and investigated article number three. Finally we went back another three issues and perused article number four. This selection criteria was used to get a manageable sample for the analysis.

The coding process of the 89 references we gathered in our selected review began soon after the first round of material was gathered, and we reduced the complexity created by our maximum variation sampling (Snow and Anderson 1993 :22) to four different categories within which questions on the nature and properties of qualitative research were discussed. We call them: Qualitative and Quantitative Research, Qualitative Research, Fieldwork, and Grounded Theory. This – which may appear as an illogical grouping – merely reflects the “context” in which the matter of “qualitative” is discussed. If the selection process of the material – books and articles – was informed by pre-knowledge, we used an inductive strategy to code the material. When studying our material, we identified four central notions related to “qualitative” that appear in various combinations in the literature which indicate what is the core of qualitative research. We have labeled them: “distinctions”, “process,” “closeness,” and “improved understanding.” During the research process the categories and notions were improved, refined, changed, and reordered. The coding ended when a sense of saturation in the material arose. In the presentation below all quotations and references come from our empirical material of texts on qualitative research.

Analysis – What is Qualitative Research?

In this section we describe the four categories we identified in the coding, how they differently discuss qualitative research, as well as their overall content. Some salient quotations are selected to represent the type of text sorted under each of the four categories. What we present are examples from the literature.

Qualitative and Quantitative

This analytic category comprises quotations comparing qualitative and quantitative research, a distinction that is frequently used (Brown 2010 :231); in effect this is a conceptual pair that structures the discussion and that may be associated with opposing interests. While the general goal of quantitative and qualitative research is the same – to understand the world better – their methodologies and focus in certain respects differ substantially (Becker 1966 :55). Quantity refers to that property of something that can be determined by measurement. In a dictionary of Statistics and Methodology we find that “(a) When referring to *variables, ‘qualitative’ is another term for *categorical or *nominal. (b) When speaking of kinds of research, ‘qualitative’ refers to studies of subjects that are hard to quantify, such as art history. Qualitative research tends to be a residual category for almost any kind of non-quantitative research” (Stiles 1998:183). But it should be obvious that one could employ a quantitative approach when studying, for example, art history.

The same dictionary states that quantitative is “said of variables or research that can be handled numerically, usually (too sharply) contrasted with *qualitative variables and research” (Stiles 1998:184). From a qualitative perspective “quantitative research” is about numbers and counting, and from a quantitative perspective qualitative research is everything that is not about numbers. But this does not say much about what is “qualitative.” If we turn to encyclopedias we find that in the 1932 edition of the Encyclopedia of the Social Sciences there is no mention of “qualitative.” In the Encyclopedia from 1968 we can read:

Qualitative Analysis. For methods of obtaining, analyzing, and describing data, see [the various entries:] CONTENT ANALYSIS; COUNTED DATA; EVALUATION RESEARCH, FIELD WORK; GRAPHIC PRESENTATION; HISTORIOGRAPHY, especially the article on THE RHETORIC OF HISTORY; INTERVIEWING; OBSERVATION; PERSONALITY MEASUREMENT; PROJECTIVE METHODS; PSYCHOANALYSIS, article on EXPERIMENTAL METHODS; SURVEY ANALYSIS, TABULAR PRESENTATION; TYPOLOGIES. (Vol. 13:225)

Some, like Alford, divide researchers into methodologists or, in his words, “quantitative and qualitative specialists” (Alford 1998 :12). Qualitative research uses a variety of methods, such as intensive interviews or in-depth analysis of historical materials, and it is concerned with a comprehensive account of some event or unit (King et al. 1994 :4). Like quantitative research it can be utilized to study a variety of issues, but it tends to focus on meanings and motivations that underlie cultural symbols, personal experiences, phenomena and detailed understanding of processes in the social world. In short, qualitative research centers on understanding processes, experiences, and the meanings people assign to things (Kalof et al. 2008 :79).

Others simply say that qualitative methods are inherently unscientific (Jovanović 2011 :19). Hood, for instance, argues that words are intrinsically less precise than numbers, and that they are therefore more prone to subjective analysis, leading to biased results (Hood 2006 :219). Qualitative methodologies have raised concerns over the limitations of quantitative templates (Brady et al. 2004 :4). Scholars such as King et al. ( 1994 ), for instance, argue that non-statistical research can produce more reliable results if researchers pay attention to the rules of scientific inference commonly stated in quantitative research. Also, researchers such as Becker ( 1966 :59; 1970 :42–43) have asserted that, if conducted properly, qualitative research and in particular ethnographic field methods, can lead to more accurate results than quantitative studies, in particular, survey research and laboratory experiments.

Some researchers, such as Kalof, Dan, and Dietz ( 2008 :79) claim that the boundaries between the two approaches are becoming blurred, and Small ( 2009 ) argues that currently much qualitative research (especially in North America) tries unsuccessfully and unnecessarily to emulate quantitative standards. For others, qualitative research tends to be more humanistic and discursive (King et al. 1994 :4). Ragin ( 1994 ), and similarly also Becker, ( 1996 :53), Marchel and Owens ( 2007 :303) think that the main distinction between the two styles is overstated and does not rest on the simple dichotomy of “numbers versus words” (Ragin 1994 :xii). Some claim that quantitative data can be utilized to discover associations, but in order to unveil cause and effect a complex research design involving the use of qualitative approaches needs to be devised (Gilbert 2009 :35). Consequently, qualitative data are useful for understanding the nuances lying beyond those processes as they unfold (Gilbert 2009 :35). Others contend that qualitative research is particularly well suited both to identify causality and to uncover fine descriptive distinctions (Fine and Hallett 2014 ; Lichterman and Isaac Reed 2014 ; Katz 2015 ).

There are other ways to separate these two traditions, including normative statements about what qualitative research should be (that is, better or worse than quantitative approaches, concerned with scientific approaches to societal change or vice versa; Snow and Morrill 1995 ; Denzin and Lincoln 2005 ), or whether it should develop falsifiable statements; Best 2004 ).

We propose that quantitative research is largely concerned with pre-determined variables (Small 2008 ); the analysis concerns the relations between variables. These categories are primarily not questioned in the study, only their frequency or degree, or the correlations between them (cf. Franzosi 2016 ). If a researcher studies wage differences between women and men, he or she works with given categories: x number of men are compared with y number of women, with a certain wage attributed to each person. The idea is not to move beyond the given categories of wage, men and women; they are the starting point as well as the end point, and undergo no “qualitative change.” Qualitative research, in contrast, investigates relations between categories that are themselves subject to change in the research process. Returning to Becker’s study ( 1963 ), we see that he questioned pre-dispositional theories of deviant behavior working with pre-determined variables such as an individual’s combination of personal qualities or emotional problems. His take, in contrast, was to understand marijuana consumption by developing “variables” as part of the investigation. Thereby he presented new variables, or as we would say today, theoretical concepts, but which are grounded in the empirical material.

Qualitative Research

This category contains quotations that refer to descriptions of qualitative research without making comparisons with quantitative research. Researchers such as Denzin and Lincoln, who have written a series of influential handbooks on qualitative methods (1994; Denzin and Lincoln 2003 ; 2005 ), citing Nelson et al. (1992:4), argue that because qualitative research is “interdisciplinary, transdisciplinary, and sometimes counterdisciplinary” it is difficult to derive one single definition of it (Jovanović 2011 :3). According to them, in fact, “the field” is “many things at the same time,” involving contradictions, tensions over its focus, methods, and how to derive interpretations and findings ( 2003 : 11). Similarly, others, such as Flick ( 2007 :ix–x) contend that agreeing on an accepted definition has increasingly become problematic, and that qualitative research has possibly matured different identities. However, Best holds that “the proliferation of many sorts of activities under the label of qualitative sociology threatens to confuse our discussions” ( 2004 :54). Atkinson’s position is more definite: “the current state of qualitative research and research methods is confused” ( 2005 :3–4).

Qualitative research is about interpretation (Blumer 1969 ; Strauss and Corbin 1998 ; Denzin and Lincoln 2003 ), or Verstehen [understanding] (Frankfort-Nachmias and Nachmias 1996 ). It is “multi-method,” involving the collection and use of a variety of empirical materials (Denzin and Lincoln 1998; Silverman 2013 ) and approaches (Silverman 2005 ; Flick 2007 ). It focuses not only on the objective nature of behavior but also on its subjective meanings: individuals’ own accounts of their attitudes, motivations, behavior (McIntyre 2005 :127; Creswell 2009 ), events and situations (Bryman 1989) – what people say and do in specific places and institutions (Goodwin and Horowitz 2002 :35–36) in social and temporal contexts (Morrill and Fine 1997). For this reason, following Weber ([1921-22] 1978), it can be described as an interpretative science (McIntyre 2005 :127). But could quantitative research also be concerned with these questions? Also, as pointed out below, does all qualitative research focus on subjective meaning, as some scholars suggest?

Others also distinguish qualitative research by claiming that it collects data using a naturalistic approach (Denzin and Lincoln 2005 :2; Creswell 2009 ), focusing on the meaning actors ascribe to their actions. But again, does all qualitative research need to be collected in situ? And does qualitative research have to be inherently concerned with meaning? Flick ( 2007 ), referring to Denzin and Lincoln ( 2005 ), mentions conversation analysis as an example of qualitative research that is not concerned with the meanings people bring to a situation, but rather with the formal organization of talk. Still others, such as Ragin ( 1994 :85), note that qualitative research is often (especially early on in the project, we would add) less structured than other kinds of social research – a characteristic connected to its flexibility and that can lead both to potentially better, but also worse results. But is this not a feature of this type of research, rather than a defining description of its essence? Wouldn’t this comment also apply, albeit to varying degrees, to quantitative research?

In addition, Strauss ( 2003 ), along with others, such as Alvesson and Kärreman ( 2011 :10–76), argue that qualitative researchers struggle to capture and represent complex phenomena partially because they tend to collect a large amount of data. While his analysis is correct at some points – “It is necessary to do detailed, intensive, microscopic examination of the data in order to bring out the amazing complexity of what lies in, behind, and beyond those data” (Strauss 2003 :10) – much of his analysis concerns the supposed focus of qualitative research and its challenges, rather than exactly what it is about. But even in this instance we would make a weak case arguing that these are strictly the defining features of qualitative research. Some researchers seem to focus on the approach or the methods used, or even on the way material is analyzed. Several researchers stress the naturalistic assumption of investigating the world, suggesting that meaning and interpretation appear to be a core matter of qualitative research.

We can also see that in this category there is no consensus about specific qualitative methods nor about qualitative data. Many emphasize interpretation, but quantitative research, too, involves interpretation; the results of a regression analysis, for example, certainly have to be interpreted, and the form of meta-analysis that factor analysis provides indeed requires interpretation However, there is no interpretation of quantitative raw data, i.e., numbers in tables. One common thread is that qualitative researchers have to get to grips with their data in order to understand what is being studied in great detail, irrespective of the type of empirical material that is being analyzed. This observation is connected to the fact that qualitative researchers routinely make several adjustments of focus and research design as their studies progress, in many cases until the very end of the project (Kalof et al. 2008 ). If you, like Becker, do not start out with a detailed theory, adjustments such as the emergence and refinement of research questions will occur during the research process. We have thus found a number of useful reflections about qualitative research scattered across different sources, but none of them effectively describe the defining characteristics of this approach.

Although qualitative research does not appear to be defined in terms of a specific method, it is certainly common that fieldwork, i.e., research that entails that the researcher spends considerable time in the field that is studied and use the knowledge gained as data, is seen as emblematic of or even identical to qualitative research. But because we understand that fieldwork tends to focus primarily on the collection and analysis of qualitative data, we expected to find within it discussions on the meaning of “qualitative.” But, again, this was not the case.

Instead, we found material on the history of this approach (for example, Frankfort-Nachmias and Nachmias 1996 ; Atkinson et al. 2001), including how it has changed; for example, by adopting a more self-reflexive practice (Heyl 2001), as well as the different nomenclature that has been adopted, such as fieldwork, ethnography, qualitative research, naturalistic research, participant observation and so on (for example, Lofland et al. 2006 ; Gans 1999 ).

We retrieved definitions of ethnography, such as “the study of people acting in the natural courses of their daily lives,” involving a “resocialization of the researcher” (Emerson 1988 :1) through intense immersion in others’ social worlds (see also examples in Hammersley 2018 ). This may be accomplished by direct observation and also participation (Neuman 2007 :276), although others, such as Denzin ( 1970 :185), have long recognized other types of observation, including non-participant (“fly on the wall”). In this category we have also isolated claims and opposing views, arguing that this type of research is distinguished primarily by where it is conducted (natural settings) (Hughes 1971:496), and how it is carried out (a variety of methods are applied) or, for some most importantly, by involving an active, empathetic immersion in those being studied (Emerson 1988 :2). We also retrieved descriptions of the goals it attends in relation to how it is taught (understanding subjective meanings of the people studied, primarily develop theory, or contribute to social change) (see for example, Corte and Irwin 2017 ; Frankfort-Nachmias and Nachmias 1996 :281; Trier-Bieniek 2012 :639) by collecting the richest possible data (Lofland et al. 2006 ) to derive “thick descriptions” (Geertz 1973 ), and/or to aim at theoretical statements of general scope and applicability (for example, Emerson 1988 ; Fine 2003 ). We have identified guidelines on how to evaluate it (for example Becker 1996 ; Lamont 2004 ) and have retrieved instructions on how it should be conducted (for example, Lofland et al. 2006 ). For instance, analysis should take place while the data gathering unfolds (Emerson 1988 ; Hammersley and Atkinson 2007 ; Lofland et al. 2006 ), observations should be of long duration (Becker 1970 :54; Goffman 1989 ), and data should be of high quantity (Becker 1970 :52–53), as well as other questionable distinctions between fieldwork and other methods:

Field studies differ from other methods of research in that the researcher performs the task of selecting topics, decides what questions to ask, and forges interest in the course of the research itself . This is in sharp contrast to many ‘theory-driven’ and ‘hypothesis-testing’ methods. (Lofland and Lofland 1995 :5)

But could not, for example, a strictly interview-based study be carried out with the same amount of flexibility, such as sequential interviewing (for example, Small 2009 )? Once again, are quantitative approaches really as inflexible as some qualitative researchers think? Moreover, this category stresses the role of the actors’ meaning, which requires knowledge and close interaction with people, their practices and their lifeworld.

It is clear that field studies – which are seen by some as the “gold standard” of qualitative research – are nonetheless only one way of doing qualitative research. There are other methods, but it is not clear why some are more qualitative than others, or why they are better or worse. Fieldwork is characterized by interaction with the field (the material) and understanding of the phenomenon that is being studied. In Becker’s case, he had general experience from fields in which marihuana was used, based on which he did interviews with actual users in several fields.

Grounded Theory

Another major category we identified in our sample is Grounded Theory. We found descriptions of it most clearly in Glaser and Strauss’ ([1967] 2010 ) original articulation, Strauss and Corbin ( 1998 ) and Charmaz ( 2006 ), as well as many other accounts of what it is for: generating and testing theory (Strauss 2003 :xi). We identified explanations of how this task can be accomplished – such as through two main procedures: constant comparison and theoretical sampling (Emerson 1998:96), and how using it has helped researchers to “think differently” (for example, Strauss and Corbin 1998 :1). We also read descriptions of its main traits, what it entails and fosters – for instance, an exceptional flexibility, an inductive approach (Strauss and Corbin 1998 :31–33; 1990; Esterberg 2002 :7), an ability to step back and critically analyze situations, recognize tendencies towards bias, think abstractly and be open to criticism, enhance sensitivity towards the words and actions of respondents, and develop a sense of absorption and devotion to the research process (Strauss and Corbin 1998 :5–6). Accordingly, we identified discussions of the value of triangulating different methods (both using and not using grounded theory), including quantitative ones, and theories to achieve theoretical development (most comprehensively in Denzin 1970 ; Strauss and Corbin 1998 ; Timmermans and Tavory 2012 ). We have also located arguments about how its practice helps to systematize data collection, analysis and presentation of results (Glaser and Strauss [1967] 2010 :16).

Grounded theory offers a systematic approach which requires researchers to get close to the field; closeness is a requirement of identifying questions and developing new concepts or making further distinctions with regard to old concepts. In contrast to other qualitative approaches, grounded theory emphasizes the detailed coding process, and the numerous fine-tuned distinctions that the researcher makes during the process. Within this category, too, we could not find a satisfying discussion of the meaning of qualitative research.

Defining Qualitative Research

In sum, our analysis shows that some notions reappear in the discussion of qualitative research, such as understanding, interpretation, “getting close” and making distinctions. These notions capture aspects of what we think is “qualitative.” However, a comprehensive definition that is useful and that can further develop the field is lacking, and not even a clear picture of its essential elements appears. In other words no definition emerges from our data, and in our research process we have moved back and forth between our empirical data and the attempt to present a definition. Our concrete strategy, as stated above, is to relate qualitative and quantitative research, or more specifically, qualitative and quantitative work. We use an ideal-typical notion of quantitative research which relies on taken for granted and numbered variables. This means that the data consists of variables on different scales, such as ordinal, but frequently ratio and absolute scales, and the representation of the numbers to the variables, i.e. the justification of the assignment of numbers to object or phenomenon, are not questioned, though the validity may be questioned. In this section we return to the notion of quality and try to clarify it while presenting our contribution.

Broadly, research refers to the activity performed by people trained to obtain knowledge through systematic procedures. Notions such as “objectivity” and “reflexivity,” “systematic,” “theory,” “evidence” and “openness” are here taken for granted in any type of research. Next, building on our empirical analysis we explain the four notions that we have identified as central to qualitative work: distinctions, process, closeness, and improved understanding. In discussing them, ultimately in relation to one another, we make their meaning even more precise. Our idea, in short, is that only when these ideas that we present separately for analytic purposes are brought together can we speak of qualitative research.

Distinctions

We believe that the possibility of making new distinctions is one the defining characteristics of qualitative research. It clearly sets it apart from quantitative analysis which works with taken-for-granted variables, albeit as mentioned, meta-analyses, for example, factor analysis may result in new variables. “Quality” refers essentially to distinctions, as already pointed out by Aristotle. He discusses the term “qualitative” commenting: “By a quality I mean that in virtue of which things are said to be qualified somehow” (Aristotle 1984:14). Quality is about what something is or has, which means that the distinction from its environment is crucial. We see qualitative research as a process in which significant new distinctions are made to the scholarly community; to make distinctions is a key aspect of obtaining new knowledge; a point, as we will see, that also has implications for “quantitative research.” The notion of being “significant” is paramount. New distinctions by themselves are not enough; just adding concepts only increases complexity without furthering our knowledge. The significance of new distinctions is judged against the communal knowledge of the research community. To enable this discussion and judgements central elements of rational discussion are required (cf. Habermas [1981] 1987 ; Davidsson [ 1988 ] 2001) to identify what is new and relevant scientific knowledge. Relatedly, Ragin alludes to the idea of new and useful knowledge at a more concrete level: “Qualitative methods are appropriate for in-depth examination of cases because they aid the identification of key features of cases. Most qualitative methods enhance data” (1994:79). When Becker ( 1963 ) studied deviant behavior and investigated how people became marihuana smokers, he made distinctions between the ways in which people learned how to smoke. This is a classic example of how the strategy of “getting close” to the material, for example the text, people or pictures that are subject to analysis, may enable researchers to obtain deeper insight and new knowledge by making distinctions – in this instance on the initial notion of learning how to smoke. Others have stressed the making of distinctions in relation to coding or theorizing. Emerson et al. ( 1995 ), for example, hold that “qualitative coding is a way of opening up avenues of inquiry,” meaning that the researcher identifies and develops concepts and analytic insights through close examination of and reflection on data (Emerson et al. 1995 :151). Goodwin and Horowitz highlight making distinctions in relation to theory-building writing: “Close engagement with their cases typically requires qualitative researchers to adapt existing theories or to make new conceptual distinctions or theoretical arguments to accommodate new data” ( 2002 : 37). In the ideal-typical quantitative research only existing and so to speak, given, variables would be used. If this is the case no new distinction are made. But, would not also many “quantitative” researchers make new distinctions?

Process does not merely suggest that research takes time. It mainly implies that qualitative new knowledge results from a process that involves several phases, and above all iteration. Qualitative research is about oscillation between theory and evidence, analysis and generating material, between first- and second -order constructs (Schütz 1962 :59), between getting in contact with something, finding sources, becoming deeply familiar with a topic, and then distilling and communicating some of its essential features. The main point is that the categories that the researcher uses, and perhaps takes for granted at the beginning of the research process, usually undergo qualitative changes resulting from what is found. Becker describes how he tested hypotheses and let the jargon of the users develop into theoretical concepts. This happens over time while the study is being conducted, exemplifying what we mean by process.

In the research process, a pilot-study may be used to get a first glance of, for example, the field, how to approach it, and what methods can be used, after which the method and theory are chosen or refined before the main study begins. Thus, the empirical material is often central from the start of the project and frequently leads to adjustments by the researcher. Likewise, during the main study categories are not fixed; the empirical material is seen in light of the theory used, but it is also given the opportunity to kick back, thereby resisting attempts to apply theoretical straightjackets (Becker 1970 :43). In this process, coding and analysis are interwoven, and thus are often important steps for getting closer to the phenomenon and deciding what to focus on next. Becker began his research by interviewing musicians close to him, then asking them to refer him to other musicians, and later on doubling his original sample of about 25 to include individuals in other professions (Becker 1973:46). Additionally, he made use of some participant observation, documents, and interviews with opiate users made available to him by colleagues. As his inductive theory of deviance evolved, Becker expanded his sample in order to fine tune it, and test the accuracy and generality of his hypotheses. In addition, he introduced a negative case and discussed the null hypothesis ( 1963 :44). His phasic career model is thus based on a research design that embraces processual work. Typically, process means to move between “theory” and “material” but also to deal with negative cases, and Becker ( 1998 ) describes how discovering these negative cases impacted his research design and ultimately its findings.

Obviously, all research is process-oriented to some degree. The point is that the ideal-typical quantitative process does not imply change of the data, and iteration between data, evidence, hypotheses, empirical work, and theory. The data, quantified variables, are, in most cases fixed. Merging of data, which of course can be done in a quantitative research process, does not mean new data. New hypotheses are frequently tested, but the “raw data is often the “the same.” Obviously, over time new datasets are made available and put into use.

Another characteristic that is emphasized in our sample is that qualitative researchers – and in particular ethnographers – can, or as Goffman put it, ought to ( 1989 ), get closer to the phenomenon being studied and their data than quantitative researchers (for example, Silverman 2009 :85). Put differently, essentially because of their methods qualitative researchers get into direct close contact with those being investigated and/or the material, such as texts, being analyzed. Becker started out his interview study, as we noted, by talking to those he knew in the field of music to get closer to the phenomenon he was studying. By conducting interviews he got even closer. Had he done more observations, he would undoubtedly have got even closer to the field.

Additionally, ethnographers’ design enables researchers to follow the field over time, and the research they do is almost by definition longitudinal, though the time in the field is studied obviously differs between studies. The general characteristic of closeness over time maximizes the chances of unexpected events, new data (related, for example, to archival research as additional sources, and for ethnography for situations not necessarily previously thought of as instrumental – what Mannay and Morgan ( 2015 ) term the “waiting field”), serendipity (Merton and Barber 2004 ; Åkerström 2013 ), and possibly reactivity, as well as the opportunity to observe disrupted patterns that translate into exemplars of negative cases. Two classic examples of this are Becker’s finding of what medical students call “crocks” (Becker et al. 1961 :317), and Geertz’s ( 1973 ) study of “deep play” in Balinese society.

By getting and staying so close to their data – be it pictures, text or humans interacting (Becker was himself a musician) – for a long time, as the research progressively focuses, qualitative researchers are prompted to continually test their hunches, presuppositions and hypotheses. They test them against a reality that often (but certainly not always), and practically, as well as metaphorically, talks back, whether by validating them, or disqualifying their premises – correctly, as well as incorrectly (Fine 2003 ; Becker 1970 ). This testing nonetheless often leads to new directions for the research. Becker, for example, says that he was initially reading psychological theories, but when facing the data he develops a theory that looks at, you may say, everything but psychological dispositions to explain the use of marihuana. Especially researchers involved with ethnographic methods have a fairly unique opportunity to dig up and then test (in a circular, continuous and temporal way) new research questions and findings as the research progresses, and thereby to derive previously unimagined and uncharted distinctions by getting closer to the phenomenon under study.

Let us stress that getting close is by no means restricted to ethnography. The notion of hermeneutic circle and hermeneutics as a general way of understanding implies that we must get close to the details in order to get the big picture. This also means that qualitative researchers can literally also make use of details of pictures as evidence (cf. Harper 2002). Thus, researchers may get closer both when generating the material or when analyzing it.

Quantitative research, we maintain, in the ideal-typical representation cannot get closer to the data. The data is essentially numbers in tables making up the variables (Franzosi 2016 :138). The data may originally have been “qualitative,” but once reduced to numbers there can only be a type of “hermeneutics” about what the number may stand for. The numbers themselves, however, are non-ambiguous. Thus, in quantitative research, interpretation, if done, is not about the data itself—the numbers—but what the numbers stand for. It follows that the interpretation is essentially done in a more “speculative” mode without direct empirical evidence (cf. Becker 2017 ).

Improved Understanding

While distinction, process and getting closer refer to the qualitative work of the researcher, improved understanding refers to its conditions and outcome of this work. Understanding cuts deeper than explanation, which to some may mean a causally verified correlation between variables. The notion of explanation presupposes the notion of understanding since explanation does not include an idea of how knowledge is gained (Manicas 2006 : 15). Understanding, we argue, is the core concept of what we call the outcome of the process when research has made use of all the other elements that were integrated in the research. Understanding, then, has a special status in qualitative research since it refers both to the conditions of knowledge and the outcome of the process. Understanding can to some extent be seen as the condition of explanation and occurs in a process of interpretation, which naturally refers to meaning (Gadamer 1990 ). It is fundamentally connected to knowing, and to the knowing of how to do things (Heidegger [1927] 2001 ). Conceptually the term hermeneutics is used to account for this process. Heidegger ties hermeneutics to human being and not possible to separate from the understanding of being ( 1988 ). Here we use it in a broader sense, and more connected to method in general (cf. Seiffert 1992 ). The abovementioned aspects – for example, “objectivity” and “reflexivity” – of the approach are conditions of scientific understanding. Understanding is the result of a circular process and means that the parts are understood in light of the whole, and vice versa. Understanding presupposes pre-understanding, or in other words, some knowledge of the phenomenon studied. The pre-understanding, even in the form of prejudices, are in qualitative research process, which we see as iterative, questioned, which gradually or suddenly change due to the iteration of data, evidence and concepts. However, qualitative research generates understanding in the iterative process when the researcher gets closer to the data, e.g., by going back and forth between field and analysis in a process that generates new data that changes the evidence, and, ultimately, the findings. Questioning, to ask questions, and put what one assumes—prejudices and presumption—in question, is central to understand something (Heidegger [1927] 2001 ; Gadamer 1990 :368–384). We propose that this iterative process in which the process of understanding occurs is characteristic of qualitative research.

Improved understanding means that we obtain scientific knowledge of something that we as a scholarly community did not know before, or that we get to know something better. It means that we understand more about how parts are related to one another, and to other things we already understand (see also Fine and Hallett 2014 ). Understanding is an important condition for qualitative research. It is not enough to identify correlations, make distinctions, and work in a process in which one gets close to the field or phenomena. Understanding is accomplished when the elements are integrated in an iterative process.

It is, moreover, possible to understand many things, and researchers, just like children, may come to understand new things every day as they engage with the world. This subjective condition of understanding – namely, that a person gains a better understanding of something –is easily met. To be qualified as “scientific,” the understanding must be general and useful to many; it must be public. But even this generally accessible understanding is not enough in order to speak of “scientific understanding.” Though we as a collective can increase understanding of everything in virtually all potential directions as a result also of qualitative work, we refrain from this “objective” way of understanding, which has no means of discriminating between what we gain in understanding. Scientific understanding means that it is deemed relevant from the scientific horizon (compare Schütz 1962 : 35–38, 46, 63), and that it rests on the pre-understanding that the scientists have and must have in order to understand. In other words, the understanding gained must be deemed useful by other researchers, so that they can build on it. We thus see understanding from a pragmatic, rather than a subjective or objective perspective. Improved understanding is related to the question(s) at hand. Understanding, in order to represent an improvement, must be an improvement in relation to the existing body of knowledge of the scientific community (James [ 1907 ] 1955). Scientific understanding is, by definition, collective, as expressed in Weber’s famous note on objectivity, namely that scientific work aims at truths “which … can claim, even for a Chinese, the validity appropriate to an empirical analysis” ([1904] 1949 :59). By qualifying “improved understanding” we argue that it is a general defining characteristic of qualitative research. Becker‘s ( 1966 ) study and other research of deviant behavior increased our understanding of the social learning processes of how individuals start a behavior. And it also added new knowledge about the labeling of deviant behavior as a social process. Few studies, of course, make the same large contribution as Becker’s, but are nonetheless qualitative research.

Understanding in the phenomenological sense, which is a hallmark of qualitative research, we argue, requires meaning and this meaning is derived from the context, and above all the data being analyzed. The ideal-typical quantitative research operates with given variables with different numbers. This type of material is not enough to establish meaning at the level that truly justifies understanding. In other words, many social science explanations offer ideas about correlations or even causal relations, but this does not mean that the meaning at the level of the data analyzed, is understood. This leads us to say that there are indeed many explanations that meet the criteria of understanding, for example the explanation of how one becomes a marihuana smoker presented by Becker. However, we may also understand a phenomenon without explaining it, and we may have potential explanations, or better correlations, that are not really understood.

We may speak more generally of quantitative research and its data to clarify what we see as an important distinction. The “raw data” that quantitative research—as an idealtypical activity, refers to is not available for further analysis; the numbers, once created, are not to be questioned (Franzosi 2016 : 138). If the researcher is to do “more” or “change” something, this will be done by conjectures based on theoretical knowledge or based on the researcher’s lifeworld. Both qualitative and quantitative research is based on the lifeworld, and all researchers use prejudices and pre-understanding in the research process. This idea is present in the works of Heidegger ( 2001 ) and Heisenberg (cited in Franzosi 2010 :619). Qualitative research, as we argued, involves the interaction and questioning of concepts (theory), data, and evidence.

Ragin ( 2004 :22) points out that “a good definition of qualitative research should be inclusive and should emphasize its key strengths and features, not what it lacks (for example, the use of sophisticated quantitative techniques).” We define qualitative research as an iterative process in which improved understanding to the scientific community is achieved by making new significant distinctions resulting from getting closer to the phenomenon studied. Qualitative research, as defined here, is consequently a combination of two criteria: (i) how to do things –namely, generating and analyzing empirical material, in an iterative process in which one gets closer by making distinctions, and (ii) the outcome –improved understanding novel to the scholarly community. Is our definition applicable to our own study? In this study we have closely read the empirical material that we generated, and the novel distinction of the notion “qualitative research” is the outcome of an iterative process in which both deduction and induction were involved, in which we identified the categories that we analyzed. We thus claim to meet the first criteria, “how to do things.” The second criteria cannot be judged but in a partial way by us, namely that the “outcome” —in concrete form the definition-improves our understanding to others in the scientific community.

We have defined qualitative research, or qualitative scientific work, in relation to quantitative scientific work. Given this definition, qualitative research is about questioning the pre-given (taken for granted) variables, but it is thus also about making new distinctions of any type of phenomenon, for example, by coining new concepts, including the identification of new variables. This process, as we have discussed, is carried out in relation to empirical material, previous research, and thus in relation to theory. Theory and previous research cannot be escaped or bracketed. According to hermeneutic principles all scientific work is grounded in the lifeworld, and as social scientists we can thus never fully bracket our pre-understanding.

We have proposed that quantitative research, as an idealtype, is concerned with pre-determined variables (Small 2008 ). Variables are epistemically fixed, but can vary in terms of dimensions, such as frequency or number. Age is an example; as a variable it can take on different numbers. In relation to quantitative research, qualitative research does not reduce its material to number and variables. If this is done the process of comes to a halt, the researcher gets more distanced from her data, and it makes it no longer possible to make new distinctions that increase our understanding. We have above discussed the components of our definition in relation to quantitative research. Our conclusion is that in the research that is called quantitative there are frequent and necessary qualitative elements.

Further, comparative empirical research on researchers primarily working with ”quantitative” approaches and those working with ”qualitative” approaches, we propose, would perhaps show that there are many similarities in practices of these two approaches. This is not to deny dissimilarities, or the different epistemic and ontic presuppositions that may be more or less strongly associated with the two different strands (see Goertz and Mahoney 2012 ). Our point is nonetheless that prejudices and preconceptions about researchers are unproductive, and that as other researchers have argued, differences may be exaggerated (e.g., Becker 1996 : 53, 2017 ; Marchel and Owens 2007 :303; Ragin 1994 ), and that a qualitative dimension is present in both kinds of work.

Several things follow from our findings. The most important result is the relation to quantitative research. In our analysis we have separated qualitative research from quantitative research. The point is not to label individual researchers, methods, projects, or works as either “quantitative” or “qualitative.” By analyzing, i.e., taking apart, the notions of quantitative and qualitative, we hope to have shown the elements of qualitative research. Our definition captures the elements, and how they, when combined in practice, generate understanding. As many of the quotations we have used suggest, one conclusion of our study holds that qualitative approaches are not inherently connected with a specific method. Put differently, none of the methods that are frequently labelled “qualitative,” such as interviews or participant observation, are inherently “qualitative.” What matters, given our definition, is whether one works qualitatively or quantitatively in the research process, until the results are produced. Consequently, our analysis also suggests that those researchers working with what in the literature and in jargon is often called “quantitative research” are almost bound to make use of what we have identified as qualitative elements in any research project. Our findings also suggest that many” quantitative” researchers, at least to some extent, are engaged with qualitative work, such as when research questions are developed, variables are constructed and combined, and hypotheses are formulated. Furthermore, a research project may hover between “qualitative” and “quantitative” or start out as “qualitative” and later move into a “quantitative” (a distinct strategy that is not similar to “mixed methods” or just simply combining induction and deduction). More generally speaking, the categories of “qualitative” and “quantitative,” unfortunately, often cover up practices, and it may lead to “camps” of researchers opposing one another. For example, regardless of the researcher is primarily oriented to “quantitative” or “qualitative” research, the role of theory is neglected (cf. Swedberg 2017 ). Our results open up for an interaction not characterized by differences, but by different emphasis, and similarities.

Let us take two examples to briefly indicate how qualitative elements can fruitfully be combined with quantitative. Franzosi ( 2010 ) has discussed the relations between quantitative and qualitative approaches, and more specifically the relation between words and numbers. He analyzes texts and argues that scientific meaning cannot be reduced to numbers. Put differently, the meaning of the numbers is to be understood by what is taken for granted, and what is part of the lifeworld (Schütz 1962 ). Franzosi shows how one can go about using qualitative and quantitative methods and data to address scientific questions analyzing violence in Italy at the time when fascism was rising (1919–1922). Aspers ( 2006 ) studied the meaning of fashion photographers. He uses an empirical phenomenological approach, and establishes meaning at the level of actors. In a second step this meaning, and the different ideal-typical photographers constructed as a result of participant observation and interviews, are tested using quantitative data from a database; in the first phase to verify the different ideal-types, in the second phase to use these types to establish new knowledge about the types. In both of these cases—and more examples can be found—authors move from qualitative data and try to keep the meaning established when using the quantitative data.

A second main result of our study is that a definition, and we provided one, offers a way for research to clarify, and even evaluate, what is done. Hence, our definition can guide researchers and students, informing them on how to think about concrete research problems they face, and to show what it means to get closer in a process in which new distinctions are made. The definition can also be used to evaluate the results, given that it is a standard of evaluation (cf. Hammersley 2007 ), to see whether new distinctions are made and whether this improves our understanding of what is researched, in addition to the evaluation of how the research was conducted. By making what is qualitative research explicit it becomes easier to communicate findings, and it is thereby much harder to fly under the radar with substandard research since there are standards of evaluation which make it easier to separate “good” from “not so good” qualitative research.

To conclude, our analysis, which ends with a definition of qualitative research can thus both address the “internal” issues of what is qualitative research, and the “external” critiques that make it harder to do qualitative research, to which both pressure from quantitative methods and general changes in society contribute.

Acknowledgements

Financial Support for this research is given by the European Research Council, CEV (263699). The authors are grateful to Susann Krieglsteiner for assistance in collecting the data. The paper has benefitted from the many useful comments by the three reviewers and the editor, comments by members of the Uppsala Laboratory of Economic Sociology, as well as Jukka Gronow, Sebastian Kohl, Marcin Serafin, Richard Swedberg, Anders Vassenden and Turid Rødne.

Biographies

is professor of sociology at the Department of Sociology, Uppsala University and Universität St. Gallen. His main focus is economic sociology, and in particular, markets. He has published numerous articles and books, including Orderly Fashion (Princeton University Press 2010), Markets (Polity Press 2011) and Re-Imagining Economic Sociology (edited with N. Dodd, Oxford University Press 2015). His book Ethnographic Methods (in Swedish) has already gone through several editions.

is associate professor of sociology at the Department of Media and Social Sciences, University of Stavanger. His research has been published in journals such as Social Psychology Quarterly, Sociological Theory, Teaching Sociology, and Music and Arts in Action. As an ethnographer he is working on a book on he social world of big-wave surfing.

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Contributor Information

Patrik Aspers, Email: [email protected] .

Ugo Corte, Email: [email protected] .

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