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Types of Interviews in Research | Guide & Examples

Types of Interviews in Research | Guide & Examples

Published on March 10, 2022 by Tegan George . Revised on June 22, 2023.

An interview is a qualitative research method that relies on asking questions in order to collect data . Interviews involve two or more people, one of whom is the interviewer asking the questions.

There are several types of interviews, often differentiated by their level of structure.

Structured interviews have predetermined questions asked in a predetermined order.
Unstructured interviews are more free-flowing.
Semi-structured interviews fall in between.

Interviews are commonly used in market research, social science, and ethnographic research .

What is a structured interview, what is a semi-structured interview, what is an unstructured interview, what is a focus group, examples of interview questions, advantages and disadvantages of interviews, other interesting articles, frequently asked questions about types of interviews.

Structured interviews have predetermined questions in a set order. They are often closed-ended, featuring dichotomous (yes/no) or multiple-choice questions. While open-ended structured interviews exist, they are much less common. The types of questions asked make structured interviews a predominantly quantitative tool.

Asking set questions in a set order can help you see patterns among responses, and it allows you to easily compare responses between participants while keeping other factors constant. This can mitigate research biases and lead to higher reliability and validity. However, structured interviews can be overly formal, as well as limited in scope and flexibility.

You feel very comfortable with your topic. This will help you formulate your questions most effectively.
You have limited time or resources. Structured interviews are a bit more straightforward to analyze because of their closed-ended nature, and can be a doable undertaking for an individual.
Your research question depends on holding environmental conditions between participants constant.

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Semi-structured interviews are a blend of structured and unstructured interviews. While the interviewer has a general plan for what they want to ask, the questions do not have to follow a particular phrasing or order.

Semi-structured interviews are often open-ended, allowing for flexibility, but follow a predetermined thematic framework, giving a sense of order. For this reason, they are often considered “the best of both worlds.”

However, if the questions differ substantially between participants, it can be challenging to look for patterns, lessening the generalizability and validity of your results.

You have prior interview experience. It’s easier than you think to accidentally ask a leading question when coming up with questions on the fly. Overall, spontaneous questions are much more difficult than they may seem.
Your research question is exploratory in nature. The answers you receive can help guide your future research.

An unstructured interview is the most flexible type of interview. The questions and the order in which they are asked are not set. Instead, the interview can proceed more spontaneously, based on the participant’s previous answers.

Unstructured interviews are by definition open-ended. This flexibility can help you gather detailed information on your topic, while still allowing you to observe patterns between participants.

However, so much flexibility means that they can be very challenging to conduct properly. You must be very careful not to ask leading questions, as biased responses can lead to lower reliability or even invalidate your research.

You have a solid background in your research topic and have conducted interviews before.
Your research question is exploratory in nature, and you are seeking descriptive data that will deepen and contextualize your initial hypotheses.
Your research necessitates forming a deeper connection with your participants, encouraging them to feel comfortable revealing their true opinions and emotions.

A focus group brings together a group of participants to answer questions on a topic of interest in a moderated setting. Focus groups are qualitative in nature and often study the group’s dynamic and body language in addition to their answers. Responses can guide future research on consumer products and services, human behavior, or controversial topics.

Focus groups can provide more nuanced and unfiltered feedback than individual interviews and are easier to organize than experiments or large surveys . However, their small size leads to low external validity and the temptation as a researcher to “cherry-pick” responses that fit your hypotheses.

Your research focuses on the dynamics of group discussion or real-time responses to your topic.
Your questions are complex and rooted in feelings, opinions, and perceptions that cannot be answered with a “yes” or “no.”
Your topic is exploratory in nature, and you are seeking information that will help you uncover new questions or future research ideas.

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Depending on the type of interview you are conducting, your questions will differ in style, phrasing, and intention. Structured interview questions are set and precise, while the other types of interviews allow for more open-endedness and flexibility.

Here are some examples.

Semi-structured
Unstructured
Focus group
Do you like dogs? Yes/No
Do you associate dogs with feeling: happy; somewhat happy; neutral; somewhat unhappy; unhappy
If yes, name one attribute of dogs that you like.
If no, name one attribute of dogs that you don’t like.
What feelings do dogs bring out in you?
When you think more deeply about this, what experiences would you say your feelings are rooted in?

Interviews are a great research tool. They allow you to gather rich information and draw more detailed conclusions than other research methods, taking into consideration nonverbal cues, off-the-cuff reactions, and emotional responses.

However, they can also be time-consuming and deceptively challenging to conduct properly. Smaller sample sizes can cause their validity and reliability to suffer, and there is an inherent risk of interviewer effect arising from accidentally leading questions.

Here are some advantages and disadvantages of each type of interview that can help you decide if you’d like to utilize this research method.

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

Student’s t -distribution
Normal distribution
Null and Alternative Hypotheses
Chi square tests
Confidence interval
Quartiles & Quantiles
Cluster sampling
Stratified sampling
Data cleansing
Reproducibility vs Replicability
Peer review
Prospective cohort study

Research bias

Implicit bias
Cognitive bias
Placebo effect
Hawthorne effect
Hindsight bias
Affect heuristic
Social desirability bias

The four most common types of interviews are:

Structured interviews : The questions are predetermined in both topic and order.
Semi-structured interviews : A few questions are predetermined, but other questions aren’t planned.
Unstructured interviews : None of the questions are predetermined.
Focus group interviews : The questions are presented to a group instead of one individual.

The interviewer effect is a type of bias that emerges when a characteristic of an interviewer (race, age, gender identity, etc.) influences the responses given by the interviewee.

There is a risk of an interviewer effect in all types of interviews , but it can be mitigated by writing really high-quality interview questions.

Social desirability bias is the tendency for interview participants to give responses that will be viewed favorably by the interviewer or other participants. It occurs in all types of interviews and surveys , but is most common in semi-structured interviews , unstructured interviews , and focus groups .

Social desirability bias can be mitigated by ensuring participants feel at ease and comfortable sharing their views. Make sure to pay attention to your own body language and any physical or verbal cues, such as nodding or widening your eyes.

This type of bias can also occur in observations if the participants know they’re being observed. They might alter their behavior accordingly.

A focus group is a research method that brings together a small group of people to answer questions in a moderated setting. The group is chosen due to predefined demographic traits, and the questions are designed to shed light on a topic of interest. It is one of 4 types of interviews .

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

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

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Chapter 11. Interviewing

Introduction.

Interviewing people is at the heart of qualitative research. It is not merely a way to collect data but an intrinsically rewarding activity—an interaction between two people that holds the potential for greater understanding and interpersonal development. Unlike many of our daily interactions with others that are fairly shallow and mundane, sitting down with a person for an hour or two and really listening to what they have to say is a profound and deep enterprise, one that can provide not only “data” for you, the interviewer, but also self-understanding and a feeling of being heard for the interviewee. I always approach interviewing with a deep appreciation for the opportunity it gives me to understand how other people experience the world. That said, there is not one kind of interview but many, and some of these are shallower than others. This chapter will provide you with an overview of interview techniques but with a special focus on the in-depth semistructured interview guide approach, which is the approach most widely used in social science research.

An interview can be variously defined as “a conversation with a purpose” ( Lune and Berg 2018 ) and an attempt to understand the world from the point of view of the person being interviewed: “to unfold the meaning of peoples’ experiences, to uncover their lived world prior to scientific explanations” ( Kvale 2007 ). It is a form of active listening in which the interviewer steers the conversation to subjects and topics of interest to their research but also manages to leave enough space for those interviewed to say surprising things. Achieving that balance is a tricky thing, which is why most practitioners believe interviewing is both an art and a science. In my experience as a teacher, there are some students who are “natural” interviewers (often they are introverts), but anyone can learn to conduct interviews, and everyone, even those of us who have been doing this for years, can improve their interviewing skills. This might be a good time to highlight the fact that the interview is a product between interviewer and interviewee and that this product is only as good as the rapport established between the two participants. Active listening is the key to establishing this necessary rapport.

Patton ( 2002 ) makes the argument that we use interviews because there are certain things that are not observable. In particular, “we cannot observe feelings, thoughts, and intentions. We cannot observe behaviors that took place at some previous point in time. We cannot observe situations that preclude the presence of an observer. We cannot observe how people have organized the world and the meanings they attach to what goes on in the world. We have to ask people questions about those things” ( 341 ).

Types of Interviews

There are several distinct types of interviews. Imagine a continuum (figure 11.1). On one side are unstructured conversations—the kind you have with your friends. No one is in control of those conversations, and what you talk about is often random—whatever pops into your head. There is no secret, underlying purpose to your talking—if anything, the purpose is to talk to and engage with each other, and the words you use and the things you talk about are a little beside the point. An unstructured interview is a little like this informal conversation, except that one of the parties to the conversation (you, the researcher) does have an underlying purpose, and that is to understand the other person. You are not friends speaking for no purpose, but it might feel just as unstructured to the “interviewee” in this scenario. That is one side of the continuum. On the other side are fully structured and standardized survey-type questions asked face-to-face. Here it is very clear who is asking the questions and who is answering them. This doesn’t feel like a conversation at all! A lot of people new to interviewing have this ( erroneously !) in mind when they think about interviews as data collection. Somewhere in the middle of these two extreme cases is the “ semistructured” interview , in which the researcher uses an “interview guide” to gently move the conversation to certain topics and issues. This is the primary form of interviewing for qualitative social scientists and will be what I refer to as interviewing for the rest of this chapter, unless otherwise specified.

Types of Interviewing Questions: Unstructured conversations, Semi-structured interview, Structured interview, Survey questions

Informal (unstructured conversations). This is the most “open-ended” approach to interviewing. It is particularly useful in conjunction with observational methods (see chapters 13 and 14). There are no predetermined questions. Each interview will be different. Imagine you are researching the Oregon Country Fair, an annual event in Veneta, Oregon, that includes live music, artisan craft booths, face painting, and a lot of people walking through forest paths. It’s unlikely that you will be able to get a person to sit down with you and talk intensely about a set of questions for an hour and a half. But you might be able to sidle up to several people and engage with them about their experiences at the fair. You might have a general interest in what attracts people to these events, so you could start a conversation by asking strangers why they are here or why they come back every year. That’s it. Then you have a conversation that may lead you anywhere. Maybe one person tells a long story about how their parents brought them here when they were a kid. A second person talks about how this is better than Burning Man. A third person shares their favorite traveling band. And yet another enthuses about the public library in the woods. During your conversations, you also talk about a lot of other things—the weather, the utilikilts for sale, the fact that a favorite food booth has disappeared. It’s all good. You may not be able to record these conversations. Instead, you might jot down notes on the spot and then, when you have the time, write down as much as you can remember about the conversations in long fieldnotes. Later, you will have to sit down with these fieldnotes and try to make sense of all the information (see chapters 18 and 19).

Interview guide ( semistructured interview ). This is the primary type employed by social science qualitative researchers. The researcher creates an “interview guide” in advance, which she uses in every interview. In theory, every person interviewed is asked the same questions. In practice, every person interviewed is asked mostly the same topics but not always the same questions, as the whole point of a “guide” is that it guides the direction of the conversation but does not command it. The guide is typically between five and ten questions or question areas, sometimes with suggested follow-ups or prompts . For example, one question might be “What was it like growing up in Eastern Oregon?” with prompts such as “Did you live in a rural area? What kind of high school did you attend?” to help the conversation develop. These interviews generally take place in a quiet place (not a busy walkway during a festival) and are recorded. The recordings are transcribed, and those transcriptions then become the “data” that is analyzed (see chapters 18 and 19). The conventional length of one of these types of interviews is between one hour and two hours, optimally ninety minutes. Less than one hour doesn’t allow for much development of questions and thoughts, and two hours (or more) is a lot of time to ask someone to sit still and answer questions. If you have a lot of ground to cover, and the person is willing, I highly recommend two separate interview sessions, with the second session being slightly shorter than the first (e.g., ninety minutes the first day, sixty minutes the second). There are lots of good reasons for this, but the most compelling one is that this allows you to listen to the first day’s recording and catch anything interesting you might have missed in the moment and so develop follow-up questions that can probe further. This also allows the person being interviewed to have some time to think about the issues raised in the interview and go a little deeper with their answers.

Standardized questionnaire with open responses ( structured interview ). This is the type of interview a lot of people have in mind when they hear “interview”: a researcher comes to your door with a clipboard and proceeds to ask you a series of questions. These questions are all the same whoever answers the door; they are “standardized.” Both the wording and the exact order are important, as people’s responses may vary depending on how and when a question is asked. These are qualitative only in that the questions allow for “open-ended responses”: people can say whatever they want rather than select from a predetermined menu of responses. For example, a survey I collaborated on included this open-ended response question: “How does class affect one’s career success in sociology?” Some of the answers were simply one word long (e.g., “debt”), and others were long statements with stories and personal anecdotes. It is possible to be surprised by the responses. Although it’s a stretch to call this kind of questioning a conversation, it does allow the person answering the question some degree of freedom in how they answer.

Survey questionnaire with closed responses (not an interview!). Standardized survey questions with specific answer options (e.g., closed responses) are not really interviews at all, and they do not generate qualitative data. For example, if we included five options for the question “How does class affect one’s career success in sociology?”—(1) debt, (2) social networks, (3) alienation, (4) family doesn’t understand, (5) type of grad program—we leave no room for surprises at all. Instead, we would most likely look at patterns around these responses, thinking quantitatively rather than qualitatively (e.g., using regression analysis techniques, we might find that working-class sociologists were twice as likely to bring up alienation). It can sometimes be confusing for new students because the very same survey can include both closed-ended and open-ended questions. The key is to think about how these will be analyzed and to what level surprises are possible. If your plan is to turn all responses into a number and make predictions about correlations and relationships, you are no longer conducting qualitative research. This is true even if you are conducting this survey face-to-face with a real live human. Closed-response questions are not conversations of any kind, purposeful or not.

In summary, the semistructured interview guide approach is the predominant form of interviewing for social science qualitative researchers because it allows a high degree of freedom of responses from those interviewed (thus allowing for novel discoveries) while still maintaining some connection to a research question area or topic of interest. The rest of the chapter assumes the employment of this form.

Creating an Interview Guide

Your interview guide is the instrument used to bridge your research question(s) and what the people you are interviewing want to tell you. Unlike a standardized questionnaire, the questions actually asked do not need to be exactly what you have written down in your guide. The guide is meant to create space for those you are interviewing to talk about the phenomenon of interest, but sometimes you are not even sure what that phenomenon is until you start asking questions. A priority in creating an interview guide is to ensure it offers space. One of the worst mistakes is to create questions that are so specific that the person answering them will not stray. Relatedly, questions that sound “academic” will shut down a lot of respondents. A good interview guide invites respondents to talk about what is important to them, not feel like they are performing or being evaluated by you.

Good interview questions should not sound like your “research question” at all. For example, let’s say your research question is “How do patriarchal assumptions influence men’s understanding of climate change and responses to climate change?” It would be worse than unhelpful to ask a respondent, “How do your assumptions about the role of men affect your understanding of climate change?” You need to unpack this into manageable nuggets that pull your respondent into the area of interest without leading him anywhere. You could start by asking him what he thinks about climate change in general. Or, even better, whether he has any concerns about heatwaves or increased tornadoes or polar icecaps melting. Once he starts talking about that, you can ask follow-up questions that bring in issues around gendered roles, perhaps asking if he is married (to a woman) and whether his wife shares his thoughts and, if not, how they negotiate that difference. The fact is, you won’t really know the right questions to ask until he starts talking.

There are several distinct types of questions that can be used in your interview guide, either as main questions or as follow-up probes. If you remember that the point is to leave space for the respondent, you will craft a much more effective interview guide! You will also want to think about the place of time in both the questions themselves (past, present, future orientations) and the sequencing of the questions.

Researcher Note

Suggestion : As you read the next three sections (types of questions, temporality, question sequence), have in mind a particular research question, and try to draft questions and sequence them in a way that opens space for a discussion that helps you answer your research question.

Type of Questions

Experience and behavior questions ask about what a respondent does regularly (their behavior) or has done (their experience). These are relatively easy questions for people to answer because they appear more “factual” and less subjective. This makes them good opening questions. For the study on climate change above, you might ask, “Have you ever experienced an unusual weather event? What happened?” Or “You said you work outside? What is a typical summer workday like for you? How do you protect yourself from the heat?”

Opinion and values questions , in contrast, ask questions that get inside the minds of those you are interviewing. “Do you think climate change is real? Who or what is responsible for it?” are two such questions. Note that you don’t have to literally ask, “What is your opinion of X?” but you can find a way to ask the specific question relevant to the conversation you are having. These questions are a bit trickier to ask because the answers you get may depend in part on how your respondent perceives you and whether they want to please you or not. We’ve talked a fair amount about being reflective. Here is another place where this comes into play. You need to be aware of the effect your presence might have on the answers you are receiving and adjust accordingly. If you are a woman who is perceived as liberal asking a man who identifies as conservative about climate change, there is a lot of subtext that can be going on in the interview. There is no one right way to resolve this, but you must at least be aware of it.

Feeling questions are questions that ask respondents to draw on their emotional responses. It’s pretty common for academic researchers to forget that we have bodies and emotions, but people’s understandings of the world often operate at this affective level, sometimes unconsciously or barely consciously. It is a good idea to include questions that leave space for respondents to remember, imagine, or relive emotional responses to particular phenomena. “What was it like when you heard your cousin’s house burned down in that wildfire?” doesn’t explicitly use any emotion words, but it allows your respondent to remember what was probably a pretty emotional day. And if they respond emotionally neutral, that is pretty interesting data too. Note that asking someone “How do you feel about X” is not always going to evoke an emotional response, as they might simply turn around and respond with “I think that…” It is better to craft a question that actually pushes the respondent into the affective category. This might be a specific follow-up to an experience and behavior question —for example, “You just told me about your daily routine during the summer heat. Do you worry it is going to get worse?” or “Have you ever been afraid it will be too hot to get your work accomplished?”

Knowledge questions ask respondents what they actually know about something factual. We have to be careful when we ask these types of questions so that respondents do not feel like we are evaluating them (which would shut them down), but, for example, it is helpful to know when you are having a conversation about climate change that your respondent does in fact know that unusual weather events have increased and that these have been attributed to climate change! Asking these questions can set the stage for deeper questions and can ensure that the conversation makes the same kind of sense to both participants. For example, a conversation about political polarization can be put back on track once you realize that the respondent doesn’t really have a clear understanding that there are two parties in the US. Instead of asking a series of questions about Republicans and Democrats, you might shift your questions to talk more generally about political disagreements (e.g., “people against abortion”). And sometimes what you do want to know is the level of knowledge about a particular program or event (e.g., “Are you aware you can discharge your student loans through the Public Service Loan Forgiveness program?”).

Sensory questions call on all senses of the respondent to capture deeper responses. These are particularly helpful in sparking memory. “Think back to your childhood in Eastern Oregon. Describe the smells, the sounds…” Or you could use these questions to help a person access the full experience of a setting they customarily inhabit: “When you walk through the doors to your office building, what do you see? Hear? Smell?” As with feeling questions , these questions often supplement experience and behavior questions . They are another way of allowing your respondent to report fully and deeply rather than remain on the surface.

Creative questions employ illustrative examples, suggested scenarios, or simulations to get respondents to think more deeply about an issue, topic, or experience. There are many options here. In The Trouble with Passion , Erin Cech ( 2021 ) provides a scenario in which “Joe” is trying to decide whether to stay at his decent but boring computer job or follow his passion by opening a restaurant. She asks respondents, “What should Joe do?” Their answers illuminate the attraction of “passion” in job selection. In my own work, I have used a news story about an upwardly mobile young man who no longer has time to see his mother and sisters to probe respondents’ feelings about the costs of social mobility. Jessi Streib and Betsy Leondar-Wright have used single-page cartoon “scenes” to elicit evaluations of potential racial discrimination, sexual harassment, and classism. Barbara Sutton ( 2010 ) has employed lists of words (“strong,” “mother,” “victim”) on notecards she fans out and asks her female respondents to select and discuss.

Background/Demographic Questions

You most definitely will want to know more about the person you are interviewing in terms of conventional demographic information, such as age, race, gender identity, occupation, and educational attainment. These are not questions that normally open up inquiry. [1] For this reason, my practice has been to include a separate “demographic questionnaire” sheet that I ask each respondent to fill out at the conclusion of the interview. Only include those aspects that are relevant to your study. For example, if you are not exploring religion or religious affiliation, do not include questions about a person’s religion on the demographic sheet. See the example provided at the end of this chapter.

Temporality

Any type of question can have a past, present, or future orientation. For example, if you are asking a behavior question about workplace routine, you might ask the respondent to talk about past work, present work, and ideal (future) work. Similarly, if you want to understand how people cope with natural disasters, you might ask your respondent how they felt then during the wildfire and now in retrospect and whether and to what extent they have concerns for future wildfire disasters. It’s a relatively simple suggestion—don’t forget to ask about past, present, and future—but it can have a big impact on the quality of the responses you receive.

Question Sequence

Having a list of good questions or good question areas is not enough to make a good interview guide. You will want to pay attention to the order in which you ask your questions. Even though any one respondent can derail this order (perhaps by jumping to answer a question you haven’t yet asked), a good advance plan is always helpful. When thinking about sequence, remember that your goal is to get your respondent to open up to you and to say things that might surprise you. To establish rapport, it is best to start with nonthreatening questions. Asking about the present is often the safest place to begin, followed by the past (they have to know you a little bit to get there), and lastly, the future (talking about hopes and fears requires the most rapport). To allow for surprises, it is best to move from very general questions to more particular questions only later in the interview. This ensures that respondents have the freedom to bring up the topics that are relevant to them rather than feel like they are constrained to answer you narrowly. For example, refrain from asking about particular emotions until these have come up previously—don’t lead with them. Often, your more particular questions will emerge only during the course of the interview, tailored to what is emerging in conversation.

Once you have a set of questions, read through them aloud and imagine you are being asked the same questions. Does the set of questions have a natural flow? Would you be willing to answer the very first question to a total stranger? Does your sequence establish facts and experiences before moving on to opinions and values? Did you include prefatory statements, where necessary; transitions; and other announcements? These can be as simple as “Hey, we talked a lot about your experiences as a barista while in college.… Now I am turning to something completely different: how you managed friendships in college.” That is an abrupt transition, but it has been softened by your acknowledgment of that.

Probes and Flexibility

Once you have the interview guide, you will also want to leave room for probes and follow-up questions. As in the sample probe included here, you can write out the obvious probes and follow-up questions in advance. You might not need them, as your respondent might anticipate them and include full responses to the original question. Or you might need to tailor them to how your respondent answered the question. Some common probes and follow-up questions include asking for more details (When did that happen? Who else was there?), asking for elaboration (Could you say more about that?), asking for clarification (Does that mean what I think it means or something else? I understand what you mean, but someone else reading the transcript might not), and asking for contrast or comparison (How did this experience compare with last year’s event?). “Probing is a skill that comes from knowing what to look for in the interview, listening carefully to what is being said and what is not said, and being sensitive to the feedback needs of the person being interviewed” ( Patton 2002:374 ). It takes work! And energy. I and many other interviewers I know report feeling emotionally and even physically drained after conducting an interview. You are tasked with active listening and rearranging your interview guide as needed on the fly. If you only ask the questions written down in your interview guide with no deviations, you are doing it wrong. [2]

The Final Question

Every interview guide should include a very open-ended final question that allows for the respondent to say whatever it is they have been dying to tell you but you’ve forgotten to ask. About half the time they are tired too and will tell you they have nothing else to say. But incredibly, some of the most honest and complete responses take place here, at the end of a long interview. You have to realize that the person being interviewed is often discovering things about themselves as they talk to you and that this process of discovery can lead to new insights for them. Making space at the end is therefore crucial. Be sure you convey that you actually do want them to tell you more, that the offer of “anything else?” is not read as an empty convention where the polite response is no. Here is where you can pull from that active listening and tailor the final question to the particular person. For example, “I’ve asked you a lot of questions about what it was like to live through that wildfire. I’m wondering if there is anything I’ve forgotten to ask, especially because I haven’t had that experience myself” is a much more inviting final question than “Great. Anything you want to add?” It’s also helpful to convey to the person that you have the time to listen to their full answer, even if the allotted time is at the end. After all, there are no more questions to ask, so the respondent knows exactly how much time is left. Do them the courtesy of listening to them!

Conducting the Interview

Once you have your interview guide, you are on your way to conducting your first interview. I always practice my interview guide with a friend or family member. I do this even when the questions don’t make perfect sense for them, as it still helps me realize which questions make no sense, are poorly worded (too academic), or don’t follow sequentially. I also practice the routine I will use for interviewing, which goes something like this:

Introduce myself and reintroduce the study
Provide consent form and ask them to sign and retain/return copy
Ask if they have any questions about the study before we begin
Ask if I can begin recording
Ask questions (from interview guide)
Turn off the recording device
Ask if they are willing to fill out my demographic questionnaire
Collect questionnaire and, without looking at the answers, place in same folder as signed consent form
Thank them and depart

A note on remote interviewing: Interviews have traditionally been conducted face-to-face in a private or quiet public setting. You don’t want a lot of background noise, as this will make transcriptions difficult. During the recent global pandemic, many interviewers, myself included, learned the benefits of interviewing remotely. Although face-to-face is still preferable for many reasons, Zoom interviewing is not a bad alternative, and it does allow more interviews across great distances. Zoom also includes automatic transcription, which significantly cuts down on the time it normally takes to convert our conversations into “data” to be analyzed. These automatic transcriptions are not perfect, however, and you will still need to listen to the recording and clarify and clean up the transcription. Nor do automatic transcriptions include notations of body language or change of tone, which you may want to include. When interviewing remotely, you will want to collect the consent form before you meet: ask them to read, sign, and return it as an email attachment. I think it is better to ask for the demographic questionnaire after the interview, but because some respondents may never return it then, it is probably best to ask for this at the same time as the consent form, in advance of the interview.

What should you bring to the interview? I would recommend bringing two copies of the consent form (one for you and one for the respondent), a demographic questionnaire, a manila folder in which to place the signed consent form and filled-out demographic questionnaire, a printed copy of your interview guide (I print with three-inch right margins so I can jot down notes on the page next to relevant questions), a pen, a recording device, and water.

After the interview, you will want to secure the signed consent form in a locked filing cabinet (if in print) or a password-protected folder on your computer. Using Excel or a similar program that allows tables/spreadsheets, create an identifying number for your interview that links to the consent form without using the name of your respondent. For example, let’s say that I conduct interviews with US politicians, and the first person I meet with is George W. Bush. I will assign the transcription the number “INT#001” and add it to the signed consent form. [3] The signed consent form goes into a locked filing cabinet, and I never use the name “George W. Bush” again. I take the information from the demographic sheet, open my Excel spreadsheet, and add the relevant information in separate columns for the row INT#001: White, male, Republican. When I interview Bill Clinton as my second interview, I include a second row: INT#002: White, male, Democrat. And so on. The only link to the actual name of the respondent and this information is the fact that the consent form (unavailable to anyone but me) has stamped on it the interview number.

Many students get very nervous before their first interview. Actually, many of us are always nervous before the interview! But do not worry—this is normal, and it does pass. Chances are, you will be pleasantly surprised at how comfortable it begins to feel. These “purposeful conversations” are often a delight for both participants. This is not to say that sometimes things go wrong. I often have my students practice several “bad scenarios” (e.g., a respondent that you cannot get to open up; a respondent who is too talkative and dominates the conversation, steering it away from the topics you are interested in; emotions that completely take over; or shocking disclosures you are ill-prepared to handle), but most of the time, things go quite well. Be prepared for the unexpected, but know that the reason interviews are so popular as a technique of data collection is that they are usually richly rewarding for both participants.

One thing that I stress to my methods students and remind myself about is that interviews are still conversations between people. If there’s something you might feel uncomfortable asking someone about in a “normal” conversation, you will likely also feel a bit of discomfort asking it in an interview. Maybe more importantly, your respondent may feel uncomfortable. Social research—especially about inequality—can be uncomfortable. And it’s easy to slip into an abstract, intellectualized, or removed perspective as an interviewer. This is one reason trying out interview questions is important. Another is that sometimes the question sounds good in your head but doesn’t work as well out loud in practice. I learned this the hard way when a respondent asked me how I would answer the question I had just posed, and I realized that not only did I not really know how I would answer it, but I also wasn’t quite as sure I knew what I was asking as I had thought.

—Elizabeth M. Lee, Associate Professor of Sociology at Saint Joseph’s University, author of Class and Campus Life , and co-author of Geographies of Campus Inequality

How Many Interviews?

Your research design has included a targeted number of interviews and a recruitment plan (see chapter 5). Follow your plan, but remember that “ saturation ” is your goal. You interview as many people as you can until you reach a point at which you are no longer surprised by what they tell you. This means not that no one after your first twenty interviews will have surprising, interesting stories to tell you but rather that the picture you are forming about the phenomenon of interest to you from a research perspective has come into focus, and none of the interviews are substantially refocusing that picture. That is when you should stop collecting interviews. Note that to know when you have reached this, you will need to read your transcripts as you go. More about this in chapters 18 and 19.

Your Final Product: The Ideal Interview Transcript

A good interview transcript will demonstrate a subtly controlled conversation by the skillful interviewer. In general, you want to see replies that are about one paragraph long, not short sentences and not running on for several pages. Although it is sometimes necessary to follow respondents down tangents, it is also often necessary to pull them back to the questions that form the basis of your research study. This is not really a free conversation, although it may feel like that to the person you are interviewing.

Final Tips from an Interview Master

Annette Lareau is arguably one of the masters of the trade. In Listening to People , she provides several guidelines for good interviews and then offers a detailed example of an interview gone wrong and how it could be addressed (please see the “Further Readings” at the end of this chapter). Here is an abbreviated version of her set of guidelines: (1) interview respondents who are experts on the subjects of most interest to you (as a corollary, don’t ask people about things they don’t know); (2) listen carefully and talk as little as possible; (3) keep in mind what you want to know and why you want to know it; (4) be a proactive interviewer (subtly guide the conversation); (5) assure respondents that there aren’t any right or wrong answers; (6) use the respondent’s own words to probe further (this both allows you to accurately identify what you heard and pushes the respondent to explain further); (7) reuse effective probes (don’t reinvent the wheel as you go—if repeating the words back works, do it again and again); (8) focus on learning the subjective meanings that events or experiences have for a respondent; (9) don’t be afraid to ask a question that draws on your own knowledge (unlike trial lawyers who are trained never to ask a question for which they don’t already know the answer, sometimes it’s worth it to ask risky questions based on your hypotheses or just plain hunches); (10) keep thinking while you are listening (so difficult…and important); (11) return to a theme raised by a respondent if you want further information; (12) be mindful of power inequalities (and never ever coerce a respondent to continue the interview if they want out); (13) take control with overly talkative respondents; (14) expect overly succinct responses, and develop strategies for probing further; (15) balance digging deep and moving on; (16) develop a plan to deflect questions (e.g., let them know you are happy to answer any questions at the end of the interview, but you don’t want to take time away from them now); and at the end, (17) check to see whether you have asked all your questions. You don’t always have to ask everyone the same set of questions, but if there is a big area you have forgotten to cover, now is the time to recover ( Lareau 2021:93–103 ).

Sample: Demographic Questionnaire

ASA Taskforce on First-Generation and Working-Class Persons in Sociology – Class Effects on Career Success

Supplementary Demographic Questionnaire

Thank you for your participation in this interview project. We would like to collect a few pieces of key demographic information from you to supplement our analyses. Your answers to these questions will be kept confidential and stored by ID number. All of your responses here are entirely voluntary!

What best captures your race/ethnicity? (please check any/all that apply)

White (Non Hispanic/Latina/o/x)
Black or African American
Hispanic, Latino/a/x of Spanish
Asian or Asian American
American Indian or Alaska Native
Middle Eastern or North African
Native Hawaiian or Pacific Islander
Other : (Please write in: ________________)

What is your current position?

Grad Student
Full Professor

Please check any and all of the following that apply to you:

I identify as a working-class academic
I was the first in my family to graduate from college
I grew up poor

What best reflects your gender?

Transgender female/Transgender woman
Transgender male/Transgender man
Gender queer/ Gender nonconforming

Anything else you would like us to know about you?

Example: Interview Guide

In this example, follow-up prompts are italicized. Note the sequence of questions. That second question often elicits an entire life history , answering several later questions in advance.

Introduction Script/Question

Thank you for participating in our survey of ASA members who identify as first-generation or working-class. As you may have heard, ASA has sponsored a taskforce on first-generation and working-class persons in sociology and we are interested in hearing from those who so identify. Your participation in this interview will help advance our knowledge in this area.

The first thing we would like to as you is why you have volunteered to be part of this study? What does it mean to you be first-gen or working class? Why were you willing to be interviewed?
How did you decide to become a sociologist?
Can you tell me a little bit about where you grew up? ( prompts: what did your parent(s) do for a living? What kind of high school did you attend?)
Has this identity been salient to your experience? (how? How much?)
How welcoming was your grad program? Your first academic employer?
Why did you decide to pursue sociology at the graduate level?
Did you experience culture shock in college? In graduate school?
Has your FGWC status shaped how you’ve thought about where you went to school? debt? etc?
Were you mentored? How did this work (not work)? How might it?
What did you consider when deciding where to go to grad school? Where to apply for your first position?
What, to you, is a mark of career success? Have you achieved that success? What has helped or hindered your pursuit of success?
Do you think sociology, as a field, cares about prestige?
Let’s talk a little bit about intersectionality. How does being first-gen/working class work alongside other identities that are important to you?
What do your friends and family think about your career? Have you had any difficulty relating to family members or past friends since becoming highly educated?
Do you have any debt from college/grad school? Are you concerned about this? Could you explain more about how you paid for college/grad school? (here, include assistance from family, fellowships, scholarships, etc.)
(You’ve mentioned issues or obstacles you had because of your background.) What could have helped? Or, who or what did? Can you think of fortuitous moments in your career?
Do you have any regrets about the path you took?
Is there anything else you would like to add? Anything that the Taskforce should take note of, that we did not ask you about here?

Library Support for Qualitative Research

Interview Research
Resources for Methodology
Remote Research & Virtual Fieldwork

Resources for Research Interviewing

Nih-funded qualitative research.

Oral History
Data Management & Repositories
Campus Access

Types of Interviews

Engaging Participants

Interview Questions

Conducting Interviews
Transcription
Coding and Analysis
Managing & Finding Interview Data
UX & Market Research Interviews

Textbooks, Guidebooks, and Handbooks

The Ethnographic Interview by James P. Spradley “Spradley wrote this book for the professional and student who have never done ethnographic fieldwork (p. 231) and for the professional ethnographer who is interested in adapting the author’s procedures (p. iv). Part 1 outlines in 3 chapters Spradley’s version of ethnographic research, and it provides the background for Part 2 which consists of 12 guided steps (chapters) ranging from locating and interviewing an informant to writing an ethnography. Most of the examples come from the author’s own fieldwork among U.S. subcultures . . . Steps 6 and 8 explain lucidly how to construct a domain and a taxonomic analysis” (excerpted from book review by James D. Sexton, 1980).
Fundamentals of Qualitative Research by Johnny Saldana (Series edited by Patricia Leavy) Provides a soup-to-nuts overview of the qualitative data collection process, including interviewing, participant observation, and other methods.
InterViews by Steinar Kvale Interviewing is an essential tool in qualitative research and this introduction to interviewing outlines both the theoretical underpinnings and the practical aspects of the process. After examining the role of the interview in the research process, Steinar Kvale considers some of the key philosophical issues relating to interviewing: the interview as conversation, hermeneutics, phenomenology, concerns about ethics as well as validity, and postmodernism. Having established this framework, the author then analyzes the seven stages of the interview process - from designing a study to writing it up.
Practical Evaluation by Michael Quinn Patton Surveys different interviewing strategies, from, a) informal/conversational, to b) interview guide approach, to c) standardized and open-ended, to d) closed/quantitative. Also discusses strategies for wording questions that are open-ended, clear, sensitive, and neutral, while supporting the speaker. Provides suggestions for probing and maintaining control of the interview process, as well as suggestions for recording and transcription.
The SAGE Handbook of Interview Research by Amir B. Marvasti (Editor); James A. Holstein (Editor); Jaber F. Gubrium (Editor); Karyn D. McKinney (Editor) The new edition of this landmark volume emphasizes the dynamic, interactional, and reflexive dimensions of the research interview. Contributors highlight the myriad dimensions of complexity that are emerging as researchers increasingly frame the interview as a communicative opportunity as much as a data-gathering format. The book begins with the history and conceptual transformations of the interview, which is followed by chapters that discuss the main components of interview practice. Taken together, the contributions to The SAGE Handbook of Interview Research: The Complexity of the Craft encourage readers simultaneously to learn the frameworks and technologies of interviewing and to reflect on the epistemological foundations of the interview craft.
The SAGE Handbook of Online Research Methods by Nigel G. Fielding, Raymond M. Lee and Grant Blank (Editors) Bringing together the leading names in both qualitative and quantitative online research, this new edition is organised into nine sections: 1. Online Research Methods 2. Designing Online Research 3. Online Data Capture and Data Collection 4. The Online Survey 5. Digital Quantitative Analysis 6. Digital Text Analysis 7. Virtual Ethnography 8. Online Secondary Analysis: Resources and Methods 9. The Future of Online Social Research

ONLINE RESOURCES, COMMUNITIES, AND DATABASES

Interviews as a Method for Qualitative Research (video) This short video summarizes why interviews can serve as useful data in qualitative research.
Companion website to Bloomberg and Volpe's Completing Your Qualitative Dissertation: A Road Map from Beginning to End, 4th ed Provides helpful templates and appendices featured in the book, as well as links to other useful dissertation resources.
International Congress of Qualitative Inquiry Annual conference hosted by the International Center for Qualitative Inquiry at the University of Illinois at Urbana-Champaign, which aims to facilitate the development of qualitative research methods across a wide variety of academic disciplines, among other initiatives.
METHODSPACE An online home of the research methods community, where practicing researchers share how to make research easier.
SAGE researchmethods Researchers can explore methods concepts to help them design research projects, understand particular methods or identify a new method, conduct their research, and write up their findings. A "methods map" facilitates finding content on methods.

The decision to conduct interviews, and the type of interviewing to use, should flow from, or align with, the methodological paradigm chosen for your study, whether that paradigm is interpretivist, critical, positivist, or participative in nature (or a combination of these).

Structured:

Structured Interview. Entry in The SAGE Encyclopedia of Social Science Research Methodsby Floyd J. Fowler Jr., Editors: Michael S. Lewis-Beck; Alan E. Bryman; Tim Futing Liao (Editor) A concise article noting standards, procedures, and recommendations for developing and testing structured interviews. For an example of structured interview questions, you may view the Current Population Survey, May 2008: Public Participation in the Arts Supplement (ICPSR 29641), Apr 15, 2011 at https://doi.org/10.3886/ICPSR29641.v1 (To see the survey questions, preview the user guide, which can be found under the "Data and Documentation" tab. Then, look for page 177 (attachment 8).

Semi-Structured:

Semi-Structured Interview. Entry in The SAGE Encyclopedia of Qualitative Research Methodsby Lioness Ayres; Editor: Lisa M. Given The semi-structured interview is a qualitative data collection strategy in which the researcher asks informants a series of predetermined but open-ended questions. The researcher has more control over the topics of the interview than in unstructured interviews, but in contrast to structured interviews or questionnaires that use closed questions, there is no fixed range of responses to each question.

Unstructured:

Unstructured Interview. Entry in The SAGE Encyclopedia of Qualitative Research Methodsby Michael W. Firmin; Editor: Lisa M. Given Unstructured interviews in qualitative research involve asking relatively open-ended questions of research participants in order to discover their percepts on the topic of interest. Interviews, in general, are a foundational means of collecting data when using qualitative research methods. They are designed to draw from the interviewee constructs embedded in his or her thinking and rationale for decision making. The researcher uses an inductive method in data gathering, regardless of whether the interview method is open, structured, or semi-structured. That is, the researcher does not wish to superimpose his or her own viewpoints onto the person being interviewed. Rather, inductively, the researcher wishes to understand the participant's perceptions, helping him or her to articulate percepts such that they will be understood clearly by the journal reader.

Genres and Uses

Focus groups:.

"Focus Groups." Annual Review of Sociology 22 (1996): 129-1524.by David L. Morgan Discusses the use of focus groups and group interviews as methods for gathering qualitative data used by sociologists and other academic and applied researchers. Focus groups are recommended for giving voice to marginalized groups and revealing the group effect on opinion formation.
Qualitative Research Methods: A Data Collector's Field Guide (See Module 4: "Focus Groups")by Mack, N., et al. This field guide is based on an approach to doing team-based, collaborative qualitative research that has repeatedly proven successful in research projects sponsored by Family Health International (FHI) throughout the developing world. With its straightforward delivery of information on the main qualitative methods being used in public health research today, the guide speaks to the need for simple yet effective instruction on how to do systematic and ethically sound qualitative research. The aim of the guide is thus practical. In bypassing extensive discussion on the theoretical underpinnings of qualitative research, it distinguishes itself as a how-to guide to be used in the field.

In-Depth (typically One-on-One):

A Practical Introduction to in-Depth Interviewingby Alan Morris Are you new to qualitative research or a bit rusty and in need of some inspiration? Are you doing a research project involving in-depth interviews? Are you nervous about carrying out your interviews? This book will help you complete your qualitative research project by providing a nuts and bolts introduction to interviewing. With coverage of ethics, preparation strategies and advice for handling the unexpected in the field, this handy guide will help you get to grips with the basics of interviewing before embarking on your research. While recognising that your research question and the context of your research will drive your approach to interviewing, this book provides practical advice often skipped in traditional methods textbooks.
Qualitative Research Methods: A Data Collector's Field Guide (See Module 3: "In-Depth Interviews")by Mack, N., et al. This field guide is based on an approach to doing team-based, collaborative qualitative research that has repeatedly proven successful in research projects sponsored by Family Health International (FHI) throughout the developing world. With its straightforward delivery of information on the main qualitative methods being used in public health research today, the guide speaks to the need for simple yet effective instruction on how to do systematic and ethically sound qualitative research. The aim of the guide is thus practical. In bypassing extensive discussion on the theoretical underpinnings of qualitative research, it distinguishes itself as a how-to guide to be used in the field.

Folklore Research and Oral Histories:

In addition to the following resource, see the Oral History page of this guide for helpful resources on Oral History interviewing.

American Folklife Center at the Library of Congress. Folklife and Fieldwork: A Layman’s Introduction to Field Techniques Interviews gathered for purposes of folklore research are similar to standard social science interviews in some ways, but also have a good deal in common with oral history approaches to interviewing. The focus in a folklore research interview is on documenting and trying to understand the interviewee's way of life relative to a culture or subculture you are studying. This guide includes helpful advice and tips for conducting fieldwork in folklore, such as tips for planning, conducting, recording, and archiving interviews.

An interdisciplinary scientific program within the Institute for Quantitative Social Science which encourages and facilitates research and instruction in the theory and practice of survey research. The primary mission of PSR is to provide survey research resources to enhance the quality of teaching and research at Harvard.

Internet, Phone, Mail, and Mixed-Mode Surveysby Don A. Dillman; Jolene D. Smyth; Leah Melani Christian The classic survey design reference, updated for the digital age. The new edition is thoroughly updated and revised, and covers all aspects of survey research. It features expanded coverage of mobile phones, tablets, and the use of do-it-yourself surveys, and Dillman's unique Tailored Design Method is also thoroughly explained. This new edition is complemented by copious examples within the text and accompanying website. It includes: Strategies and tactics for determining the needs of a given survey, how to design it, and how to effectively administer it. How and when to use mail, telephone, and Internet surveys to maximum advantage. Proven techniques to increase response rates. Guidance on how to obtain high-quality feedback from mail, electronic, and other self-administered surveys. Direction on how to construct effective questionnaires, including considerations of layout. The effects of sponsorship on the response rates of surveys. Use of capabilities provided by newly mass-used media: interactivity, presentation of aural and visual stimuli. The Fourth Edition reintroduces the telephone--including coordinating land and mobile.

User Experience (UX) and Marketing:

See the "UX & Market Research Interviews" tab on this guide, above. May include Focus Groups, above.

Screening for Research Site Selection:

Research interviews are used not only to furnish research data for theoretical analysis in the social sciences, but also to plan other kinds of studies. For example, interviews may allow researchers to screen appropriate research sites to conduct empirical studies (such as randomized controlled trials) in a variety of fields, from medicine to law. In contrast to interviews conducted in the course of social research, such interviews do not typically serve as the data for final analysis and publication.

ENGAGING PARTICIPANTS

Research ethics .

Human Subjects (IRB) The Committee on the Use of Human Subjects (CUHS) serves as the Institutional Review Board for the University area which includes the Cambridge and Allston campuses at Harvard. Find your IRB contact person , or learn about required ethics training. You may also find the IRB Lifecycle Guide helpful. This is the preferred IRB portal for Harvard graduate students and other researchers. IRB forms can be downloaded via the ESTR Library (click on the "Templates and Forms" tab, then navigate to pages 2 and 3 to find the documents labelled with “HUA” for the Harvard University Area IRB. Nota bene: You may use these forms only if you submit your study to the Harvard University IRB). The IRB office can be reached through email at [email protected] or by telephone at (617) 496-2847.
Undergraduate Research Training Program (URTP) Portal The URTP at Harvard University is a comprehensive platform to create better prepared undergraduate researchers. The URTP is comprised of research ethics training sessions, a student-focused curriculum, and an online decision form that will assist students in determining whether their project requires IRB review. Students should examine the URTP's guide for student researchers: Introduction to Human Subjects Research Protection.
Ethics reports From the Association of Internet Researchers (AoIR)
Respect, Beneficence, and Justice: QDR General Guidance for Human Participants If you are hoping to share your qualitative interview data in a repository after it has been collected, you will need to plan accordingly via informed consent, careful de-identification procedures, and data access controls. Consider consulting with the Qualitative Research Support Group at Harvard Library and consulting with Harvard's Dataverse contacts to help you think through all of the contingencies and processes.
"Conducting a Qualitative Child Interview: Methodological Considerations." Journal of Advanced Nursing 42/5 (2003): 434-441 by Kortesluoma, R., et al. The purpose of this article is to illustrate the theoretical premises of child interviewing, as well as to describe some practical methodological solutions used during interviews. Factors that influence data gathered from children and strategies for taking these factors into consideration during the interview are also described.
"Crossing Cultural Barriers in Research Interviewing." Qualitative Social Work 63/3 (2007): 353-372 by Sands, R., et al. This article critically examines a qualitative research interview in which cultural barriers between a white non-Muslim female interviewer and an African American Muslim interviewee, both from the USA, became evident and were overcome within the same interview.
Decolonizing Methodologies: Research and Indigenous Peoples by Linda Tuhiwai Smith This essential volume explores intersections of imperialism and research - specifically, the ways in which imperialism is embedded in disciplines of knowledge and tradition as 'regimes of truth.' Concepts such as 'discovery' and 'claiming' are discussed and an argument presented that the decolonization of research methods will help to reclaim control over indigenous ways of knowing and being. The text includes case-studies and examples, and sections on new indigenous literature and the role of research in indigenous struggles for social justice.

This resource, sponsored by University of Oregon Libraries, exemplifies the use of interviewing methodologies in research that foregrounds traditional knowledge. The methodology page summarizes the approach.

Ethics: The Need to Tread Carefully. Chapter in A Practical Introduction to in-Depth Interviewing by Alan Morris Pay special attention to the sections in chapter 2 on "How to prevent and respond to ethical issues arising in the course of the interview," "Ethics in the writing up of your interviews," and "The Ethics of Care."
Handbook on Ethical Issues in Anthropology by Joan Cassell (Editor); Sue-Ellen Jacobs (Editor) This publication of the American Anthropological Association presents and discusses issues and sources on ethics in anthropology, as well as realistic case studies of ethical dilemmas. It is meant to help social science faculty introduce discussions of ethics in their courses. Some of the topics are relevant to interviews, or at least to studies of which interviews are a part. See chapters 3 and 4 for cases, with solutions and commentary, respectively.
Research Ethics from the Chanie Wenjack School for Indigenous Studies, Trent University (Open Access) An overview of Indigenous research ethics and protocols from the across the globe.
Resources for Equity in Research Consult these resources for guidance on creating and incorporating equitable materials into public health research studies that entail community engagement.

The SAGE Handbook of Qualitative Research Ethics by Ron Iphofen (Editor); Martin Tolich (Editor) This handbook is a much-needed and in-depth review of the distinctive set of ethical considerations which accompanies qualitative research. This is particularly crucial given the emergent, dynamic and interactional nature of most qualitative research, which too often allows little time for reflection on the important ethical responsibilities and obligations. Contributions from leading international researchers have been carefully organized into six key thematic sections: Part One: Thick Descriptions Of Qualitative Research Ethics; Part Two: Qualitative Research Ethics By Technique; Part Three: Ethics As Politics; Part Four: Qualitative Research Ethics With Vulnerable Groups; Part Five: Relational Research Ethics; Part Six: Researching Digitally. This Handbook is a one-stop resource on qualitative research ethics across the social sciences that draws on the lessons learned and the successful methods for surmounting problems - the tried and true, and the new.

RESEARCH COMPLIANCE AND PRIVACY LAWS

Research Compliance Program for FAS/SEAS at Harvard : The Faculty of Arts and Sciences (FAS), including the School of Engineering and Applied Sciences (SEAS), and the Office of the Vice Provost for Research (OVPR) have established a shared Research Compliance Program (RCP). An area of common concern for interview studies is international projects and collaboration . RCP is a resource to provide guidance on which international activities may be impacted by US sanctions on countries, individuals, or entities and whether licenses or other disclosure are required to ship or otherwise share items, technology, or data with foreign collaborators.

Harvard Global Support Services (GSS) is for students, faculty, staff, and researchers who are studying, researching, or working abroad. Their services span safety and security, health, culture, outbound immigration, employment, financial and legal matters, and research center operations. These include travel briefings and registration, emergency response, guidance on international projects, and managing in-country operations.

Generative AI: Harvard-affiliated researchers should not enter data classified as confidential ( Level 2 and above ), including non-public research data, into publicly-available generative AI tools, in accordance with the University’s Information Security Policy. Information shared with generative AI tools using default settings is not private and could expose proprietary or sensitive information to unauthorized parties.

Privacy Laws: Be mindful of any potential privacy laws that may apply wherever you conduct your interviews. The General Data Protection Regulation is a high-profile example (see below):

General Data Protection Regulation (GDPR) This Regulation lays down rules relating to the protection of natural persons with regard to the processing of personal data and rules relating to the free movement of personal data. It protects fundamental rights and freedoms of natural persons and in particular their right to the protection of personal data. The free movement of personal data within the Union shall be neither restricted nor prohibited for reasons connected with the protection of natural persons with regard to the processing of personal data. For a nice summary of what the GDPR requires, check out the GDPR "crash course" here .

SEEKING CONSENT

If you would like to see examples of consent forms, ask your local IRB, or take a look at these resources:

Model consent forms for oral history, suggested by the Centre for Oral History and Digital Storytelling at Concordia University
For NIH-funded research, see this resource for developing informed consent language in research studies where data and/or biospecimens will be stored and shared for future use.

POPULATION SAMPLING

If you wish to assemble resources to aid in sampling, such as the USPS Delivery Sequence File, telephone books, or directories of organizations and listservs, please contact our data librarian or write to [email protected] .

Research Randomizer A free web-based service that permits instant random sampling and random assignment. It also contains an interactive tutorial perfect for students taking courses in research methods.
Practical Tools for Designing and Weighting Survey Samples by Richard Valliant; Jill A. Dever; Frauke Kreuter Survey sampling is fundamentally an applied field. The goal in this book is to put an array of tools at the fingertips of practitioners by explaining approaches long used by survey statisticians, illustrating how existing software can be used to solve survey problems, and developing some specialized software where needed. This book serves at least three audiences: (1) Students seeking a more in-depth understanding of applied sampling either through a second semester-long course or by way of a supplementary reference; (2) Survey statisticians searching for practical guidance on how to apply concepts learned in theoretical or applied sampling courses; and (3) Social scientists and other survey practitioners who desire insight into the statistical thinking and steps taken to design, select, and weight random survey samples. Several survey data sets are used to illustrate how to design samples, to make estimates from complex surveys for use in optimizing the sample allocation, and to calculate weights. Realistic survey projects are used to demonstrate the challenges and provide a context for the solutions. The book covers several topics that either are not included or are dealt with in a limited way in other texts. These areas include: sample size computations for multistage designs; power calculations related to surveys; mathematical programming for sample allocation in a multi-criteria optimization setting; nuts and bolts of area probability sampling; multiphase designs; quality control of survey operations; and statistical software for survey sampling and estimation. An associated R package, PracTools, contains a number of specialized functions for sample size and other calculations. The data sets used in the book are also available in PracTools, so that the reader may replicate the examples or perform further analyses.
Sampling: Design and Analysis by Sharon L. Lohr Provides a modern introduction to the field of sampling. With a multitude of applications from a variety of disciplines, the book concentrates on the statistical aspects of taking and analyzing a sample. Overall, the book gives guidance on how to tell when a sample is valid or not, and how to design and analyze many different forms of sample surveys.
Sampling Techniques by William G. Cochran Clearly demonstrates a wide range of sampling methods now in use by governments, in business, market and operations research, social science, medicine, public health, agriculture, and accounting. Gives proofs of all the theoretical results used in modern sampling practice. New topics in this edition include the approximate methods developed for the problem of attaching standard errors or confidence limits to nonlinear estimates made from the results of surveys with complex plans.
"Understanding the Process of Qualitative Data Collection" in Chapter 13 (pp. 103–1162) of 30 Essential Skills for the Qualitative Researcher by John W. Creswell Provides practical "how-to" information for beginning researchers in the social, behavioral, and health sciences with many applied examples from research design, qualitative inquiry, and mixed methods.The skills presented in this book are crucial for a new qualitative researcher starting a qualitative project.
Survey Methodology by Robert M. Groves; Floyd J. Fowler; Mick P. Couper; James M. Lepkowski; Eleanor Singer; Roger Tourangeau; Floyd J. Fowler coverage includes sampling frame evaluation, sample design, development of questionnaires, evaluation of questions, alternative modes of data collection, interviewing, nonresponse, post-collection processing of survey data, and practices for maintaining scientific integrity.

The way a qualitative researcher constructs and approaches interview questions should flow from, or align with, the methodological paradigm chosen for the study, whether that paradigm is interpretivist, critical, positivist, or participative in nature (or a combination of these).

Constructing Your Questions

Helpful texts:.

"Developing Questions" in Chapter 4 (pp. 98–108) of Becoming Qualitative Researchers by Corrine Glesne Ideal for introducing the novice researcher to the theory and practice of qualitative research, this text opens students to the diverse possibilities within this inquiry approach, while helping them understand how to design and implement specific research methods.
"Learning to Interview in the Social Sciences" Qualitative Inquiry, 9(4) 2003, 643–668 by Roulston, K., deMarrais, K., & Lewis, J. B. See especially the section on "Phrasing and Negotiating Questions" on pages 653-655 and common problems with framing questions noted on pages 659 - 660.
Qualitative Research Interviewing: Biographic Narrative and Semi-Structured Methods (See sections on “Lightly and Heavily Structured Depth Interviewing: Theory-Questions and Interviewer-Questions” and “Preparing for any Interviewing Sequence") by Tom Wengraf Unique in its conceptual coherence and the level of practical detail, this book provides a comprehensive resource for those concerned with the practice of semi-structured interviewing, the most commonly used interview approach in social research, and in particular for in-depth, biographic narrative interviewing. It covers the full range of practices from the identification of topics through to strategies for writing up research findings in diverse ways.
"Scripting a Qualitative Purpose Statement and Research Questions" in Chapter 12 (pp. 93–102) of 30 Essential Skills for the Qualitative Researcher by John W. Creswell Provides practical "how-to" information for beginning researchers in the social, behavioral, and health sciences with many applied examples from research design, qualitative inquiry, and mixed methods.The skills presented in this book are crucial for a new qualitative researcher starting a qualitative project.
Some Strategies for Developing Interview Guides for Qualitative Interviews by Sociology Department, Harvard University Includes general advice for conducting qualitative interviews, pros and cons of recording and transcription, guidelines for success, and tips for developing and phrasing effective interview questions.
Tip Sheet on Question Wording by Harvard University Program on Survey Research

Let Theory Guide You:

The quality of your questions depends on how you situate them within a wider body of knowledge. Consider the following advice:

A good literature review has many obvious virtues. It enables the investigator to define problems and assess data. It provides the concepts on which percepts depend. But the literature review has a special importance for the qualitative researcher. This consists of its ability to sharpen his or her capacity for surprise (Lazarsfeld, 1972b). The investigator who is well versed in the literature now has a set of expectations the data can defy. Counterexpectational data are conspicuous, readable, and highly provocative data. They signal the existence of unfulfilled theoretical assumptions, and these are, as Kuhn (1962) has noted, the very origins of intellectual innovation. A thorough review of the literature is, to this extent, a way to manufacture distance. It is a way to let the data of one's research project take issue with the theory of one's field.

McCracken, G. (1988), The Long Interview, Sage: Newbury Park, CA, p. 31

When drafting your interview questions, remember that everything follows from your central research question. Also, on the way to writing your "operationalized" interview questions, it's helpful to draft broader, intermediate questions, couched in theory. Nota bene: While it is important to know the literature well before conducting your interview(s), be careful not to present yourself to your research participant(s) as "the expert," which would be presumptuous and could be intimidating. Rather, the purpose of your knowledge is to make you a better, keener listener.

If you'd like to supplement what you learned about relevant theories through your coursework and literature review, try these sources:

Annual Reviews Review articles sum up the latest research in many fields, including social sciences, biomedicine, life sciences, and physical sciences. These are timely collections of critical reviews written by leading scientists.
HOLLIS - search for resources on theories in your field Modify this example search by entering the name of your field in place of "your discipline," then hit search.
Oxford Bibliographies Written and reviewed by academic experts, every article in this database is an authoritative guide to the current scholarship in a variety of fields, containing original commentary and annotations.
ProQuest Dissertations & Theses (PQDT) Indexes dissertations and masters' theses from most North American graduate schools as well as some European universities. Provides full text for most indexed dissertations from 1990-present.
Very Short Introductions Launched by Oxford University Press in 1995, Very Short Introductions offer concise introductions to a diverse range of subjects from Climate to Consciousness, Game Theory to Ancient Warfare, Privacy to Islamic History, Economics to Literary Theory.

CONDUCTING INTERVIEWS

Equipment and software: .

Lamont Library loans microphones and podcast starter kits, which will allow you to capture audio (and you may record with software, such as Garage Band).
Cabot Library loans digital recording devices, as well as USB microphones.

If you prefer to use your own device, you may purchase a small handheld audio recorder, or use your cell phone.

Audio Capture Basics (PDF) - Helpful instructions, courtesy of the Lamont Library Multimedia Lab.
Getting Started with Podcasting/Audio: Guidelines from Harvard Library's Virtual Media Lab for preparing your interviewee for a web-based recording (e.g., podcast, interview)
Camtasia Screen Recorder and Video Editor
Zoom: Video Conferencing, Web Conferencing
Visit the Multimedia Production Resources guide! Consult it to find and learn how to use audiovisual production tools, including: cameras, microphones, studio spaces, and other equipment at Cabot Science Library and Lamont Library.
Try the virtual office hours offered by the Lamont Multimedia Lab!

TIPS FOR CONDUCTING INTERVIEWS

Quick handout: .

Research Interviewing Tips (Courtesy of Dr. Suzanne Spreadbury)

Remote Interviews:

For Online or Distant Interviews, See "Remote Research & Virtual Fieldwork" on this guide .
Deborah Lupton's Bibliography: Doing Fieldwork in a Pandemic

Seeking Consent:

Books and articles: .

"App-Based Textual Interviews: Interacting With Younger Generations in a Digitalized Social Reallity."International Journal of Social Research Methodology (12 June 2022). Discusses the use of texting platforms as a means to reach young people. Recommends useful question formulations for this medium.
"Learning to Interview in the Social Sciences." Qualitative Inquiry, 9(4) 2003, 643–668 by Roulston, K., deMarrais, K., & Lewis, J. B. See especially the section on "Phrasing and Negotiating Questions" on pages 653-655 and common problems with framing questions noted on pages 659-660.
"Slowing Down and Digging Deep: Teaching Students to Examine Interview Interaction in Depth." LEARNing Landscapes, Spring 2021 14(1) 153-169 by Herron, Brigette A. and Kathryn Roulston. Suggests analysis of videorecorded interviews as a precursor to formulating one's own questions. Includes helpful types of probes.
Using Interviews in a Research Project by Nigel Joseph Mathers; Nicholas J Fox; Amanda Hunn; Trent Focus Group. A work pack to guide researchers in developing interviews in the healthcare field. Describes interview structures, compares face-to-face and telephone interviews. Outlines the ways in which different types of interview data can be analysed.
“Working through Challenges in Doing Interview Research.” International Journal of Qualitative Methods, (December 2011), 348–66 by Roulston, Kathryn. The article explores (1) how problematic interactions identified in the analysis of focus group data can lead to modifications in research design, (2) an approach to dealing with reported data in representations of findings, and (3) how data analysis can inform question formulation in successive rounds of data generation. Findings from these types of examinations of interview data generation and analysis are valuable for informing both interview practice as well as research design.

Videos:

The way a qualitative researcher transcribes interviews should flow from, or align with, the methodological paradigm chosen for the study, whether that paradigm is interpretivist, critical, positivist, or participative in nature (or a combination of these).

TRANSCRIPTION

Before embarking on a transcription project, it's worthwhile to invest in the time and effort necessary to capture good audio, which will make the transcription process much easier. If you haven't already done so, check out the audio capture guidelines from Harvard Library's Virtual Media Lab , or contact a media staff member for customized recommendations. First and foremost, be mindful of common pitfalls by watching this short video that identifies the most common errors to avoid!

SOFTWARE:

Adobe Premiere Pro Speech-To-Text automatically generates transcripts and adds captions to your videos. Harvard affiliates can download Adobe Premiere in the Creative Cloud Suite.
GoTranscript provides cost-effective human-generated transcriptions.
pyTranscriber is an app for generating automatic transcription and/or subtitles for audio and video files. It uses the Google Cloud Speech-to-Text service, has a friendly graphical user interface, and is purported to work nicely with Chinese.
Otter provides a new way to capture, store, search and share voice conversations, lectures, presentations, meetings, and interviews. The startup is based in Silicon Valley with a team of experienced Ph.Ds and engineers from Google, Facebook, Yahoo and Nuance (à la Dragon). Free accounts available. This is the software that Zoom uses to generate automated transcripts, so if you have access to a Zoom subscription, you have access to Otter transcriptions with it (applicable in several languages ). As with any automated approach, be prepared to correct any errors after the fact, by hand.
Panopto is available to Harvard affiliates and generates ASR (automated speech recognition) captions . You may upload compatible audio files into it. As with any automatically generated transcription, you will need to make manual revisions. ASR captioning is available in several languages . Panopto maintains robust security practices, including strong authentication measures and end-to-end encryption, ensuring your content remains private and protected.
REV.Com allows you to record and transcribe any calls on the iPhone, both outgoing and incoming. It may be useful for recording phone interviews. Rev lets you choose whether you want an AI- or human-generated transcription, with a fast turnaround. Rev has Service Organization Controls Type II (SOC2) certification (a SOC2 cert looks at and verifies an organization’s processing integrity, privacy practices, and security safeguards).
Scribie Audio/Video Transcription provides automated or manual transcriptions for a small fee. As with any transcription service, some revisions will be necessary after the fact, particularly for its automated transcripts.
Sonix automatically transcribes, translates, and helps to organize audio and video files in over 40 languages. It's fast and affordable, with good accuracy. The free trial includes 30 minutes of free transcription.
TranscriptionWing uses a human touch process to clean up machine-generated transcripts so that the content will far more accurately reflect your audio recording.
Whisper is a tool from OpenAI that facilitates transcription of sensitive audiovisual recordings (e.g., of research interviews) on your own device. Installation and use depends on your operating system and which version you install. Important Note: The Whisper API, where audio is sent to OpenAI to be processed by them and then sent back (usually through a programming language like Python) is NOT appropriate for sensitive data. The model should be downloaded with tools such as those described in this FAQ , so that audio is kept to your local machine. For assistance, contact James Capobianco .

EQUIPMENT:

Transcription pedals are in circulation and available to borrow from the Circulation desk at Lamont, or use at Lamont Library's Media Lab on level B. For hand-transcribing your interviews, they work in conjunction with software such as Express Scribe , which is loaded on Media Lab computers, or you may download for free on your own machine (Mac or PC versions; scroll down the downloads page for the latter). The pedals are plug-and-play USB, allow a wide range of playback speeds, and have 3 programmable buttons, which are typically set to rewind/play/fast-forward. Instructions are included in the bag that covers installation and set-up of the software, and basic use of the pedals.

NEED HELP?

Try the virtual office hours offered by the Lamont Multimedia Lab!
If you're creating podcasts, login to Canvas and check out the Podcasting/Audio guide .

Helpful Texts:

"Transcription as a Crucial Step of Data Analysis" in Chapter 5 of The SAGE Handbook of Qualitative Data Analysisby Uwe Flick (Editor) Covers basic terminology for transcription, shares caveats for transcribers, and identifies components of vocal behavior. Provides notation systems for transcription, suggestions for transcribing turn-taking, and discusses new technologies and perspectives. Includes a bibliography for further reading.
"Transcribing the Oral Interview: Part Art, Part Science " on p. 10 of the Centre for Community Knowledge (CCK) newsletter: TIMESTAMPby Mishika Chauhan and Saransh Srivastav

QUALITATIVE DATA ANALYSIS

Software .

Free download available for Harvard Faculty of Arts and Sciences (FAS) affiliates
Desktop access at Lamont Library Media Lab, 3rd floor
Desktop access at Harvard Kennedy School Library (with HKS ID)
Remote desktop access for Harvard affiliates from IQSS Computer Labs . Email them at [email protected] and ask for a new lab account and remote desktop access to NVivo.
Virtual Desktop Infrastructure (VDI) access available to Harvard T.H. Chan School of Public Health affiliates

CODING AND THEMEING YOUR DATA

Data analysis methods should flow from, or align with, the methodological paradigm chosen for your study, whether that paradigm is interpretivist, critical, positivist, or participative in nature (or a combination of these). Some established methods include Content Analysis, Critical Analysis, Discourse Analysis, Gestalt Analysis, Grounded Theory Analysis, Interpretive Analysis, Narrative Analysis, Normative Analysis, Phenomenological Analysis, Rhetorical Analysis, and Semiotic Analysis, among others. The following resources should help you navigate your methodological options and put into practice methods for coding, themeing, interpreting, and presenting your data.

Users can browse content by topic, discipline, or format type (reference works, book chapters, definitions, etc.). SRM offers several research tools as well: a methods map, user-created reading lists, a project planner, and advice on choosing statistical tests.
Abductive Coding: Theory Building and Qualitative (Re)Analysis by Vila-Henninger, et al. The authors recommend an abductive approach to guide qualitative researchers who are oriented towards theory-building. They outline a set of tactics for abductive analysis, including the generation of an abductive codebook, abductive data reduction through code equations, and in-depth abductive qualitative analysis.
Analyzing and Interpreting Qualitative Research: After the Interview by Charles F. Vanover, Paul A. Mihas, and Johnny Saldana (Editors) Providing insight into the wide range of approaches available to the qualitative researcher and covering all steps in the research process, the authors utilize a consistent chapter structure that provides novice and seasoned researchers with pragmatic, "how-to" strategies. Each chapter author introduces the method, uses one of their own research projects as a case study of the method described, shows how the specific analytic method can be used in other types of studies, and concludes with three questions/activities to prompt class discussion or personal study.
"Analyzing Qualitative Data." Theory Into Practice 39, no. 3 (2000): 146-54 by Margaret D. LeCompte This article walks readers though rules for unbiased data analysis and provides guidance for getting organized, finding items, creating stable sets of items, creating patterns, assembling structures, and conducting data validity checks.
"Coding is Not a Dirty Word" in Chapter 1 (pp. 1–30) of Enhancing Qualitative and Mixed Methods Research with Technology by Shalin Hai-Jew (Editor) Current discourses in qualitative research, especially those situated in postmodernism, represent coding and the technology that assists with coding as reductive, lacking complexity, and detached from theory. In this chapter, the author presents a counter-narrative to this dominant discourse in qualitative research. The author argues that coding is not necessarily devoid of theory, nor does the use of software for data management and analysis automatically render scholarship theoretically lightweight or barren. A lack of deep analytical insight is a consequence not of software but of epistemology. Using examples informed by interpretive and critical approaches, the author demonstrates how NVivo can provide an effective tool for data management and analysis. The author also highlights ideas for critical and deconstructive approaches in qualitative inquiry while using NVivo. By troubling the positivist discourse of coding, the author seeks to create dialogic spaces that integrate theory with technology-driven data management and analysis, while maintaining the depth and rigor of qualitative research.
The Coding Manual for Qualitative Researchers by Johnny Saldana An in-depth guide to the multiple approaches available for coding qualitative data. Clear, practical and authoritative, the book profiles 32 coding methods that can be applied to a range of research genres from grounded theory to phenomenology to narrative inquiry. For each approach, Saldaña discusses the methods, origins, a description of the method, practical applications, and a clearly illustrated example with analytic follow-up. Essential reading across the social sciences.
Flexible Coding of In-depth Interviews: A Twenty-first-century Approach by Nicole M. Deterding and Mary C. Waters The authors suggest steps in data organization and analysis to better utilize qualitative data analysis technologies and support rigorous, transparent, and flexible analysis of in-depth interview data.
From the Editors: What Grounded Theory is Not by Roy Suddaby Walks readers through common misconceptions that hinder grounded theory studies, reinforcing the two key concepts of the grounded theory approach: (1) constant comparison of data gathered throughout the data collection process and (2) the determination of which kinds of data to sample in succession based on emergent themes (i.e., "theoretical sampling").
“Good enough” methods for life-story analysis, by Wendy Luttrell. In Quinn N. (Ed.), Finding culture in talk (pp. 243–268). Demonstrates for researchers of culture and consciousness who use narrative how to concretely document reflexive processes in terms of where, how and why particular decisions are made at particular stages of the research process.
Presentation slides on coding and themeing your data, derived from Saldana, Spradley, and LeCompte Click to request access.
Qualitative Data Analysis by Matthew B. Miles; A. Michael Huberman A practical sourcebook for researchers who make use of qualitative data, presenting the current state of the craft in the design, testing, and use of qualitative analysis methods. Strong emphasis is placed on data displays matrices and networks that go beyond ordinary narrative text. Each method of data display and analysis is described and illustrated.
"A Survey of Qualitative Data Analytic Methods" in Chapter 4 (pp. 89–138) of Fundamentals of Qualitative Research by Johnny Saldana Provides an in-depth introduction to coding as a heuristic, particularly focusing on process coding, in vivo coding, descriptive coding, values coding, dramaturgical coding, and versus coding. Includes advice on writing analytic memos, developing categories, and themeing data.
"Thematic Networks: An Analytic Tool for Qualitative Research." Qualitative Research : QR, 1(3), 385–405 by Jennifer Attride-Stirling Details a technique for conducting thematic analysis of qualitative material, presenting a step-by-step guide of the analytic process, with the aid of an empirical example. The analytic method presented employs established, well-known techniques; the article proposes that thematic analyses can be usefully aided by and presented as thematic networks.
Using Thematic Analysis in Psychology by Virginia Braun and Victoria Clark Walks readers through the process of reflexive thematic analysis, step by step. The method may be adapted in fields outside of psychology as relevant. Pair this with One Size Fits All? What Counts as Quality Practice in Reflexive Thematic Analysis? by Virginia Braun and Victoria Clark

TESTING OR GENERATING THEORIES

The quality of your data analysis depends on how you situate what you learn within a wider body of knowledge. Consider the following advice:

Once you have coalesced around a theory, realize that a theory should reveal rather than color your discoveries. Allow your data to guide you to what's most suitable. Grounded theory researchers may develop their own theory where current theories fail to provide insight. This guide on Theoretical Models from Alfaisal University Library provides a helpful overview on using theory.

MANAGING & FINDING INTERVIEW DATA

Managing your elicited interview data, general guidance: .

Research Data Management @ Harvard A reference guide with information and resources to help you manage your research data. See also: Harvard Research Data Security Policy , on the Harvard University Research Data Management website.
Data Management For Researchers: Organize, Maintain and Share Your Data for Research Success by Kristin Briney. A comprehensive guide for scientific researchers providing everything they need to know about data management and how to organize, document, use and reuse their data.
Open Science Framework (OSF) An open-source project management tool that makes it easy to collaborate within and beyond Harvard throughout a project's lifecycle. With OSF you can manage, store, and share documents, datasets, and other information with your research team. You can also publish your work to share it with a wider audience. Although data can be stored privately, because this platform is hosted on the Internet and designed with open access in mind, it is not a good choice for highly sensitive data.
Free cloud storage solutions for Harvard affiliates to consider include: Google Drive , DropBox , or OneDrive ( up to DSL3 )

Data Confidentiality and Secure Handling:

Data Security Levels at Harvard - Research Data Examples This resource provided by Harvard Data Security helps you determine what level of access is appropriate for your data. Determine whether it should be made available for public use, limited to the Harvard community, or be protected as either "confidential and sensitive," "high risk," or "extremely sensitive." See also: Harvard Data Classification Table
Harvard's Best Practices for Protecting Privacy and Harvard Information Security Collaboration Tools Matrix Follow the nuts-and-bolts advice for privacy best practices at Harvard. The latter resource reveals the level of security that can be relied upon for a large number of technological tools and platforms used at Harvard to conduct business, such as email, Slack, Accellion Kiteworks, OneDrive/SharePoint, etc.
“Protecting Participant Privacy While Maintaining Content and Context: Challenges in Qualitative Data De‐identification and Sharing.” Proceedings of the ASIST Annual Meeting 57 (1) (2020): e415-420 by Myers, Long, and Polasek Presents an informed and tested protocol, based on the De-Identification guidelines published by the Qualitative Data Repository (QDR) at Syracuse University. Qualitative researchers may consult it to guide their data de-identification efforts.
QDS Qualitative Data Sharing Toolkit The Qualitative Data Sharing (QDS) project and its toolkit was funded by the NIH National Human Genome Research Institute (R01HG009351). It provides tools and resources to help researchers, especially those in the health sciences, share qualitative research data while protecting privacy and confidentiality. It offers guidance on preparing data for sharing through de-identification and access control. These health sciences research datasets in ICPSR's Qualitative Data Sharing (QDS) Project Series were de-identified using the QuaDS Software and the project’s QDS guidelines.
Table of De-Identification Techniques
Generative AI Harvard-affiliated researchers should not enter data classified as confidential ( Level 2 and above ), including non-public research data, into publicly-available generative AI tools, in accordance with the University’s Information Security Policy. Information shared with generative AI tools using default settings is not private and could expose proprietary or sensitive information to unauthorized parties.
Harvard Information Security Quick Reference Guide Storage guidelines, based on the data's security classification level (according to its IRB classification) is displayed on page 2, under "handling."
Email Encryption Harvard Microsoft 365 users can now send encrypted messages and files directly from the Outlook web or desktop apps. Encrypting an email adds an extra layer of security to the message and its attachments (up to 150MB), and means only the intended recipient (and their inbox delegates with full access) can view it. Message encryption in Outlook is approved for sending high risk ( level 4 ) data and below.

Sharing Qualitative Data:

Repositories for Qualitative Data If you have cleared this intention with your IRB, secured consent from participants, and properly de-identified your data, consider sharing your interviews in one of the data repositories included in the link above. Depending on the nature of your research and the level of risk it may present to participants, sharing your interview data may not be appropriate. If there is any chance that sharing such data will be desirable, you will be much better off if you build this expectation into your plans from the beginning.
Guide for Sharing Qualitative Data at ICPSR The Inter-university Consortium for Political and Social Research (ICPSR) has created this resource for investigators planning to share qualitative data at ICPSR. This guide provides an overview of elements and considerations for archiving qualitative data, identifies steps for investigators to follow during the research life cycle to ensure that others can share and reuse qualitative data, and provides information about exemplars of qualitative data

International Projects:

Research Compliance Program for FAS/SEAS at Harvard The Faculty of Arts and Sciences (FAS), including the School of Engineering and Applied Sciences (SEAS), and the Office of the Vice Provost for Research (OVPR) have established a shared Research Compliance Program (RCP). An area of common concern for interview studies is international projects and collaboration . RCP is a resource to provide guidance on which international activities may be impacted by US sanctions on countries, individuals, or entities and whether licenses or other disclosure are required to ship or otherwise share items, technology, or data with foreign collaborators.

Finding Extant Interview Data

Finding journalistic interviews: .

Academic Search Premier This all-purpose database is great for finding articles from magazines and newspapers. In the Advanced Search, it allows you to specify "Document Type": Interview.
Guide to Newspapers and Newspaper Indexes Use this guide created to Harvard Librarians to identify newspapers collections you'd like to search. To locate interviews, try adding the term "interview" to your search, or explore a database's search interface for options to limit your search to interviews. Nexis Uni and Factiva are the two main databases for current news.
Listen Notes Search for podcast episodes at this podcast aggregator, and look for podcasts that include interviews. Make sure to vet the podcaster for accuracy and quality! (Listen Notes does not do much vetting.)
NPR and ProPublica are two sites that offer high-quality long-form reporting, including journalistic interviews, for free.

Finding Oral History and Social Research Interviews:

To find oral histories, see the Oral History page of this guide for helpful resources on Oral History interviewing.
Repositories for Qualitative Data It has not been a customary practice among qualitative researchers in the social sciences to share raw interview data, but some have made this data available in repositories, such as the ones listed on the page linked above. You may find published data from structured interview surveys (e.g., questionnaire-based computer-assisted telephone interview data), as well as some semi-structured and unstructured interviews.
If you are merely interested in studies interpreting data collected using interviews, rather than finding raw interview data, try databases like PsycInfo , Sociological Abstracts , or Anthropology Plus , among others.

Finding Interviews in Archival Collections at Harvard Library:

In addition to the databases and search strategies mentioned under the "Finding Oral History and Social Research Interviews" category above, you may search for interviews and oral histories (whether in textual or audiovisual formats) held in archival collections at Harvard Library.

HOLLIS searches all documented collections at Harvard, whereas HOLLIS for Archival Discovery searches only those with finding aids. Although HOLLIS for Archival Discovery covers less material, you may find it easier to parse your search results, especially when you wish to view results at the item level (within collections). Try these approaches:

Search in HOLLIS :

To retrieve items available online, do an Advanced Search for interview* OR "oral histor*" (in Subject), with Resource Type "Archives/Manuscripts," then refine your search by selecting "Online" under "Show Only" on the right of your initial result list. Revise the search above by adding your topic in the Keywords or Subject field (for example: African Americans ) and resubmitting the search.
To enlarge your results set, you may also leave out the "Online" refinement; if you'd like to limit your search to a specific repository, try the technique of searching for Code: Library + Collection on the "Advanced Search" page .

Search in HOLLIS for Archival Discovery :

To retrieve items available online, search for interview* OR "oral histor*" limited to digital materials . Revise the search above by adding your topic (for example: artist* ) in the second search box (if you don't see the box, click +).
To preview results by collection, search for interview* OR "oral histor*" limited to collections . Revise the search above by adding your topic (for example: artist* ) in the second search box (if you don't see the box, click +). Although this method does not allow you to isolate digitized content, you may find the refinement options on the right side of the screen (refine by repository, subject or names) helpful. Once your select a given collection, you may search within it (e.g., for your topic or the term interview).

UX & MARKET RESEARCH INTERVIEWS

Ux at harvard library .

User Experience and Market Research interviews can inform the design of tangible products and services through responsive, outcome-driven insights. The User Research Center at Harvard Library specializes in this kind of user-centered design, digital accessibility, and testing. They also offer guidance and resources to members of the Harvard Community who are interested in learning more about UX methods. Contact [email protected] or consult the URC website for more information.

Websites

User Interviews: The Beginner’s Guide (Chris Mears)
Interviewing Users (Jakob Nielsen)

Books

Interviewing Users: How to Uncover Compelling Insights by Steve Portigal; Grant McCracken (Foreword by) Interviewing is a foundational user research tool that people assume they already possess. Everyone can ask questions, right? Unfortunately, that's not the case. Interviewing Users provides invaluable interviewing techniques and tools that enable you to conduct informative interviews with anyone. You'll move from simply gathering data to uncovering powerful insights about people.
Rapid Contextual Design by Jessamyn Wendell; Karen Holtzblatt; Shelley Wood This handbook introduces Rapid CD, a fast-paced, adaptive form of Contextual Design. Rapid CD is a hands-on guide for anyone who needs practical guidance on how to use the Contextual Design process and adapt it to tactical projects with tight timelines and resources. Rapid Contextual Design provides detailed suggestions on structuring the project and customer interviews, conducting interviews, and running interpretation sessions. The handbook walks you step-by-step through organizing the data so you can see your key issues, along with visioning new solutions, storyboarding to work out the details, and paper prototype interviewing to iterate the design all with as little as a two-person team with only a few weeks to spare *Includes real project examples with actual customer data that illustrate how a CD project actually works.

Videos

Instructional Presentations on Interview Skills

Interview/Oral History Research for RSRA 298B: Master's Thesis Reading and Research (Spring 2023) Slideshow covers: Why Interviews?, Getting Context, Engaging Participants, Conducting the Interview, The Interview Guide, Note Taking, Transcription, File management, and Data Analysis.
Interview Skills From an online class on February 13, 2023: Get set up for interview research. You will leave prepared to choose among the three types of interviewing methods, equipped to develop an interview schedule, aware of data management options and their ethical implications, and knowledgeable of technologies you can use to record and transcribe your interviews. This workshop complements Intro to NVivo, a qualitative data analysis tool useful for coding interview data.

NIH Data Management & Sharing Policy (DMSP) This policy, effective January 25, 2023, applies to all research, funded or conducted in whole or in part by NIH, that results in the generation of scientific data , including NIH-funded qualitative research. Click here to see some examples of how the DMSP policy has been applied in qualitative research studies featured in the 2021 Qualitative Data Management Plan (DMP) Competition . As a resource for the community, NIH has developed a resource for developing informed consent language in research studies where data and/or biospecimens will be stored and shared for future use. It is important to note that the DMS Policy does NOT require that informed consent obtained from research participants must allow for broad sharing and the future use of data (either with or without identifiable private information). See the FAQ for more information.

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Except where otherwise noted, this work is subject to a Creative Commons Attribution 4.0 International License , which allows anyone to share and adapt our material as long as proper attribution is given. For details and exceptions, see the Harvard Library Copyright Policy ©2021 Presidents and Fellows of Harvard College.

How to conduct qualitative interviews (tips and best practices)

Last updated

18 May 2023

Reviewed by

Miroslav Damyanov

However, conducting qualitative interviews can be challenging, even for seasoned researchers. Poorly conducted interviews can lead to inaccurate or incomplete data, significantly compromising the validity and reliability of your research findings.

When planning to conduct qualitative interviews, you must adequately prepare yourself to get the most out of your data. Fortunately, there are specific tips and best practices that can help you conduct qualitative interviews effectively.

What is a qualitative interview?

A qualitative interview is a research technique used to gather in-depth information about people's experiences, attitudes, beliefs, and perceptions. Unlike a structured questionnaire or survey, a qualitative interview is a flexible, conversational approach that allows the interviewer to delve into the interviewee's responses and explore their insights and experiences.

In a qualitative interview, the researcher typically develops a set of open-ended questions that provide a framework for the conversation. However, the interviewer can also adapt to the interviewee's responses and ask follow-up questions to understand their experiences and views better.

How to conduct interviews in qualitative research

Conducting interviews involves a well-planned and deliberate process to collect accurate and valid data.

Here’s a step-by-step guide on how to conduct interviews in qualitative research, broken down into three stages:

1. Before the interview

The first step in conducting a qualitative interview is determining your research question . This will help you identify the type of participants you need to recruit. Once you have your research question, you can start recruiting participants by identifying potential candidates and contacting them to gauge their interest in participating in the study.

After that, it's time to develop your interview questions. These should be open-ended questions that will elicit detailed responses from participants. You'll also need to get consent from the participants, ideally in writing, to ensure that they understand the purpose of the study and their rights as participants. Finally, choose a comfortable and private location to conduct the interview and prepare the interview guide.

2. During the interview

Start by introducing yourself and explaining the purpose of the study. Establish a rapport by putting the participants at ease and making them feel comfortable. Use the interview guide to ask the questions, but be flexible and ask follow-up questions to gain more insight into the participants' responses.

Take notes during the interview, and ask permission to record the interview for transcription purposes. Be mindful of the time, and cover all the questions in the interview guide.

3. After the interview

Once the interview is over, transcribe the interview if you recorded it. If you took notes, review and organize them to make sure you capture all the important information. Then, analyze the data you collected by identifying common themes and patterns. Use the findings to answer your research question.

Finally, debrief with the participants to thank them for their time, provide feedback on the study, and answer any questions they may have.

What kinds of questions should you ask in a qualitative interview?

Qualitative interviews involve asking questions that encourage participants to share their experiences, opinions, and perspectives on a particular topic. These questions are designed to elicit detailed and nuanced responses rather than simple yes or no answers.

Effective questions in a qualitative interview are generally open-ended and non-leading. They avoid presuppositions or assumptions about the participant's experience and allow them to share their views in their own words.

In customer research , you might ask questions such as:

What motivated you to choose our product/service over our competitors?

How did you first learn about our product/service?

Can you walk me through your experience with our product/service?

What improvements or changes would you suggest for our product/service?

Have you recommended our product/service to others, and if so, why?

The key is to ask questions relevant to the research topic and allow participants to share their experiences meaningfully and informally.

How to determine the right qualitative interview participants

Choosing the right participants for a qualitative interview is a crucial step in ensuring the success and validity of the research . You need to consider several factors to determine the right participants for a qualitative interview. These may include:

Relevant experiences : Participants should have experiences related to the research topic that can provide valuable insights.

Diversity : Aim to include diverse participants to ensure the study's findings are representative and inclusive.

Access : Identify participants who are accessible and willing to participate in the study.

Informed consent : Participants should be fully informed about the study's purpose, methods, and potential risks and benefits and be allowed to provide informed consent.

You can use various recruitment methods, such as posting ads in relevant forums, contacting community organizations or social media groups, or using purposive sampling to identify participants who meet specific criteria.

How to make qualitative interview subjects comfortable

Making participants comfortable during a qualitative interview is essential to obtain rich, detailed data. Participants are more likely to share their experiences openly when they feel at ease and not judged.

Here are some ways to make interview subjects comfortable:

Explain the purpose of the study

Start the interview by explaining the research topic and its importance. The goal is to give participants a sense of what to expect.

Create a comfortable environment

Conduct the interview in a quiet, private space where the participant feels comfortable. Turn off any unnecessary electronics that can create distractions. Ensure your equipment works well ahead of time. Arrive at the interview on time. If you conduct a remote interview, turn on your camera and mute all notetakers and observers.

Build rapport

Greet the participant warmly and introduce yourself. Show interest in their responses and thank them for their time.

Use open-ended questions

Ask questions that encourage participants to elaborate on their thoughts and experiences.

Listen attentively

Resist the urge to multitask . Pay attention to the participant's responses, nod your head, or make supportive comments to show you’re interested in their answers. Avoid interrupting them.

Avoid judgment

Show respect and don't judge the participant's views or experiences. Allow the participant to speak freely without feeling judged or ridiculed.

Offer breaks

If needed, offer breaks during the interview, especially if the topic is sensitive or emotional.

Creating a comfortable environment and establishing rapport with the participant fosters an atmosphere of trust and encourages open communication. This helps participants feel at ease and willing to share their experiences.

How to analyze a qualitative interview

Analyzing a qualitative interview involves a systematic process of examining the data collected to identify patterns, themes, and meanings that emerge from the responses.

Here are some steps on how to analyze a qualitative interview:

1. Transcription

The first step is transcribing the interview into text format to have a written record of the conversation. This step is essential to ensure that you can refer back to the interview data and identify the important aspects of the interview.

2. Data reduction

Once you’ve transcribed the interview, read through it to identify key themes, patterns, and phrases emerging from the data. This process involves reducing the data into more manageable pieces you can easily analyze.

The next step is to code the data by labeling sections of the text with descriptive words or phrases that reflect the data's content. Coding helps identify key themes and patterns from the interview data.

4. Categorization

After coding, you should group the codes into categories based on their similarities. This process helps to identify overarching themes or sub-themes that emerge from the data.

5. Interpretation

You should then interpret the themes and sub-themes by identifying relationships, contradictions, and meanings that emerge from the data. Interpretation involves analyzing the themes in the context of the research question.

6. Comparison

The next step is comparing the data across participants or groups to identify similarities and differences. This step helps to ensure that the findings aren’t just specific to one participant but can be generalized to the wider population.

7. Triangulation

To ensure the findings are valid and reliable, you should use triangulation by comparing the findings with other sources, such as observations or interview data.

8. Synthesis

The final step is synthesizing the findings by summarizing the key themes and presenting them clearly and concisely. This step involves writing a report that presents the findings in a way that is easy to understand, using quotes and examples from the interview data to illustrate the themes.

Tips for transcribing a qualitative interview

Transcribing a qualitative interview is a crucial step in the research process. It involves converting the audio or video recording of the interview into written text.

Here are some tips for transcribing a qualitative interview:

Use transcription software

Transcription software can save time and increase accuracy by automatically transcribing audio or video recordings.

Listen carefully

When manually transcribing, listen carefully to the recording to ensure clarity. Pause and rewind the recording as necessary.

Use appropriate formatting

Use a consistent format for transcribing, such as marking pauses, overlaps, and interruptions. Indicate non-verbal cues such as laughter, sighs, or changes in tone.

Edit for clarity

Edit the transcription to ensure clarity and readability. Use standard grammar and punctuation, correct misspellings, and remove filler words like "um" and "ah."

Proofread and edit

Verify the accuracy of the transcription by listening to the recording again and reviewing the notes taken during the interview.

Use timestamps

Add timestamps to the transcription to reference specific interview sections.

Transcribing a qualitative interview can be time-consuming, but it’s essential to ensure the accuracy of the data collected. Following these tips can produce high-quality transcriptions useful for analysis and reporting.

Why are interview techniques in qualitative research effective?

Unlike quantitative research methods, which rely on numerical data, qualitative research seeks to understand the richness and complexity of human experiences and perspectives.

Interview techniques involve asking open-ended questions that allow participants to express their views and share their stories in their own words. This approach can help researchers to uncover unexpected or surprising insights that may not have been discovered through other research methods.

Interview techniques also allow researchers to establish rapport with participants, creating a comfortable and safe space for them to share their experiences. This can lead to a deeper level of trust and candor, leading to more honest and authentic responses.

What are the weaknesses of qualitative interviews?

Qualitative interviews are an excellent research approach when used properly, but they have their drawbacks.

The weaknesses of qualitative interviews include the following:

Subjectivity and personal biases

Qualitative interviews rely on the researcher's interpretation of the interviewee's responses. The researcher's biases or preconceptions can affect how the questions are framed and how the responses are interpreted, which can influence results.

Small sample size

The sample size in qualitative interviews is often small, which can limit the generalizability of the results to the larger population.

Data quality

The quality of data collected during interviews can be affected by various factors, such as the interviewee's mood, the setting of the interview, and the interviewer's skills and experience.

Socially desirable responses

Interviewees may provide responses that they believe are socially acceptable rather than truthful or genuine.

Conducting qualitative interviews can be expensive, especially if the researcher must travel to different locations to conduct the interviews.

Time-consuming

The data analysis process can be time-consuming and labor-intensive, as researchers need to transcribe and analyze the data manually.

Despite these weaknesses, qualitative interviews remain a valuable research tool. You can take steps to mitigate the impact of these weaknesses by incorporating the perspectives of other researchers or participants in the analysis process, using multiple data sources , and critically analyzing your biases and assumptions.

Mastering the art of qualitative interviews is an essential skill for businesses looking to gain deep insights into their customers' needs, preferences, and behaviors. By following the tips and best practices outlined in this article, you can conduct interviews that provide you with rich data that you can use to make informed decisions about your products, services, and marketing strategies.

Remember that effective communication, active listening, and proper analysis are critical components of successful qualitative interviews. By incorporating these practices into your customer research, you can gain a competitive edge and build stronger customer relationships.

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Interviewing in Qualitative Research

First Online: 14 December 2017

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Svetlana Gudkova 4

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The interview is one of the basic methods of data collection employed in the social sciences. It is worth noting that this method is not restricted solely to the qualitative research. Interviews have been actively taken advantage of by representatives of various scientific traditions. Both the supporters of the positivist paradigm and the interpretivist one use the technique of the interview to collect data even though the expectations and assumptions of researchers as well as the process of preparing the interview and the conclusion sphere differ fundamentally. The chapter presents different types of interviews employed by the researchers to collect the data in a qualitative research and discusses the process of preparation and conducting the interviews.

Group and individual interviews
Structured vs unstructured interviews
conducting an interview

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Gudkova, S. (2018). Interviewing in Qualitative Research. In: Ciesielska, M., Jemielniak, D. (eds) Qualitative Methodologies in Organization Studies. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-319-65442-3_4

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Introduction to Research Methods

6 qualitative research and interviews.

So we’ve described doing a survey and collecting quantitative data. But not all questions can best be answered by a survey. A survey is great for understanding what people think (for example), but not why they think what they do. If your research is intending to understand the underlying motivations or reasons behind peoples actions, or to build a deeper understanding on the background of a subject, an interview may be the more appropriate data collection method.

Interviews are a method of data collection that consist of two or more people exchanging information through a structured process of questions and answers. Questions are designed by the researcher to thoughtfully collect in-depth information on a topic or set of topics as related to the central research question. Interviews typically occur in-person, although good interviews can also be conducted remotely via the phone or video conferencing. Unlike surveys, interviews give the opportunity to ask follow-up questions and thoughtfully engage with participants on the spot (rather than the anonymous and impartial format of survey research).

And surveys can be used in qualitative or quantitative research – though they’re more typically a qualitative technique. In-depth interviews , containing open-ended questions and structured by an interview guide . One can also do a standardized interview with closed-ended questions (i.e. answer options) that are structured by an interview schedule as part of quantitative research. While these are called interviews they’re far closer to surveys, so we wont cover them again in this chapter. The terms used for in-depth interviews we’ll cover in the next section.

6.1 Interviews

In-depth interviews allow participants to describe experiences in their own words (a primary strength of the interview format). Strong in-depth interviews will include many open-ended questions that allow participants to respond in their own words, share new ideas, and lead the conversation in different directions. The purpose of open-ended questions and in-depth interviews is to hear as much as possible in the person’s own voice, to collect new information and ideas, and to achieve a level of depth not possible in surveys or most other forms of data collection.

Typically, an interview guide is used to create a soft structure for the conversation and is an important preparation tool for the researcher. You can not go into an interview unprepared and just “wing it”; what the interview guide allows you to do is map out a framework, order of topics, and may include specific questions to use during the interview. Generally, the interview guide is thought of as just that — a guide to use in order to keep the interview focused. It is not set in stone and a skilled researcher can change the order of questions or topics in an interviews based on the organic conversation flow.

Depending on the experience and skill level of the researcher, an interview guide can be as simple as a list of topics to cover. However, for consistency and quality of research, the interviewer may want to take the time to at least practice writing out questions in advance to ensure that phrasing and word choices are as clear, objective, and focused as possible. It’s worth remembering that working out the wording of questions in advance allows researchers to ensure more consistency across interview. The interview guide below, taken from the wonderful and free textbook Principles of Sociological Inquiry , shows an interview guide that just has topics.

interview method for qualitative research

Alternatively, you can use a more detailed guide that lists out possible questions, as shown below. A more detailed guide is probably better for an interviewer that has less experience, or is just beginning to work on a given topic.

The purpose of an interview guide is to help ask effective questions and to support the process of acquiring the best possible data for your research. Topics and questions should be organized thematically, and in a natural progression that will allow the conversation to flow and deepen throughout the course of the interview. Often, researchers will attempt to memorize or partially memorize the interview guide, in order to be more fully present with the participant during the conversation.

6.2 Asking good Questions

Remember, the purposes of interviews is to go more in-depth with an individual than is possible with a generalized survey. For this reason, it is important to use the guide as a starting point but not to be overly tethered to it during the actual interview process. You may get stuck when respondents give you shorter answers than you expect, or don’t provide the type of depth that you need for your research. Often, you may want to probe for more specifics. Think about using follow up questions like “How does/did that affect you?” or “How does X make you feel?” and “Tell me about a time where X…”

For example, if I was researching the relationship between pets and mental health, some strong open-ended questions might be: * How does your pet typically make you feel when you wake up in the morning? * How does your pet generally affect your mood when you arrive home in the evening? * Tell me about a time when your pet had a significant impact on your emotional state.

Questions framed in this manner leave plenty of room for the respondent to answer in their own words, as opposed to leading and/or truncated questions, such as: * Does being with your pet make you happy? * After a bad day, how much does seeing your pet improve your mood? * Tell me about how important your pet is to your mental health.

These questions assume outcomes and will not result in high quality research. Researchers should always avoid asking leading questions that give away an expected answer or suggest particular responses. For instance, if I ask “we need to spend more on public schools, don’t you think?” the respondent is more likely to agree regardless of their own thoughts. Some wont, but humans generally have a strong natural desire to be agreeable. That’s why leaving your questions neutral and open so that respondents can speak to their experiences and views is critical.

6.3 Analyzing Interview Data

Writing good questions and interviewing respondents are just the first steps of the interview process. After these stages, the researcher still has a lot of work to do to collect usable data from the interview. The researcher must spend time coding and analyzing the interview to retrieve this data. Just doing an interview wont produce data. Think about how many conversations you have everyday, and none of those are leaving you swimming in data.

Hopefully you can record your interviews. Recording your interviews will allow you the opportunity to transcribe them word for word later. If you can’t record the interview you’ll need to take detailed notes so that you can reconstruct what you heard later. Do not trust yourself to “just remember” the conversation. You’re collecting data, precious data that you’re spending time and energy to collect. Treat it as important and valuable. Remember our description of the methodology section from Chapter 2, you need to maintain a chain of custody on your data. If you just remembered the interview, you could be accused of making up the results. Your interview notes and the recording become part of that chain of custody to prove to others that your interviews were real and that your results are accurate.

Assuming you recorded your interview, the first step in the analysis process is transcribing the interview. A transcription is a written record of every word in an interview. Transcriptions can either be completed by the researcher or by a hired worker, though it is good practice for the researcher to transcribe the interview him or herself. Researchers should keep the following points in mind regarding transcriptions: * The interview should take place in a quiet location with minimal background noise to produce a clear recording; * Transcribing interviews is a time-consuming process and may take two to three times longer than the actual interview; * Transcriptions provide a more precise record of the interview than hand written notes and allow the interviewer to focus during the interview.

After transcribing the interview, the next step is to analyze the responses. Coding is the main form of analysis used for interviews and involves studying a transcription to identify important themes. These themes are categorized into codes, which are words or phrases that denote an idea.

You’ll typically being with several codes in mind that are generated by key ideas you week seeking in the questions, but you can also being by using open coding to understand the results. An open coding process involves reading through the transcript multiple times and paying close attention to each line of the text to discover noteworthy concepts. During the open coding process, the researcher keeps an open mind to find any codes that may be relevant to the research topic.

After the open coding process is complete, focused coding can begin. Focused coding takes a closer look at the notes compiled during the open coding stage to merge common codes and define what the codes mean in the context of the research project.

Imagine a researcher is conducting interviews to learn about various people’s experiences of childhood in New Orleans. The following example shows several codes that this researcher extrapolated from an interview with one of their subjects.

6.4 Using interview data

The next chapter will address ways to identify people to interview, but most of the remainder of the book will address how to analyze quantitative data. That shouldn’t be taken as a sign that quantitative data is better, or that it’s easier to use interview data. Because in an interview the researcher must interpret the words of others it is often more challenging to identify your findings and clearly answer your research question. However, quantitative data is more common, and there are more different things you can do with it, so we spend a lot of the textbook focusing on it.

I’ll work through one more example of using interview data though. It takes a lot of practice to be a good and skilled interviewer. What I show below is a brief excerpt of an interview I did, and how that data was used in a resulting paper I wrote. These aren’t the only way you can use interview data, but it’s an example of what the intermediary and final product might look like.

The overall project these are drawn from was concerned with minor league baseball stadiums, but the specific part I’m pulling from here was studying the decline and rejuvenation of downtown around those stadiums in several cities. You’ll see that I’m using the words of the respondent fairly directly, because that’s my data. But I’m not just relying on one respondent and trusting them, I did a few dozen interviews in order to understand the commonalities in people’s perspectives to build a narrative around my research question.

Excerpt from Notes

Excerpt from Resulting Paper

How many interviews are necessary? It actually doesn’t take many. What you want to observe in your interviews is theoretical saturation , where the codes you use in the transcript begin to appear across conversations and groups. If different people disagree that’s fine, but what you want to understand is the commonalities across peoples perspectives. Most research on the subject says that with 8 interviews you’ll typically start to see a decline in new information gathered. That doesn’t mean you won’t get new words , but you’ll stop hearing completely unique perspectives or gain novel insights. At that point, where you’ve ‘heard it all before’ you can stop, because you’ve probably identified the answer to the questions you were trying to research.

6.5 Ensuring Anonymity

One significant ethical concern with interviews, that also applies to surveys, is making sure that respondents maintain anonymity. In either form of data collection you may be asking respondents deeply personal questions, that if exposed may cause legal, personal, or professional harm. Notice that in the excerpt of the paper above the respondents are only identified by an id I assigned (Louisville D) and their career, rather than their name. I can only include the excerpt of the interview notes above because there are no details that might lead to them being identified.

You may want to report details about a person to contextualize the data you gathered, but you should always ensure that no one can be identified from your research. For instance, if you were doing research on racism at large companies, you may want to preface people’s comments by their race, as there is a good chance that white and minority employees would feel differently about the issues. However, if you preface someones comments by saying they’re a minority manager, that may violate their anonymity. Even if you don’t state what company you did interviews with, that may be enough detail for their co-workers to identify them if there are few minority managers at the company. As such, always think long and hard about whether there is any way that the participation of respondents may be exposed.

6.6 Why not both?

We’ve discussed surveys and interviews as different methods the last two chapters, but they can also complement each other.

For instance, let’s say you’re curious to study people who change opinions on abortion, either going from support to opposition or vice versa. You could use a survey to understand the prevalence of changing opinions, i.e. what percentage of people in your city have changed their views. That would help to establish whether this is a prominent issue, or whether it’s a rare phenomenon. But it would be difficult to understand from the survey what makes people change their views. You could add an open ended question for anyone that said they changed their opinion, but many people won’t respond and few will provide the level of detail necessary to understand their motivations. Interviews with people that have changed their opinions would give you an opportunity to explore how their experiences and beliefs have changed in combination with their views towards abortion.

6.7 Summary

In the last two chapters we’ve discussed the two most prominent methods of data collection in the social sciences: surveys and interviews. What we haven’t discussed though is how to identify the people you’ll collect data from; that’s called a sampling strategy. In the next chapter

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How to carry out great interviews in qualitative research.

11 min read An interview is one of the most versatile methods used in qualitative research. Here’s what you need to know about conducting great qualitative interviews.

What is a qualitative research interview?

Qualitative research interviews are a mainstay among q ualitative research techniques, and have been in use for decades either as a primary data collection method or as an adjunct to a wider research process. A qualitative research interview is a one-to-one data collection session between a researcher and a participant. Interviews may be carried out face-to-face, over the phone or via video call using a service like Skype or Zoom.

There are three main types of qualitative research interview – structured, unstructured or semi-structured.

Structured interviews Structured interviews are based around a schedule of predetermined questions and talking points that the researcher has developed. At their most rigid, structured interviews may have a precise wording and question order, meaning that they can be replicated across many different interviewers and participants with relatively consistent results.
Unstructured interviews Unstructured interviews have no predetermined format, although that doesn’t mean they’re ad hoc or unplanned. An unstructured interview may outwardly resemble a normal conversation, but the interviewer will in fact be working carefully to make sure the right topics are addressed during the interaction while putting the participant at ease with a natural manner.
Semi-structured interviews Semi-structured interviews are the most common type of qualitative research interview, combining the informality and rapport of an unstructured interview with the consistency and replicability of a structured interview. The researcher will come prepared with questions and topics, but will not need to stick to precise wording. This blended approach can work well for in-depth interviews.

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What are the pros and cons of interviews in qualitative research?

As a qualitative research method interviewing is hard to beat, with applications in social research, market research, and even basic and clinical pharmacy. But like any aspect of the research process, it’s not without its limitations. Before choosing qualitative interviewing as your research method, it’s worth weighing up the pros and cons.

Pros of qualitative interviews:

provide in-depth information and context
can be used effectively when their are low numbers of participants
provide an opportunity to discuss and explain questions
useful for complex topics
rich in data – in the case of in-person or video interviews , the researcher can observe body language and facial expression as well as the answers to questions

Cons of qualitative interviews:

can be time-consuming to carry out
costly when compared to some other research methods
because of time and cost constraints, they often limit you to a small number of participants
difficult to standardize your data across different researchers and participants unless the interviews are very tightly structured
As the Open University of Hong Kong notes, qualitative interviews may take an emotional toll on interviewers

Qualitative interview guides

Semi-structured interviews are based on a qualitative interview guide, which acts as a road map for the researcher. While conducting interviews, the researcher can use the interview guide to help them stay focused on their research questions and make sure they cover all the topics they intend to.

An interview guide may include a list of questions written out in full, or it may be a set of bullet points grouped around particular topics. It can prompt the interviewer to dig deeper and ask probing questions during the interview if appropriate.

Consider writing out the project’s research question at the top of your interview guide, ahead of the interview questions. This may help you steer the interview in the right direction if it threatens to head off on a tangent.

Avoid bias in qualitative research interviews

According to Duke University , bias can create significant problems in your qualitative interview.

Acquiescence bias is common to many qualitative methods, including focus groups. It occurs when the participant feels obliged to say what they think the researcher wants to hear. This can be especially problematic when there is a perceived power imbalance between participant and interviewer. To counteract this, Duke University’s experts recommend emphasizing the participant’s expertise in the subject being discussed, and the value of their contributions.
Interviewer bias is when the interviewer’s own feelings about the topic come to light through hand gestures, facial expressions or turns of phrase. Duke’s recommendation is to stick to scripted phrases where this is an issue, and to make sure researchers become very familiar with the interview guide or script before conducting interviews, so that they can hone their delivery.

What kinds of questions should you ask in a qualitative interview?

The interview questions you ask need to be carefully considered both before and during the data collection process. As well as considering the topics you’ll cover, you will need to think carefully about the way you ask questions.

Open-ended interview questions – which cannot be answered with a ‘yes’ ‘no’ or ‘maybe’ – are recommended by many researchers as a way to pursue in depth information.

An example of an open-ended question is “What made you want to move to the East Coast?” This will prompt the participant to consider different factors and select at least one. Having thought about it carefully, they may give you more detailed information about their reasoning.

A closed-ended question , such as “Would you recommend your neighborhood to a friend?” can be answered without too much deliberation, and without giving much information about personal thoughts, opinions and feelings.

Follow-up questions can be used to delve deeper into the research topic and to get more detail from open-ended questions. Examples of follow-up questions include:

What makes you say that?
What do you mean by that?
Can you tell me more about X?
What did/does that mean to you?

As well as avoiding closed-ended questions, be wary of leading questions. As with other qualitative research techniques such as surveys or focus groups, these can introduce bias in your data. Leading questions presume a certain point of view shared by the interviewer and participant, and may even suggest a foregone conclusion.

An example of a leading question might be: “You moved to New York in 1990, didn’t you?” In answering the question, the participant is much more likely to agree than disagree. This may be down to acquiescence bias or a belief that the interviewer has checked the information and already knows the correct answer.

Other leading questions involve adjectival phrases or other wording that introduces negative or positive connotations about a particular topic. An example of this kind of leading question is: “Many employees dislike wearing masks to work. How do you feel about this?” It presumes a positive opinion and the participant may be swayed by it, or not want to contradict the interviewer.

Harvard University’s guidelines for qualitative interview research add that you shouldn’t be afraid to ask embarrassing questions – “if you don’t ask, they won’t tell.” Bear in mind though that too much probing around sensitive topics may cause the interview participant to withdraw. The Harvard guidelines recommend leaving sensitive questions til the later stages of the interview when a rapport has been established.

More tips for conducting qualitative interviews

Observing a participant’s body language can give you important data about their thoughts and feelings. It can also help you decide when to broach a topic, and whether to use a follow-up question or return to the subject later in the interview.

Be conscious that the participant may regard you as the expert, not themselves. In order to make sure they express their opinions openly, use active listening skills like verbal encouragement and paraphrasing and clarifying their meaning to show how much you value what they are saying.

Remember that part of the goal is to leave the interview participant feeling good about volunteering their time and their thought process to your research. Aim to make them feel empowered , respected and heard.

Unstructured interviews can demand a lot of a researcher, both cognitively and emotionally. Be sure to leave time in between in-depth interviews when scheduling your data collection to make sure you maintain the quality of your data, as well as your own well-being .

Recording and transcribing interviews

Historically, recording qualitative research interviews and then transcribing the conversation manually would have represented a significant part of the cost and time involved in research projects that collect qualitative data.

Fortunately, researchers now have access to digital recording tools, and even speech-to-text technology that can automatically transcribe interview data using AI and machine learning. This type of tool can also be used to capture qualitative data from qualitative research (focus groups,ect.) making this kind of social research or market research much less time consuming.

Data analysis

Qualitative interview data is unstructured, rich in content and difficult to analyze without the appropriate tools. Fortunately, machine learning and AI can once again make things faster and easier when you use qualitative methods like the research interview.

Text analysis tools and natural language processing software can ‘read’ your transcripts and voice data and identify patterns and trends across large volumes of text or speech. They can also perform khttps://www.qualtrics.com/experience-management/research/sentiment-analysis/

which assesses overall trends in opinion and provides an unbiased overall summary of how participants are feeling.

Another feature of text analysis tools is their ability to categorize information by topic, sorting it into groupings that help you organize your data according to the topic discussed.

All in all, interviews are a valuable technique for qualitative research in business, yielding rich and detailed unstructured data. Historically, they have only been limited by the human capacity to interpret and communicate results and conclusions, which demands considerable time and skill.

When you combine this data with AI tools that can interpret it quickly and automatically, it becomes easy to analyze and structure, dovetailing perfectly with your other business data. An additional benefit of natural language analysis tools is that they are free of subjective biases, and can replicate the same approach across as much data as you choose. By combining human research skills with machine analysis, qualitative research methods such as interviews are more valuable than ever to your business.

Related resources

Market intelligence 10 min read, marketing insights 11 min read, ethnographic research 11 min read, qualitative vs quantitative research 13 min read, qualitative research questions 11 min read, qualitative research design 12 min read, primary vs secondary research 14 min read, request demo.

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Research Methods Guide: Interview Research

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Interview as a Method for Qualitative Research

Goals of Interview Research

Preferences
They help you explain, better understand, and explore research subjects' opinions, behavior, experiences, phenomenon, etc.
Interview questions are usually open-ended questions so that in-depth information will be collected.

Mode of Data Collection

There are several types of interviews, including:

Face-to-Face
Online (e.g. Skype, Googlehangout, etc)

FAQ: Conducting Interview Research

What are the important steps involved in interviews?

Think about who you will interview
Think about what kind of information you want to obtain from interviews
Think about why you want to pursue in-depth information around your research topic
Introduce yourself and explain the aim of the interview
Devise your questions so interviewees can help answer your research question
Have a sequence to your questions / topics by grouping them in themes
Make sure you can easily move back and forth between questions / topics
Make sure your questions are clear and easy to understand
Do not ask leading questions
Do you want to bring a second interviewer with you?
Do you want to bring a notetaker?
Do you want to record interviews? If so, do you have time to transcribe interview recordings?
Where will you interview people? Where is the setting with the least distraction?
How long will each interview take?
Do you need to address terms of confidentiality?

Do I have to choose either a survey or interviewing method?

No. In fact, many researchers use a mixed method - interviews can be useful as follow-up to certain respondents to surveys, e.g., to further investigate their responses.

Is training an interviewer important?

Yes, since the interviewer can control the quality of the result, training the interviewer becomes crucial. If more than one interviewers are involved in your study, it is important to have every interviewer understand the interviewing procedure and rehearse the interviewing process before beginning the formal study.

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Last Updated: Aug 21, 2023 10:42 AM

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Qualitative Interview: What it is & How to conduct one

A qualitative interview is commonly used in research projects involving new products, brand positioning, purchase dynamics, market research, social research, behavioral analysis, exploring market segments, etc. Recent data also suggests that it is highly effective when used in employee engagement initiatives.

It has also proven to be extremely helpful when it comes to problem definition as well as developing an approach to a particular problem.

What is a Qualitative Interview?

A qualitative Interview is a research approach used in a qualitative study where more personal interaction is required and detailed in depth information is gathered from the participant. Qualitative interviews usually involve follow-up questions and are conducted in a conversation or discussion format.

A qualitative interview is a more personal form of research agenda compared to general questionnaires or focused group studies. Such formats often include open-ended and follow-up questions .

LEARN ABOUT: Behavioral Research

How to conduct a Qualitative Interview?

Conducting a qualitative interview requires careful planning and implementation to ensure that you gather meaningful and rich data. Here are some steps to consider when conducting a qualitative research interview:

Clearly define the purpose of your qualitative interview and the specific research method questions you want to address. It will help you design appropriate research interview questions and interview guides for your data analysis.

Identify the target population or specific individuals who can provide valuable insights related to your research questions. Consider criteria such as demographics, expertise, or experiences that align with your research methods and objectives. Use appropriate methods, such as purposive sampling of data collection, to recruit participants who can offer diverse perspectives.

Before conducting the interview, ensure that participants understand the purpose, procedures, and potential risks or benefits of their involvement. Obtain their informed consent, clearly explaining their rights as participants, including confidentiality and their ability to withdraw from the study at any time.

Prepare a flexible in depth interviews guide that includes a set of open-ended interview questions for an interview participant. The guide should be designed to elicit participants’ perspectives, experiences, and insights related to your research objectives for conducting interviews. Consider using probing techniques to encourage participants to elaborate on their responses and explore different dimensions of the topic.

Select a suitable location for the in depth interviews that is comfortable, private, and free from distractions for an interview participant. Create a relaxed and welcoming atmosphere to help participants feel at ease and encourage open communication for qualitative interviewing. Establish rapport and build trust with participants by introducing yourself, explaining the purpose of conducting interviews, and actively listening to their responses.

Start by asking introductory questions to establish a rapport with the participant. Follow the qualitative interview guide, but remain flexible and responsive to participants’ responses. Allow participants to speak freely and provide detailed answers, using probing techniques to delve deeper into their experiences, emotions, and perspectives. Take notes or record the interview (with participants’ consent) to capture accurate and detailed information.

Show respect for their experiences and perspectives, even if they differ from yours. Avoid making judgments or imposing your own beliefs during the interview. Create a non-judgmental and inclusive environment that encourages participants to share their thoughts and feelings honestly.

Transcribe the interview recordings or review your notes promptly after each interview while the details remain fresh. Analyze the qualitative data using appropriate methods, such as thematic data analysis, to identify patterns, themes, and insights. Ensure that the data is anonymized and handled following ethical guidelines.

By following these steps, you can conduct a qualitative research interview that facilitates rich and meaningful discussions, resulting in valuable data analysis for your research process.

LEARN ABOUT: Research Process Steps

Types of Qualitative Interviews

The interview itself can be conducted over multiple formats. Qualitative researchers can employ several types of qualitative interviews based on their research objectives and the nature of the study. Here are some popular types of qualitative interviews:

Structured interviews involve a predetermined set of questions that are asked in the same order and manner to each participant. The questions of structured interviews are typically closed-ended or have limited response options. This type of interview is proper when researchers aim to collect specific information in a standardized way, allowing for easier comparison and analysis of responses across participants.

Semi-structured interviews combine predetermined questions with flexibility for additional probing and follow-up questions. Researchers have a set of core questions to guide the interview but can adapt the interview data collection process based on participants’ responses. This type of approach allows for a deeper exploration of participants’ experiences, thoughts, and perspectives while maintaining some standardization level.

Unstructured interviews involve open-ended questions and a free-flowing conversation between the interviewer and the participant. The interviewer may have a general topic or area of interest but allows the conversation to evolve naturally. Unstructured interviews provide a high degree of flexibility and allow participants to express themselves more freely, often leading to rich and nuanced data.

Each qualitative interview type has its strengths and is suited for different research purposes. Researchers or a research team should carefully select the appropriate type of research interview that aligns with their research objectives, the nature of the phenomenon under investigation, and the population being studied.

LEARN ABOUT: Structured Question

Advantages of Using Qualitative Interviews

Qualitative interview techniques offer several advantages as a research method. Here are some of the key advantages:

A qualitative interview allows researchers to delve deeply into participants’ experiences, perspectives, and opinions. Using open-ended questions and probing techniques, researchers can uncover rich and detailed information beyond mere surface-level responses. This in-depth exploration provides a comprehensive understanding of the research topic.

Qualitative interviews offer flexibility in adapting the interview data collection process to the specific needs of each participant. Researchers can tailor their questions, follow-up probes, and overall approach based on the participant’s responses, allowing for a more personalized and engaging research experience. This flexibility enhances the quality and richness of the data collection.

Qualitative interview prioritizes the voices and perspectives of participants. Through interactive and conversational exchanges, participants can express their thoughts, emotions, and beliefs in their own words. This approach ensures that the research captures individuals’ nuanced and diverse experiences, offering insights that may not be obtained through other methods.

A qualitative research interview provides a holistic understanding of the social and cultural context surrounding participants’ experiences. Researchers can explore the factors influencing participants’ perspectives, such as cultural norms, societal expectations, or personal histories. This contextual understanding enhances the interpretation and analysis of the data, providing a comprehensive view of the research topic.

Qualitative interviews are particularly effective when studying sensitive or complex topics. It allows participants to share their experiences and emotions in a safe and confidential environment, facilitating a deeper exploration of potentially challenging subjects. This method also enables researchers to capture these topics’ nuances, contradictions, and subtleties, contributing to a more comprehensive understanding.

Qualitative research interviews can empower participants by giving them a voice and acknowledging the value of their experiences. By actively listening and engaging in meaningful dialogue, researchers validate participants’ contributions and foster a sense of ownership over their narratives. This empowerment can positively affect participants’ self-esteem, self-reflection, and personal growth.

Overall, qualitative interview provides researchers with a powerful tool to explore complex phenomena, gain in-depth insights, and understand the subjective experiences of individuals. By capitalizing on the advantages of this method, researchers can generate valuable and nuanced data that contributes to the advancement of knowledge in their respective fields.

Learn more by reading our guide: Types of Interviews .

Disadvantages of a Qualitative Interview

While a qualitative interview has many advantages, it is essential to acknowledge their potential limitations. Here are some of the disadvantages associated with qualitative interviews:

Qualitative interviews involve interaction between the researcher and participants, which introduces the possibility of subjective interpretations and biases. Researchers may unintentionally influence participants’ responses through questioning techniques, non-verbal cues, or personal beliefs. Researchers must be aware of their biases and take steps to minimize their impact on data collection and analysis.

The findings from qualitative research interviews are typically based on small sample size and specific context, making it difficult to generalize the results to a larger population. While qualitative research aims to provide an in-depth understanding, it may need more statistical representativeness than quantitative research methods offer. Therefore, when applying qualitative interview findings to broader populations or contexts, caution must be exercised.

Qualitative interviews can be time-consuming and require substantial resources. Conducting in depth interviews, transcribing data, and analyzing the qualitative data are labor-intensive tasks that require significant time and effort. Researchers must be prepared for qualitative interviews of a detailed and time-consuming nature, especially when working with large or diverse participant samples.

Ensuring the validity and reliability of qualitative research interviews can be challenging. Validity refers to the extent to which the interview data accurately represent participants’ experiences and perspectives, while reliability relates to the consistency and replicability of the findings. Factors such as interviewer bias, participant recall, and social desirability may compromise the validity and reliability of the data. Researchers must employ rigorous methodologies, triangulate data from multiple sources, and establish trustworthiness to enhance the credibility of their findings.

Qualitative interviews capture participants’ experiences and perspectives at a specific time and within a particular context. However, these experiences may evolve or change over time or in different contexts. Researchers must be mindful of the limitations of capturing participants’ experiences, recognizing that their findings may only partially represent the dynamic nature of human behavior and perceptions.

Despite these disadvantages, qualitative interviews remain a valuable research method that offers unique insights into individuals’ experiences and perspectives.

Learn About: Steps in qualitative Research

Qualitative interviews are valuable for gaining in-depth insights into individuals’ experiences, perspectives, and behaviors. They offer a unique opportunity to explore complex phenomena, uncover rich narratives, and understand the underlying meanings and interpretations that individuals assign to their experiences.

To summarize, Qualitative Research can either be a valuable tool to discover problems or help elevate any research programs with subjective data or leave researchers with amorphous and contradictory data. The key is to use the approach in combination with other qualitative and quantitative research techniques to enhance the depth of the data gathered.

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How to use and assess qualitative research methods

Loraine busetto.

1 Department of Neurology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany

Wolfgang Wick

2 Clinical Cooperation Unit Neuro-Oncology, German Cancer Research Center, Heidelberg, Germany

Christoph Gumbinger

Associated data.

Not applicable.

This paper aims to provide an overview of the use and assessment of qualitative research methods in the health sciences. Qualitative research can be defined as the study of the nature of phenomena and is especially appropriate for answering questions of why something is (not) observed, assessing complex multi-component interventions, and focussing on intervention improvement. The most common methods of data collection are document study, (non-) participant observations, semi-structured interviews and focus groups. For data analysis, field-notes and audio-recordings are transcribed into protocols and transcripts, and coded using qualitative data management software. Criteria such as checklists, reflexivity, sampling strategies, piloting, co-coding, member-checking and stakeholder involvement can be used to enhance and assess the quality of the research conducted. Using qualitative in addition to quantitative designs will equip us with better tools to address a greater range of research problems, and to fill in blind spots in current neurological research and practice.

The aim of this paper is to provide an overview of qualitative research methods, including hands-on information on how they can be used, reported and assessed. This article is intended for beginning qualitative researchers in the health sciences as well as experienced quantitative researchers who wish to broaden their understanding of qualitative research.

What is qualitative research?

Qualitative research is defined as “the study of the nature of phenomena”, including “their quality, different manifestations, the context in which they appear or the perspectives from which they can be perceived” , but excluding “their range, frequency and place in an objectively determined chain of cause and effect” [ 1 ]. This formal definition can be complemented with a more pragmatic rule of thumb: qualitative research generally includes data in form of words rather than numbers [ 2 ].

Why conduct qualitative research?

Because some research questions cannot be answered using (only) quantitative methods. For example, one Australian study addressed the issue of why patients from Aboriginal communities often present late or not at all to specialist services offered by tertiary care hospitals. Using qualitative interviews with patients and staff, it found one of the most significant access barriers to be transportation problems, including some towns and communities simply not having a bus service to the hospital [ 3 ]. A quantitative study could have measured the number of patients over time or even looked at possible explanatory factors – but only those previously known or suspected to be of relevance. To discover reasons for observed patterns, especially the invisible or surprising ones, qualitative designs are needed.

While qualitative research is common in other fields, it is still relatively underrepresented in health services research. The latter field is more traditionally rooted in the evidence-based-medicine paradigm, as seen in " research that involves testing the effectiveness of various strategies to achieve changes in clinical practice, preferably applying randomised controlled trial study designs (...) " [ 4 ]. This focus on quantitative research and specifically randomised controlled trials (RCT) is visible in the idea of a hierarchy of research evidence which assumes that some research designs are objectively better than others, and that choosing a "lesser" design is only acceptable when the better ones are not practically or ethically feasible [ 5 , 6 ]. Others, however, argue that an objective hierarchy does not exist, and that, instead, the research design and methods should be chosen to fit the specific research question at hand – "questions before methods" [ 2 , 7 – 9 ]. This means that even when an RCT is possible, some research problems require a different design that is better suited to addressing them. Arguing in JAMA, Berwick uses the example of rapid response teams in hospitals, which he describes as " a complex, multicomponent intervention – essentially a process of social change" susceptible to a range of different context factors including leadership or organisation history. According to him, "[in] such complex terrain, the RCT is an impoverished way to learn. Critics who use it as a truth standard in this context are incorrect" [ 8 ] . Instead of limiting oneself to RCTs, Berwick recommends embracing a wider range of methods , including qualitative ones, which for "these specific applications, (...) are not compromises in learning how to improve; they are superior" [ 8 ].

Research problems that can be approached particularly well using qualitative methods include assessing complex multi-component interventions or systems (of change), addressing questions beyond “what works”, towards “what works for whom when, how and why”, and focussing on intervention improvement rather than accreditation [ 7 , 9 – 12 ]. Using qualitative methods can also help shed light on the “softer” side of medical treatment. For example, while quantitative trials can measure the costs and benefits of neuro-oncological treatment in terms of survival rates or adverse effects, qualitative research can help provide a better understanding of patient or caregiver stress, visibility of illness or out-of-pocket expenses.

How to conduct qualitative research?

Given that qualitative research is characterised by flexibility, openness and responsivity to context, the steps of data collection and analysis are not as separate and consecutive as they tend to be in quantitative research [ 13 , 14 ]. As Fossey puts it : “sampling, data collection, analysis and interpretation are related to each other in a cyclical (iterative) manner, rather than following one after another in a stepwise approach” [ 15 ]. The researcher can make educated decisions with regard to the choice of method, how they are implemented, and to which and how many units they are applied [ 13 ]. As shown in Fig. 1 , this can involve several back-and-forth steps between data collection and analysis where new insights and experiences can lead to adaption and expansion of the original plan. Some insights may also necessitate a revision of the research question and/or the research design as a whole. The process ends when saturation is achieved, i.e. when no relevant new information can be found (see also below: sampling and saturation). For reasons of transparency, it is essential for all decisions as well as the underlying reasoning to be well-documented.

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Iterative research process

While it is not always explicitly addressed, qualitative methods reflect a different underlying research paradigm than quantitative research (e.g. constructivism or interpretivism as opposed to positivism). The choice of methods can be based on the respective underlying substantive theory or theoretical framework used by the researcher [ 2 ].

Data collection

The methods of qualitative data collection most commonly used in health research are document study, observations, semi-structured interviews and focus groups [ 1 , 14 , 16 , 17 ].

Document study

Document study (also called document analysis) refers to the review by the researcher of written materials [ 14 ]. These can include personal and non-personal documents such as archives, annual reports, guidelines, policy documents, diaries or letters.

Observations

Observations are particularly useful to gain insights into a certain setting and actual behaviour – as opposed to reported behaviour or opinions [ 13 ]. Qualitative observations can be either participant or non-participant in nature. In participant observations, the observer is part of the observed setting, for example a nurse working in an intensive care unit [ 18 ]. In non-participant observations, the observer is “on the outside looking in”, i.e. present in but not part of the situation, trying not to influence the setting by their presence. Observations can be planned (e.g. for 3 h during the day or night shift) or ad hoc (e.g. as soon as a stroke patient arrives at the emergency room). During the observation, the observer takes notes on everything or certain pre-determined parts of what is happening around them, for example focusing on physician-patient interactions or communication between different professional groups. Written notes can be taken during or after the observations, depending on feasibility (which is usually lower during participant observations) and acceptability (e.g. when the observer is perceived to be judging the observed). Afterwards, these field notes are transcribed into observation protocols. If more than one observer was involved, field notes are taken independently, but notes can be consolidated into one protocol after discussions. Advantages of conducting observations include minimising the distance between the researcher and the researched, the potential discovery of topics that the researcher did not realise were relevant and gaining deeper insights into the real-world dimensions of the research problem at hand [ 18 ].

Semi-structured interviews

Hijmans & Kuyper describe qualitative interviews as “an exchange with an informal character, a conversation with a goal” [ 19 ]. Interviews are used to gain insights into a person’s subjective experiences, opinions and motivations – as opposed to facts or behaviours [ 13 ]. Interviews can be distinguished by the degree to which they are structured (i.e. a questionnaire), open (e.g. free conversation or autobiographical interviews) or semi-structured [ 2 , 13 ]. Semi-structured interviews are characterized by open-ended questions and the use of an interview guide (or topic guide/list) in which the broad areas of interest, sometimes including sub-questions, are defined [ 19 ]. The pre-defined topics in the interview guide can be derived from the literature, previous research or a preliminary method of data collection, e.g. document study or observations. The topic list is usually adapted and improved at the start of the data collection process as the interviewer learns more about the field [ 20 ]. Across interviews the focus on the different (blocks of) questions may differ and some questions may be skipped altogether (e.g. if the interviewee is not able or willing to answer the questions or for concerns about the total length of the interview) [ 20 ]. Qualitative interviews are usually not conducted in written format as it impedes on the interactive component of the method [ 20 ]. In comparison to written surveys, qualitative interviews have the advantage of being interactive and allowing for unexpected topics to emerge and to be taken up by the researcher. This can also help overcome a provider or researcher-centred bias often found in written surveys, which by nature, can only measure what is already known or expected to be of relevance to the researcher. Interviews can be audio- or video-taped; but sometimes it is only feasible or acceptable for the interviewer to take written notes [ 14 , 16 , 20 ].

Focus groups

Focus groups are group interviews to explore participants’ expertise and experiences, including explorations of how and why people behave in certain ways [ 1 ]. Focus groups usually consist of 6–8 people and are led by an experienced moderator following a topic guide or “script” [ 21 ]. They can involve an observer who takes note of the non-verbal aspects of the situation, possibly using an observation guide [ 21 ]. Depending on researchers’ and participants’ preferences, the discussions can be audio- or video-taped and transcribed afterwards [ 21 ]. Focus groups are useful for bringing together homogeneous (to a lesser extent heterogeneous) groups of participants with relevant expertise and experience on a given topic on which they can share detailed information [ 21 ]. Focus groups are a relatively easy, fast and inexpensive method to gain access to information on interactions in a given group, i.e. “the sharing and comparing” among participants [ 21 ]. Disadvantages include less control over the process and a lesser extent to which each individual may participate. Moreover, focus group moderators need experience, as do those tasked with the analysis of the resulting data. Focus groups can be less appropriate for discussing sensitive topics that participants might be reluctant to disclose in a group setting [ 13 ]. Moreover, attention must be paid to the emergence of “groupthink” as well as possible power dynamics within the group, e.g. when patients are awed or intimidated by health professionals.

Choosing the “right” method

As explained above, the school of thought underlying qualitative research assumes no objective hierarchy of evidence and methods. This means that each choice of single or combined methods has to be based on the research question that needs to be answered and a critical assessment with regard to whether or to what extent the chosen method can accomplish this – i.e. the “fit” between question and method [ 14 ]. It is necessary for these decisions to be documented when they are being made, and to be critically discussed when reporting methods and results.

Let us assume that our research aim is to examine the (clinical) processes around acute endovascular treatment (EVT), from the patient’s arrival at the emergency room to recanalization, with the aim to identify possible causes for delay and/or other causes for sub-optimal treatment outcome. As a first step, we could conduct a document study of the relevant standard operating procedures (SOPs) for this phase of care – are they up-to-date and in line with current guidelines? Do they contain any mistakes, irregularities or uncertainties that could cause delays or other problems? Regardless of the answers to these questions, the results have to be interpreted based on what they are: a written outline of what care processes in this hospital should look like. If we want to know what they actually look like in practice, we can conduct observations of the processes described in the SOPs. These results can (and should) be analysed in themselves, but also in comparison to the results of the document analysis, especially as regards relevant discrepancies. Do the SOPs outline specific tests for which no equipment can be observed or tasks to be performed by specialized nurses who are not present during the observation? It might also be possible that the written SOP is outdated, but the actual care provided is in line with current best practice. In order to find out why these discrepancies exist, it can be useful to conduct interviews. Are the physicians simply not aware of the SOPs (because their existence is limited to the hospital’s intranet) or do they actively disagree with them or does the infrastructure make it impossible to provide the care as described? Another rationale for adding interviews is that some situations (or all of their possible variations for different patient groups or the day, night or weekend shift) cannot practically or ethically be observed. In this case, it is possible to ask those involved to report on their actions – being aware that this is not the same as the actual observation. A senior physician’s or hospital manager’s description of certain situations might differ from a nurse’s or junior physician’s one, maybe because they intentionally misrepresent facts or maybe because different aspects of the process are visible or important to them. In some cases, it can also be relevant to consider to whom the interviewee is disclosing this information – someone they trust, someone they are otherwise not connected to, or someone they suspect or are aware of being in a potentially “dangerous” power relationship to them. Lastly, a focus group could be conducted with representatives of the relevant professional groups to explore how and why exactly they provide care around EVT. The discussion might reveal discrepancies (between SOPs and actual care or between different physicians) and motivations to the researchers as well as to the focus group members that they might not have been aware of themselves. For the focus group to deliver relevant information, attention has to be paid to its composition and conduct, for example, to make sure that all participants feel safe to disclose sensitive or potentially problematic information or that the discussion is not dominated by (senior) physicians only. The resulting combination of data collection methods is shown in Fig. 2 .

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Possible combination of data collection methods

Attributions for icons: “Book” by Serhii Smirnov, “Interview” by Adrien Coquet, FR, “Magnifying Glass” by anggun, ID, “Business communication” by Vectors Market; all from the Noun Project

The combination of multiple data source as described for this example can be referred to as “triangulation”, in which multiple measurements are carried out from different angles to achieve a more comprehensive understanding of the phenomenon under study [ 22 , 23 ].

Data analysis

To analyse the data collected through observations, interviews and focus groups these need to be transcribed into protocols and transcripts (see Fig. 3 ). Interviews and focus groups can be transcribed verbatim , with or without annotations for behaviour (e.g. laughing, crying, pausing) and with or without phonetic transcription of dialects and filler words, depending on what is expected or known to be relevant for the analysis. In the next step, the protocols and transcripts are coded , that is, marked (or tagged, labelled) with one or more short descriptors of the content of a sentence or paragraph [ 2 , 15 , 23 ]. Jansen describes coding as “connecting the raw data with “theoretical” terms” [ 20 ]. In a more practical sense, coding makes raw data sortable. This makes it possible to extract and examine all segments describing, say, a tele-neurology consultation from multiple data sources (e.g. SOPs, emergency room observations, staff and patient interview). In a process of synthesis and abstraction, the codes are then grouped, summarised and/or categorised [ 15 , 20 ]. The end product of the coding or analysis process is a descriptive theory of the behavioural pattern under investigation [ 20 ]. The coding process is performed using qualitative data management software, the most common ones being InVivo, MaxQDA and Atlas.ti. It should be noted that these are data management tools which support the analysis performed by the researcher(s) [ 14 ].

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From data collection to data analysis

Attributions for icons: see Fig. Fig.2, 2 , also “Speech to text” by Trevor Dsouza, “Field Notes” by Mike O’Brien, US, “Voice Record” by ProSymbols, US, “Inspection” by Made, AU, and “Cloud” by Graphic Tigers; all from the Noun Project

How to report qualitative research?

Protocols of qualitative research can be published separately and in advance of the study results. However, the aim is not the same as in RCT protocols, i.e. to pre-define and set in stone the research questions and primary or secondary endpoints. Rather, it is a way to describe the research methods in detail, which might not be possible in the results paper given journals’ word limits. Qualitative research papers are usually longer than their quantitative counterparts to allow for deep understanding and so-called “thick description”. In the methods section, the focus is on transparency of the methods used, including why, how and by whom they were implemented in the specific study setting, so as to enable a discussion of whether and how this may have influenced data collection, analysis and interpretation. The results section usually starts with a paragraph outlining the main findings, followed by more detailed descriptions of, for example, the commonalities, discrepancies or exceptions per category [ 20 ]. Here it is important to support main findings by relevant quotations, which may add information, context, emphasis or real-life examples [ 20 , 23 ]. It is subject to debate in the field whether it is relevant to state the exact number or percentage of respondents supporting a certain statement (e.g. “Five interviewees expressed negative feelings towards XYZ”) [ 21 ].

How to combine qualitative with quantitative research?

Qualitative methods can be combined with other methods in multi- or mixed methods designs, which “[employ] two or more different methods [ …] within the same study or research program rather than confining the research to one single method” [ 24 ]. Reasons for combining methods can be diverse, including triangulation for corroboration of findings, complementarity for illustration and clarification of results, expansion to extend the breadth and range of the study, explanation of (unexpected) results generated with one method with the help of another, or offsetting the weakness of one method with the strength of another [ 1 , 17 , 24 – 26 ]. The resulting designs can be classified according to when, why and how the different quantitative and/or qualitative data strands are combined. The three most common types of mixed method designs are the convergent parallel design , the explanatory sequential design and the exploratory sequential design. The designs with examples are shown in Fig. 4 .

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Three common mixed methods designs

In the convergent parallel design, a qualitative study is conducted in parallel to and independently of a quantitative study, and the results of both studies are compared and combined at the stage of interpretation of results. Using the above example of EVT provision, this could entail setting up a quantitative EVT registry to measure process times and patient outcomes in parallel to conducting the qualitative research outlined above, and then comparing results. Amongst other things, this would make it possible to assess whether interview respondents’ subjective impressions of patients receiving good care match modified Rankin Scores at follow-up, or whether observed delays in care provision are exceptions or the rule when compared to door-to-needle times as documented in the registry. In the explanatory sequential design, a quantitative study is carried out first, followed by a qualitative study to help explain the results from the quantitative study. This would be an appropriate design if the registry alone had revealed relevant delays in door-to-needle times and the qualitative study would be used to understand where and why these occurred, and how they could be improved. In the exploratory design, the qualitative study is carried out first and its results help informing and building the quantitative study in the next step [ 26 ]. If the qualitative study around EVT provision had shown a high level of dissatisfaction among the staff members involved, a quantitative questionnaire investigating staff satisfaction could be set up in the next step, informed by the qualitative study on which topics dissatisfaction had been expressed. Amongst other things, the questionnaire design would make it possible to widen the reach of the research to more respondents from different (types of) hospitals, regions, countries or settings, and to conduct sub-group analyses for different professional groups.

How to assess qualitative research?

A variety of assessment criteria and lists have been developed for qualitative research, ranging in their focus and comprehensiveness [ 14 , 17 , 27 ]. However, none of these has been elevated to the “gold standard” in the field. In the following, we therefore focus on a set of commonly used assessment criteria that, from a practical standpoint, a researcher can look for when assessing a qualitative research report or paper.

Assessors should check the authors’ use of and adherence to the relevant reporting checklists (e.g. Standards for Reporting Qualitative Research (SRQR)) to make sure all items that are relevant for this type of research are addressed [ 23 , 28 ]. Discussions of quantitative measures in addition to or instead of these qualitative measures can be a sign of lower quality of the research (paper). Providing and adhering to a checklist for qualitative research contributes to an important quality criterion for qualitative research, namely transparency [ 15 , 17 , 23 ].

Reflexivity

While methodological transparency and complete reporting is relevant for all types of research, some additional criteria must be taken into account for qualitative research. This includes what is called reflexivity, i.e. sensitivity to the relationship between the researcher and the researched, including how contact was established and maintained, or the background and experience of the researcher(s) involved in data collection and analysis. Depending on the research question and population to be researched this can be limited to professional experience, but it may also include gender, age or ethnicity [ 17 , 27 ]. These details are relevant because in qualitative research, as opposed to quantitative research, the researcher as a person cannot be isolated from the research process [ 23 ]. It may influence the conversation when an interviewed patient speaks to an interviewer who is a physician, or when an interviewee is asked to discuss a gynaecological procedure with a male interviewer, and therefore the reader must be made aware of these details [ 19 ].

Sampling and saturation

The aim of qualitative sampling is for all variants of the objects of observation that are deemed relevant for the study to be present in the sample “ to see the issue and its meanings from as many angles as possible” [ 1 , 16 , 19 , 20 , 27 ] , and to ensure “information-richness [ 15 ]. An iterative sampling approach is advised, in which data collection (e.g. five interviews) is followed by data analysis, followed by more data collection to find variants that are lacking in the current sample. This process continues until no new (relevant) information can be found and further sampling becomes redundant – which is called saturation [ 1 , 15 ] . In other words: qualitative data collection finds its end point not a priori , but when the research team determines that saturation has been reached [ 29 , 30 ].

This is also the reason why most qualitative studies use deliberate instead of random sampling strategies. This is generally referred to as “ purposive sampling” , in which researchers pre-define which types of participants or cases they need to include so as to cover all variations that are expected to be of relevance, based on the literature, previous experience or theory (i.e. theoretical sampling) [ 14 , 20 ]. Other types of purposive sampling include (but are not limited to) maximum variation sampling, critical case sampling or extreme or deviant case sampling [ 2 ]. In the above EVT example, a purposive sample could include all relevant professional groups and/or all relevant stakeholders (patients, relatives) and/or all relevant times of observation (day, night and weekend shift).

Assessors of qualitative research should check whether the considerations underlying the sampling strategy were sound and whether or how researchers tried to adapt and improve their strategies in stepwise or cyclical approaches between data collection and analysis to achieve saturation [ 14 ].

Good qualitative research is iterative in nature, i.e. it goes back and forth between data collection and analysis, revising and improving the approach where necessary. One example of this are pilot interviews, where different aspects of the interview (especially the interview guide, but also, for example, the site of the interview or whether the interview can be audio-recorded) are tested with a small number of respondents, evaluated and revised [ 19 ]. In doing so, the interviewer learns which wording or types of questions work best, or which is the best length of an interview with patients who have trouble concentrating for an extended time. Of course, the same reasoning applies to observations or focus groups which can also be piloted.

Ideally, coding should be performed by at least two researchers, especially at the beginning of the coding process when a common approach must be defined, including the establishment of a useful coding list (or tree), and when a common meaning of individual codes must be established [ 23 ]. An initial sub-set or all transcripts can be coded independently by the coders and then compared and consolidated after regular discussions in the research team. This is to make sure that codes are applied consistently to the research data.

Member checking

Member checking, also called respondent validation , refers to the practice of checking back with study respondents to see if the research is in line with their views [ 14 , 27 ]. This can happen after data collection or analysis or when first results are available [ 23 ]. For example, interviewees can be provided with (summaries of) their transcripts and asked whether they believe this to be a complete representation of their views or whether they would like to clarify or elaborate on their responses [ 17 ]. Respondents’ feedback on these issues then becomes part of the data collection and analysis [ 27 ].

Stakeholder involvement

In those niches where qualitative approaches have been able to evolve and grow, a new trend has seen the inclusion of patients and their representatives not only as study participants (i.e. “members”, see above) but as consultants to and active participants in the broader research process [ 31 – 33 ]. The underlying assumption is that patients and other stakeholders hold unique perspectives and experiences that add value beyond their own single story, making the research more relevant and beneficial to researchers, study participants and (future) patients alike [ 34 , 35 ]. Using the example of patients on or nearing dialysis, a recent scoping review found that 80% of clinical research did not address the top 10 research priorities identified by patients and caregivers [ 32 , 36 ]. In this sense, the involvement of the relevant stakeholders, especially patients and relatives, is increasingly being seen as a quality indicator in and of itself.

How not to assess qualitative research

The above overview does not include certain items that are routine in assessments of quantitative research. What follows is a non-exhaustive, non-representative, experience-based list of the quantitative criteria often applied to the assessment of qualitative research, as well as an explanation of the limited usefulness of these endeavours.

Protocol adherence

Given the openness and flexibility of qualitative research, it should not be assessed by how well it adheres to pre-determined and fixed strategies – in other words: its rigidity. Instead, the assessor should look for signs of adaptation and refinement based on lessons learned from earlier steps in the research process.

Sample size

For the reasons explained above, qualitative research does not require specific sample sizes, nor does it require that the sample size be determined a priori [ 1 , 14 , 27 , 37 – 39 ]. Sample size can only be a useful quality indicator when related to the research purpose, the chosen methodology and the composition of the sample, i.e. who was included and why.

Randomisation

While some authors argue that randomisation can be used in qualitative research, this is not commonly the case, as neither its feasibility nor its necessity or usefulness has been convincingly established for qualitative research [ 13 , 27 ]. Relevant disadvantages include the negative impact of a too large sample size as well as the possibility (or probability) of selecting “ quiet, uncooperative or inarticulate individuals ” [ 17 ]. Qualitative studies do not use control groups, either.

Interrater reliability, variability and other “objectivity checks”

The concept of “interrater reliability” is sometimes used in qualitative research to assess to which extent the coding approach overlaps between the two co-coders. However, it is not clear what this measure tells us about the quality of the analysis [ 23 ]. This means that these scores can be included in qualitative research reports, preferably with some additional information on what the score means for the analysis, but it is not a requirement. Relatedly, it is not relevant for the quality or “objectivity” of qualitative research to separate those who recruited the study participants and collected and analysed the data. Experiences even show that it might be better to have the same person or team perform all of these tasks [ 20 ]. First, when researchers introduce themselves during recruitment this can enhance trust when the interview takes place days or weeks later with the same researcher. Second, when the audio-recording is transcribed for analysis, the researcher conducting the interviews will usually remember the interviewee and the specific interview situation during data analysis. This might be helpful in providing additional context information for interpretation of data, e.g. on whether something might have been meant as a joke [ 18 ].

Not being quantitative research

Being qualitative research instead of quantitative research should not be used as an assessment criterion if it is used irrespectively of the research problem at hand. Similarly, qualitative research should not be required to be combined with quantitative research per se – unless mixed methods research is judged as inherently better than single-method research. In this case, the same criterion should be applied for quantitative studies without a qualitative component.

The main take-away points of this paper are summarised in Table Table1. 1 . We aimed to show that, if conducted well, qualitative research can answer specific research questions that cannot to be adequately answered using (only) quantitative designs. Seeing qualitative and quantitative methods as equal will help us become more aware and critical of the “fit” between the research problem and our chosen methods: I can conduct an RCT to determine the reasons for transportation delays of acute stroke patients – but should I? It also provides us with a greater range of tools to tackle a greater range of research problems more appropriately and successfully, filling in the blind spots on one half of the methodological spectrum to better address the whole complexity of neurological research and practice.

Take-away-points

Acknowledgements

Abbreviations, authors’ contributions.

LB drafted the manuscript; WW and CG revised the manuscript; all authors approved the final versions.

no external funding.

Availability of data and materials

Ethics approval and consent to participate, consent for publication, competing interests.

The authors declare no competing interests.

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Published: 05 October 2018

Interviews and focus groups in qualitative research: an update for the digital age

P. Gill 1 &
J. Baillie 2

British Dental Journal volume 225 , pages 668–672 ( 2018 ) Cite this article

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Highlights that qualitative research is used increasingly in dentistry. Interviews and focus groups remain the most common qualitative methods of data collection.

Suggests the advent of digital technologies has transformed how qualitative research can now be undertaken.

Suggests interviews and focus groups can offer significant, meaningful insight into participants' experiences, beliefs and perspectives, which can help to inform developments in dental practice.

Qualitative research is used increasingly in dentistry, due to its potential to provide meaningful, in-depth insights into participants' experiences, perspectives, beliefs and behaviours. These insights can subsequently help to inform developments in dental practice and further related research. The most common methods of data collection used in qualitative research are interviews and focus groups. While these are primarily conducted face-to-face, the ongoing evolution of digital technologies, such as video chat and online forums, has further transformed these methods of data collection. This paper therefore discusses interviews and focus groups in detail, outlines how they can be used in practice, how digital technologies can further inform the data collection process, and what these methods can offer dentistry.

You have full access to this article via your institution.

Interviews in the social sciences

Eleanor Knott, Aliya Hamid Rao, … Chana Teeger

Professionalism in dentistry: deconstructing common terminology

Andrew Trathen, Sasha Scambler & Jennifer E. Gallagher

A review of technical and quality assessment considerations of audio-visual and web-conferencing focus groups in qualitative health research

Hiba Bawadi, Sara Elshami, … Banan Mukhalalati

Introduction

Traditionally, research in dentistry has primarily been quantitative in nature. 1 However, in recent years, there has been a growing interest in qualitative research within the profession, due to its potential to further inform developments in practice, policy, education and training. Consequently, in 2008, the British Dental Journal (BDJ) published a four paper qualitative research series, 2 , 3 , 4 , 5 to help increase awareness and understanding of this particular methodological approach.

Since the papers were originally published, two scoping reviews have demonstrated the ongoing proliferation in the use of qualitative research within the field of oral healthcare. 1 , 6 To date, the original four paper series continue to be well cited and two of the main papers remain widely accessed among the BDJ readership. 2 , 3 The potential value of well-conducted qualitative research to evidence-based practice is now also widely recognised by service providers, policy makers, funding bodies and those who commission, support and use healthcare research.

Besides increasing standalone use, qualitative methods are now also routinely incorporated into larger mixed method study designs, such as clinical trials, as they can offer additional, meaningful insights into complex problems that simply could not be provided by quantitative methods alone. Qualitative methods can also be used to further facilitate in-depth understanding of important aspects of clinical trial processes, such as recruitment. For example, Ellis et al . investigated why edentulous older patients, dissatisfied with conventional dentures, decline implant treatment, despite its established efficacy, and frequently refuse to participate in related randomised clinical trials, even when financial constraints are removed. 7 Through the use of focus groups in Canada and the UK, the authors found that fears of pain and potential complications, along with perceived embarrassment, exacerbated by age, are common reasons why older patients typically refuse dental implants. 7

The last decade has also seen further developments in qualitative research, due to the ongoing evolution of digital technologies. These developments have transformed how researchers can access and share information, communicate and collaborate, recruit and engage participants, collect and analyse data and disseminate and translate research findings. 8 Where appropriate, such technologies are therefore capable of extending and enhancing how qualitative research is undertaken. 9 For example, it is now possible to collect qualitative data via instant messaging, email or online/video chat, using appropriate online platforms.

These innovative approaches to research are therefore cost-effective, convenient, reduce geographical constraints and are often useful for accessing 'hard to reach' participants (for example, those who are immobile or socially isolated). 8 , 9 However, digital technologies are still relatively new and constantly evolving and therefore present a variety of pragmatic and methodological challenges. Furthermore, given their very nature, their use in many qualitative studies and/or with certain participant groups may be inappropriate and should therefore always be carefully considered. While it is beyond the scope of this paper to provide a detailed explication regarding the use of digital technologies in qualitative research, insight is provided into how such technologies can be used to facilitate the data collection process in interviews and focus groups.

In light of such developments, it is perhaps therefore timely to update the main paper 3 of the original BDJ series. As with the previous publications, this paper has been purposely written in an accessible style, to enhance readability, particularly for those who are new to qualitative research. While the focus remains on the most common qualitative methods of data collection – interviews and focus groups – appropriate revisions have been made to provide a novel perspective, and should therefore be helpful to those who would like to know more about qualitative research. This paper specifically focuses on undertaking qualitative research with adult participants only.

Overview of qualitative research

Qualitative research is an approach that focuses on people and their experiences, behaviours and opinions. 10 , 11 The qualitative researcher seeks to answer questions of 'how' and 'why', providing detailed insight and understanding, 11 which quantitative methods cannot reach. 12 Within qualitative research, there are distinct methodologies influencing how the researcher approaches the research question, data collection and data analysis. 13 For example, phenomenological studies focus on the lived experience of individuals, explored through their description of the phenomenon. Ethnographic studies explore the culture of a group and typically involve the use of multiple methods to uncover the issues. 14

While methodology is the 'thinking tool', the methods are the 'doing tools'; 13 the ways in which data are collected and analysed. There are multiple qualitative data collection methods, including interviews, focus groups, observations, documentary analysis, participant diaries, photography and videography. Two of the most commonly used qualitative methods are interviews and focus groups, which are explored in this article. The data generated through these methods can be analysed in one of many ways, according to the methodological approach chosen. A common approach is thematic data analysis, involving the identification of themes and subthemes across the data set. Further information on approaches to qualitative data analysis has been discussed elsewhere. 1

Qualitative research is an evolving and adaptable approach, used by different disciplines for different purposes. Traditionally, qualitative data, specifically interviews, focus groups and observations, have been collected face-to-face with participants. In more recent years, digital technologies have contributed to the ongoing evolution of qualitative research. Digital technologies offer researchers different ways of recruiting participants and collecting data, and offer participants opportunities to be involved in research that is not necessarily face-to-face.

Research interviews are a fundamental qualitative research method 15 and are utilised across methodological approaches. Interviews enable the researcher to learn in depth about the perspectives, experiences, beliefs and motivations of the participant. 3 , 16 Examples include, exploring patients' perspectives of fear/anxiety triggers in dental treatment, 17 patients' experiences of oral health and diabetes, 18 and dental students' motivations for their choice of career. 19

Interviews may be structured, semi-structured or unstructured, 3 according to the purpose of the study, with less structured interviews facilitating a more in depth and flexible interviewing approach. 20 Structured interviews are similar to verbal questionnaires and are used if the researcher requires clarification on a topic; however they produce less in-depth data about a participant's experience. 3 Unstructured interviews may be used when little is known about a topic and involves the researcher asking an opening question; 3 the participant then leads the discussion. 20 Semi-structured interviews are commonly used in healthcare research, enabling the researcher to ask predetermined questions, 20 while ensuring the participant discusses issues they feel are important.

Interviews can be undertaken face-to-face or using digital methods when the researcher and participant are in different locations. Audio-recording the interview, with the consent of the participant, is essential for all interviews regardless of the medium as it enables accurate transcription; the process of turning the audio file into a word-for-word transcript. This transcript is the data, which the researcher then analyses according to the chosen approach.

Types of interview

Qualitative studies often utilise one-to-one, face-to-face interviews with research participants. This involves arranging a mutually convenient time and place to meet the participant, signing a consent form and audio-recording the interview. However, digital technologies have expanded the potential for interviews in research, enabling individuals to participate in qualitative research regardless of location.

Telephone interviews can be a useful alternative to face-to-face interviews and are commonly used in qualitative research. They enable participants from different geographical areas to participate and may be less onerous for participants than meeting a researcher in person. 15 A qualitative study explored patients' perspectives of dental implants and utilised telephone interviews due to the quality of the data that could be yielded. 21 The researcher needs to consider how they will audio record the interview, which can be facilitated by purchasing a recorder that connects directly to the telephone. One potential disadvantage of telephone interviews is the inability of the interviewer and researcher to see each other. This is resolved using software for audio and video calls online – such as Skype – to conduct interviews with participants in qualitative studies. Advantages of this approach include being able to see the participant if video calls are used, enabling observation of non-verbal communication, and the software can be free to use. However, participants are required to have a device and internet connection, as well as being computer literate, potentially limiting who can participate in the study. One qualitative study explored the role of dental hygienists in reducing oral health disparities in Canada. 22 The researcher conducted interviews using Skype, which enabled dental hygienists from across Canada to be interviewed within the research budget, accommodating the participants' schedules. 22

A less commonly used approach to qualitative interviews is the use of social virtual worlds. A qualitative study accessed a social virtual world – Second Life – to explore the health literacy skills of individuals who use social virtual worlds to access health information. 23 The researcher created an avatar and interview room, and undertook interviews with participants using voice and text methods. 23 This approach to recruitment and data collection enables individuals from diverse geographical locations to participate, while remaining anonymous if they wish. Furthermore, for interviews conducted using text methods, transcription of the interview is not required as the researcher can save the written conversation with the participant, with the participant's consent. However, the researcher and participant need to be familiar with how the social virtual world works to engage in an interview this way.

Conducting an interview

Ensuring informed consent before any interview is a fundamental aspect of the research process. Participants in research must be afforded autonomy and respect; consent should be informed and voluntary. 24 Individuals should have the opportunity to read an information sheet about the study, ask questions, understand how their data will be stored and used, and know that they are free to withdraw at any point without reprisal. The qualitative researcher should take written consent before undertaking the interview. In a face-to-face interview, this is straightforward: the researcher and participant both sign copies of the consent form, keeping one each. However, this approach is less straightforward when the researcher and participant do not meet in person. A recent protocol paper outlined an approach for taking consent for telephone interviews, which involved: audio recording the participant agreeing to each point on the consent form; the researcher signing the consent form and keeping a copy; and posting a copy to the participant. 25 This process could be replicated in other interview studies using digital methods.

There are advantages and disadvantages of using face-to-face and digital methods for research interviews. Ultimately, for both approaches, the quality of the interview is determined by the researcher. 16 Appropriate training and preparation are thus required. Healthcare professionals can use their interpersonal communication skills when undertaking a research interview, particularly questioning, listening and conversing. 3 However, the purpose of an interview is to gain information about the study topic, 26 rather than offering help and advice. 3 The researcher therefore needs to listen attentively to participants, enabling them to describe their experience without interruption. 3 The use of active listening skills also help to facilitate the interview. 14 Spradley outlined elements and strategies for research interviews, 27 which are a useful guide for qualitative researchers:

Greeting and explaining the project/interview

Asking descriptive (broad), structural (explore response to descriptive) and contrast (difference between) questions

Asymmetry between the researcher and participant talking

Expressing interest and cultural ignorance

Repeating, restating and incorporating the participant's words when asking questions

Creating hypothetical situations

Asking friendly questions

Knowing when to leave.

For semi-structured interviews, a topic guide (also called an interview schedule) is used to guide the content of the interview – an example of a topic guide is outlined in Box 1 . The topic guide, usually based on the research questions, existing literature and, for healthcare professionals, their clinical experience, is developed by the research team. The topic guide should include open ended questions that elicit in-depth information, and offer participants the opportunity to talk about issues important to them. This is vital in qualitative research where the researcher is interested in exploring the experiences and perspectives of participants. It can be useful for qualitative researchers to pilot the topic guide with the first participants, 10 to ensure the questions are relevant and understandable, and amending the questions if required.

Regardless of the medium of interview, the researcher must consider the setting of the interview. For face-to-face interviews, this could be in the participant's home, in an office or another mutually convenient location. A quiet location is preferable to promote confidentiality, enable the researcher and participant to concentrate on the conversation, and to facilitate accurate audio-recording of the interview. For interviews using digital methods the same principles apply: a quiet, private space where the researcher and participant feel comfortable and confident to participate in an interview.

Box 1: Example of a topic guide

Study focus: Parents' experiences of brushing their child's (aged 0–5) teeth

1. Can you tell me about your experience of cleaning your child's teeth?

How old was your child when you started cleaning their teeth?

Why did you start cleaning their teeth at that point?

How often do you brush their teeth?

What do you use to brush their teeth and why?

2. Could you explain how you find cleaning your child's teeth?

Do you find anything difficult?

What makes cleaning their teeth easier for you?

3. How has your experience of cleaning your child's teeth changed over time?

Has it become easier or harder?

Have you changed how often and how you clean their teeth? If so, why?

4. Could you describe how your child finds having their teeth cleaned?

What do they enjoy about having their teeth cleaned?

Is there anything they find upsetting about having their teeth cleaned?

5. Where do you look for information/advice about cleaning your child's teeth?

What did your health visitor tell you about cleaning your child's teeth? (If anything)

What has the dentist told you about caring for your child's teeth? (If visited)

Have any family members given you advice about how to clean your child's teeth? If so, what did they tell you? Did you follow their advice?

6. Is there anything else you would like to discuss about this?

Focus groups

A focus group is a moderated group discussion on a pre-defined topic, for research purposes. 28 , 29 While not aligned to a particular qualitative methodology (for example, grounded theory or phenomenology) as such, focus groups are used increasingly in healthcare research, as they are useful for exploring collective perspectives, attitudes, behaviours and experiences. Consequently, they can yield rich, in-depth data and illuminate agreement and inconsistencies 28 within and, where appropriate, between groups. Examples include public perceptions of dental implants and subsequent impact on help-seeking and decision making, 30 and general dental practitioners' views on patient safety in dentistry. 31

Focus groups can be used alone or in conjunction with other methods, such as interviews or observations, and can therefore help to confirm, extend or enrich understanding and provide alternative insights. 28 The social interaction between participants often results in lively discussion and can therefore facilitate the collection of rich, meaningful data. However, they are complex to organise and manage, due to the number of participants, and may also be inappropriate for exploring particularly sensitive issues that many participants may feel uncomfortable about discussing in a group environment.

Focus groups are primarily undertaken face-to-face but can now also be undertaken online, using appropriate technologies such as email, bulletin boards, online research communities, chat rooms, discussion forums, social media and video conferencing. 32 Using such technologies, data collection can also be synchronous (for example, online discussions in 'real time') or, unlike traditional face-to-face focus groups, asynchronous (for example, online/email discussions in 'non-real time'). While many of the fundamental principles of focus group research are the same, regardless of how they are conducted, a number of subtle nuances are associated with the online medium. 32 Some of which are discussed further in the following sections.

Focus group considerations

Some key considerations associated with face-to-face focus groups are: how many participants are required; should participants within each group know each other (or not) and how many focus groups are needed within a single study? These issues are much debated and there is no definitive answer. However, the number of focus groups required will largely depend on the topic area, the depth and breadth of data needed, the desired level of participation required 29 and the necessity (or not) for data saturation.

The optimum group size is around six to eight participants (excluding researchers) but can work effectively with between three and 14 participants. 3 If the group is too small, it may limit discussion, but if it is too large, it may become disorganised and difficult to manage. It is, however, prudent to over-recruit for a focus group by approximately two to three participants, to allow for potential non-attenders. For many researchers, particularly novice researchers, group size may also be informed by pragmatic considerations, such as the type of study, resources available and moderator experience. 28 Similar size and mix considerations exist for online focus groups. Typically, synchronous online focus groups will have around three to eight participants but, as the discussion does not happen simultaneously, asynchronous groups may have as many as 10–30 participants. 33

The topic area and potential group interaction should guide group composition considerations. Pre-existing groups, where participants know each other (for example, work colleagues) may be easier to recruit, have shared experiences and may enjoy a familiarity, which facilitates discussion and/or the ability to challenge each other courteously. 3 However, if there is a potential power imbalance within the group or if existing group norms and hierarchies may adversely affect the ability of participants to speak freely, then 'stranger groups' (that is, where participants do not already know each other) may be more appropriate. 34 , 35

Focus group management

Face-to-face focus groups should normally be conducted by two researchers; a moderator and an observer. 28 The moderator facilitates group discussion, while the observer typically monitors group dynamics, behaviours, non-verbal cues, seating arrangements and speaking order, which is essential for transcription and analysis. The same principles of informed consent, as discussed in the interview section, also apply to focus groups, regardless of medium. However, the consent process for online discussions will probably be managed somewhat differently. For example, while an appropriate participant information leaflet (and consent form) would still be required, the process is likely to be managed electronically (for example, via email) and would need to specifically address issues relating to technology (for example, anonymity and use, storage and access to online data). 32

The venue in which a face to face focus group is conducted should be of a suitable size, private, quiet, free from distractions and in a collectively convenient location. It should also be conducted at a time appropriate for participants, 28 as this is likely to promote attendance. As with interviews, the same ethical considerations apply (as discussed earlier). However, online focus groups may present additional ethical challenges associated with issues such as informed consent, appropriate access and secure data storage. Further guidance can be found elsewhere. 8 , 32

Before the focus group commences, the researchers should establish rapport with participants, as this will help to put them at ease and result in a more meaningful discussion. Consequently, researchers should introduce themselves, provide further clarity about the study and how the process will work in practice and outline the 'ground rules'. Ground rules are designed to assist, not hinder, group discussion and typically include: 3 , 28 , 29

Discussions within the group are confidential to the group

Only one person can speak at a time

All participants should have sufficient opportunity to contribute

There should be no unnecessary interruptions while someone is speaking

Everyone can be expected to be listened to and their views respected

Challenging contrary opinions is appropriate, but ridiculing is not.

Moderating a focus group requires considered management and good interpersonal skills to help guide the discussion and, where appropriate, keep it sufficiently focused. Avoid, therefore, participating, leading, expressing personal opinions or correcting participants' knowledge 3 , 28 as this may bias the process. A relaxed, interested demeanour will also help participants to feel comfortable and promote candid discourse. Moderators should also prevent the discussion being dominated by any one person, ensure differences of opinions are discussed fairly and, if required, encourage reticent participants to contribute. 3 Asking open questions, reflecting on significant issues, inviting further debate, probing responses accordingly, and seeking further clarification, as and where appropriate, will help to obtain sufficient depth and insight into the topic area.

Moderating online focus groups requires comparable skills, particularly if the discussion is synchronous, as the discussion may be dominated by those who can type proficiently. 36 It is therefore important that sufficient time and respect is accorded to those who may not be able to type as quickly. Asynchronous discussions are usually less problematic in this respect, as interactions are less instant. However, moderating an asynchronous discussion presents additional challenges, particularly if participants are geographically dispersed, as they may be online at different times. Consequently, the moderator will not always be present and the discussion may therefore need to occur over several days, which can be difficult to manage and facilitate and invariably requires considerable flexibility. 32 It is also worth recognising that establishing rapport with participants via online medium is often more challenging than via face-to-face and may therefore require additional time, skills, effort and consideration.

As with research interviews, focus groups should be guided by an appropriate interview schedule, as discussed earlier in the paper. For example, the schedule will usually be informed by the review of the literature and study aims, and will merely provide a topic guide to help inform subsequent discussions. To provide a verbatim account of the discussion, focus groups must be recorded, using an audio-recorder with a good quality multi-directional microphone. While videotaping is possible, some participants may find it obtrusive, 3 which may adversely affect group dynamics. The use (or not) of a video recorder, should therefore be carefully considered.

At the end of the focus group, a few minutes should be spent rounding up and reflecting on the discussion. 28 Depending on the topic area, it is possible that some participants may have revealed deeply personal issues and may therefore require further help and support, such as a constructive debrief or possibly even referral on to a relevant third party. It is also possible that some participants may feel that the discussion did not adequately reflect their views and, consequently, may no longer wish to be associated with the study. 28 Such occurrences are likely to be uncommon, but should they arise, it is important to further discuss any concerns and, if appropriate, offer them the opportunity to withdraw (including any data relating to them) from the study. Immediately after the discussion, researchers should compile notes regarding thoughts and ideas about the focus group, which can assist with data analysis and, if appropriate, any further data collection.

Qualitative research is increasingly being utilised within dental research to explore the experiences, perspectives, motivations and beliefs of participants. The contributions of qualitative research to evidence-based practice are increasingly being recognised, both as standalone research and as part of larger mixed-method studies, including clinical trials. Interviews and focus groups remain commonly used data collection methods in qualitative research, and with the advent of digital technologies, their utilisation continues to evolve. However, digital methods of qualitative data collection present additional methodological, ethical and practical considerations, but also potentially offer considerable flexibility to participants and researchers. Consequently, regardless of format, qualitative methods have significant potential to inform important areas of dental practice, policy and further related research.

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Gill, P., Baillie, J. Interviews and focus groups in qualitative research: an update for the digital age. Br Dent J 225 , 668–672 (2018). https://doi.org/10.1038/sj.bdj.2018.815

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The qualitative research interview

Affiliation.

1 Department of Family Medicine, University of Medicine and Dentistry at Robert Wood Johnson Medical School, Somerset, New Jersey 08873, USA. [email protected]
PMID: 16573666
DOI: 10.1111/j.1365-2929.2006.02418.x

Background: Interviews are among the most familiar strategies for collecting qualitative data. The different qualitative interviewing strategies in common use emerged from diverse disciplinary perspectives resulting in a wide variation among interviewing approaches. Unlike the highly structured survey interviews and questionnaires used in epidemiology and most health services research, we examine less structured interview strategies in which the person interviewed is more a participant in meaning making than a conduit from which information is retrieved.

Purpose: In this article we briefly review the more common qualitative interview methods and then focus on the widely used individual face-to-face in-depth interview, which seeks to foster learning about individual experiences and perspectives on a given set of issues. We discuss methods for conducting in-depth interviews and consider relevant ethical issues with particular regard to the rights and protection of the participants.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Data Collection / methods
Ethics, Research
Interpersonal Relations
Interviews as Topic / methods*
Qualitative Research*

Grants and funding

1D12HP00167/PHS HHS/United States

9 methodologies for a successful qualitative research assignment

Qualitative research is important in the educational and scientific domains. It enables a deeper understanding of phenomena, experiences, and context. Many researchers employ such research activities in the fields of history, sociology, and anthropology. For such researchers, learning quality analysis insights is crucial. This way, they can perform well throughout their research journey. Writing a qualitative research assignment is one such way to practice qualitative interpretations. When students address various qualitative questions in these projects, they become efficient in conducting these activities at a higher level, such as for a master’s or Ph.D. thesis.

The FormPlus highlights why researchers prefer qualitative research over quantitative research. It is faster, scientific, objective, focused, and acceptable. Researchers who don’t know what to expect from the research outcomes usually choose qualitative research. In this guide, we will discuss the top methodologies that students can employ while writing their qualitative research assignments. This way, you can write an appealing document that perfectly demonstrates your qualitative research skills.

However, being stressed with academic and daily life commitments, if you find it challenging to manage time exclusively for such projects, availing of assignment writing services can make it manageable. Instead of doing anything wrong in the hustle, get it done by the professionals specifically working to handle these academic write-ups. Now, let’s define quality research before we discuss the actual topic.

What is meant by qualitative research?

Quality research is a market research method that gathers data from conversational and open-ended communication. In simple words, it is about what people think and why they think so. It relates to the nature or standard of something rather than dealing with its quantity. Such researchers collect nonnumerical data to understand opinions, concepts, and ideas.

How do you write a qualitative research assignment? Top 9 methodologies

Writing an assignment requires your command of various tasks. Qualitative research assignment design involves research, writing, structuring, and providing citations of the resources used. Assignment writing plays a crucial role in upgrading your grades.

So, you must make it accurate and authentic. Write it with the utmost care without skipping any important aspects. Sometimes, it can be hard, but it becomes easy if you correctly use effective methodologies. This is why we have brought together some of the common methodologies you can use to write your qualitative research assignments.

1. Interviews

A qualitative interview is mostly used in projects that involve market research. In this study personal interaction is required to collect in-depth information of the participants. In qualitative research for assignment, consider the interview as a personal form of research agenda rather than a focused group study. A qualitative interview requires careful planning so that you can gather meaningful data.

Here are the simple steps to consider for its implementation in a qualitative research assignment:

Define research objectives.
Identify the target population.
Obtain informed consent of participants.
Make an interview guideline.
Select a suitable location.
Conduct the interview.
Show respect for participant’s perspectives.
Analyse the data.

2. Observation

In qualitative observation, the researcher gathers data from five senses: sight, hearing, touch, smell, and taste. It is a subject approach that depends on the sensory organ of the researcher. This method allows you to better understand the culture, process, and people under study. Some of its characteristics to consider for writing a qualitative research assignment include,

It is a naturalistic inquiry of the participants in a natural environment.
This approach is subjective and depends on the researcher’s observation.
It does not seek a definite answer to a query.
The researcher can recognise their own biases when compiling findings.

3. Questionnaires

In this type of survey, the researcher asks open-ended questions to participants. This way, they price the long written or typed document. In writing qualitative research assignments, these questions aim to reveal the participants’ narratives and experiences. Once you know what type of information you need, you can start curating your questionnaire form. The questions must be specific and clear enough that the participants can comprehend them.

Below are the main points that must be considered when creating qualitative research questionnaires.

Avoid jargon and ambiguity in the questions.
Each question should contribute to the research objectives.
Use simple language.
The questions should be neutral and unbiased.
Be precise, as the complex questions can overwhelm the respondents.
Always conduct a pilot test.
Put yourself in the respondent’s shoes while asking questions.

4. Case Study

A case study is a detailed analysis of a person, place, thing, organisation, or phenomenon. This method is appropriate when you want to gain a contextual, concrete, and in-depth understanding of the real-world problem for writing your qualitative research assignment. This method is especially helpful when you need more time to conduct large-scale research activities.

The four crucial steps below can be followed up with this methodology.

Select a case that has the potential to provide new and unexpected insights into the subject.
Make a theoretical framework.
Collect your data from various primary and secondary resources.
Describe and analyse the case to provide a clear picture of the subject.

5. Focus Groups

Focused group research has some interesting properties. In this method, a planned interview is conducted within a small group. For this purpose, some of the participants are sampled from the study population to record data for writing a qualitative research assignment. Typically, a focused group has features like,

At least four to ten participants must meet for up to two hours.
There must be a facilitator who can guide the discussion by asking open-ended questions.
The emphasis must be put on the group discussion rather than the discussion of the group members with the facilitator.
The discussion should be recorded and transcribed by the researchers.

6. Ethnographic Research

It is the most in-depth research method that involves studying people in their natural environment. It requires the researcher to adopt the target audience environment. The environment can be anything from an organisation to a city or any remote location.

However, the geographical constraints can be a problem in this study. For students who are writing their qualitative research assignment, some of the features of ethnographic research to write in their document include,

The researcher can get a more realistic picture of the study.
It uncovers extremely valuable insights.
Provides accurate predictions.
You can extend the observation to create more in-depth data.
You can interact with people within a particular context.

7. Record Keeping

This method is similar to going to the library to collect data from books. You consult various relayed books, note the important points, and take note of the referencing. So, the researcher uses already existing data rather than introducing new things in the field.

Later on, this data can be used to conduct new research. Yet, when faced with the vast resources available in your institution’s library, seeking assistance from UK-based assignment writing services is an excellent solution if you need help pinpointing the most relevant information for your topic. Proficient in data gathering and adept at structuring qualitative research assignments, these professionals can significantly elevate your academic results.

This method is mostly used by companies to understand a group of customers’ behaviour, characteristics, and motivation. It allows respondents to ask in-depth questions about their experience. In a business market, it helps you understand how your customers make decisions. The intent is to understand them at their level and make related changes in your setup. The researcher must ask generic and precise questions that have a clear purpose.

Consider the below examples of qualitative survey questions. It can be useful in recording data and writing qualitative research assignments.

Why did you buy this skin care product?
What is the overall narrative of this brand?
How do you feel after buying this product?
What sets this brand apart from others?
How will this product fulfil your needs?
What are the things that you expect from this brand to grant you?

9. Action Research

This method involves collaboration and empowerment of the participants. It is mostly appropriate for marginalised groups where there is no flexibility.

The primary characteristics of the action research that can be quoted in your qualitative research assignment include,

It is action-oriented, and participants are actively involved in the research.
There is a collaborative process between participants and researchers.
The nature of action research is flexible to the changing situation.

However, the survey also accompanies some of the limitations, including,

The researcher can misinterpret the open-ended questions.
The data ownership between the researcher and participants needs to be negotiated.
The ethical considerations must be kept.
It is not considered a scientific method as it is fluid in data collection. Consequently, it may not attract the finding.

What is the difference between quantitative and qualitative research?

Both research types share the common aim of knowledge acquisition. In quantitative research, the use of numbers and objective measures is used. It seeks answers to questions like when and where.

On the other hand, in qualitative research, the researcher is concerned with subjective phenomena. Such data can’t be numerically measured. For example, you might conduct a survey to analyse how different people experience grief.

What are the 4 types of qualitative research?

There are various types of qualitative research. It may include,

● Phenomenological studies:

It examines the human experience via description provided by the people involved. These are the lived experiences of the people. It is usually used in research areas where little knowledge is known.

● Ethnographic studies:

It involves the analysis of data about cultural groups. In such analysis, the researcher mostly lives with different communities and becomes part of their culture to provide solid interpretations.

● Grounded theory studies:

In this qualitative approach, the researcher collects and analyses the data. Later on, a theory is developed that is grounded in the data. It used both inductive and deductive approaches for theory development.

● Historical studies:

It is concerned with the location, identification, evaluation, and synthesis of data from the past. These researchers are not concerned with discovering past events but with relating these events to the present happenings.

The Research Gate provides a flow chart illustrating various qualitative research methods.

What are The 7 characteristics of qualitative research?

The following are some of the distinct features of qualitative research. You can write about them in your qualitative research assignment, as they are collected from reliable sources.

It can even capture the changing attitude within the target group.
It is beyond the limitations associated with quantitative research
It explains something that numbers alone can’t describe.
It is a flexible approach to improve the outcomes.
A researcher is not supposed to become more speculative about the results.
This approach is more targeted.
It keeps the cost of data collection down.

What are the advantages and disadvantages of qualitative research?

The pros of qualitative research can’t be denied. However, some cons are also associated with this research.

Explore attitudes and behaviours in depth.
It encourages discussions for better results.
Generate descriptive data that can formulate new theories.
The small sample size can be a problem.
Bias in the sample collection.
Lack of privacy if you are covering a sensitive topic.

Qualitative research assignment examples

The Afe Babalola University ePortal provides an example of a qualitative assignment. Here is the description of quality questions and related answers. You can get an idea about how to handle your quality research assignment project with this sample.

The questions asked in the paper are displayed below.

The Slide Team presents a template for further compressing other details, such as the qualitative research assignment template. You can use it to make your presentation look professional.

Writing a qualitative research assignment is crucial, especially if you want to engage in research activities for your master’s thesis. Most researchers choose this method because of the associated credibility and reliability of the results. In the above guide, we have discussed some of the prominent features of this method. All of the given data can help you in writing your assignments. We have discussed the benefits of each methodology and a brief account of how you can carry it.

However, even after going through this whole guideline, if the concepts of the Qualitative Research methods assignment seem ambiguous and you think you can’t write a good project, then ask professional to “ write my assignment .” These experts can consult the best sources for the data collection of your project. Consequently, they will deliver you the winning document that can stand out among other write-ups.

Open access
Published: 09 April 2024

A qualitative study on the health system-related needs in women survivors of rape

Leila Asadi 1 , 2 ,
Mahnaz Noroozi 3 ,
Hajar Salimi 4 ,
Sara Jambarsang 5 &
Fardin Mardani 6

BMC Health Services Research volume 24 , Article number: 443 ( 2024 ) Cite this article

Metrics details

Rape, as an adverse incidence, leads to irreparable complications and consequences in women. Provision of health services to women survivors of rape requires catering for their real needs and identifying current deficits as well as barriers. The present study aimed to explore health system-related needs in women survivors of rape.

In the present qualitative study, the participants consisted of 39 individuals, including 19 women survivors of rape and 20 individuals with work experience in providing services to women survivors of rape. The participants were selected using the purposive sampling method with a maximum variation in Isfahan, Iran. Data were collected through in-depth interviews as well as field notes and were concurrently analyzed via conventional qualitative content analysis method.

After analyzing the interviews, the health system-related needs of women survivors of rape were classified into two main categories: 1- The need for efficient medical care services with three sub-categories, namely “receiving services with respect for privacy and confidentiality”, “non-judgmental behavior and approach”, and “the need to receive empathy and the feeling of not being alone”, and 2- The need for desirable conditions and structure to provide services with two sub-categories, namely “the need to receive comprehensive and integrated services”, and “establishing specialized centers for providing services to survivors”.

Conclusions

Overall, explaining and highlighting the health system-related needs of women survivors of rape could provide a suitable basis for policy-making and planning according to their real needs. Receiving continuous services in separate centers with confidentiality and empathy could reduce the worries and concerns of women survivors of rape and help improve their health.

Peer Review reports

Rape, as a violation of health and human rights, affects numerous women worldwide [ 1 ]. The prevalence of rape is different in every region in the world. Dworkin et al., who studied the prevalence of rape based on studies in the last 10 years, reported a mean rape prevalence of 29% in women in different countries, and 59% in some countries, including South Africa, indicating a very high prevalence of rape in this region [ 2 ]. Statistics related to rape in many countries are not accurate for various reasons such as lack of reporting by survivors. It is believed that about 80% of rape cases go unreported for various reasons [ 3 , 4 ]. In Iran, as with many countries in the world, due to the taboo and fear of social stigma, there are no accurate and reliable statistics on rape cases. Nevertheless, the lack of statistics is not a reason for the absence of such a problem. In some studies, incest rates are reported to be about 22–25% [ 5 ].

Women survivors of rape experience a large number of short and long-term consequences in different aspects of health [ 6 ]. The most important psychological consequences include post-traumatic stress disorder (PTSD), as well as other anxiety disorders, depression, and suicide [ 7 , 8 , 9 , 10 , 11 ]. Other implications include sexually transmitted infections (STIs), HIV/AIDS, chronic diseases, physical injuries to the body and genital area, unwanted pregnancy, and unsafe abortion [ 12 , 13 , 14 , 15 ].

Even though rape is a very important threat to the health of many women, the use of health services is very low among survivors in many societies [ 16 , 17 ]. The provision of health services to survivors of gender-based violence, including rape, has been significantly developed since 2000 thanks to the extensive activity of reproductive health activists. Based on a global evaluation of sexual and reproductive health in 2004, the clinical management of rape in humanitarian settings is associated with many deficits, but such services were more widely available 10 years later [ 18 ]. Despite the considerable developments, the provision of suitable services to survivors faces problems owing to several reasons, including insufficient budgets of countries, lack of correct referral of survivors, limited supply and stock of drugs, and gender biases in societies [ 19 , 20 ]. The survivors also seldom use these services even in countries where such barriers have been removed [ 19 ]. Women survivors of rape face numerous barriers to receiving health services, including stigma, rejection, and non-confidentiality, leading to under usage of health services by survivors [ 20 ]. Meanwhile, the needs of women survivors of rape should be recognized and they should receive suitable services and support according to their needs. Providing services while neglecting their needs will cause them to be re-victimized and suffer more injuries [ 21 ].

Knowledge about perceptions and experiences of women survivors of rape regarding services, as well as the existing barriers and deficits in healthcare systems is significantly important in comprehensive and cultural-based interventions for improving health services, and ultimately, their health. There is little research on the proper and desirable services of this group of women, and it is not yet clear whether the existing services are fully tailored to their needs. Qualitative research is an approach to discovering and describing the experiences of participants and conceptualizing them. It could enhance insight, perception, and knowledge of human experiences [ 22 ]. Considering the differences in the social and cultural context of Iran with other countries as well as the importance of sexual and reproductive health of women survivors of rape, this qualitative study aimed to explore the health system-related needs of women survivors of rape.

This research was part of a large mixed-methods study conducted with a content analysis approach from November 2021 to August 2022.

Settings, sample, and recruitment

The participants of the study included women survivors of rape ( n = 19) and individuals with work experience in providing services to them ( n = 20) in Isfahan, Iran. The selection of rape survivors began through purposive sampling and then continued with a strategy of maximum variation regarding age, job, education level, marital status, number of pregnancies and deliveries, and length of time after rape. Subsequently, a number of participants were included in the research using the snowball method based on the introduction of the primary participants. The inclusion criteria for women survivors of rape were informed consent and willingness to participate in the interview, being able to communicate and express experiences of rape, Iranian nationality (due to the difference in the needs of rape survivors according to cultural and social conditions and background), being 21 years old or older during the research [ 23 ], a minimum of 6 months and a maximum of 2 years past the rape [ 10 , 24 ], lack of well-known psychological disorders and a history of psychiatric treatment before rape or now (based on the participant’s report), no previous experience of rape, and no experience of adverse incidents in life (death of a family member, etc.) over the past three months. Exclusion criteria included reluctance to continue participation in the study at any stage of the study. Service providers were also first selected via purposive sampling, and then sampling continued with a strategy of maximum variation in terms of work experience. Inclusion criteria for service providers included willingness to participate in the study plus having expertise and work experience in the field of rape.

In the present study, access to the participants was done through the special counseling centers for vulnerable women, Drop in Centers (DIC), addiction treatment centers, social emergency, together with women’s rehabilitation centers, midwives and reproductive health specialists’ offices, counseling and midwifery service centers, emergency and women’s and midwifery clinics of hospitals, legal medicine centers, counseling centers for behavioral diseases, private offices of general practitioners and specialists (obstetrics and gynecology, infectious diseases and psychiatry), psychology and counseling centers, guidance and counseling centers at universities, social deputy of the Law Enforcement Force, and Crime Prevention Unit (affiliated to the judicial system) of Isfahan city. In these centers, participants were invited to the study through phone calls. In order to maintain confidentiality, phone calls were made to the women survivors of rape and the criteria for their entry into the research were checked by the service providers working in the centers; the researcher was able to access their contact information only after obtaining informed consent from the survivors. In the present study, no one refused to participate or dropped out of this study once they were recruited to participate. The first author (L.A) had no previous relationship with the participants and centers.

Data collection

In the present study, data collection methods included semi-structured in-depth interviews and field notes. The first author (L.A) conducted the interviews and filed notes. She had 11 years of working experience in midwifery and was a Ph.D. candidate in reproductive health in Isfahan University of Medical Sciences. Four other authors had previous experience in qualitative paper/report writing and interviewing. Prior to data collection, the first author (L.A) wrote down initial preconceptions about the study topic based on her previous working experience and from literature review. Questions, prompts, and guides were provided and this was piloted in two pilot interviews. Interviews with women survivors of rape began with the general questions: “What problems have you faced in receiving health services since this incident (rape)? What needs did you feel in this regard? Please explain it.“ , and then the participants’ open and interpretative answers guided the process. The interviews with service providers began with the general question: “ What do you think women, who have experienced rape, need about the healthcare system? Please explain it.“ , and then the participants’ open and interpretative answers guided the process. All interviews were digitally recorded using an MP4 device. In this research, 39 interviews (lasting 45 to 60 min) were conducted in participants’ preferred places (such as parks). No one else was present at the interview besides the participants and the researchers. The interviews continued until data saturation was reached by interviewing 36 persons, with no new code being formed, and all codes previously obtained and duplicated. However, to avoid false data saturation, the researchers conducted another three interviews after repletion of codes in interview NO.36, to be more confident of achieving accurate data saturation, with no new data in the next three interviews. At this point, the researchers concluded that they would stop the data collection and analysis since data saturation had been obtained. In the present study, the first author (L.A) recorded observations of participants’ non-verbal behavior and interaction in field notes.

Data analysis

In the present study, conventional qualitative content analysis based on the method by Graneheim and Lundman was used to analyze the data [ 25 ]. Data analysis was performed manually where no software was used. The data were regularly transcribed after each interview. Then, the interviews were read repeatedly to obtain a complete understanding of them. Sentences and expressions were coded by the first author (L.A) and after the formation of codes by the inductive method, similar codes were merged; those with similar meanings were placed in one category and created sub-categories. Thereafter, the conceptually similar categories were placed in a main category and constituted the main categories.

Rigor and trustworthiness

A variety of methods, including in-depth interviews at different times and places, field notes, and selecting participants with a maximum variation were utilized to validate the results. In the present study, the results were presented to three women survivors of rape with the same characteristics as the participants, who did not participate in the study, to judge the similarity of the study results with their own experiences so that the transferability could improve. To enhance the confirmability of the data, coded interviews were discussed with five participants in other meetings and their final comments were summarized to achieve a review by participants. To augment the dependability of the results, the opinions of five experts were used to match and ensure the consistency of the results with the participants’ statements.

Ethical considerations

The research was approved by the ethics committee of Isfahan University of Medical Sciences (approval code: IR.MUI.NUREMA.REC.1400.133). Informed consent, right to withdraw at any time, confidentiality, and preservation of anonymity were respected in this research. The objectives for the study were explained prior to each individual interview.

The demographic characteristics of the participants are reported in Table 1 . A total of 34 inferential codes, five sub-categories, and two main categories were extracted after data analysis. The two main categories included “The need for efficient medical care services” and “The need for desirable conditions and structure to provide services” (Table 2 ).

1-The need for efficient medical care services

According to the participants, the health services provided to the survivors were inefficient and did not meet their needs. Many of the participating survivors expressed their discomfort with the lack of respect for privacy and confidentiality while receiving services, recording personal information when providing services, wrong behaviors and judgments, and lack of understanding, acceptance, and empathy. Further, many of these women faced such issues when going to the centers, then left the center or gave up receiving health services. This main category was composed of three sub-categories, namely “receiving services with respect for privacy and confidentiality”, “non-judgmental behavior and approach”, and “the need to receive empathy and the feeling of not being alone”.

A-Receiving services with respect for privacy and confidentiality

Participating rape survivors were worried about the disclosure of their names and identity when visiting healthcare centers. They expressed that they needed special attention from service providers to maintain confidentiality and non-disclosure of their identity information at all stages. For this reason, many of them had refused to go to pharmacies and health centers owing to being worried about their identity information being revealed.

“I was frightened to go to the doctor. I was afraid that someone might know my name. For example, I used to say (to myself) that they would know my name and recognize me, lest they wrote my name in a list.” (A 37-year-old survivor) . “… I was worried that if I go to the pharmacy to buy pills or go to the doctor, my information would be read and they would record what medicine I took.” (A 35-year-old survivor) .

The service providers narrated that most survivors of rape were worried about the disclosure of their identity when they were in healthcare centers, and thus they often refused to continue attending those centers and received incomplete services.

“… When the result of their HIV or HBS Ag tests are positive and we inform them, either they don’t come to receive medication and continue treatment and we have to follow up regularly, or they insist on not recording their test results in their files.” (Midwife) .

B-Non-judgmental behavior and approach

According to most participating survivors, when they received healthcare services, they face service providers’ judgmental behavior which was very annoying for them. They were dissatisfied with the fact that they were considered guilty in the incident of rape and the behavior of health service providers that made them feel guilty. Therefore, they did not express real health problems and needs due to the worry and embarrassment of being judged.

“… When I went to the pharmacy and took pills, that man looked at me in an unsatisfactory way. In these cases, society looks at girls very badly. They always think that it is often due to girls’ fault. “(A 37-year-old survivor) . “… When I went to the laboratory, they didn’t treat me well. They never talked to me. I gave the doctor’s prescription to take a specimen from me. After reading, he looked at me and just said: Go sit in the room. His behavior was annoying.” (A 25-year-old survivor) .

The service providers argued that behavior with judgment and blame could be barriers to receiving correct healthcare services in survivors. When survivors were faced with such blaming behavior combined with judgment, they would have doubts about disclosing the rape, leading them to postpone receiving healthcare services.

“… I had clients who came with other complaints, including anxiety and stress. When they received empathy and non-judgment, they slowly started to reveal the rape and ask for help.” (Psychiatrist) .

C-The need to receive empathy and the feeling of not being alone

The participating rape survivors narrated that they needed to receive empathy from service providers due to the bitter experience of rape. Many of them expressed that they needed service providers to understand their situation and empathize so that they felt they were not the only people who were raped. They needed to receive the necessary support resources to disclose the rape incidence in the healthcare system. Many of them were annoyed by the lack of empathy. An important negative experience of these women about not receiving empathy was during the virginity examination.

“… Here (The Forensic Medicine Organization), they didn’t pay attention to my feelings, nor to my voice and cries, and said like a normal patient, go upstairs and sleep. I had never been examined. My hands and legs were shaking.” (A 21-year-old survivor) .

The service providers argued that if rape survivors received empathy and support from service providers, they would attend diagnostic and treatment processes more favorably and make more efforts to improve their health status.

“Our behavior in the first meetings definitely has a great effect on not abandoning the person. When a person finds out we understand her and that she is not alone, it will definitely facilitate her future visits. In these women, not leaving care and follow-up is very important, where understanding and empathy with the surviving person should be a high priority for us.” (Psychiatrist) .

2-The need for desirable conditions and structure to provide services

According to the results, healthcare services must be provided in optimal conditions and structures to meet the maximum needs of rape survivors. According to the participants, the current structure of health services did not fully cover the rape survivors’ needs and it required changes. This main category was obtained from the two sub-categories, namely “the need to receive comprehensive and integrated services”, and “establishing specialized centers for providing services to survivors”.

A-The need to receive comprehensive and integrated services

The participating rape survivors narrated that they were referred to different centers (including private clinics and offices, behavioral disease centers, medical centers, and centers affiliated with the welfare organization) to receive health services, and in each center, they received separate services that sometimes overlapped with other services. Based on the results, not only this issue led to spending a lot of time and money for the survivors, the lack of integrated services caused failure in receiving some essential services (e.g. diagnosis and treatment of STIs, contraception, supportive and psychological services). The impossibility of follow-up, failure to examine the survivors’ real needs at different stages after the rape, and providing interrupted services regardless of personal records were the most important disadvantages of such services.

“… After my presence in the Forensic Medicine Organization, I went to the gynecologist’s office, and she gave me medicine for the infection. After some time, I still had a vaginal discharge. With my friend’s advice, I went to the infectious disease specialist and now I am taking a new medicine, but I still haven’t seen any difference.” (A 38-year-old survivor) .

According to participating service providers, survivors of rape needed to receive comprehensive and integrated services provided by a team with different specialists comprising a gynecologist, a forensic medicine specialist, a psychiatrist, a social worker, and a psychologist to enhance their access to all necessary services and prevent long-term complications. They also recommended the establishment of centers for survivors of rape to provide services to them with long-term continuous follow-up.

“The services and support for these women should be presented by a more specialized organization or group; hence, when these women visit, they know that the services are provided in a package, and all of their issues will be resolved without any problems.” (A forensic medicine specialist) . “… The services for these women need to be presented by a team. Comprehensive, complete, and timely services should be provided, and this team should consist of gynecologists, social workers, psychologists, forensic medicine specialists, and psychiatrists.” (Psychiatrist) .

B- establishing specialized centers for providing services to survivors

The lack of specialized centers to provide services to women survivors of rape is another deficiency of the healthcare systems which was taken into account and stated by the participating rape survivors.

“… In my opinion, I wish the Forensic Medicine Organization would follow up on the issue. I wish they had a consultant here who would follow up on our bad situation and we could follow up on the spot because we don’t like to talk about this issue everywhere.” (A 23-year-old survivor) .

The participating service providers argued that due to the rape survivors’ need to visit psychological, gynecological, midwifery, and laboratory centers to receive a variety of services, many of them did not present to these centers and missed necessary services due to the lack of special service centers. Also, they emphasized consideration of centers specialized in providing services to women survivors of rape.

“… Most of the visiting survivors finally reach us after wandering around and visiting different centers and places.” (Gynecologist) . “The (health) system should move towards a separate center for these women to receive necessary procedures and consultations so that when the examination is conducted (legally), this person knows that she does not need to go elsewhere to prevent pregnancy and infections.” (A forensic medicine specialist) .

The present study aimed to explore the health system-related needs of women survivors of rape. The results indicated that women survivors of rape needed desirable, structured, and efficient care as well as treatment services. Survivors participating in the present study had experiences of non-preserved confidentiality, non-respected privacy, and blaming behaviors far from empathy in receiving healthcare services. There is a belief that women survivors of rape have many unmet physical and psychological needs making them dependent on health care systems. These needs should be identified and resolved in cultural contexts [ 26 ]. In this regard, the results of a systematic review by Bach et al. indicated that service providers’ insufficient knowledge about the way of empathizing with rape survivors without judgment and preserving confidentiality was an important barrier to survivors receiving healthcare services [ 27 ]. Conducting an exploratory descriptive qualitative study through interviews with survivors of rape, Sebaeng et al. reported that health service providers should be sensitive to problems experienced by women survivors of rape, not consider them as survivors of the crime scene, nor think of just collecting medical and legal evidence as their duties [ 28 ]. Polite et al. also confirmed that physicians and service providers not only must comply with medical and judicial guidelines and perform their therapeutic duties, but also should provide support and build trust through understanding, empathy, and non-judgment of the survivors [ 29 ]. Munala et al. reported that survivors of rape were concerned about the attitude of physicians and healthcare providers, normalization of rape, and blaming them [ 30 ]. Ferdowsian et al. found that profession was significantly associated with beliefs and attitudes about sexual violence and survivors. Law enforcement professionals were more likely than health professionals and lawyers to indicate that survivors should feel ashamed [ 31 ]. Thus, women survivors of rape need to receive survivor-based healthcare services which include non-judgmental and empathic behaviors. Health service providers should be supportive, not judge the survivors, and consider survivors’ dignity while providing services to bring aobut an efficient service procedure. It seems that the existing health services for women survivors of rape in Iran need detailed policies and plans based on women , s needs, since the absence or incomplete health services can re-victimize and have many consequences for them. The results of the present study emphasized providing survivor-based medical care services for women survivors of rape since the way of providing services to survivors greatly contributed to the process of incident disclosure by survivors and their presence in the next meetings and follow-ups. Also, our findings suggest a need for interventions that adequately address potentially harmful beliefs as well as attitudes of some professionals serving women survivors of rape.

The present study also found that the necessary services for women survivors of rape should be comprehensive, integrated, and be provided by a team. Furthermore, these services should be provided in specialized centers that were specific to women survivors of rape. In this way, they would be assured of the provision of necessary and efficient services with long-term continuous follow-up. Sebaeng et al. study also indicated that survivors of rape needed to receive healthcare services through integrated specialized “Sexual Assault Response Teams (SART)” which provide all integrated services in teams by different specialists in separate centers to enhance the survivors’ access to all essential services and prevent long-term complications [ 28 ]. Shahali evaluated the healthcare providers’ experiences in dealing with survivors of rape and reported that two important barriers for survivors to receive health services included the lack of a single center for the provision of essential healthcare services to survivors of rape and the lack of organized guidelines for interdepartmental interaction [ 32 ]. Sepeng et al. in a study in Africa reported that most rape survivors received managed care for acute psychological health problems, injuries, pregnancy, STIs, and HIV; however, few survivors of rape received managed psychological healthcare during follow-up care sessions. They attributed the low attendance of survivors in psychological follow-up sessions to the lack of an integrated and continuous medical care system [ 33 ]. Ades et al. observed that even though patients with a history of sexual assault often had essential health needs, which continued long after the traumatic incident, most of the available services to survivors of rape only focused on acute care immediately after the violence, and a few clinics managed long-term medical outcomes and consequences of rape in a specialized trauma center [ 34 ]. Bougard et al. evaluated the quality of service provision in comprehensive multi-specialty centers for providing integrated rape services in South Africa and reported that the quality of service provision was satisfactory in these specialized centers, and survivors were highly satisfied with the available services as they received all services in a specialized center [ 35 ]. The results of the present study emphasized women survivors of rape need care and treatment services according to their basic needs in such a way that continuous services and long-term follow-up are provided with respect for confidentiality and privacy without judgment, stigma, and blame. Also, establishing specialized centers, which provide all required healthcare services to women survivors of rape, is particularly important in improving the quality of care for these women in Iran.

Practical implications

Recognizing health system-related needs in women survivors of rape could facilitate evidence-based policymaking, planning, and making necessary changes in the health system. In addition, the results of the present study can help service providers understand, evaluate, and recognize the needs of women survivors of rape so that they can try to meet these needs and solve existing problems to improve women’s health. It is expected that the results of the present study will be utilized as a basis for conducting wider and more comprehensive studies about women survivors of rape and result in the identification of newer research domains. Future studies are suggested to design, conduct, and evaluate effective survivor-based health programs for women survivors of rape in Iran.

Strengths and limitations

Through presenting an image of health system-related needs in women survivors of rape for the first time in Iran, the present study could contribute to designing the necessary interventions to improve health of these women. The most important limitation of the present study was the survivors’ shame or modesty to talk about the rape due to cultural and social taboos in Iran. Therefore, attempts were made to build the participants’ trust by providing explanations about the importance of the issue, committing the researchers to preserve confidentiality, as well as providing a safe and calm space for effective communication. Furthermore, researchers faced difficulties in obtaining permission to access participants in a number of research environments. In this sense, the researchers had to attend the centers that had issued sampling permits as well as reached the participants using the snowball sampling method.

Based on the results of the present study, necessary measures should be taken to provide efficient medical care services to women survivors of rape and develop a desirable structure for providing health services in such a way that they can receive necessary services continuously in special centers with confidentiality and empathy. These results can be helpful for policy-making, planning, designing successful interventions, as well as providing basic and comprehensive care programs to improve women’s health.

Data availability

The datasets generated and/or analyzed during the current research are not publicly available as individual privacy could be compromised but are available from the corresponding author on reasonable request.

Abbreviations

Post-Traumatic Stress Disorder

Sexually Transmitted Infections

Drop-in Centers

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Acknowledgements

We should thank the Vice-chancellor for Research of Isfahan University of Medical Sciences for their support.

Financial support by Isfahan University of Medical Sciences, Research proposal No: 3400527.

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Leila Asadi

Research Center for Nursing and Midwifery Care, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran

Mahnaz Noroozi

Behavioral Sciences Research Center, Department of Psychiatry, Isfahan University of Medical Sciences, Isfahan, Iran

Hajar Salimi

Research Center of Prevention and Epidemiology of Non-Communicable Disease, Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

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Forensic Medicine Research Center, Isfahan, Iran

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All the authors contributed to the conception and design of the study. L.A drafted the first version of the manuscript. M.N, H.S, F.M and S.J revised the manuscript. M.N critically reviewed the manuscript for important intellectual content. All authors approved the final version.

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Correspondence to Mahnaz Noroozi .

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The Ethics Committee of the Isfahan University of Medical Sciences in Isfahan, Iran approved the protocol of this study (code number: IR.MUI.NUREMA.REC.1400.133). Written informed consent is taken from each participant. In this study, all methods were carried out in accordance with the Declaration of Helsinki.

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Asadi, L., Noroozi, M., Salimi, H. et al. A qualitative study on the health system-related needs in women survivors of rape. BMC Health Serv Res 24 , 443 (2024). https://doi.org/10.1186/s12913-024-10852-0

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Experiences of patients with advanced cancer coping with chronic pain: a qualitative analysis

Wanting Xia 1 , 2 ,
Meijun Ou 3 ,
Yongyi Chen 1 ,
Furong Chen 1 ,
Mengyao Yan 1 , 2 ,
Zhirui Xiao 1 &
Xianghua Xu 4

BMC Palliative Care volume 23 , Article number: 94 ( 2024 ) Cite this article

Metrics details

To gain insight into the perceptions, and beliefs of patients with advanced cancer coping with chronic pain and to identify their attitudes and demands on pain management.

From July to September 2022, 17 patients with advanced cancer living with chronic pain were recruited from a tertiary cancer hospital in Hunan Province, China. Qualitative and semi-structured interviews were conducted individually, with 30-45 minutes for each. The Colaizzi 7-step analysis method in phenomenological research was used for data analysis.

The experience of pain acceptance by advanced cancer patients with chronic pain was summarized into four themes: pain catastrophizing (unable to ignore the pain, try various methods to relieve the pain, exaggerating pain perception, and lack of knowledge about proper pain management), rumination (compulsive rumination and worrying rumination), avoidance coping (situational avoidance and repressive avoidance) and constructive action (setting clear value goal and taking reciprocal action).

Most patients with advanced cancer had low pain acceptance and negative attitudes. Feeling helpless in the face of pain and suffering alone were their norm. Long-term negative emotions could lead to gradual depression and loss of hope for treatment, resulting in pain catastrophizing and persistent rumination. Nevertheless, a few patients accepted pain with positive attitudes. Medical professionals should pay more attention to the psychological status of advanced cancer patients with chronic pain, and employ alternative therapies, for example, cognitive behavioral therapy. More efforts are needed to reduce patients’ pain catastrophizing, and promote their pain acceptance by a better understanding of pain through health education.

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Introduction

Pain, as one of the most common symptoms in patients with advanced cancer, is an unpleasant feeling and emotional experience related to actual or potential tissue damage [ 1 , 2 ]. The International Association for the Study of Pain (IASP) defines chronic pain as pain that persists or recurs for more than three months, including cancer pain, neuropathic pain, and musculoskeletal pain [ 1 ]. Cancer pain is a persistent physical pain caused by tumor involvement in the bone, joint, muscle, or connective tissue. According to pathophysiological criteria, cancer pain can be divided into nociceptive pain and neuropathic pain [ 3 , 4 ]. Nociceptive pain, which includes somatic and visceral pain, is caused by actual or threatened damage to non-neural tissues caused by nociception stimulation [ 5 ], while neuropathic pain arises from lesions or damage to the somatosensory nervous system [ 6 ]. The mechanism contributing to cancer pain development is complicated, and not every type of pain in a patient with cancer is attributed to the tumor [ 5 ]. Studies have shown that around two-thirds to three-quarters of pains are triggered by tumor, around 10% to 20% by cancer treatment (particularly, chemotherapy and surgery), and about 10% by comorbidities [ 7 , 8 ].

Chronic pain may not always be a disruptive condition, yet the patient’s response to chronic pain can be quiet disabling [ 9 ]. A systematic review showed that the duration and chronicity of pain in maladjustment were also associated with the patient’s cognitive and emotional status, such as pain catastrophizing, kinesiophobia, and perception of motion [ 10 ]. Advanced cancer patients who suffer from chronic pain for a long time may experience symptoms such as anger, desperation, hopelessness, fatalism, pessimism, difficulty in adaptation, social withdrawal, fatigue, persistent anxiety, lack of planning, loss of ideas, and reduced activities [ 11 , 12 ], which hence requires different coping strategies.

In contrast to focusing on pain reduction, pain acceptance is a process of changing behavioral patterns, in which individuals adapt to pain experience without directing efforts towards reducing or resisting it [ 13 ]. Interestingly, attempting to control or reduce pain is the most common approach in clinical practice, while accepting pain seems counterintuitive. Baranoff et al. [ 14 ] found that pain acceptance was associated with lower pain intensity and higher pain tolerance, which may reduce further efforts to remove pain, thereby ending the negative effects of repeated failures [ 15 ]. A study by Gauthier et al. [ 16 ] on 81 patients attending pain and palliative care clinics in Canada also revealed a link between pain acceptance and psychological impact of ongoing disease-related pain. Advanced cancer patients who experience pain that cannot be completely cured maintain or restore their health in the following ways: acknowledging the ineffectiveness of some pain control strategies, accepting the pain, reducing focus on pain, taking their limited energy elsewhere ,and pursuing personal goals bravely [ 17 , 18 ]

Pain acceptance consists of two aspects: pain willingness (PW) and activity engagement (AE) [ 19 ]. PW refers to the recognition that avoidance and control are often ineffective ways to adapt to chronic pain, and the willingness to face pain and life changes it brings, reflecting the attitude of pain acceptance that can reduce negative feelings [ 15 ]. On the other hand, AE is characterized by the extent to which patients can perform daily activities regardless of pain, reflecting the behavior of pain acceptance [ 20 ]. The underlying mechanism of pain acceptance is that attempts to control and avoid pain instead aggravate pain symptoms or psychological distress [ 21 ]. Adjustment to pain can be promoted by pursuing goals and engaging in valued activities.

Cancer patients commonly believe that anxiety, depression, and sleep disorders are brought by chronic pain, but these factors are also inclined to induce chronic pain [ 22 ]. Previous evidence demonstrated that emotional support was a resilient factor in chronic pain that reduced its chronicity [ 23 ]. Studies have found that pain acceptance can effectively alleviate the pain of chronic pain patients and relieve anxiety, depression, and other negative emotions [ 24 ]. In a cross-sectional survey on 156 cancer patients in Hunan Province, China conducted by Xu X et al [ 25 ] found that cancer patients’ acceptance of pain was related to age, gender, marital status, pain duration, number of pain sites and duration of taking analgesics. Hassankhani et al [ 26 ] interviewed 17 Iranian patients with cancer pain about their pain experience, and found that nurses did not only need to ease patients’ physical pain, but also pay attention to their sociocultural and spiritual wellbeing, which was consistent with Orujlu et al’s findings [ 27 ]. Although there have been studies on the degree of acceptance among patients with chronic pain, most of them were quantitative studies with non-cancer pain as the main subjects [ 28 , 29 , 30 ], and little is known about the perceptions, needs, and pain acceptance of advanced cancer patients with chronic pain. Therefore, the aim of this study was to understand the illness experience, coping styles and dilemmas of patients with advanced cancer through semi-structured interviews. In understanding the real needs of advanced cancer patients for chronic pain, these interview results were embeded within a larger study, which aimed to construct an intervention program targeting the characteristics of chronic pain in advanced cancer patients to improve the quality of life of advanced cancer patients and better manage chronic pain.

Study design

This study adopted the phenomenological research method of qualitative research and utilized semi-structured interviews to explore the perceptions and feelings of pain acceptance in advanced cancer patients with chronic pain. This study adhered strictly to the Consolidated Criteria for Reporting Qualitative Studies (COREQ), and all research procedures were approved by the institutional ethics committee.

Setting and participants

The study was conducted at a cancer hospital in south-central China, which served as the province’s center for cancer treatment and offered medical care to an average of 25,200 cancer patients annually. To ensure maximum variation sampling, the researcher selected patients of different ages, occupations, and cancer types from July to September 2022. Inclusion criteria were: (1) aged ≥18 years; (2) pathologically diagnosed with malignant tumor in clinical stage III or stage IV; (3) showed symptoms of distant metastasis; (4) hospitalized with recurrent disease; (5) had pain lasting for over three months; (6) self-reported pain intensity >3 based on an 11-point Numerical Rating Scale (NRS); and (7) were aware of their own conditions. Patients with visual, auditory, cognitive or mental impairments; barriers in verbal expression and communication; or physical inability to receive interviews were not eligible.

Data collection and interview procedures

The researchers jointly developed a preliminary interview outline on the physical and mental changes, concerns, and coping strategies of advanced cancer patients experiencing chronic pain by reading relevant literature. A pilot interview was conducted on two of the candidates who met the inclusion criteria. With the feedback from the pilot interviewees, the researchers added patients’ views on pain relief treatment to the outline, and delete the question “How do you view pain differently before and after pain?”. The final revised interview questions were as follows: (1) Please describe your experience of illness. (2) Please describe your pain. (3) What do you do when the pain occurs? (4) How do you perceive pain and its alleviating methods? (5) How does pain affect your life? and (6) What changes have you made in the face of pain?

Prior to the interview, the researcher would explain the research purpose, method, and significance, patient’s rights as study participants, as well as detailed privacy protection measures. The appropriate time for the interview during non-therapy period (usually in the afternoon) was set after obtaining patient’s informed consent. Since the interviewer was the tool of qualitative research, a postgraduate student of the research group acted as the sole interviewer. The face-to-face semi-structured interviews were conducted in a private, comfortable and quite room free from distractions. Each interview usually lasted about 30-45 minutes and audiotaped for transcription within 24 hours. During the interview, the interviewer would stay neutral and avoid leading questions, while observing and taking notes on the interviewee’s demeanor, tone, emotional changes, and body movements. The questions were asked in a flexible order depending on the actual situation, with feedback given to the patients through retelling and rhetorical questioning, and unclear answers confirmed.

Dataanalysis

The descriptive phenomenological method for qualitative data analysis proposed by Colaizzi was adopted through the following process [ 31 ]: 1. read repeatedly the same interview data by two researchers to determine the feelings of the interviewees; 2. extract meaningful statements that occurred repeatedly and were relevant to pain acceptance; 3. summarize and extract meaning from important statements; 4. explore the common characteristics and internal correlation of different meanings, and classify them into different themes, and sub-theme groups; 5. link each theme with the research phenomenon and try to describe it comprehensively; 6. describe the intrinsic structure of pain acceptance experience in advanced cancer patients with chronic pain; 7. present the respondents the results to verify their authenticity and modify them based on feedback. Inconsistent results were analyzed and discussed by other research members. After several rounds of analysis, the final themes and topic words are determined.

Participant characteristics

The 17 participants included 7 females (41.2%) and 10 males (58.8%), ranged in age between 40 and 86 years ( mean age = 56.76±12.00). Fifteen participants (88.2%) were married; 13 participants (76.4%) had secondary school education. The NRS scored ranged from 5 to 10 (mean score = 8.12±1.45 points). Other demographic and disease information of the participants are as follows. (Table 1 ).

Themes and sub-themes

Four themes and nine sub-themes have been identified: 1) pain catastrophizing; 2) rumination; 3) avoidance coping; and 4) constructive action, as shown in Table 2 .

Theme 1: pain catastrophizing

Unable to ignore the pain.

Patients with advanced cancer often experience irregular and recurring pain that is difficult to control. Those who catastrophized their pain were preoccupied with pain perception and resistance. They can't ignore the misery of chronic pain, leading to a reduced awareness of their surroundings, and important people and matters in their lives. All participants in the study reported incapability to ignore the pain, most of whom identified sleep disturbance, limited activity, and decreased appetite as the biggest challenges associated with pain.

“I find it easy to fall asleep, but also easy to wake up. I am particularly prone to nightmares. Whether walking or biking along the edge of a cliff, it always makes for good horror. As for my current state, I can't stop thinking about it, the pain is making me restless and affecting my ability to eat and function properly.” (P7) “It hurts whether I stand or sit... (sighed)I can't ignore it, how can I even think about anything else?” (P8, P10)

Try various methods to relieve the pain

Patients with advanced cancer tried their best to manage and eliminate pain, as well as uncomfortable thoughts or feelings in the face of long-term chronic pain stimuli. However, these attempts often trapped them in a struggle with pain, diminishing their enthusiasm for valuable activities. All interviewees reported having tried various pain-relieving methods, such as traditional Chinese medicine, moxibustion, and painkillers, yet ended up finding none of them effective, which was a shattering blow to their confidence.

“I can not overcome this bad experience (lowered his head).” (P4) “I have tried all methods to relieve the pain, but nothing has worked.” (P6) “There is nothing I can do to alleviate the pain. As long as I heard that there was any way to relieve the pain, I was willing to try, and finally came to the hospital for hospitalization” (P17)

Exaggerating pain perception

Some advanced cancer patients expressed pain differently. They might exhibit exaggerated pain behaviors, mainly manifested as an excessive display of pain distress and threat. When a patient showed pain through frowning or crying aloud, he was intending to draw attention from others around them, seek sympathy and assistance, or dramatize their experience of existing or anticipated pain.

“When I am in pain, I become mentally upset and irritable.” (P6) “I am in so much pain that it feels like death, and I will cry to my daughter (with tears in her eyes).” (P9)

The participants were inclined to exaggerate the impact or threat of pain on their health, who were more likely to experience unpleasant emotions such as depression, anxiety, grief and anger. As pain catastrophizing might trigger negative feelings, making patients overwrought and sensitive to pain, the painkillers became less effective, leading to a vicious cycle.

“What if I have long-term pain in the future (looked away)?” (P4) “Anyway, if it hurts, what can I do? (sighed) There is no way. (shook head)” (P3) “Pain certainly has caused a lot of inconvenience to my life. It’s proof that I'm not getting better.” (P7) “Every time I went to the hospital, I would tell my family that this might be the end.” (P8) “As soon as the pain started, I felt I might as well die.” (P9)

Lack of knowledge about proper pain management

Participants felt helpless due to fear of recurrence and progressive loss of function. They were highly diffident in managing disease by medical care, who seemed as powerless towards pain relief and subsequent treatment. Most of them lacked knowledge about pain and even held misconceptions about pain and painkillers. However, these patients remain willing to try a variety of treatments, such as biotherapy, immunotherapy, new targeted drugs, and clinical trials to seek a glimmer of hope.

“My biggest wish is to cure the pain, please help me (hands clenched).” (P1) “Basically what pain relief methods haven’t you tried?...... (sighed) The pain seems to be getting worse.” (P6) “I don't know why, but sometimes taking 6 hydrocodone pills does not completely stop the pain.” (P9) “Painkillers are okay, but I do not want to use morphine because I am afraid of getting addicted even though it relieves the pain..... (Voice raised) Why should I take morphine?” (P12) “I am not sure if I can take painkillers for my condition, so I dare not take them.” (P13)

Theme 2: rumination

Compulsive rumination.

Generally, compulsive rumination is mainly characterized by thought cognition and self-cognition. It is self-reinforcing recalling of painful feelings that repeatedly occur, which can intensify pain and negative emotions. Advanced cancer patients with prolonged bed rest can experience muscle atrophy and general fatigue, hence impairing their self-care ability. These patients often have uncontrollable thoughts about their illness and worry they are a burden to their family.

“Why am I living so tired? (crouched shoulders)” “How could I be so bad...... (sighed).” (P4) “My son's economic condition is not good, so I am a burden to him. The more he tries to take care of me, the more it weighs on him.” (P5) “My husband is the sole breadwinner and he has to take care of both our elderly parents and children. Unfortunately, I cannot contribute financially.” (P10) “I do not smoke or drink, nor I have any bad habits. (turned emotional) How could I get this disease?” (P11) “Pain lingers in my mind and I can't get rid of it.” (P15) “Why do I have this disease? I feel like crying just thinking about it (eyes turned red).” (P9)

Worrying rumination

Worrying rumination is shown by worries about health and economic status. Patients with worrying rumination were concerned about changes in their disease and predicted their disease progression by pain severity. The participants, especially those middle-aged patients who might face job loss, income reduction or increasing expenses, would weigh the cost-effectiveness of treatment as they were afraid of bringing significant economic pressure to their families.

“Pain means that my disease is not getting better. If there is no pain, then my disease is under control.” (P3, P7) “When I come for chemotherapy, I suffer and my money is gone...... I don’t know if I can be cured.” “To pay for my treatment, I had to borrow money from all my relatives. I really do not know what to do next time.” (P10) “I am afraid it will end up costing so much that I will not be able to afford it anymore......” (P11) “I have not been able to work since I got sick. (with a forced smile) Where else can I get a job?” (P13) “Continuing with this treatment is not worthwhile in the end...... (looked away with tears in his eyes)” (P14)

Theme 3: avoidance coping

Situational avoidance.

Situational avoidance is the avoidance of pain and a painful environment. At first, patients with advanced cancer develop a fear of pain after a prolonged chronic pain, and their excessive fear increases dependence on painkillers which leads to lower placebo effect and pain relief. If they pay too much attention to painful experiences or activities, they will then take relevant avoidance measures. Some patients suffered from the side effects of the disease or painkillers, including edema, constipation, breathing difficulties and other symptoms that resulted in activity intolerance and inability to live a normal life. These patients felt that time passed so slowly that they did not see the meaning of life and hope of survival.

“Sometimes when I am in pain, I feel like going to extremes, such as euthanasia or jumping from a building to end my life as soon as possible” (P1) “ I got some sleeping pills, so it will not hurt when I die (depressed).” (P4) “ I want to die painlessly and quietly (in a firm tone).” (P5) “I have taken a lot of painkillers. Whenever I have a little pain, I am afraid that the pain will get worse, so I need to take painkillers to prevent the coming pain.” (P7) “Without painkillers, I would have already died.” (P9)

Repressive avoidance

Patients with advanced cancer often present repressive avoidance through behavior and mentality. They tend to suffer alone rather than share their feelings with family or others, and remain motionless in coping with the pain, such as through sleeping or keeping seated. Once they perceive pain as unbearable, they are unwilling to acknowledge the pain from within. They are afraid of not being understood or accepted, and social prejudice against them, hence impacting their psychological, and social/relational wellbeing.

“I usually don't move much, so I usually choose to watch TV alone at home.” (P6) “At first, I talked to my daughter about the pain. But after a long time, I stopped sharing (looked away)...... It didn’t help. It only made them worried.” (P8, P15) “I have experienced being abandoned by my friends because of my illness...... (in tears)” (P13) “Now I feel useless and incapable of doing anything. People in my village talked behind my back.” (P14)

Theme 4: constructive action

Setting clear value goal.

Defining value goals mainly involves re-establishing social bonds and regaining confidence in life. Despite being in the terminal stage of cancer, the participants maintained a positive attitude towards treatment, actively built close emotional connections with family members, looked forward to returning to work, strived to improve interpersonal relationships, and established a new social network.

“I am more willing to share my thoughts and feelings with my closest family members than I was before.” (P9) “Chronic pain has made me realize that the person I care about most is my son. He is the pillar of my treatment. I want to cherish the present life more.” (P11) “I can’t live like this forever. It should be me that take care of them (parents), but now they worry about me.” (P12) “I want to go back to work. I’m still so young (looking away), I should have a better life.” (P13, P14)

Taking reciprocal action

Almost all respondents expressed their aspiration to live a fulfilling life. Most patients chose to reconcile, and coexist with the pain by accepting the reality of living with pain, learning its etiology through various channels, changing unhealthy lifestyles, setting goals and action plans, taking corresponding pain-reduction measures as advised by their doctors, making positive changes, and improving their ability of pain management.

“If the doctor continues to prescribe me this painkiller, I will keep coming as long as the pain subsides.” (P3) “I still want to travel, make videos and do something I like.” (P9) “If the pain reduces, I would like to have a blast and breathe more fresh air.” (P10) “I will take my medication regularly, attend therapy sessions and embrace a more vibrant lifestyle instead of confining myself in the hospital.” (P13, P15)

The present study summarized the experiences of patients with advanced cancer coping with chronic pain into four themes: pain catastrophizing, rumination, avoidance coping, and constructive action. All participants reported an urgent need for pain reduction, a constant struggle with pain, and failed efforts to relieve the pain, with most of whom showing low acceptance of pain. It was believed that alleviating cancer-related psychological distress and physical pain were equally important. But patients should not be expected to ignore their pain. Some participants in this study developed pain avoidance behaviors as well as negative mood, such as pain catastrophizing and rumination, whereas a small number of participants with high levels of pain acceptance chose to reconcile with the pain, and devoted their time and energy to worthwhile pursuits. They re-established social connections, and regained confidence in life.

Unlike other non-malignant chronic pain, cancer pain is a complex physical, pathological and emotional experience caused by various factors such as the tumor itself, diagnostic/therapeutic procedures, or treatment-related adverse events [ 32 ]. The etiology of chronic pain in advanced cancer patients remains unknown and the mechanism is relatively complex [ 33 ]. Studies have shown that pain catastrophizing persists even after pain intensity was under controlled [ 34 ]. From a psychological perspective, it is the perception of chronic pain that triggers the anxious response [ 35 ]. Since advanced cancer patients are eager to remove pain and emotional stress, they tend to exaggerate the threat of pain, fear, and helplessness in the face of unpredictable pain, which may be a reason for their low level of pain acceptance. Such finding conforms to de Boer’s conclusion that acceptance level is a strong predictor of pain catastrophizing [ 36 ].

Rumination occurs when an individual repeatedly thinks about the same things, which often hinders a person’s ability to suppress thoughts, generate alternative ways of thinking, or move on [ 35 ]. In this study, most chronic pain patients were unable to distract themselves from their depressed mood and involuntarily engaged in compulsive rumination and worrying rumination. Studies have shown that rumination is a major predictor of disability and closely related to pain intensity [ 37 ]. Many patients in extreme pain believed that rumination was helpful in solving problems, even though the sense of lacking control over it could have a negative impact on mental health [ 38 ].

During the interview, the vast majority of participants expressed concerns about follow-up treatment and their financial capacities, whereas some even viewed themselves as a burden to families and gave up treatment. This finding is consistent with the results of Clarke’s qualitative study on elderly individuals with chronic pain in the community [ 38 ]. In addition, most patients with advanced cancer were reluctant to disclose their condition, influencing their normal social life and pursuit for goals. Consequently, they suffered from social stress, difficulty in coping with pain, and mental health disorders, as supported by the findings of a systematic review [ 39 ].

When dealing with chronic pain, patients often fall into unhelpful patterns of behavior that increase the risk of overtreatment, complications, and even death [ 40 , 41 ]. From the perspective of biopsychosocial integration, advanced cancer patients experiencing chronic pain are in urgent need of psychological interventions [ 42 ], which can promote self-management by changing behaviors [ 43 ], such as cognitive behavioral therapy [ 44 ], behavioral therapy, acceptance and commitment therapy, along with physical treatments such as routine massage and gymnastics, and educational interventions of the disease and its treatment. Acceptance represents the psychological flexibility of acceptance and commitment therapy, which reflects one’s flexibility in action, willingness to experience pain without struggle, and recognition that thoughts are not facts [ 45 ]. Only a few participants in this study expressed a willingness to identify value goals, and take appropriate actions accordingly. They hoped to improve their function and reduce pain interference through value-driven effects. Various forms of psychotherapy can assist chronic pain patients in enhancing their acceptance of pain.

There may be some possible limitations in this study. First, the small sample size may raise concerns regarding the representativeness of data for advanced cancer patients experiencing chronic pain. However, such concern can be dispelled by the abundance of data, since the study subjects were enrolled until data saturation occurred, i.e., until no additional information appeared and no further themes were derived from the data during the sampling. Second, despite the researchers’ training and expertise in conducting qualitative interviews, the quality of data collection and results depended largely on the researchers’ abilities as well as their analysis process.

This study found that most participants had a low level of pain acceptance and were unable to ignore their chronic pain experience. They exhibited pain avoidance behaviors, pain catastrophizing, rumination, and other negative emotions. Yet, a small number of participants with high pain acceptance chose to make peace with pain and devoted their time and energy to other worthwhile pursuits. It is critical to attach importance to the psychological health of patients with advanced cancer, and formulate reasonable psychological intervention strategies. We hope that these findings will encourage further efforts to develop and evaluate strategies that can effectively address patients’ inquiries of chronic pain, enhance communication between patients and healthcare professionals, and alleviate psychological stress in patients with chronic pain.

Availability of data and materials

No datasets were generated or analysed during the current study.

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Acknowledgment

The authors express their gratitude to all the patients for their generous efforts and time for the interviews.

This study was supported by grants from the Natural Science Foundation of Hunan Province, China (Grant No. 2021JJ40327) and the National Natural Science Foundation of China (Grant No. 82103026).

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Department of Nursing, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China

Wanting Xia, Yongyi Chen, Furong Chen, Mengyao Yan & Zhirui Xiao

Xiangya Nursing School, Central South University, Changsha, China

Wanting Xia & Mengyao Yan

Head & Neck Plastic Surgery, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China

Health Service Center, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China

Xianghua Xu

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Xia WT wrote the main manuscript. Ou MJ conceived and designed the study. Chen YY and Xu XH supervised and managed the manuscript. Chen FR, Yan MY and Xiao ZR were responsible for the phonetic text transcription. All authors reviewed and approved the final manuscript.

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The study was approved by the Institutional Review Board of Hunan Cancer Hospital (Scientific Review 2021 [04]) prior to data collection. Before the formal interview, informed consent was obtained from patients and their families, who were explained the study purpose, the length of interview, the voluntary nature of participation in the study, their right to refuse participation, and confidentiality. Participants were entitled to terminate the interview if they felt uncomfortable during the interview. The interview audio was transcribed, encoded, and assigned a unique individual number for management purposes. The results were described using participant numbers to ensure participants’ privacy. The text data was used for this study only.

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Xia, W., Ou, M., Chen, Y. et al. Experiences of patients with advanced cancer coping with chronic pain: a qualitative analysis. BMC Palliat Care 23 , 94 (2024). https://doi.org/10.1186/s12904-024-01418-2

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The environmental awareness of nurses as environmentally sustainable health care leaders: a mixed method analysis

Olga María Luque-Alcaraz ORCID: orcid.org/0000-0003-1598-1422 1 , 2 , 3 , 5 ,
Pilar Aparicio-Martínez ORCID: orcid.org/0000-0002-2940-8697 3 , 4 ,
Antonio Gomera ORCID: orcid.org/0000-0003-0603-3017 2 &
Manuel Vaquero-Abellán ORCID: orcid.org/0000-0002-0602-317X 2 , 3 , 4

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People worldwide are concerned with the possibility of climate change, microplastics, air pollution, and extreme weather affecting human health. Countries are implementing measures to reduce environmental impacts. Nurses play a vital role, primarily through Green Teams, in the process of promoting sustainable practices and minimizing the environmental footprint of health care facilities. Despite existing knowledge on this topic, assessing nurses’ environmental awareness and behavior, including the barriers they face, is crucial with regard to improving sustainable health care practices.

To analyze the environmental awareness and behavior of nurses, especially nurse leaders, as members of the Green Team and to identify areas for improvement with regard to the creation of a sustainable environment.

A sequential mixed-method study was conducted to investigate Spanish nurses. The study utilized an online survey and interviews, including participant observation. An online survey was administered to collect quantitative data regarding environmental awareness and behavior. Qualitative interviews were conducted with environmental nurses in specific regions, with a focus on Andalusia, Spain.

Most of the surveyed nurses ( N = 314) exhibited moderate environmental awareness (70.4%), but their environmental behavior and activities in the workplace were limited (52.23% of participants rarely performed relevant actions, and 35.03% indicated that doing so was difficult). Nurses who exhibited higher levels of environmental awareness were more likely to engage in sustainable behaviors such as waste reduction, energy conservation, and environmentally conscious purchasing decisions ( p < 0.05). Additionally, the adjusted model indicated that nurses’ environmental behavior and activities in the workplace depend on the frequency of their environmental behaviors outside work as well as their sustainable knowledge ( p < 0.01). The results of the qualitative study ( N = 10) highlighted certain limitations in their daily practices related to environmental sustainability, including a lack of time, a lack of bins and the pandemic. Additionally, sustainable environmental behavior on the part of nursing leadership and the Green Team must be improved.

Conclusions

This study revealed that most nurses have adequate knowledge, attitudes, and behaviors related to environmental sustainability both inside and outside the workplace. Limitations were associated with their knowledge and behaviors outside of work. This study also highlighted the barriers and difficulties that nurses face in their attempts to engage in adequate environmental behaviors in the workplace. Based on these findings, interventions led by nurses and the Green Team should be developed to promote sustainable behaviors among nurses and address the barriers and limitations identified in this research.

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Introduction

The impact of climate change on human society is a global concern, especially with regard to microplastics, resource shortages, air pollution, droughts, and extreme weather. Such consequences affect human health both directly and indirectly, resulting in an increase in pathologies and a deterioration in medical attention [ 1 , 2 ]. In this context, diverse measures aimed at reducing the environmental impact of daily activities and minimizing the ecological footprint thereof [ 3 ] have been implemented by multiple countries [ 4 , 5 , 6 , 7 ]; these activities have been framed as environmental regulations in line with the Sustainable Development Goals (SDGs) [ 8 ].

The SDGs are being integrated into governments and a variety of other contexts, including the health care system. Spain is dedicated to such a goal, i.e., that of promoting a greener and more democratic health care transition. To achieve this goal, strategic plans have been developed to mitigate the effects of climate change [ 9 , 10 ]. One specific such program is the Strategic Health and Environment Plan (PESMA) [ 11 ], whose aim is to enhance the synergy between health and the environment innovatively by assessing the impact of the population in terms of 14 environmental indicators [ 12 ].

One such indicator focuses on the resources and support needed for sustainable practices, especially for nurses, due to the impact of the environment on their work [ 13 , 14 ]. The PESMA highlights the fact that health care providers should be included in strategies to reduce carbon footprints, build resilience to address the challenges associated with climate change and embrace a leadership role in the task of promoting sustainable health care practices [ 13 , 14 , 15 , 16 ]. Another critical aspect of PESMA focuses on education, training, and incentives that can promote sustainable behavior among health care workers, especially nurses [ 17 , 18 ]. As frontline health care workers, nurses have a unique opportunity to advocate for sustainable practices and reduce the environmental impact of the health care system. Nurses’ knowledge and behavior are limited despite the fact that nurses have positive attitudes toward environmental sustainability [ 19 ].

This situation stands in contrast to the role of nurses in the creation of more sustainable hospitals via the “Green Team” [ 20 ]. The Green Team, which originated in the United States of America a decade ago, is a committee that is responsible for finding and implementing sustainability projects to decrease the environmental impacts of daily operations. Members of various departments collaborate with sustainability staff to detect opportunities, spread awareness, and promote staff involvement in line with the Committee’s mission [ 21 ]. The team, which typically consists of and is led by nurses, aims to increase awareness of the health care industry’s effect on the environment and to develop tactics to mitigate the adverse environmental effects of hospitals.

In Spain, Green Teams, which span multiple disciplines and usually led by nursing professionals, are committed to sustainable change in health care [ 22 ]. Environmental nursing leaders on Green Teams control environmental sustainability in health care settings and provide education, resources, and support to other professionals with regard to the implementation of sustainable practices [ 23 ]. Accordingly, all nurses can contribute to the tasks of mitigating the impact of climate change on public health outcomes and promoting sustainable health for all [ 24 ]. These actions improve nurses’ knowledge, attitudes, and behavior in terms of sustainability and promote sustainable practices in health care settings, thus leading to a better understanding of the barriers faced by nurses in this context [ 24 , 25 , 26 ].

However, measuring and identifying nurses’ environmental awareness is essential for the promotion of sustainable hospitals [ 27 , 28 ]. Multidimensional indicators have been proposed for this purpose [ 16 ], the responsibility for which lies with nurse leaders on Green Teams. Nurses are responsible for promoting sustainability in health care organizations, as discussed by Kallio et al. (2018) [ 29 ], as well as for promoting nursing competencies related to environmental sustainability [ 30 ]. Several studies, including Harris et al. (2009) and Phiri et al. (2022), have examined nurses’ roles in environmental health and the effects of their leadership on the promotion of sustainability, especially during the COVID-19 pandemic, thereby emphasizing the importance of leadership [ 31 , 32 ].

As Ojemeni et al. (2019) discussed, leadership effectiveness in Green Teams, nursing teams and health care organizations must prioritize quality control and health care improvement to ensure sustainable development [ 33 ].

The topic of environmental management in health care organizations has been studied extensively, and an environmental or ecological model of care for promoting sustainability has been proposed [ 34 ]. As environmental creators and leaders on Green Teams, nurses are vital for minimizing hazardous waste in health care settings and improving awareness [ 35 ].

Although nurses have some degree of existing knowledge and awareness of sustainability, it is crucial to assess their proficiency in environmental matters and to gauge their environmental awareness. Such an evaluation can help identify areas for improvement within clinical management units [ 20 , 33 , 36 ]. Education and training programs can effectively promote sustainable behavior among nurses, but interventions should also address the barriers they face in their attempts to implement sustainable practices [ 37 ]. Therefore, it is imperative to examine the factors that foster sustainable behavior among nurses and to identify effective interventions that can promote sustainable health care practices and minimize the environmental footprint of health care facilities. Accordingly, this study aimed to analyze the environmental awareness and behavior of nurses, especially nurse leaders, as members of the Green Team and to identify areas for improvement with regard to creating a sustainable environment.

Study design

A sequential mixed-method study was conducted based on an online survey and interviews with a representative sample of Spanish nurses, including participant observation.

The study was divided into two phases. In the first phase, a cross-sectional, descriptive exploratory analysis was performed; this analysis relied on the results revealed using the Nurse’s Environmental Awareness Tool in Spanish (NEAT-es) [ 38 ], which was divided into three subscales: nursing awareness scale (NAS), environmental behaviors outside the workplace (PEB) and sustainable behaviors in the workplace (NPEB). In the second phase, qualitative interviews with environmental nurses (see Supplementary file 1 ) were conducted in regions featuring specific environmental units that were available in person (Andalusia).

Participants

The participants were recruited from public and private institutions associated with the National Health System, particularly from the nursing staff. The scope of the study focused on Spain, and the sample included all the nursing staff who completed the questionnaire and met the inclusion criteria.

The sampling process focused on the population of nurses in Spain in 2020, which was estimated to consist of 388,153 nurses. Therefore, a random sample of 314 participating individuals was sufficient to estimate the population with 95% confidence and an accuracy of +/- 2% units, which was expected to account for approximately 90% of the overall population. The inclusion and exclusion criteria used for the sample focused on nursing staff, nursing care auxiliary technicians, and students with relevant degrees, as this members of this group have the most significant presence in the health system and engage in direct and daily contact with environmental management in health centers (hospitals, primary care centers, sociosanitary centers and others). The remaining health and nonhealth personnel were excluded.

Additionally, the person from each unit who served as the environmental coordinator and other nurses from the ward who were members of the Green Team were asked to participate in the interviews and observations. The environmental coordinators, most of who were nursing supervisors, were determined based on the number of members of the Green Team and the sampling calculation used for the observational study. The interviews took place after various sessions, talks, or courses pertaining to environmental sustainability at the clinical management units.

Data collection

An intentional sampling process was implemented, and the data collection period spanned from November 2019 to March 2021. The observational data were collected in Spain via messages and posts on social media with the goal of quantifying nurses’ environmental awareness.

The initial sample of qualitative study included five environmental nursing leaders (NLs), 14 registered nurses (RNs), and ten nursing undergraduates. The final sample was reduced when the interviews reached data saturation ( N = 10, five NLs, and five RNs). Before the interviews, a focal group composed of one nurse, one physician, two engineers and a psychologist was tested using the questions included in this research as part of a pilot study ( Supplementary file 1 ). These interviews were conducted at the beginning of the participant’s shift, usually in the morning, and they featured a median time of 30 min, a minimum of 20 min and a maximum of one hour per participant.

One researcher (O.A.L.) also observed nurses during their daily work after the interview from a position within the ward as an added team member or staff member. Nevertheless, the observer did not highlight mistakes or sustainability issues during the observation process. No other researcher was involved in this step of the ethnographic analysis to avoid bias with regard to observing a variety of tasks ranging from preparing medication to implementing treatments.

The data collected through the interviews were recorded on a Samsung Galaxy 31 A, and observations were collected in a field notebook based on the Google Keep and Evernote mobile applications from November 2019 to mid-March 2021. This study was conducted at a regional level 1 hospital in southern Spain, particularly in various clinical management units (neurosurgery, internal medicine, cardiology, traumatology, and COVID-19 units, among others), and it focused on nursing supervisors, who are the leaders who bear responsibility for environmental awareness (NLs), and registered nurses (RNs) who were members of the Green Team.

Data analysis

The quantitative data were analyzed by reference to descriptive statistics, including the mean, standard deviation (SD), and 95% confidence interval (CI); the relative frequencies of the variables were also analyzed. Normalization tests, Kolmogorov‒Smirnov tests with Lilliefors correction, and Q‒Q tests were used to compare the goodness-of-fit to an average data distribution with regard to continuous or discrete quantitative variables. The comparison of two or three independent means was performed using Student’s t test and analyses of variance for each variable. The Χ 2 test with Yates’ correction was used to compare percentages and Pearson’s correlation (r) coefficients across the quantitative variables. Finally, associations among the NPEB and the other variables were studied through multiple linear regression. Participant observation was used to support the qualitative study of the reflective ethnographic type [ 39 , 40 ], and this process ended when the data reached saturation. Two researchers developed transcripts for the interviews based on the recorded interviews and added descriptions based on the notes from the field notebook. The identification of themes and patrons was based on a process of triangulation among the researchers and by cross-checking the results. The interviews with nurses were analyzed to summarize the content analysis and identify keywords and concurrency among the terms. The themes thus identified included Green Teams, sustainable environmental behaviors, environment awareness, leadership barriers and limitations and areas for improvement.

EPIDAT (version 4.2) and SPSS (version 25) software were used to support the quantitative analysis. The computer program ATLAS.ti (version 22) and the Office Package with Microsoft Word Excel (version 2019) were used for the interviews and the visualization of the keywords based on the themes identified based on the records, observations and field notebooks.

Nurses’ awareness, knowledge, attitudes and skills.

The ages of the Spanish staff, mainly nurses, included in this study ( N = 314) ranged from 19 to 68, with a mean age of 37.02 ± 12.7, CI = 95%, 35.6–38.4 years); in addition, 76.4% of these participants were women with more than 20 years of working experience (35.1%), and the majority were registered nurses (70.4%). Moreover, 113 (36%) participants worked at a local or regional hospital (30%) and were employees of a public institution (85.3%). Half of the nurses (157) worked only a morning shift (Table 1 ) in Andalusia, Madrid, or Catalonia (62.4%). The diverse autonomous regions on which this research focused were homogenously distributed and structured in line with the population. The analysis of these areas was also based on the specific inclusion of environmental units led by nurses (Andalusia, Madrid, and Catalonia), in contrast with regions featuring undetermined units or leaders related to this topic (such as Valencia) (37.5%).

Regarding nursing awareness, nurses scored higher on the PEB (31.83 ± 8.02 CI 95% 30.94–32.72 with regard to frequency vs. 32.36 ± 7.15 CI 95% 31.57–33.15 with respect to difficulty) than on the NAS (26.13 ± 9.91 CI 95% 25.03–27.23 with regard to knowledge vs. 47.39 ± 5.97 CI 95% 46.73–48.05 with respect to impact) and the NPEB (23.82 ± 6.45 CI 95% 23.10-24.53 with regard to frequency vs. 25.71 ± 6.31 CI 95% 25.01–26.41 with respect to difficulty). These results indicated that environmental knowledge among the Spanish population was limited (55.7%), although the nurses included in this research were aware of their potential impact on the environment (70.4%). The PEB subscale focused mostly on following environmental guidelines in their homes (57.3%) because these sustainable domestic tasks are easier for them (63.1%) than tasks in the professional field. The second subscale, NPEB, indicated that sustainable activities such as recycling were easy for the participants (57.6%), but sometimes they engaged in such activities less frequently than they would like (52.2%) (Fig. 1 and Fig. 2 ).

Representation of the frequency of nursing environmental behavior

Difficulty of engaging in adequate environmental behaviors

The sociodemographic variables indicated differences among the NEAT subscales (Table 2 ). Gender, working experience (with a median value of 10 years), and the position held in the institution and region were relevant with regard to environmental knowledge ( p < 0.01), environmental behavior outside the workplace ( p < 0.01), and environmental behavior in the workplace ( p < 0.01).

The NPEB was associated with the worst scores, thereby reflecting the nurses’ environmental behavior and activities in the workplace (52.23% rarely performed relevant activities, and 35.03% indicated that doing so was difficult) (Fig. 1 and Fig. 2 ). The NPEB values pertaining to environmental behavior were positively linked to age ( r = 0.412; p < 0.001), NAS knowledge ( r = 0.526; p < 0.001), PEB frequency ( r = 0. 57; p < 0.001), PEB difficulty ( r = 0.329; p < 0.001), and finally, difficulty performing adequate environmental behaviors ( r = 0.499; p < 0.001). Additionally, the value of the NPEB with regard to the difficulty of performing adequate environmental behaviors was positively associated with age ( r = 0.149; p = 0.008), NAS knowledge ( r = 0.249; p < 0.001), PEB frequency ( r = 0. 244; p < 0.001) and PEB difficulty ( r = 0.442; p < 0.001).

Based on the relevance of certain sociodemographic variables, the nurses’ environmental awareness (NAS) and their behavior outside the workplace (PEB), linear multiple regression was performed to investigate nursing behavior in the workplace (NPEB). The initial model (square sum = 488.655; p < 0.0001) indicated that age, the impact of nursing awareness (NAS), and the frequency of sustainable behaviors outside the workplace (PEB) were not relevant to nursing behavior in the workplace (NPEB) in terms of the frequency of performing adequate behavior or the difficulties experienced ( p > 0.05). Based on these results, the adjusted model was calculated (Table 3 ), indicating that NPEB depends on PEB frequency and NAS knowledge ( p < 0.01).

Nursing environmental behavior in the context of Green Teams: Barriers and areas for improvement.

The participants in the qualitative study ( N = 10) included nine women and one man; their median age was 49 years; they exhibited an interval quartile range of 35–60; they had levels of working experience ranging between 20 and 30 years, and they worked only in the mornings (7/10). Furthermore, the group including nurses and nursing supervisors (5/10) exhibited higher levels of education (see Supplementary file 2 ). The themes identified via repetition and associations during the interviews and observations indicated links among nurses’ responsibilities on the Green Team since they conformed to the nature of such teams (i). This team and nursing leaders identified sustainable environmental behavior (ii) that could improve environmental awareness (iii), knowledge, aptitude, and skills. The nurses who are responsible for sustainable changes should be the leaders (iv), and the relevant barriers and limitations (v) and areas for improvement (vi) in diverse areas should be identified simultaneously.

Green teams were linked to nursing responsibilities in the context of environmental sustainability.

In the interviews, the Green Teams, led by environmental leader nurses and comprising various staff members, were identified as crucial committees dedicated to enhancing environmental awareness and knowledge among hospital staff. Participants indicated that these teams facilitated regular meetings to discuss sustainable practices and played a pivotal role in testing behaviors and knowledge related to environmental sustainability. The Green Teams were highlighted as platforms for fostering collaboration and discussion surrounding sustainable practices. Participants noted that these teams facilitated the main purpose of the team and its members to improve the hospital staff’s knowledge and attitudes via meetings (RN 2,3 and NL 1,3). Subsequently, the NL also indicated a key role of the team in the testing of behaviors and knowledge. The behavior of registered nurses should be tested using questions according to the NLs. Also, the NLs are included in disponibility of of proper disposal methods for medical waste:

“So, where is the rubbish bin for medicines, that white one that you showed in the session that is used for the remains of medicines that we do not give to patients?” [(NL5)]

By such comments, it can be inferred that the Green Team not only disseminates information, manages the training and measures knowledge but also ensures that staff members understand and adhere to best practices in waste management. These tasks of the NLs and other RNs in the Green Team contribute to the overall efficiency and effectiveness of environmental sustainability efforts within the hospital.

Sustainable environmental behaviors were emerged by Green Teams.

The results of the analysis indicated some degree of resistance among the nurses working at the clinical management units with regard to their lack of competencies, especially those pertaining to knowledge, skills and attitudes. The comments from the interviews highlighted potential factors contributing to this resistance, including age-related differences, varying levels of awareness, and challenges in applying the principles of reduce, reuse, and recycle (the three Rs). For instance, one repetitive comment expressed a sentiment of uncertainty, stating “It is what is, but we don’t know it or what to do with it” (RN 3,4,5, and NL 2,3).

“We know what the light packing is, and they (maintenance people) installed it to reduce the lights and reduce the expense and cost, but we don’t know what to do with the rubbish bins” [(NL 4)]

This comment highlights a disconnect between awareness of specific sustainable initiatives and the practical knowledge to implement them effectively. All comments reflect the importance of addressing knowledge gaps and providing practical guidance to support nurses in adopting sustainable environmental behaviours. By acknowledging and addressing these challenges, healthcare facilities can enhance their environmental stewardship efforts and promote a culture of sustainability among staff members.

Environmental awareness were drawn from the nursing responsibilities that led to the creation of the Green Team.

The comments indicated that environmental awareness among nurses was influenced by training sessions and courses on environmental sustainability. After receiving training featuring lectures and courses on environmental sustainability, the leaders also reflected on the ways in which nurses put the recommendations made during the environmental sustainability courses into practice. Moreover, the leaders indicated that education should be beyond formal training sessions. The environmental leaders were interested in supplementing these courses with environmental education practices for the general population, as noted, for example, in reports of discharge from patient care or cycling on the ward. These activities indicated the ideal of including a holistic approach to sustainability within the healthcare setting.

Relevant statements included, “We have to separate residues according to the material… light plastic goes to… it is important for the unit and all of us” (NL 2,5). One key point that the referees and registered nurses highlighted pertained to the climate, particularly the lack of water (NL 1–5 and RN 1,2).

“The drought is getting worse; I don’t know how we are going to keep up… we hope it rains soon” [(RN1)]

Overall, the interviews shed light on the efforts to foster environmental awareness among nurses through formal training and practical integration into everyday practices. These observations emphasize the importance of ongoing education and action in addressing environmental concerns within healthcare settings.

Leadership, which was linked by comments to the Green Teams.

The interviews revealed that leadership, particularly within the context of Green Teams, is crucial in promoting environmental awareness and fostering a culture of sustainability among nursing staff. All the participants ( n = 10) indicated that the presence of adequate knowledge, meetings and awareness among nursing staff were the most important factors. These factors were identified as key drivers in promoting sustainable practices within the healthcare environment. NLs indicated the importance of creating a supportive working environment where nurses feel comfortable asking questions and seeking clarification without fear of negative feedback. Relevant statements included, “It is key to receive feedback from the nurses and provide a good working environment so that they can ask questions and reflect without negative comments” (NL 1,2,4, and RN 1,2). This working environment allowed the registered nurses to ask for help regarding the three Rs:

“Could you remind me (referring to the environmental coordinator) how the sustainable guidelines were included in the discharge report for the continuity of care; I remember some things from the course you gave us, but I want to convey it completely to my patient” [(RN2)]

Barriers and limitations, were drawn from nurses’ responsibilities.

Several nurses indicated that the difficulties they encountered with regard to performing environmental behaviors pertained to the lack of time, adequate bins, and space as well as the limited number of nurses per patient in the wards. Despite these challenges, participants noted a positive outcome in the form of increased awareness of sustainability issues among nurses, indicating a growing recognition of the importance of environmental stewardship within the healthcare setting. One factor that increased the barriers to environmental adequacy was the pandemic, which increased waste and rubbish. Despite these challenges, participants noted a positive outcome in the form of increased awareness of sustainability issues among nurses, indicating a growing recognition of the importance of environmental stewardship within the healthcare setting. Relevant statements included “There are not enough green rubbish bins for COVID waste” (EL 1,4,5 and RN1,2) and “How are we going to recycle if we don’t even have time to care for patients?” (RN 1,2 and NL 3).

All these comments indicated the barriers the nurses faced, but they also suggested possibilities for improvement. The pandemic, despite overloading nurses, also improved their awareness.

Areas subject to improvement emerged from nursing responsibilities, limitations and leadership.

Nurses indicated that despite their general levels of environmental awareness and the courses they had received, participants performed better regarding their recycling behaviors at home than at the hospital. Participants acknowledged performing better in recycling practices within their personal spaces, suggesting a potential gap in translating theoretical knowledge into practical action within the healthcare environment. Relevant statements included “It’s just that I recycle almost everything in my house, especially glass…, but here, there is no time…” (RN 1,4,5).

Moreover, time constraints emerged as a significant barrier impeding nurses’ ability to engage fully in environmental sustainability efforts. Participants cited the demanding nature of their work, particularly in the context of patient care responsibilities, as limiting their capacity to prioritize sustainability initiatives. This highlights the need for strategies to streamline environmental practices and integrate them seamlessly into nurses’ daily routines without adding undue burden.

Some statements also highlighted nurses’ willingness to improve paperwork and records. Nurses recognized the importance of incorporating environmental considerations into patient discharge reports and other documentation processes but sought further guidance on how to effectively implement these practices. Relevant statements included “Can you tell me how the patient’s continuity care report upon discharge was included in the recommendations for environmental sustainability… I want to do the report well with what you gave us in the clinical session the other day…” [(NL4)]

These comments indicated the opportunities for improvement in fostering a culture of environmental sustainability within the hospital setting. By addressing the identified challenges and providing targeted support and guidance, especially the lack of time, nurses can contribute to environmental stewardship efforts more effectively.

The current research highlights the relevance of nurses as promoters of environmentally sustainable behaviors in their roles as members of Green Teams and important leaders. The findings suggest that nurses exhibit acceptable knowledge, attitudes, and behaviors with regard to environmental sustainability both inside and outside the workplace. These results are complemented by a qualitative analysis indicating that such behaviors originate from nursing responsibility, Green Teams, leadership identification of barriers and areas of improvement. Both analyses highlight the fact that environmental nursing behavior in the workplace depends on sustainable behaviors outside the workplace. The qualitative analysis also identifies diverse barriers to the task of promoting sustainable behavior within the workplace, such as the COVID-19 pandemic and the need for more time to be allocated to this process. One key point identified by both analyses is that nurses have acceptable levels of knowledge; however, their attitudes, although as yet imperfect, are improving.

Several studies of nurses’ awareness of environmental sustainability have revealed that nurses exhibit moderate levels of awareness and a considerable degree of concern regarding the health impacts of climate change [ 37 , 42 , 43 ], as reflected in the NEAT-es results.

Interestingly, the participants exhibited a tendency to perform environmentally sustainable behaviors more consistently in their personal lives than in professional settings. These results are consistent with previous research on registered nurse and nursing students [ 36 , 41 , 42 ]. According to Swedish research, nurses generally recognize environmental issues but may lack awareness of the environmental impact of health care [ 43 ]. Polivka Barbara J. et al. (2012) highlighted the gap between nurses’ knowledge of sustainability and workplace behaviors, thereby emphasizing the need for education and training programs to promote sustainable practices [ 44 ]. These issues were also observed in a study conducted in Taiwan, which revealed that while nursing students exhibit positive attitudes toward sustainability, their knowledge and behaviors are inadequate [ 45 ].

By conducting qualitative analysis, this research also identified multiple barriers to the adoption of sustainable practices among nurses, including time constraints, disruptions caused by the COVID-19 pandemic, a lack of bins, and a lack of health care personnel. These findings are in line with those reported in other research, but certain barriers (in terms of resources, time, and support) to the implementation of sustainable practices in the workplace remain [ 29 ]. This study suggests that interventions should be designed to address these barriers and promote sustainable behavior among nurses, a suggestion which is consistent with the current research. These findings highlight the importance of comprehending nurses’ perspectives on environmental sustainability in health care contexts as well as the necessity for targeted interventions and support mechanisms [ 46 ]. The tasks assigned to nursing leaders and the Green Team involved addressing these barriers and promoting sustainable practices among nurses in the context of their professional roles. Environmental nursing leaders seem to be crucial with regard to establishing a more environmentally conscious health care environment, which is in line with recommendations to create a greener health care system [ 21 , 31 ]. Despite the results of the interviews, some global qualitative studies of nurses’ views on environmental issues have exhibited variations across countries [ 47 , 48 ]. In Sweden, nurses already exhibit pro-sustainability attitudes before the introduction of the 2030 SDGs [ 16 ]. However, the integration of environmental sustainability education into nursing programs can prepare future nurses more effectively to address the challenges associated with climate change and promote sustainable health outcomes [ 49 ].

Limitations

Although this investigation provides valuable insights, it is important to acknowledge its limitations. First, the study was conducted during the COVID-19 pandemic in Spain, which may have influenced the results due to the unique circumstances and stressors faced by health care workers during this period. Additionally, the assessment of nurses’ environmental awareness was performed on a larger scale, i.e., across multiple regions, and therefore may not accurately reflect individual attitudes and behaviors since the qualitative investigations focused on a specific region. However, this approach was adopted to minimize the risk of the ecological fallacy. Future studies could explore individual perspectives and experiences by reference to more diverse and representative samples.

Despite these limitations, this research is highly relevant because it sheds light on the role of nurses in the task of promoting environmental sustainability in health care settings. The research also emphasized the role of nursing leadership in the tasks of promoting environmental sustainability and providing nurses with the necessary resources and support to implement sustainable practices.

In conclusion, while nurses generally exhibit acceptable levels of knowledge, attitudes, and behaviors regarding environmental sustainability, a notable gap persists in terms of the frequency of sustainable actions within the professional settings in which they operate. This finding highlights the importance of closely aligning nurses’ personal and professional sustainability practices.

The qualitative analysis conducted as part of this study identified several barriers to the adoption of sustainable practices among nurses, including time constraints, disruptions resulting from the COVID-19 pandemic, issues with waste disposal, and challenges related to health care personnel. Despite the fact that these findings are in line with those reported in previous research, persistent barriers such as limited resources, time, and support hinder the implementation of sustainable practices in the workplace. Therefore, interventions aimed at addressing these barriers and promoting sustainable behavior among nurses are essential, as highlighted by both current research and the corresponding qualitative insights. Therefore, nursing leaders and Green Teams are pivotal with regard to overcoming these barriers and fostering sustainable practices within health care environments. Environmental nursing leaders in particular are instrumental to the cultivation of a more environmentally conscious health care system, thereby aligning with recommendations for greener health care practices.

Data availability

The datasets used and/or analyzed as part of the current study are available from the corresponding author upon reasonable request.

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Acknowledgements

The authors would like to thank the Excellent Official Nursing School and all the professionals who participated in this research for their support.

This research received no external funding; however, the project did receive an award from the Excellent Official Nursing School in Cordoba, Spain, in 2020.

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A.G. and M. V-A. conceived and designed the study, and O.M. L. and P.A-M. acquired the data, analyzed and interpreted the data, and drafted the article. The publication and supervision of the article were the responsibility of A.G. and M. V-A. All authors contributed equally to the writing and preparation of the final manuscript.

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Correspondence to Pilar Aparicio-Martínez .

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Ethical approval was obtained from the Ethics Committee of Reina Sofia Hospital of Cordoba, which is part of the Andalusian Health Care System in Spain (Act No. 267, ref.3605). This research was in line with the Organic Law 3/2018 of December 5 on the Protection of Personal Data and Guarantee of Digital Rights as well as the Nursing Ethics Code and the 1964 Declaration of Helsinki. The participants were informed of the study’s purpose before participation; their informed consent was obtained, and they were informed that they were able to withdraw from the study at any stage. All the data were obtained after informed consent was collected; in addition, the data were anonymized and saved securely in a database, thereby maintaining all stipulations of the Personal Data Law.

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Luque-Alcaraz, O.M., Aparicio-Martínez, P., Gomera, A. et al. The environmental awareness of nurses as environmentally sustainable health care leaders: a mixed method analysis. BMC Nurs 23 , 229 (2024). https://doi.org/10.1186/s12912-024-01895-z

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Chapter 11. Interviewing

Types of Interviews

Creating an Interview Guide

Type of Questions

Background/Demographic Questions

Temporality

Question Sequence

Probes and Flexibility

The Final Question

Conducting the Interview

How Many Interviews?

Your Final Product: The Ideal Interview Transcript

Final Tips from an Interview Master

Sample: Demographic Questionnaire

Example: Interview Guide

Further Readings

Library Support for Qualitative Research

Resources for Research Interviewing

Types of Interviews

Interview Questions

Textbooks, Guidebooks, and Handbooks

ONLINE RESOURCES, COMMUNITIES, AND DATABASES

Structured:

Semi-Structured:

Unstructured:

Genres and Uses

In-Depth (typically One-on-One):

Folklore Research and Oral Histories:

User Experience (UX) and Marketing:

Screening for Research Site Selection:

ENGAGING PARTICIPANTS

RESEARCH COMPLIANCE AND PRIVACY LAWS

SEEKING CONSENT

POPULATION SAMPLING

Constructing Your Questions

Let Theory Guide You:

CONDUCTING INTERVIEWS

TIPS FOR CONDUCTING INTERVIEWS

Remote Interviews:

Seeking Consent:

Videos:

TRANSCRIPTION

SOFTWARE:

EQUIPMENT:

NEED HELP?

Helpful Texts:

QUALITATIVE DATA ANALYSIS

CODING AND THEMEING YOUR DATA

TESTING OR GENERATING THEORIES

MANAGING & FINDING INTERVIEW DATA

Data Confidentiality and Secure Handling:

Sharing Qualitative Data:

International Projects:

Finding Extant Interview Data

Finding Oral History and Social Research Interviews:

Finding Interviews in Archival Collections at Harvard Library:

Search in HOLLIS :

Search in HOLLIS for Archival Discovery :

UX & MARKET RESEARCH INTERVIEWS

Websites

Books

Videos

Instructional Presentations on Interview Skills

How to conduct qualitative interviews (tips and best practices)

1. Before the interview

2. During the interview

3. After the interview

Explain the purpose of the study

Create a comfortable environment

Build rapport

Use open-ended questions

Listen attentively