How to appraise qualitative research Evid Based Nurs January 2019 | volume 22 | number 1 | 10 1Nursing Research and Diversity in Care, School of Health and Social Care, London South Bank University,...

How to appraise qualitative research
Evid Based Nurs January 2019 | volume 22 | number 1 | 10
1Nursing Research and Diversity
in Care, School of Health and
Social Care, London South Bank
University, London, UK
2Institute of Vocational Learning,
School of Health and Social Care,
London South Bank University,
London, UK
Co
espondence to:
Dr Calvin Moorley, Nursing
Research and Diversity in Care,
School of Health and Social Care,
London South Bank University,
London SE1 0AA, UK; Moorleyc@
lsbu. ac. uk
How to appraise qualitative research
Calvin Moorley,1 Xabi Cathala2
Research made simple
10.1136/ebnurs XXXXXXXXXXIntroduction
In order to make a decision about implementing evidence
into practice, nurses need to be able to critically appraise
esearch. Nurses also have a professional responsibility
to maintain up-to-date practice.1 This paper provides a
guide on how to critically appraise a qualitative research
paper.
What is qualitative research?
Qualitative research concentrates on understanding
phenomena and may focus on meanings, perceptions,
concepts, thoughts, experiences or feelings.2 Qualitative
esearch examines how or why a phenomenon occurs. It
collects data in the form of words, texts and or images
via interviews, observations, photographs or document
eviews. Qualitative research does not use discrete vari-
ables like those used in quantitative approaches. In crit-
ically appraising qualitative research, steps need to be
taken to ensure its rigour, credibility and trustworthiness
(table 1).
Some of the qualitative approaches used in nursing
esearch include grounded theory, phenomenology,
ethnography, case study (can lend itself to mixed
methods) and na
ative analysis. The data collection
methods used in qualitative research include in depth
interviews, focus groups, observations and stories in the
form of diaries or other documents.3
Authenticity
Title, keywords, authors and abstract
In a previous paper, we discussed how the title, keywords,
authors’ positions and affiliations and abstract can
influence the authenticity and readability of quanti-
tative research papers,4 the same applies to qualitative
esearch. However, other areas such as the purpose of the
study and the research question, theoretical and concep-
tual frameworks, sampling and methodology also need
consideration when appraising a qualitative paper.
Problem
Purpose and question
The topic under investigation in the study should be
guided by a clear research question or a statement of the
problem or purpose. An example of a statement can be
seen in table 2. Unlike most quantitative studies, qual-
itative research does not seek to test a hypothesis. The
esearch statement should be specific to the problem and
should be reflected in the design. This will inform the
eader of what will be studied and justify the purpose
of the study.5
Literature
An appropriate literature review should have been
conducted and summarised in the paper. It should be
linked to the subject, using peer-reviewed primary
esearch which is up to date. We suggest papers with a
age limit of 5–8 years excluding original work. The liter-
ature review should give the reader a balanced view on
what has been written on the subject. It is worth noting
that for some qualitative approaches some literature
eviews are conducted after the data collection to mini-
mise bias, for example, in grounded theory studies. In
phenomenological studies, the review sometimes occurs
after the data analysis. If this is the case, the author(s)
should make this clear.
Theoretical and conceptual frameworks
Most authors use the terms theoretical and concep-
tual frameworks interchangeably. Usually, a theoret-
ical framework is used when research is underpinned
y one theory that aims to help predict, explain and
understand the topic investigated. A theoretical frame-
work is the blueprint that can hold or scaffold a study’s
theory. Conceptual frameworks are based on concepts
from various theories and findings which help to guide
the research.6 It is the researcher’s understanding of
how different variables are connected in the study, for
example, the literature review and research question.
Theoretical and conceptual frameworks connect the
esearcher to existing knowledge and these are used in
a study to help to explain and understand what is being
investigated. A framework is the design or map for a
study. When you are appraising a qualitative paper, you
should be able to see how the framework helped with
(1) providing a rationale and (2) the development of
esearch questions or statements.7 You should be able to
identify how the framework, research question, purpose
and literature review all complement each other.
Sampling
There remains an ongoing debate in relation to what
an appropriate sample size should be for a qualitative
study. We hold the view that qualitative research does
not seek to power and a sample size can be as small
as one (eg, a single case study) or any number above
one (a grounded theory study) providing that it is appro-
priate and answers the research problem. Shorten and
Moorley8 explain that three main types of sampling exist
in qualitative research: (1) convenience (2) judgement
or (3) theoretical. In the paper , the sample size should
e stated and a rationale for how it was decided should
e clear.
Methodology
Qualitative research encompasses a variety of methods
and designs. Based on the chosen method or design, the
findings may be reported in a variety of different formats.
Table 3 provides the main qualitative approaches used in
nursing with a short description.
Procedure
The authors should make it clear why they are using
a qualitative methodology and the chosen theoretical
approach or framework. The paper should provide details
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Evid Based Nurs January 2019 | volume 22 | number 1 | 11
Research made simple
of participant inclusion and exclusion criteria as well as
ecruitment sites where the sample was drawn from, for
example, u
an, rural, hospital inpatient or community.
Methods of data collection should be identified and be
appropriate for the research statement/question.
Data collection
Overall there should be a clear trail of data collection.
The paper should explain when and how the study was
advertised, participants were recruited and consented. it
should also state when and where the data collection
took place. Data collection methods include inter-
views, this can be structured or unstructured and in
depth one to one or group.9 Group interviews are often
efe
ed to as focus group interviews these are often
voice recorded and transcribed ve
atim. It should be
clear if these were conducted face to face, telephone or
any other type of media used. Table  3 includes some
data collection methods. Other collection methods not
included in table  3 examples are observation, diaries,
video recording, photographs, documents or objects
(artefacts). The schedule of questions for interview or
the protocol for non-interview data collection should
e provided, available or discussed in the paper. Some
authors may use the term ‘recruitment ended once data
saturation was reached’. This simply mean that the
esearchers were not gaining any new information at
subsequent interviews, so they stopped data collection.
The data collection section should include details of
the ethical approval gained to ca
y out the study. For
example, the strategies used to gain participants’ consent
to take part in the study. The authors should make clear
if any ethical issues arose and how these were resolved
or managed.
Table 1 Useful terms
Term Description
Credibility Credibility is establishing the study’s
findings with reality. This demonstrates
the believability or truth of the findings.
It ascertains whether the study findings
are believable based on the participants’
original data and participants’ views.
Confirmability Confirmability questions how the
study findings are supported by the
data. It identifies any bias that may
have been present. It is the level to
which the findings can be confirmed
or co
oborated. Confirmability is
concerned with determining that data
and interpretations of the findings are not
made up by the researcher’s imagination,
ut clearly derived from the data.
Member
checking
This is a technique in which the data,
interpretations, analytical categories
and conclusions are fed back to the
participants from whom the data were
collected. This process strengthens the
data as it allows participants to clarify
and co
ect any e
ors and provide
additional information if necessary. It
can also highlight how participants and
esearchers view the data differently.
Rigour This is the systematic approach and
techniques used to ensure reliability and
validity of the study.
Reflexivity Reflexivity is the practice of critical
self-reflection about oneself as a
esearcher. It involves looking at one’s
iases, preferences and preconceptions.
The researcher should reflect on their
elationship to the participant, and how
the relationship affects participant’s
answers to questions or decisions in the
esearch. For example, how does being a
nurse impact on interviewing a patient in
your care?
Triangulation Triangulation refers to the use of different
ways of collecting or analysing data and
the cross-checking of these to see if
findings from different methods, different
analysts, different theories or different
eliability checks of sources show similar
esults.
Trustworthiness Trustworthiness is concerned with how
the researchers establish the study
findings as credible, transferable and
confirmable.
Transferability This refers to the level of which the study
findings can be transfe
ed to other
situations. The reader should look at the
detail of the study including the methods
and rigour applied and compare this to
their own situation to determine if the
findings can be applied to their own
situation.
Table 2 Example of research question and problem
statement
Research
question
How do patients’ experience postoperative
pain control management?
Statement of
problem/aim
To explore patients’ experience of
postoperative pain control
Table 3 Different qualitative approaches
Type of qualitative
approach Description
Ethnography Researches the behaviour, interaction,
perception and link between people,
groups and community. Often has
an anthropological component and
focuses on context or culture. Data
usually collected using interviews or
observations.
Grounded theory Data systematically collected usually
through interviews. The researcher