Data Analysis Software in Qualitative Research: Preconceptions, Expectations, and Adoption

"I Do Not Believe We Should Disclose Everything to an Older Patient": Challenges and Ethical Concerns in Clinical Decision-Making in Old-Age Care in Ethiopia

Clinical decision-making in old-age care is a complex and ethically sensitive process. Despite its importance, research addressing the challenges of clinical decision-making in old-age care within this cultural context is limited. This study aimed to explore the challenges and ethical concerns in clinical decision-making in old-age care in Ethiopia. This qualitative study employed an inductive approach with data collected via semi-structured interviews with 20 older patients and 26 health professionals recruited from healthcare facilities in Ethiopia. Data were analysed using reflexive thematic analysis. Our analysis identified three key themes. First, participants highlighted perceptions that older patients' religious beliefs interfere with the clinical decisions both older patients and health professionals make. Second, older patients often receive limited information from health professionals about their diagnosis and treatment. Third, families of older patients appear to strongly influence clinical decisions made by older patients or health professionals. This research enhances the understanding of clinical decision-making in old-age care within Ethiopia, a context where such research is scarce. As a result, this study contributes towards advancing the deliberation of ethical dilemmas that health professionals who work with older patients in Ethiopia might face. A key implication of the study is that there is a need for more ethics and cultural competence training for health professionals working with older patients in Ethiopia.

"I was afraid to go to the hospital": A qualitative analysis and ethical implications of the impacts of COVID-19 on the health and medical care of older adults in Ethiopia

Objective

The COVID-19 pandemic has brought severe health consequences among older adults and posed ethical challenges. The aim of this study was to explore the impacts of COVID-19 on the health and medical care of older adults in Ethiopia and associated ethical implications, regardless of older adults' COVID-19 infection status.

Methods

In this qualitative study, we followed an inductive exploratory approach based on reflexive thematic analysis. We conducted semistructured interviews between March 2021 and November 2021 with 20 older adults and 26 health professionals who were selected from healthcare facilities and communities in Ethiopia using purposive and snowball sampling techniques. We audio-recorded, transcribed, translated, and inductively analyzed the interviews using thematic analysis.

Results

Participants reported that the pandemic compromised the accessibility and quality of both COVID and non-COVID healthcare services for older adults, which negatively impacted older adults' health conditions and medical care. Moreover, participants elaborated on the health conditions and care of older patients with COVID-19 and highlighted that older COVID-19 patients often have severe health conditions, do not get adequate COVID-19 care, and may receive lower priority for admission to intensive care units compared to younger patients when resources are limited.

Conclusions

Results of this study showed that practices of COVID-19 care and measures may have led to adverse consequences such as limited availability and access to aged care in Ethiopia, which could have further health consequences on older patients. Our results contribute to a better understanding of ethical issues such as distributive justice and prioritization arising in the healthcare of older patients in times of global pandemic. It is imperative for local and international health policymakers and ethicists to further analyze and address the challenges that compromise the accessibility and continuity of quality care for older persons during a public healthcare crisis.

Computer-Assisted Qualitative Data Analysis Software, Phenomenology, and Colaizzi's Method

Technology is widely used to support qualitative research. Computer-Assisted Qualitative Data Analysis Software (CAQDAS) encompasses complementary technologies to support qualitative analysis. Advantages of CAQDAS include efficient management of data and transparency in analysis. Disadvantages include heavy emphasis on coding as a distractor from analysis and considerable time to learn the program. In this methods article, we, as less experienced, qualitative researchers describe our experiences using NVivo, a CAQDAS program, in a descriptive phenomenological study using Colaizzi's method. Over 1 year, 24 postpartum women were given a secure research link to record their experiences with pain and depression during the third trimester of pregnancy. Although NVivo analysis was helpful, the philosophy of phenomenology, reflexivity, and Colaizzi's method directed researchers away from NVivo for the final summation. Recommendations for future use of CAQDAS used concurrently with Colaizzi's method include the use of word clouds and other visualizations for bracketing and triangulation.

Using Qualitative Data Analysis Software to Support Digital Research Workflows

While software packages such as NVivo are typically considered useful for qualitative data analysis, in actuality they are powerful and flexible enough to serve as the central component of a robust digital research workflow. Various features of these packages can be used across the entire research process from reviewing the literature to writing up the study’s findings. This article provides an overview of available qualitative data analysis software (QDAS) packages, including how to: use software tactics to enact research design strategies; select an appropriate QDAS package; report the use of software in the research report; and consider implications of QDAS use for human resource development scholars.

A Pragmatic Guide to Qualitative Analysis for Pediatric Researchers

OBJECTIVE

To describe four approaches to qualitative analysis in order to provide a pragmatic, application-oriented guide to their use in research focused on children and their families.

METHODS

Four commonly used approaches to qualitative analysis-framework analysis, rapid qualitative analysis, content analysis, and reflexive thematic analysis-are described and compared, including their analytic strategies, tips for use, terminology, and application to a hypothetical example.

RESULTS

A pragmatic guide to each method is provided as well as examples of how each analytic approach could be utilized to analyze the same dataset.

CONCLUSIONS

A variety of approaches to qualitative analysis are available to both novice and experienced qualitative researchers. The approach selected from the options presented in this article will depend on numerous factors, such as the clinical problem being explored, research context, aims, objectives, research questions, and resources available such as time and funds, and the qualitative expertise of the team.

A practical guide for conducting qualitative research in medical education: Part 3-Using software for qualitative analysis

The process of performing qualitative analysis can be a daunting task. Technology can be employed to ease the burden of the work; however, the researcher may not fully appreciate how and when computer software can assist in conducting qualitative analysis. In this, the third installment of our "how-to" series on qualitative research methods, we describe basic concepts and approaches to using both simple word processing programs and specific qualitative research software programs to assist in coding and analysis. We hope that the concepts put forth in this paper will help qualitative researchers become more familiar with available technological approaches and that they will, in turn, enhance the efficiency of the research process as well as the depth, clarity and richness of research findings.

Computer-assisted textual analysis of free-text comments in the Swiss Cancer Patient Experiences (SCAPE) survey

Background

Patient experience surveys are increasingly conducted in cancer care as they provide important results to consider in future development of cancer care and health policymaking. These surveys usually include closed-ended questions (patient-reported experience measures (PREMs)) and space for free-text comments, but published results are mostly based on PREMs. We aimed to identify the underlying themes of patients’ experiences as shared in their own words in the Swiss Cancer Patient Experiences (SCAPE) survey and compare these themes with those assessed with PREMs to investigate how the textual analysis of free-text comments contributes to the understanding of patients’ experiences of care.

Methods

SCAPE is a multicenter cross-sectional survey that was conducted between October 2018 and March 2019 in French-speaking parts of Switzerland. Patients were invited to rate their care in 65 closed-ended questions (PREMs) and to add free-text comments regarding their cancer-related experiences at the end of the survey. We conducted computer-assisted textual analysis using the IRaMuTeQ software on the comments provided by 31% (n = 844) of SCAPE survey respondents (n = 2755).

Results

We identified five main thematic classes, two of which consisting of a detailed description of ‘cancer care pathways’. The remaining three classes were related to ‘medical care’, ‘gratitude and praise’, and the way patients lived with cancer (‘cancer and me’). Further analysis of this last class showed that patients’ comments related to the following themes: ‘initial shock’, ‘loneliness’, ‘understanding and acceptance’, ‘cancer repercussions’, and ‘information and communication’. While closed-ended questions related mainly to factual aspects of experiences of care, free-text comments related primarily to the personal and emotional experiences and consequences of having cancer and receiving care.

Conclusions

A computer-assisted textual analysis of free-text in our patient survey allowed a time-efficient classification of free-text data that provided insights on the personal experience of living with cancer and additional information on patient experiences that had not been collected with the closed-ended questions, underlining the importance of offering space for comments. Such results can be useful to inform questionnaire development, provide feedback to professional teams, and guide patient-centered initiatives to improve the quality and safety of cancer care.