strengths of using interviews in research

Advantages and Disadvantages of Interview in Research

Approaching the Respondent- according to the Interviewer’s Manual, the introductory tasks of the interviewer are: tell the interviewer is and whom he or she represents; telling him about what the study is, in a way to stimulate his interest. The interviewer has also ensured at this stage that his answers are confidential; tell the respondent how he was chosen; use letters and clippings of surveys in order to show the importance of the study to the respondent. The interviewer must be adaptable, friendly, responsive, and should make the interviewer feel at ease to say anything, even if it is irrelevant.

Dealing with Refusal- there can be plenty of reasons for refusing for an interview, for example, a respondent may feel that surveys are a waste of time, or may express anti-government feeling. It is the interviewer’s job to determine the reason for the refusal of the interview and attempt to overcome it.

Conducting the Interview- the questions should be asked as worded for all respondents in order to avoid misinterpretation of the question. Clarification of the question should also be avoided for the same reason. However, the questions can be repeated in case of misunderstanding. The questions should be asked in the same order as mentioned in the questionnaire, as a particular question might not make sense if the questions before they are skipped. The interviewers must be very careful to be neutral before starting the interview so as not to lead the respondent, hence minimizing bias.

listing out the advantages of interview studies, which are noted below:

• It provides flexibility to the interviewers
• The interview has a better response rate than mailed questions, and the people who cannot read and write can also answer the questions.
• The interviewer can judge the non-verbal behavior of the respondent.
• The interviewer can decide the place for an interview in a private and silent place, unlike the ones conducted through emails which can have a completely different environment.
• The interviewer can control over the order of the question, as in the questionnaire, and can judge the spontaneity of the respondent as well.

There are certain disadvantages of interview studies as well which are:

• Conducting interview studies can be very costly as well as very time-consuming.
• An interview can cause biases. For example, the respondent’s answers can be affected by his reaction to the interviewer’s race, class, age or physical appearance.
• Interview studies provide less anonymity, which is a big concern for many respondents.
• There is a lack of accessibility to respondents (unlike conducting mailed questionnaire study) since the respondents can be in around any corner of the world or country.

INTERVIEW AS SOCIAL INTERACTION

The interview subjects to the same rules and regulations of other instances of social interaction. It is believed that conducting interview studies has possibilities for all sorts of bias, inconsistency, and inaccuracies and hence many researchers are critical of the surveys and interviews. T.R. William says that in certain societies there may be patterns of people saying one thing, but doing another. He also believes that the responses should be interpreted in context and two social contexts should not be compared to each other. Derek L. Phillips says that the survey method itself can manipulate the data, and show the results that actually does not exist in the population in real. Social research becomes very difficult due to the variability in human behavior and attitude. Other errors that can be caused in social research include-

• deliberate lying, because the respondent does not want to give a socially undesirable answer;
• unconscious mistakes, which mostly occurs when the respondent has socially undesirable traits that he does not want to accept;
• when the respondent accidentally misunderstands the question and responds incorrectly;
• when the respondent is unable to remember certain details.

Apart from the errors caused by the responder, there are also certain errors made by the interviewers that may include-

• errors made by altering the questionnaire, through changing some words or omitting certain questions;
• biased, irrelevant, inadequate or unnecessary probing;
• recording errors, or consciously making errors in recording.

Bailey, K. (1994). Interview Studies in Methods of social research. Simonand Schuster, 4th ed. The Free Press, New York NY 10020.Ch8. Pp.173-213.

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The Interview Method In Psychology

Saul Mcleod, PhD

Editor-in-Chief for Simply Psychology

BSc (Hons) Psychology, MRes, PhD, University of Manchester

Saul Mcleod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.

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Interviews involve a conversation with a purpose, but have some distinct features compared to ordinary conversation, such as being scheduled in advance, having an asymmetry in outcome goals between interviewer and interviewee, and often following a question-answer format.

Interviews are different from questionnaires as they involve social interaction. Unlike questionnaire methods, researchers need training in interviewing (which costs money).

How Do Interviews Work?

Researchers can ask different types of questions, generating different types of data . For example, closed questions provide people with a fixed set of responses, whereas open questions allow people to express what they think in their own words.

The researcher will often record interviews, and the data will be written up as a transcript (a written account of interview questions and answers) which can be analyzed later.

It should be noted that interviews may not be the best method for researching sensitive topics (e.g., truancy in schools, discrimination, etc.) as people may feel more comfortable completing a questionnaire in private.

There are different types of interviews, with a key distinction being the extent of structure. Semi-structured is most common in psychology research. Unstructured interviews have a free-flowing style, while structured interviews involve preset questions asked in a particular order.

Structured Interview

A structured interview is a quantitative research method where the interviewer a set of prepared closed-ended questions in the form of an interview schedule, which he/she reads out exactly as worded.

Interviews schedules have a standardized format, meaning the same questions are asked to each interviewee in the same order (see Fig. 1).

   Figure 1. An example of an interview schedule

The interviewer will not deviate from the interview schedule (except to clarify the meaning of the question) or probe beyond the answers received.  Replies are recorded on a questionnaire, and the order and wording of questions, and sometimes the range of alternative answers, is preset by the researcher.

A structured interview is also known as a formal interview (like a job interview).

• Structured interviews are easy to replicate as a fixed set of closed questions are used, which are easy to quantify – this means it is easy to test for reliability .
• Structured interviews are fairly quick to conduct which means that many interviews can take place within a short amount of time. This means a large sample can be obtained, resulting in the findings being representative and having the ability to be generalized to a large population.

Limitations

• Structured interviews are not flexible. This means new questions cannot be asked impromptu (i.e., during the interview), as an interview schedule must be followed.
• The answers from structured interviews lack detail as only closed questions are asked, which generates quantitative data . This means a researcher won’t know why a person behaves a certain way.

Unstructured Interview

Unstructured interviews do not use any set questions, instead, the interviewer asks open-ended questions based on a specific research topic, and will try to let the interview flow like a natural conversation. The interviewer modifies his or her questions to suit the candidate’s specific experiences.

Unstructured interviews are sometimes referred to as ‘discovery interviews’ and are more like a ‘guided conservation’ than a strictly structured interview. They are sometimes called informal interviews.

Unstructured interviews are most useful in qualitative research to analyze attitudes and values. Though they rarely provide a valid basis for generalization, their main advantage is that they enable the researcher to probe social actors’ subjective points of view.

Interviewer Self-Disclosure

Interviewer self-disclosure involves the interviewer revealing personal information or opinions during the research interview. This may increase rapport but risks changing dynamics away from a focus on facilitating the interviewee’s account.

In unstructured interviews, the informal conversational style may deliberately include elements of interviewer self-disclosure, mirroring ordinary conversation dynamics.

Interviewer self-disclosure risks changing the dynamics away from facilitation of interviewee accounts. It should not be ruled out entirely but requires skillful handling informed by reflection.

• An informal interviewing style with some interviewer self-disclosure may increase rapport and participant openness. However, it also increases the chance of the participant converging opinions with the interviewer.
• Complete interviewer neutrality is unlikely. However, excessive informality and self-disclosure risk the interview becoming more of an ordinary conversation and producing consensus accounts.
• Overly personal disclosures could also be seen as irrelevant and intrusive by participants. They may invite increased intimacy on uncomfortable topics.
• The safest approach seems to be to avoid interviewer self-disclosures in most cases. Where an informal style is used, disclosures require careful judgment and substantial interviewing experience.
• If asked for personal opinions during an interview, the interviewer could highlight the defined roles and defer that discussion until after the interview.
• Unstructured interviews are more flexible as questions can be adapted and changed depending on the respondents’ answers. The interview can deviate from the interview schedule.
• Unstructured interviews generate qualitative data through the use of open questions. This allows the respondent to talk in some depth, choosing their own words. This helps the researcher develop a real sense of a person’s understanding of a situation.
• They also have increased validity because it gives the interviewer the opportunity to probe for a deeper understanding, ask for clarification & allow the interviewee to steer the direction of the interview, etc. Interviewers have the chance to clarify any questions of participants during the interview.
• It can be time-consuming to conduct an unstructured interview and analyze the qualitative data (using methods such as thematic analysis).
• Employing and training interviewers is expensive and not as cheap as collecting data via questionnaires . For example, certain skills may be needed by the interviewer. These include the ability to establish rapport and knowing when to probe.
• Interviews inevitably co-construct data through researchers’ agenda-setting and question-framing. Techniques like open questions provide only limited remedies.

Focus Group Interview

Focus group interview is a qualitative approach where a group of respondents are interviewed together, used to gain an in‐depth understanding of social issues.

This type of interview is often referred to as a focus group because the job of the interviewer ( or moderator ) is to bring the group to focus on the issue at hand. Initially, the goal was to reach a consensus among the group, but with the development of techniques for analyzing group qualitative data, there is less emphasis on consensus building.

The method aims to obtain data from a purposely selected group of individuals rather than from a statistically representative sample of a broader population.

The role of the interview moderator is to make sure the group interacts with each other and do not drift off-topic. Ideally, the moderator will be similar to the participants in terms of appearance, have adequate knowledge of the topic being discussed, and exercise mild unobtrusive control over dominant talkers and shy participants.

A researcher must be highly skilled to conduct a focus group interview. For example, the moderator may need certain skills, including the ability to establish rapport and know when to probe.

• Group interviews generate qualitative narrative data through the use of open questions. This allows the respondents to talk in some depth, choosing their own words. This helps the researcher develop a real sense of a person’s understanding of a situation. Qualitative data also includes observational data, such as body language and facial expressions.
• Group responses are helpful when you want to elicit perspectives on a collective experience, encourage diversity of thought, reduce researcher bias, and gather a wider range of contextualized views.
• They also have increased validity because some participants may feel more comfortable being with others as they are used to talking in groups in real life (i.e., it’s more natural).
• When participants have common experiences, focus groups allow them to build on each other’s comments to provide richer contextual data representing a wider range of views than individual interviews.
• Focus groups are a type of group interview method used in market research and consumer psychology that are cost – effective for gathering the views of consumers .
• The researcher must ensure that they keep all the interviewees” details confidential and respect their privacy. This is difficult when using a group interview. For example, the researcher cannot guarantee that the other people in the group will keep information private.
• Group interviews are less reliable as they use open questions and may deviate from the interview schedule, making them difficult to repeat.
• It is important to note that there are some potential pitfalls of focus groups, such as conformity, social desirability, and oppositional behavior, that can reduce the usefulness of the data collected.

For example, group interviews may sometimes lack validity as participants may lie to impress the other group members. They may conform to peer pressure and give false answers.

To avoid these pitfalls, the interviewer needs to have a good understanding of how people function in groups as well as how to lead the group in a productive discussion.

Semi-Structured Interview

Semi-structured interviews lie between structured and unstructured interviews. The interviewer prepares a set of same questions to be answered by all interviewees. Additional questions might be asked during the interview to clarify or expand certain issues.

In semi-structured interviews, the interviewer has more freedom to digress and probe beyond the answers. The interview guide contains a list of questions and topics that need to be covered during the conversation, usually in a particular order.

Semi-structured interviews are most useful to address the ‘what’, ‘how’, and ‘why’ research questions. Both qualitative and quantitative analyses can be performed on data collected during semi-structured interviews.

• Semi-structured interviews allow respondents to answer more on their terms in an informal setting yet provide uniform information making them ideal for qualitative analysis.
• The flexible nature of semi-structured interviews allows ideas to be introduced and explored during the interview based on the respondents’ answers.
• Semi-structured interviews can provide reliable and comparable qualitative data. Allows the interviewer to probe answers, where the interviewee is asked to clarify or expand on the answers provided.
• The data generated remain fundamentally shaped by the interview context itself. Analysis rarely acknowledges this endemic co-construction.
• They are more time-consuming (to conduct, transcribe, and analyze) than structured interviews.
• The quality of findings is more dependent on the individual skills of the interviewer than in structured interviews. Skill is required to probe effectively while avoiding biasing responses.

The Interviewer Effect

Face-to-face interviews raise methodological problems. These stem from the fact that interviewers are themselves role players, and their perceived status may influence the replies of the respondents.

Because an interview is a social interaction, the interviewer’s appearance or behavior may influence the respondent’s answers. This is a problem as it can bias the results of the study and make them invalid.

For example, the gender, ethnicity, body language, age, and social status of the interview can all create an interviewer effect. If there is a perceived status disparity between the interviewer and the interviewee, the results of interviews have to be interpreted with care. This is pertinent for sensitive topics such as health.

For example, if a researcher was investigating sexism amongst males, would a female interview be preferable to a male? It is possible that if a female interviewer was used, male participants might lie (i.e., pretend they are not sexist) to impress the interviewer, thus creating an interviewer effect.

Flooding interviews with researcher’s agenda

The interactional nature of interviews means the researcher fundamentally shapes the discourse, rather than just neutrally collecting it. This shapes what is talked about and how participants can respond.

• The interviewer’s assumptions, interests, and categories don’t just shape the specific interview questions asked. They also shape the framing, task instructions, recruitment, and ongoing responses/prompts.
• This flooding of the interview interaction with the researcher’s agenda makes it very difficult to separate out what comes from the participant vs. what is aligned with the interviewer’s concerns.
• So the participant’s talk ends up being fundamentally shaped by the interviewer rather than being a more natural reflection of the participant’s own orientations or practices.
• This effect is hard to avoid because interviews inherently involve the researcher setting an agenda. But it does mean the talk extracted may say more about the interview process than the reality it is supposed to reflect.

Interview Design

First, you must choose whether to use a structured or non-structured interview.

Characteristics of Interviewers

Next, you must consider who will be the interviewer, and this will depend on what type of person is being interviewed. There are several variables to consider:

• Gender and age : This can greatly affect respondents’ answers, particularly on personal issues.
• Personal characteristics : Some people are easier to get on with than others. Also, the interviewer’s accent and appearance (e.g., clothing) can affect the rapport between the interviewer and interviewee.
• Language : The interviewer’s language should be appropriate to the vocabulary of the group of people being studied. For example, the researcher must change the questions’ language to match the respondents’ social background” age / educational level / social class/ethnicity, etc.
• Ethnicity : People may have difficulty interviewing people from different ethnic groups.
• Interviewer expertise should match research sensitivity – inexperienced students should avoid interviewing highly vulnerable groups.

Interview Location

The location of a research interview can influence the way in which the interviewer and interviewee relate and may exaggerate a power dynamic in one direction or another. It is usual to offer interviewees a choice of location as part of facilitating their comfort and encouraging participation.

However, the safety of the interviewer is an overriding consideration and, as mentioned, a minimal requirement should be that a responsible person knows where the interviewer has gone and when they are due back.

Remote Interviews

The COVID-19 pandemic necessitated remote interviewing for research continuity. However online interview platforms provide increased flexibility even under normal conditions.

They enable access to participant groups across geographical distances without travel costs or arrangements. Online interviews can be efficiently scheduled to align with researcher and interviewee availability.

There are practical considerations in setting up remote interviews. Interviewees require access to internet and an online platform such as Zoom, Microsoft Teams or Skype through which to connect.

Certain modifications help build initial rapport in the remote format. Allowing time at the start of the interview for casual conversation while testing audio/video quality helps participants settle in. Minor delays can disrupt turn-taking flow, so alerting participants to speak slightly slower than usual minimizes accidental interruptions.

Keeping remote interviews under an hour avoids fatigue for stare at a screen. Seeking advanced ethical clearance for verbal consent at the interview start saves participant time. Adapting to the remote context shows care for interviewees and aids rich discussion.

However, it remains important to critically reflect on how removing in-person dynamics may shape the co-created data. Perhaps some nuances of trust and disclosure differ over video.

Vulnerable Groups

The interviewer must ensure that they take special care when interviewing vulnerable groups, such as children. For example, children have a limited attention span, so lengthy interviews should be avoided.

Developing an Interview Schedule

An interview schedule is a list of pre-planned, structured questions that have been prepared, to serve as a guide for interviewers, researchers and investigators in collecting information or data about a specific topic or issue.

• List the key themes or topics that must be covered to address your research questions. This will form the basic content.
• Organize the content logically, such as chronologically following the interviewee’s experiences. Place more sensitive topics later in the interview.
• Develop the list of content into actual questions and prompts. Carefully word each question – keep them open-ended, non-leading, and focused on examples.
• Add prompts to remind you to cover areas of interest.
• Pilot test the interview schedule to check it generates useful data and revise as needed.
• Be prepared to refine the schedule throughout data collection as you learn which questions work better.
• Practice skills like asking follow-up questions to get depth and detail. Stay flexible to depart from the schedule when needed.
• Keep questions brief and clear. Avoid multi-part questions that risk confusing interviewees.
• Listen actively during interviews to determine which pre-planned questions can be skipped based on information the participant has already provided.

The key is balancing preparation with the flexibility to adapt questions based on each interview interaction. With practice, you’ll gain skills to conduct productive interviews that obtain rich qualitative data.

The Power of Silence

Strategic use of silence is a key technique to generate interviewee-led data, but it requires judgment about appropriate timing and duration to maintain mutual understanding.

• Unlike ordinary conversation, the interviewer aims to facilitate the interviewee’s contribution without interrupting. This often means resisting the urge to speak at the end of the interviewee’s turn construction units (TCUs).
• Leaving a silence after a TCU encourages the interviewee to provide more material without being led by the interviewer. However, this simple technique requires confidence, as silence can feel socially awkward.
• Allowing longer silences (e.g. 24 seconds) later in interviews can work well, but early on even short silences may disrupt rapport if they cause misalignment between speakers.
• Silence also allows interviewees time to think before answering. Rushing to re-ask or amend questions can limit responses.
• Blunt backchannels like “mm hm” also avoid interrupting flow. Interruptions, especially to finish an interviewee’s turn, are problematic as they make the ownership of perspectives unclear.
• If interviewers incorrectly complete turns, an upside is it can produce extended interviewee narratives correcting the record. However, silence would have been better to let interviewees shape their own accounts.

Recording & Transcription

Design choices.

Design choices around recording and engaging closely with transcripts influence analytic insights, as well as practical feasibility. Weighing up relevant tradeoffs is key.

• Audio recording is standard, but video better captures contextual details, which is useful for some topics/analysis approaches. Participants may find video invasive for sensitive research.
• Digital formats enable the sharing of anonymized clips. Additional microphones reduce audio issues.
• Doing all transcription is time-consuming. Outsourcing can save researcher effort but needs confidentiality assurances. Always carefully check outsourced transcripts.
• Online platform auto-captioning can facilitate rapid analysis, but accuracy limitations mean full transcripts remain ideal. Software cleans up caption file formatting.
• Verbatim transcripts best capture nuanced meaning, but the level of detail needed depends on the analysis approach. Referring back to recordings is still advisable during analysis.
• Transcripts versus recordings highlight different interaction elements. Transcripts make overt disagreements clearer through the wording itself. Recordings better convey tone affiliativeness.

Transcribing Interviews & Focus Groups

Here are the steps for transcribing interviews:

• Play back audio/video files to develop an overall understanding of the interview
• Format the transcription document:
• Add line numbers
• Separate interviewer questions and interviewee responses
• Use formatting like bold, italics, etc. to highlight key passages
• Provide sentence-level clarity in the interviewee’s responses while preserving their authentic voice and word choices
• Break longer passages into smaller paragraphs to help with coding
• If translating the interview to another language, use qualified translators and back-translate where possible
• Select a notation system to indicate pauses, emphasis, laughter, interruptions, etc., and adapt it as needed for your data
• Insert screenshots, photos, or documents discussed in the interview at the relevant point in the transcript
• Read through multiple times, revising formatting and notations
• Double-check the accuracy of transcription against audio/videos
• De-identify transcript by removing identifying participant details

The goal is to produce a formatted written record of the verbal interview exchange that captures the meaning and highlights important passages ready for the coding process. Careful transcription is the vital first step in analysis.

Coding Transcripts

The goal of transcription and coding is to systematically transform interview responses into a set of codes and themes that capture key concepts, experiences and beliefs expressed by participants. Taking care with transcription and coding procedures enhances the validity of qualitative analysis .

• Read through the transcript multiple times to become immersed in the details
• Identify manifest/obvious codes and latent/underlying meaning codes
• Highlight insightful participant quotes that capture key concepts (in vivo codes)
• Create a codebook to organize and define codes with examples
• Use an iterative cycle of inductive (data-driven) coding and deductive (theory-driven) coding
• Refine codebook with clear definitions and examples as you code more transcripts
• Collaborate with other coders to establish the reliability of codes

Ethical Issues

Informed consent.

The participant information sheet must give potential interviewees a good idea of what is involved if taking part in the research.

This will include the general topics covered in the interview, where the interview might take place, how long it is expected to last, how it will be recorded, the ways in which participants’ anonymity will be managed, and incentives offered.

It might be considered good practice to consider true informed consent in interview research to require two distinguishable stages:

• Consent to undertake and record the interview and
• Consent to use the material in research after the interview has been conducted and the content known, or even after the interviewee has seen a copy of the transcript and has had a chance to remove sections, if desired.

Power and Vulnerability

• Early feminist views that sensitivity could equalize power differences are likely naive. The interviewer and interviewee inhabit different knowledge spheres and social categories, indicating structural disparities.
• Power fluctuates within interviews. Researchers rely on participation, yet interviewees control openness and can undermine data collection. Assumptions should be avoided.
• Interviews on sensitive topics may feel like quasi-counseling. Interviewers must refrain from dual roles, instead supplying support service details to all participants.
• Interviewees recruited for trauma experiences may reveal more than anticipated. While generating analytic insights, this risks leaving them feeling exposed.
• Ultimately, power balances resist reconciliation. But reflexively analyzing operations of power serves to qualify rather than nullify situtated qualitative accounts.

Some groups, like those with mental health issues, extreme views, or criminal backgrounds, risk being discredited – treated skeptically by researchers.

This creates tensions with qualitative approaches, often having an empathetic ethos seeking to center subjective perspectives. Analysis should balance openness to offered accounts with critically examining stakes and motivations behind them.

Potter, J., & Hepburn, A. (2005). Qualitative interviews in psychology: Problems and possibilities.  Qualitative research in Psychology ,  2 (4), 281-307.

Houtkoop-Steenstra, H. (2000). Interaction and the standardized survey interview: The living questionnaire . Cambridge University Press

Madill, A. (2011). Interaction in the semi-structured interview: A comparative analysis of the use of and response to indirect complaints. Qualitative Research in Psychology, 8 (4), 333–353.

Maryudi, A., & Fisher, M. (2020). The power in the interview: A practical guide for identifying the critical role of actor interests in environment research. Forest and Society, 4 (1), 142–150

O’Key, V., Hugh-Jones, S., & Madill, A. (2009). Recruiting and engaging with people in deprived locales: Interviewing families about their eating patterns. Social Psychological Review, 11 (20), 30–35.

Puchta, C., & Potter, J. (2004). Focus group practice . Sage.

Schaeffer, N. C. (1991). Conversation with a purpose— Or conversation? Interaction in the standardized interview. In P. P. Biemer, R. M. Groves, L. E. Lyberg, & N. A. Mathiowetz (Eds.), Measurement errors in surveys (pp. 367–391). Wiley.

Silverman, D. (1973). Interview talk: Bringing off a research instrument. Sociology, 7 (1), 31–48.

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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 .

Table of contents

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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Strengths and Weaknesses of Qualitative Interviews

As the preceding sections have suggested, qualitative interviews are an excellent way to gather detailed information. Whatever topic is of interest to the researcher employing this method can be explored in much more depth than with almost any other method. Not only are participants given the opportunity to elaborate in a way that is not possible with other methods such as survey research, but they also are able share information with researchers in their own words and from their own perspectives rather than being asked to fit those perspectives into the perhaps limited response options provided by the researcher. And because qualitative interviews are designed to elicit detailed information, they are especially useful when a researcher’s aim is to study social processes, or the “how” of various phenomena. Yet another, and sometimes overlooked, benefit of qualitative interviews that occurs in person is that researchers can make observations beyond those that a respondent is orally reporting. A respondent’s body language, and even her or his choice of time and location for the interview, might provide a researcher with useful data.

Of course, all these benefits do not come without some drawbacks. As with quantitative survey research, qualitative interviews rely on respondents’ ability to accurately and honestly recall whatever details about their lives, circumstances, thoughts, opinions, or behaviors that are being asked about. As Esterberg (2002) puts it, “If you want to know about what people actually do, rather than what they say they do, you should probably use observation [instead of interviews].” 1 Further, as you may have already guessed, qualitative interviewing is time intensive and can be quite expensive. Creating an interview guide, identifying a sample, and conducting interviews are just the beginning. Transcribing interviews is labor intensive—and that’s before coding even begins. It is also not uncommon to offer respondents some monetary incentive or thank-you for participating. Keep in mind that you are asking for more of participants’ time than if you’d simply mailed them a questionnaire containing closed-ended questions. Conducting qualitative interviews is not only labor intensive but also emotionally taxing. When I interviewed young workers about their sexual harassment experiences, I heard stories that were shocking, infuriating, and sad. Seeing and hearing the impact that harassment had had on respondents was difficult. Researchers embarking on a qualitative interview project should keep in mind their own abilities to hear stories that may be difficult to hear.

KEY TAKEAWAYS

• In-depth interviews are semi-structured interviews where the researcher has topics and questions in mind to ask, but questions are open ended and flow according to how the participant responds to each.
• Interview guides can vary in format but should contain some outline of the topics you hope to cover during the course of an interview.
• NVivo and Atlasti are computer programs that qualitative researchers use to help them with organizing, sorting, and analyzing their data.
• Qualitative interviews allow respondents to share information in their own words and are useful for gathering detailed information and understanding social processes.
• Drawbacks of qualitative interviews include reliance on respondents’ accuracy and their intensity in terms of time, expense, and possible emotional strain.
• Based on a research question you have identified through earlier exercises in this text, write a few open-ended questions you could ask were you to conduct in-depth interviews on the topic. Now critique your questions. Are any of them yes/no questions? Are any of them leading?
• Read the open-ended questions you just created, and answer them as though you were an interview participant. Were your questions easy to answer or fairly difficult? How did you feel talking about the topics you asked yourself to discuss? How might respondents feel talking about them?
• 90747 reads
• Relevance, Balance, and Accessibility
• Different Sources of Knowledge
• Ontology and Epistemology KEY TAKEAWAYS EXERCISES
• The Science of Sociology
• Specific Considerations for the Social Sciences KEY TAKEAWAYS EXERCISES
• Consuming Research and Living With Its Results
• Research as Employment Opportunity KEY TAKEAWAYS EXERCISES
• Design and Goals of This Text LEARNING OBJECTIVES KEY TAKEAWAYS EXERCISE
• Sociology at Three Different Levels KEY TAKEAWAYS EXERCISES
• Paradigms in Social Science
• Sociological Theories KEY TAKEAWAYS EXERCISES
• Inductive Approaches and Some Examples
• Deductive Approaches and Some Examples
• Complementary Approaches? KEY TAKEAWAYS EXERCISES
• Revisiting an Earlier Question LEARNING OBJECTIVES KEY TAKEAWAYS EXERCISE
• Human Research Versus Nonhuman Research
• A Historical Look at Research on Humans
• Institutional Review Boards KEY TAKEAWAYS EXERCISES
• Informed Consent
• Protection of Identities
• Disciplinary Considerations KEY TAKEAWAYS EXERCISES
• Ethics at Micro, Meso, and Macro Levels LEARNING OBJECTIVE KEY TAKEAWAYS EXERCISES
• Doing Science the Ethical Way
• Using Science the Ethical Way KEY TAKEAWAYS EXERCISES
• How Do You Feel About Where You Already Are?
• What Do You Know About Where You Already Are? KEY TAKEAWAYS EXERCISES
• Is It Empirical? LEARNING OBJECTIVES KEY TAKEAWAYS EXERCISES
• What Is Sociology?
• What Is Not Sociology? KEY TAKEAWAYS EXERCISES
• Sociologists as Paparazzi?
• Some Specific Examples KEY TAKEAWAYS EXERCISES
• Feasibility
• Field Trip: Visit Your Library KEY TAKEAWAYS EXERCISES
• Exploration, Description, Explanation
• Idiographic or Nomothetic?
• Applied or Basic? KEY TAKEAWAYS EXERCISES
• Units of Analysis and Units of Observation
• Hypotheses KEY TAKEAWAYS EXERCISES
• Triangulation LEARNING OBJECTIVES KEY TAKEAWAYS EXERCISES
• Searching for Literature
• Reviewing the Literature
• Additional Important Components KEY TAKEAWAYS EXERCISES
• What Do Social Scientists Measure?
• How Do Social Scientists Measure? KEY TAKEAWAYS EXERCISE
• Concepts and Conceptualization
• A Word of Caution About Conceptualization KEY TAKEAWAYS EXERCISES
• Putting It All Together KEY TAKEAWAYS EXERCISE
• Reliability
• Validity KEY TAKEAWAYS EXERCISES
• Levels of Measurement
• Indexes, Scales, and Typologies KEY TAKEAWAYS EXERCISES
• Populations Versus Samples LEARNING OBJECTIVE KEY TAKEAWAYS EXERCISES
• Nonprobability Sampling
• Types of Nonprobability Samples KEY TAKEAWAYS EXERCISES
• Probability Sampling
• Types of Probability Samples KEY TAKEAWAYS EXERCISES
• Who Sampled, How Sampled, and for What Purpose? KEY TAKEAWAYS EXERCISES
• Survey Research: What Is It and When Should It Be Used? LEARNING OBJECTIVES KEY TAKEAWAY EXERCISE
• Strengths of Survey Method
• Weaknesses of Survey Method KEY TAKEAWAYS EXERCISES
• Administration KEY TAKEAWAYS EXERCISES
• Asking Effective Questions
• Response Options
• Designing Questionnaires KEY TAKEAWAYS EXERCISES
• From Completed Questionnaires to Analyzable Data
• Identifying Patterns KEY TAKEAWAYS EXERCISES
• Interview Research: What Is It and When Should It Be Used? LEARNING OBJECTIVES KEY TAKEAWAYS EXERCISE
• Conducting Qualitative Interviews
• Analysis of Qualitative Interview Data
• Strengths and Weaknesses of Qualitative Interviews KEY TAKEAWAYS EXERCISES
• Conducting Quantitative Interviews
• Analysis of Quantitative Interview Data
• Strengths and Weaknesses of Quantitative Interviews KEY TAKEAWAYS EXERCISES
• Location, Location, Location
• Researcher-Respondent Relationship KEY TAKEAWAYS EXERCISES
• Field Research: What Is It and When to Use It? LEARNING OBJECTIVES KEY TAKEAWAYS EXERCISES
• Strengths of Field Research
• Weaknesses of Field Research KEY TAKEAWAYS EXERCISES
• Choosing a Site
• Choosing a Role KEY TAKEAWAYS EXERCISES
• Writing in the Field
• Writing out of the Field KEY TAKEAWAYS EXERCISE
• From Description to Analysis KEY TAKEAWAYS EXERCISE
• Unobtrusive Research: What Is It and When to Use It? LEARNING OBJECTIVES KEY TAKEAWAYS EXERCISES
• Strengths of Unobtrusive Research
• Weaknesses of Unobtrusive Research KEY TAKEAWAYS EXERCISES
• Content Analysis
• Indirect Measures
• Analysis of Unobtrusive Data Collected by You KEY TAKEAWAYS EXERCISES
• Analyzing Others’ Data LEARNING OBJECTIVES KEY TAKEAWAYS EXERCISES
• Reliability in Unobtrusive Research LEARNING OBJECTIVES KEY TAKEAWAYS EXERCISE
• Focus Groups LEARNING OBJECTIVES KEY TAKEAWAYS EXERCISES
• Experiments LEARNING OBJECTIVES KEY TAKEAWAYS EXERCISES
• Ethnomethodology and Conversation Analysis LEARNING OBJECTIVES KEY TAKEAWAYS EXERCISE
• Sharing It All: The Good, the Bad, and the Ugly
• Knowing Your Audience KEY TAKEAWAYS EXERCISE
• Presenting Your Research LEARNING OBJECTIVES KEY TAKEAWAYS EXERCISES
• Writing Up Research Results LEARNING OBJECTIVES KEY TAKEAWAYS EXERCISES
• Disseminating Findings LEARNING OBJECTIVES KEY TAKEAWAYS EXERCISES
• Reading Reports of Sociological Research LEARNING OBJECTIVES KEY TAKEAWAYS EXERCISES
• Being a Responsible Consumer of Research LEARNING OBJECTIVE KEY TAKEAWAY EXERCISE
• Media Reports of Sociological Research LEARNING OBJECTIVES KEY TAKEAWAYS EXERCISES
• Sociological Research: It’s Everywhere LEARNING OBJECTIVES KEY TAKEAWAYS EXERCISE
• Evaluation Research
• Market Research
• Policy and Other Government Research KEY TAKEAWAY EXERCISE
• Doing Research for a Cause LEARNING OBJECTIVES KEY TAKEAWAYS EXERCISE
• Public Sociology LEARNING OBJECTIVE KEY TAKEAWAYS EXERCISES
• Transferable Skills
• Understanding Yourself, Your Circumstances, and Your World KEY TAKEAWAYS EXERCISES
•  Back Matter

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Handbook of Research Methods in Health Social Sciences pp 391–410 Cite as

Qualitative Interviewing

• Sally Nathan 2 ,
• Christy Newman 3 &
• Kari Lancaster 3  
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Qualitative interviewing is a foundational method in qualitative research and is widely used in health research and the social sciences. Both qualitative semi-structured and in-depth unstructured interviews use verbal communication, mostly in face-to-face interactions, to collect data about the attitudes, beliefs, and experiences of participants. Interviews are an accessible, often affordable, and effective method to understand the socially situated world of research participants. The approach is typically informed by an interpretive framework where the data collected is not viewed as evidence of the truth or reality of a situation or experience but rather a context-bound subjective insight from the participants. The researcher needs to be open to new insights and to privilege the participant’s experience in data collection. The data from qualitative interviews is not generalizable, but its exploratory nature permits the collection of rich data which can answer questions about which little is already known. This chapter introduces the reader to qualitative interviewing, the range of traditions within which interviewing is utilized as a method, and highlights the advantages and some of the challenges and misconceptions in its application. The chapter also provides practical guidance on planning and conducting interview studies. Three case examples are presented to highlight the benefits and risks in the use of interviewing with different participants, providing situated insights as well as advice about how to go about learning to interview if you are a novice.

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Qualitative Data Collection & Analysis Methods

59 Strengths and Weaknesses of Qualitative Interviews

As the preceding sections have suggested, qualitative interviews are an excellent way to gather detailed information. Whatever topic is of interest to the researcher employing this method can be explored in much more depth than with almost any other method. Not only are participants given the opportunity to elaborate in a way that is not possible with other methods such as survey research, but they also are able share information with researchers in their own words and from their own perspectives rather than being asked to fit those perspectives into the perhaps limited response options provided by the researcher. And because qualitative interviews are designed to elicit detailed information, they are especially useful when a researcher’s aim is to study social processes, or the “how” of various phenomena. Yet another, and sometimes overlooked, benefit of qualitative interviews that occurs in person is that researchers can make observations beyond those that a respondent is orally reporting. A respondent’s body language, and even her or his choice of time and location for the interview, might provide a researcher with useful data.

Of course, all these benefits do not come without some drawbacks. As with quantitative survey research, qualitative interviews rely on respondents’ ability to accurately and honestly recall whatever details about their lives, circumstances, thoughts, opinions, or behaviours are being asked about. Further, as you may have already guessed, qualitative interviewing is time intensive and can be quite expensive. Creating an interview guide, identifying a sample, and conducting interviews are just the beginning. Transcribing interviews is labour intensive—and that is before coding even begins. It is also not uncommon to offer respondents some monetary incentive or thank-you for participating. Keep in mind that you are asking for more of the participants’ time than if you would have simply mailed them a questionnaire containing closed-ended questions. Conducting qualitative interviews is not only labour intensive but also emotionally taxing. Researchers embarking on a qualitative interview project, with a subject that is sensitive in nature, should keep in mind their own abilities to listen to stories that may be difficult to hear.

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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.

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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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Published : 05 October 2018

Issue Date : 12 October 2018

DOI : https://doi.org/10.1038/sj.bdj.2018.815

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13.2 Qualitative interview techniques

Learning objectives.

• Identify the primary aim of in-depth interviews
• Describe what makes qualitative interview techniques unique
• Define the term interview guide and describe how to construct an interview guide
• Outline the guidelines for constructing good qualitative interview questions
• Describe how writing field notes and journaling function in qualitative research
• Identify the strengths and weaknesses of interviews

Qualitative interviews are sometimes called intensive or in-depth interviews. These interviews are semi-structured ; the researcher has a particular topic about which she would like to hear from the respondent, but questions are open-ended and may not be asked in exactly the same way or in exactly the same order to each and every respondent. For in-depth interviews , the primary aim is to hear from respondents about what they think is important about the topic at hand and to hear it in their own words. In this section, we’ll take a look at how to conduct qualitative interviews, analyze interview data, and identify some of the strengths and weaknesses of this method.

Constructing an interview guide

Qualitative interviews might feel more like a conversation than an interview to respondents, but the researcher is in fact usually guiding the conversation with the goal in mind of gathering information from a respondent. Qualitative interviews use open-ended questions, which are questions that a researcher poses but does not provide answer options for. Open-ended questions are more demanding of participants than closed-ended questions for they require participants to come up with their own words, phrases, or sentences to respond.

In a qualitative interview, the researcher usually develops a guide in advance that she then refers to during the interview (or memorizes in advance of the interview). An interview guide is a list of topics or questions that the interviewer hopes to cover during the course of an interview. It is called a guide because it is simply that—it is used to guide the interviewer, but it is not set in stone. Think of an interview guide like your agenda for the day or your to-do list—both probably contain all the items you hope to check off or accomplish, though it probably won’t be the end of the world if you don’t accomplish everything on the list or if you don’t accomplish it in the exact order that you have it written down. Perhaps new events will come up that cause you to rearrange your schedule just a bit, or perhaps you simply won’t get to everything on the list.

Interview guides should outline issues that a researcher feels are likely to be important. Because participants are asked to provide answers in their own words and to raise points they believe are important, each interview is likely to flow a little differently. While the opening question in an in-depth interview may be the same across all interviews, from that point on, what the participant says will shape how the interview proceeds. This, I believe, is what makes in-depth interviewing so exciting–and rather challenging. It takes a skilled interviewer to be able to ask questions; listen to respondents; and pick up on cues about when to follow up, when to move on, and when to simply let the participant speak without guidance or interruption.

I’ve said that interview guides can list topics or questions. The specific format of an interview guide might depend on your style, experience, and comfort level as an interviewer or with your topic. Figure 13.1 provides an example of an interview guide for a study of how young people experience workplace sexual harassment. The guide is topic-based, rather than a list of specific questions. The ordering of the topics is important, though how each comes up during the interview may vary.

In my interviews with state administrators of developmental disabilities departments, the interview guide contained 15 questions all of which were asked to each participant. Sometimes, participants would cover the answer to one question before it was read. When I came to that question later on in the interview, I would acknowledge that they already addressed part of this question and ask them if they had anything to add to their response. Underneath some of the questions were more specific words or phrases for follow-up in case the participant did not mention those topics in their responses. These probes, as well as the questions, were based on our review of their department’s documentation about their programs. Our study was a challenging one in that administrators may have thought that since we were studying a particular kind of program, we may have an agenda to try and convince administrators to expand or better fund that program. We had to be very objective in how we worded questions to avoid the appearance of bias. Some of these questions are depicted in Figure 13.2.

As you might have guessed, interview guides do not appear out of thin air. They are the result of thoughtful and careful work on the part of a researcher. As you can see in both of the preceding guides, the topics and questions have been organized thematically and in the order in which they are likely to proceed (though keep in mind that the flow of a qualitative interview is in part determined by what a respondent has to say). Sometimes qualitative interviewers may create two versions of the interview guide: one version contains a very brief outline of the interview, perhaps with just topic headings, and another version contains detailed questions underneath each topic heading. In this case, the researcher might use the very detailed guide to prepare and practice in advance of actually conducting interviews and then just bring the brief outline to the interview. Bringing an outline, as opposed to a very long list of detailed questions, to an interview encourages the researcher to actually listen to what a participant is telling her. An overly detailed interview guide will be difficult to navigate during an interview and could give respondents the misimpression the interviewer is more interested in her questions than in the participant’s answers.

When beginning to construct an interview guide, brainstorming is usually the first step. There are no rules at the brainstorming stage—simply list all the topics and questions that come to mind when you think about your research question. Once you’ve got a pretty good list, you can begin to pare it down by cutting questions and topics that seem redundant and group like questions and topics together. If you haven’t done so yet, you may also want to come up with question and topic headings for your grouped categories. You should also consult the scholarly literature to find out what kinds of questions other interviewers have asked in studies of similar topics and what theory indicates might be important. As with quantitative survey research, it is best not to place very sensitive or potentially controversial questions at the very beginning of your qualitative interview guide. You need to give participants the opportunity to warm up to the interview and to feel comfortable talking with you. Finally, get some feedback on your interview guide. Ask your friends, other researchers, and your professors for some guidance and suggestions once you’ve come up with what you think is a strong guide. Chances are they’ll catch a few things you hadn’t noticed. Your participants may also suggest revisions or improvements, once you begin your interviews.

In terms of the specific questions you include in your guide, there are a few guidelines worth noting. First, avoid questions that can be answered with a simple yes or no. Try to rephrase your questions in a way that invites longer responses from your interviewees. If you choose to include yes or no questions, be sure to include follow-up questions. Remember, one of the benefits of qualitative interviews is that you can ask participants for more information—be sure to do so. While it is a good idea to ask follow-up questions, try to avoid asking “why” as your follow-up question, as this particular question can come off as confrontational, even if that is not your intent. Often people won’t know how to respond to “why,” perhaps because they don’t even know why themselves. Instead of “why,” I recommend that you say something like, “Could you tell me a little more about that?” This allows participants to explain themselves further without feeling that they’re being doubted or questioned in a hostile way.

Also, try to avoid phrasing your questions in a leading way. For example, rather than asking, “Don’t you think most people who don’t want kids are selfish?” you could ask, “What comes to mind for you when you hear someone doesn’t want kids?” Or rather than asking, “What do you think about juvenile offenders who drink and drive?” you could ask, “How do you feel about underage drinking?” or “What do you think about drinking and driving?” Finally, remember to keep most, if not all, of your questions open-ended. The key to a successful qualitative interview is giving participants the opportunity to share information in their own words and in their own way. Documenting decisions that you make along the way regarding which questions are used, thrown out, or revised can help a researcher remember during analysis the thought process behind the interview guide. Additionally, it promotes the rigor of the qualitative project as a whole, ensuring the researcher is proceeding in a reflective and deliberate manner that can be checked by others reviewing her study.

Recording qualitative data

Even after the interview guide is constructed, the interviewer is not yet ready to begin conducting interviews. The researcher next has to decide how to collect and maintain the information that is provided by participants. Researchers keep field notes or written recordings produced by the researcher during the data collection process, including before, during, and after interviews. Field notes help researchers document what they observe, and in so doing, they form the first draft of data analysis. Field notes may contain many things—observations of body language or environment, reflections on whether interview questions are working well, and connections between ideas that participants share.

Unfortunately, even the most diligent researcher cannot write down everything that is seen or heard during an interview. In particular, it is difficult for a researcher to be truly present and observant if she is also writing down everything the participant is saying. For this reason, it is quite common for interviewers to create audio recordings of the interviews they conduct. Recording interviews allows the researcher to focus on her interaction with the interview participant rather than being distracted by trying to write down every word that is said.

Of course, not all participants will feel comfortable being recorded and sometimes even the interviewer may feel that the subject is so sensitive that recording would be inappropriate. If this is the case, it is up to the researcher to balance excellent note-taking with exceptional question-asking and even better listening. I don’t think I can understate the difficulty of managing all these feats simultaneously. Whether you will be recording your interviews or not (and especially if not), practicing the interview in advance is crucial. Ideally, you’ll find a friend or two willing to participate in a couple of trial runs with you. Even better, you’ll find a friend or two who are similar in at least some ways to your sample. They can give you the best feedback on your questions and your interview demeanor.

Another issue interviewers face is documenting the decisions made during the data collection process. Qualitative research is open to new ideas that emerge through the data collection process. For example, a participant might suggest a new concept you hadn’t thought of before or define a concept in a new way. This may lead you to create new questions or ask questions in a different way to future participants. These processes should be documented in a process called journaling or memoing. Journal entries are notes to yourself about reflections or methodological decisions that emerge during the data collection process. Documenting these decisions is important, as you’d be surprised how quickly you can forget what happened. Journaling makes sure that when it comes time to analyze your data, you remember how, when, and why certain changes were made. The discipline of journaling in qualitative research helps to ensure the rigor of the research process—that is its trustworthiness and authenticity. We covered these standards of qualitative rigor in Chapter 9.

Strengths and weaknesses of qualitative interviews

As we’ve mentioned in this section, qualitative interviews are an excellent way to gather detailed information. Any topic can be explored in much more depth with interviews than with almost any other method. Not only are participants given the opportunity to elaborate in a way that is not possible with other methods such as survey research, but they also are able share information with researchers in their own words and from their own perspectives. Whereas, quantitative research asks participants to fit their perspectives into the limited response options provided by the researcher. And because qualitative interviews are designed to elicit detailed information, they are especially useful when a researcher’s aim is to study social processes or the “how” of various phenomena. Yet another, and sometimes overlooked, benefit of qualitative interviews that occurs in person is that researchers can make observations beyond those that a respondent is orally reporting. A respondent’s body language, and even their choice of time and location for the interview, might provide a researcher with useful data.

Of course, all these benefits come with some drawbacks. As with quantitative survey research, qualitative interviews rely on respondents’ ability to accurately and honestly recall specific details about their lives, circumstances, thoughts, opinions, or behaviors. As Esterberg (2002) puts it, “If you want to know about what people actually do, rather than what they say they do, you should probably use observation [instead of interviews].”  [2] Further, as you may have already guessed, qualitative interviewing is time-intensive and can be quite expensive. Creating an interview guide, identifying a sample, and conducting interviews are just the beginning. Writing out what was said in interviews and analyzing the qualitative are time consuming processes. Keep in mind you are also asking for more of participants’ time than if you’d simply mailed them a questionnaire containing closed-ended questions. Conducting qualitative interviews is not only labor-intensive but can also be emotionally taxing. Seeing and hearing the impact that social problems have on respondents is difficult. Researchers embarking on a qualitative interview project should keep in mind their own abilities to receive stories that may be difficult to hear.

Key Takeaways

• In-depth interviews are semi-structured interviews where the researcher has topics and questions in mind to ask, but questions are open-ended and flow according to how the participant responds to each.
• Interview guides can vary in format but should contain some outline of the topics you hope to cover during the course of an interview.
• Qualitative interviews allow respondents to share information in their own words and are useful for gathering detailed information and understanding social processes.
• Field notes and journaling document decisions and thoughts the researcher has that influence the research process.
• Drawbacks of qualitative interviews include reliance on respondents’ accuracy and their intensity in terms of time, expense, and possible emotional strain.
• Field notes- written notes produced by the researcher during the data collection process
• In-depth interviews- interviews in which researchers hear from respondents about what they think is important about the topic at hand in the respondent’s own words
• Interview guide- a list of topics or questions that the interviewer hopes to cover during the course of an interview
• Journaling- making notes of emerging issues and changes during the research process
• Semi-structured interviews- questions are open ended and may not be asked in exactly the same way or in exactly the same order to each and every respondent

Image attributions

questions by geralt CC-0

writing by StockSnap CC-0

• Figure 13.1 is copied from Blackstone, A. (2012) Principles of sociological inquiry: Qualitative and quantitative methods. Saylor Foundation. Retrieved from: https://saylordotorg.github.io/text_principles-of-sociological-inquiry-qualitative-and-quantitative-methods/ Shared under CC-BY-NC-SA 3.0 License (https://creativecommons.org/licenses/by-nc-sa/3.0/) ↵
• Esterberg, K. G. (2002). Qualitative methods in social research . Boston, MA: McGraw-Hill. ↵

Scientific Inquiry in Social Work Copyright © 2018 by Matthew DeCarlo is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License , except where otherwise noted.

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Research Design Review

A discussion of qualitative & quantitative research design, strengths & limitations of the in-depth interview method: an overview.

The following is a modified excerpt from Applied Qualitative Research Design: A Total Quality Framework Approach (Roller & Lavrakas, 2015, pp. 56-57).

An additional strength of the IDI method is the flexibility of the interview format, which allows the interviewer to tailor the order in which questions are asked, modify the question wording as appropriate, ask follow-up questions to clarify interviewees’ responses, and use indirect questions (e.g., the use of projective techniques ) to stimulate subconscious opinions or recall. It should be noted, however, that “flexibility” does not mean a willy-nilly approach to interviewing, and, indeed, the interviewer should employ quality measures such as those outlined in “Applying a Quality Framework to the In-depth Interview Method.”

A third key strength of the IDI method—analyzability of the data—is a byproduct of the interviewer–interviewee relationship and the depth of interviewing techniques, which produce a granularity in the IDI data that is rich in fine details and serves as the basis for deciphering the narrative within each interview. These details also enable researchers to readily identify where they agree or disagree with the meanings of codes and themes associated with specific responses, which ultimately leads to the identification of themes and connections across interview participants.

Limitations

The IDI method also presents challenges and limitations that deserve the researcher’s attention. The most important, from a Total Quality Framework standpoint, has to do with what is also considered a key strength of the IDI method: the interviewer–interviewee relationship. There are two key aspects of the relationship that can potentially limit (or even undermine) the effectiveness of the IDI method: the interviewer and the social context. The main issue with respect to the interviewer is his/her potential for biasing the information that is gathered. This can happen due to  (a) personal characteristics such as gender, age, race, ethnicity, and education (e.g., a 60-year-old Caucasian male interviewer may stifle or skew responses from young, female, African American participants); (b) personal values or beliefs (e.g., an interviewer with strongly held beliefs about global warming and its damaging impact on the environment may “tune out” or misconstrue the comments from interviewees who believe global warming is a myth); and/or (c) other factors (e.g., an interviewer’s stereotyping, misinterpreting, and/or presumptions about the interviewee based solely on the interviewee’s outward appearance). Any of these characteristics may negatively influence an interviewee’s responses to the researcher’s questions and/or the accuracy of the interviewer’s data gathering. A result of these interviewer effects may be the “difficulty of seeing the people as complex, and . . . a reduction of their humanity to a stereotypical, flat, one-dimensional paradigm” (Krumer-Nevo, 2002, p. 315).

The second key area of concern with the IDI method is related to the broader social context of the relationship, particularly what Kvale (2006) calls the “power dynamics” within the interview environment, characterized by the possibility of “a one-way dialogue” whereby “the interviewer rules the interview” (p. 484). It is important, therefore, for the researcher to carefully consider the social interactions that are integral to the interviewing process and the possible impact these interactions may have on the credibility of an IDI study. For example, the trained interviewer will maximize the social interaction by utilizing positive engagement techniques such as establishing rapport (i.e., being approachable), asking thoughtful questions that indicate the interviewer is listening carefully to the interviewee, and knowing when to stay silent and let the interviewee talk freely.

Krumer-Nevo, M. (2002). The arena of othering: A life-story study with women living in poverty and social marginality. Qualitative Social Work , 1 (3), 303–318.

Kvale, S. (2006). Dominance through interviews and dialogues. Qualitative Inquiry , 12 (3), 480–500.

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ReviseSociology

A level sociology revision – education, families, research methods, crime and deviance and more!

Interviews in Social Research: Advantages and Disadvantages

The strengths of unstructured interviews are that they are respondent led, flexible, allow empathy and can be empowering, the limitations are poor reliability due to interviewer characteristics and bias, time, and low representativeness.

Table of Contents

Last Updated on September 11, 2023 by Karl Thompson

An interview involves an interviewer asking questions verbally to a respondent. Interviews involve a more direct interaction between the researcher and the respondent than questionnaires. Interviews can either be conducted face to face, via phone, video link or social media.

This post has primarily been written for students studying the Research Methods aspect of A-level sociology, but it should also be useful for students studying methods for psychology, business studies and maybe other subjects too!

Types of interview

Structured or formal interviews are those in which the interviewer asks the interviewee the same questions in the same way to different respondents. This will typically involve reading out questions from a pre-written and pre-coded structured questionnaire, which forms the interview schedule. The most familiar form of this is with market research, where you may have been stopped on the street with a researcher ticking boxes based on your responses.

Unstructured or Informal interviews (also called discovery interviews) are more like a guided conversation. Here the interviewer has a list of topics they want the respondent to talk about, but the interviewer has complete freedom to vary the specific questions from respondent to respondent, so they can follow whatever lines of enquiry they think are most appropriated, depending on the responses given by each respondent.

Semi-Structured interviews are those in which respondents have a list of questions, but they are free to ask further, differentiated questions based on the responses given. This allows more flexibility that the structured interview yet more structure than the informal interview.

Group interviews – Interviews can be conducted either one to one (individual interviews) or in a a group, in which the interviewer interviews two or more respondents at a time. Group discussions among respondents may lead to deeper insight than just interviewing people along, as respondents ‘encourage’ each other.

Focus groups are a type of group interview in which respondents are asked to discuss certain topics.

Interviews: key terms

The Interview Schedule – A list of questions or topic areas the interviewer wishes to ask or cover in the course of the interview. The more structured the interview, the more rigid the interiew schedule will be. Before conducting an interview it is usual for the reseracher to know something about the topic area and the respondents themselves, and so they will have at least some idea of the questions they are likely to ask: even if they are doing ‘unstructred interviews’ an interviewer will have some kind of interview schedule, even if it is just a list of broad topic areas to discuss, or an opening question.

Transcription of interviews -Transcription is the process of writing down (or typing up) what respondents say in an interview. In order to be able to transcribe effectively interviews will need to be recorded.

The problem of Leading Questions – In Unstructured Interviews, the interviewer should aim to avoid asking leading questions.

The Strengths and Limitations of Unstructured Interviews 

The strengths of unstructured interviews

The key strength of unstructured interviews is good validity , but for this to happen questioning should be as open ended as possible to gain genuine, spontaneous information rather than ‘rehearsed responses’ and questioning needs to be sufficient enough to elicit in-depth answers rather than glib, easy answers.

Respondent led – unstructured interviews are ‘respondent led’ – this is because the researcher listens to what the respondent says and then asks further questions based on what the respondent says. This should allow respondents to express themselves and explain their views more fully than with structured interviews.

Flexibility – the researcher can change his or her mind about what the most important questions are as the interview develops. Unstructured Interviews thus avoid the imposition problem – respondents are less constrained than with structured interviews or questionnaires in which the questions are written in advance by the researcher. This is especially advantageous in group interviews, where interaction between respondents can spark conversations that the interviewer hadn’t thought would of happened in advance, which could then be probed further with an unstructured methodology.

Rapport and empathy – unstructured interviews encourage a good rapport between interviewee and interviewer. Because of their informal nature, like guided conversations, unstructured interviews are more likely to make respondents feel at ease than with the more formal setting of a structured questionnaire or experiment. This should encourage openness, trust and empathy.

Checking understanding – unstructured interviews also allow the interviewer to check understanding. If an interviewee doesn’t understand a question, the interviewer is free to rephrase it, or to ask follow up questions to clarify aspects of answers that were not clear in the first instance.

Unstructured interviews are good for sensitive topics because they are more likely to make respondents feel at ease with the interviewer. They also allow the interviewer to show more sympathy (if required) than with the colder more mechanical quantitative methods.

They are good for finding out why respondents do not do certain things . For example postal surveys asking why people do not claim benefits have very low response rates, but informal interviews are perfect for researching people who may have low literacy skills.

Empowerment for respondents – the researcher and respondents are on a more equal footing than with more quantitative methods. The researcher doesn’t assume they know best. This empowers the respondents. Feminists researchers in particular believe that the unstructured interview can neutralise the hierarchical, exploitative power relations that they believe to be inherent in the more traditional interview structure. They see the traditional interview as a site for the exploitation and subordination of women, with the interviewers potentially creating outcomes against their interviewees’ interests. In traditional interview formats the interviewer directs the questioning and takes ownership of the material; in the feminist (unstructured) interview method the woman would recount her experiences in her own words with the interviewer serving only as a guide to the account.

Practical advantages – there are few practical advantages with this method, but compared to full-blown participant observation, they are a relatively quick method for gaining in-depth data. They are also a good method to combine with overt participant observation in order to get respondents to further explain the meanings behind their actions. So in short, they are impractical, unless you’re in the middle of a year long Participant Observation study (it’s all relative!).

The Limitations of unstructured interviews

The main theoretical disadvantage is the lack of reliability – unstructured Interviews lack reliability because each interview is unique – a variety of different questions are asked and phrased in a variety of different ways to different respondents.

They are also difficult to repeat, because the s uccess of the interview depends on the bond of trust between the researcher and the respondent – another researcher who does not relate to the respondent may thus get different answers. Group interviews are especially difficult to repeat, given that the dynamics of the interview are influenced not just by the values of the researcher, but also by group dynamics. One person can change the dynamic of a group of three or four people enormously.

Validity can be undermined in several ways:

• respondents might prefer to give rational responses rather than fuller emotional ones (it’s harder to talk frankly about emotions with strangers)
• respondents may not reveal their true thoughts and feelings because they do not coincide with their own self-image, so they simply withhold information
• respondents may give answers they think the interviewer wants to hear, in attempt to please them!

We also need to keep in mind that interviews can only tap into what people SAY about their values, beliefs and actions, we don’t actually get to see these in action, like we would do with observational studies such as Participant Observation. This has been a particular problem with self-report studies of criminal behaviour. These have been tested using polygraphs, and follow up studies of school and criminal records and responses found to be lacking in validity, so much so that victim-surveys have become the standard method for measuring crime rather than self-report studies.

Interviewer bias might undermine the validity of unstructured interviews – this is where the values of the researcher interfere with the results. The researcher may give away whether they approve or disapprove of certain responses in their body language or tone of voice (or wording of probing questions) and this in turn might encourage or discourage respondents from being honest.

The characteristics of the interviewer might also bias the results and undermine the validity – how honest the respondent is in the course of an hour long interview might depend on the class, gender, or ethnicity of the interviewer.

Sudman and Bradburn (1974) conducted a review of literature and found that responses varied depending on the relative demographics of the interviewer and respondent. For example white interviewers received more socially acceptable responses from black respondents than they did from white respondents. Similar findings have been found with different ethnicities, age, social class and religion.

Unstructured interviews also lack representativeness – because they are time consuming, it is difficult to get a large enough sample to be representative of large populations.

It is difficult to quantify data , compare answers and find stats and trends because the data gained is qualitative.

Practical disadvantages – unstructured Interviews may take a relatively long time to conduct. Some interviews can take hours. They also need to be taped and transcribed, and in the analysis phase there may be a lot of information that is not directly relevant to one’s research topic that needs to be sifted through.

Interpersonal skills and training – A further practical problem is that some researchers may lack the interpersonal skills required to conduct informal unstructured interviews. Training might need to be more thorough for researchers undertaking unstructured interviews – to avoid the problem of interviewer bias.

Shapiro and Eberhart (1947) showed that interviewers who were more prepared to probe received fuller answers, and both response rate and extensiveness of response are greater for more experienced interviewers.

There are few ethical problems , assuming that informed consent is gained and confidentially ensured. Although having said this, the fact that the researcher is getting more in-depth data, more of an insight into who the person really is, does offer the potential for the information to do more harm to the respondent if it got into the wrong hands (but this in turn depends on the topics discussed and the exact content of the interviews.

Sociological perspectives on interviews

Interviews of any kind are not a preferred method for positivists because there is no guarantee that responses aren’t artefacts of the interview situation, rather than a reflection of underlying social reality.

If interviews must be used, Positivists prefer structured interviews that follow a standardised schedule, with each question asked to each respondent in the same way. Interviewers should be neutral, show no emotion, avoid suggesting replies, and not skip questions.

Fo r Interactionists , interviews are based on mutual participant observation. The context of the interview is intrinsic to understanding responses and no distinction between research interviews and other social interaction is recognised. Data are valid when mutual understanding between interviewer and respondent is agreed.

Interactionists prefer non-standardised interviews because they allow respondents to shape the interview according to their own world view.

Denzin (2009) goes as far as to argue that what positivists might perceive as problems with interviews are not problems, just part of the process and thus as valid as the data collected. Thus issues of self-presentation, the power relations between interviewer and respondent and opportunities for fabrication are all part of the context and part of the valid-reality that we are trying to get to.

Related Posts

For more posts on research methods please see my research methods page.

Examples of studies using interviews – Using Interviews to research education .

Participant Observation  –   A related qualitative research method – detailed class notes on overt and covert participant observation. 

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Recommended further reading: Gilbert and Stoneman (2016) Researching Social Life

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• Knowledge Base
• Methodology
• Structured Interview | Definition, Guide & Examples

Structured Interview | Definition, Guide & Examples

Published on 4 May 2022 by Tegan George . Revised on 26 August 2022.

A structured interview is a data collection method that relies on asking questions in a set order to collect data on a topic. It is one of four types of interviews .

In research, structured interviews are often quantitative in nature. They can also be used in qualitative research if the questions are open-ended, but this is less common.

While structured interviews are often associated with job interviews, they are also common in marketing, social science, survey methodology, and other research fields.

• Semi-structured interviews : A few questions are predetermined, whereas the 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.

Table of contents

What is a structured interview, when to use a structured interview, advantages of structured interviews, disadvantages of structured interviews, structured interview questions, how to conduct a structured interview, how to analyse a structured interview, presenting your results, frequently asked questions about structured interviews.

Structured interviews are the most systematised type of interview. In contrast to semi-structured or unstructured interviews, the interviewer uses predetermined questions in a set order.

Structured interviews are often closed-ended. They can be dichotomous, which means asking participants to answer ‘yes’ or ‘no’ to each question, or multiple-choice. While open-ended structured interviews do exist, they are less common.

Asking set questions in a set order allows you to easily compare responses between participants in a uniform context. This can help you see patterns and highlight areas for further research, and it can be a useful explanatory or exploratory research tool.

Prevent plagiarism, run a free check.

Structured interviews are best used when:

• You already have a very clear understanding of your topic, so you possess a baseline for designing strong structured questions
• You are constrained in terms of time or resources and need to analyse your data efficiently
• Your research question depends on strong parity between participants, with environmental conditions held constant

A structured interview is straightforward to conduct and analyse. Asking the same set of questions mitigates potential biases and leads to fewer ambiguities in analysis. It is an undertaking you can likely handle as an individual, provided you remain organised.

Differences between different types of interviews

Make sure to choose the type of interview that suits your research best. This table shows the most important differences between the four types.

Reduced bias

Increased credibility, reliability, and validity, simple, cost-effective, and efficient, formal in nature, limited flexibility, limited scope.

It can be difficult to write structured interview questions that approximate exactly what you are seeking to measure. Here are a few tips for writing questions that contribute to high internal validity :

• Define exactly what you want to discover prior to drafting your questions. This will help you write questions that really zero in on participant responses.
• Avoid jargon, compound sentences, and complicated constructions.
• Be as clear and concise as possible, so that participants can answer your question immediately.
• Do you think that employers should provide free gym memberships?
• Did any of your previous employers provide free memberships?
• Does your current employer provide a free membership?
• a) 1 time; b) 2 times; c) 3 times; d) 4 or more times
• Do you enjoy going to the gym?

Structured interviews are among the most straightforward research methods to conduct and analyse. Once you’ve determined that they’re the right fit for your research topic , you can proceed with the following steps.

Step 1: Set your goals and objectives

Start by brainstorming some guiding questions to help you conceptualise your research question, such as:

• What are you trying to learn or achieve from a structured interview?
• Why are you choosing a structured interview as opposed to a different type of interview, or another research method?

If you have satisfying reasoning for proceeding with a structured interview, you can move on to designing your questions.

Step 2: Design your questions

Pay special attention to the order and wording of your structured interview questions . Remember that in a structured interview they must remain the same. Stick to closed-ended or very simple open-ended questions.

Step 3: Assemble your participants

Depending on your topic, there are a few sampling methods you can use, such as:

• Voluntary response sampling : For example, posting a flyer on campus and finding participants based on responses
• Convenience sampling of those who are most readily accessible to you, such as fellow students at your university
• Stratified sampling of a particular age, race, ethnicity, gender identity, or other characteristic of interest to you
• Judgement sampling of a specific set of participants that you already know you want to include

Step 4: Decide on your medium

Determine whether you will be conducting your interviews in person or whether your interview will take pen-and-paper format. If conducted live, you need to decide if you prefer to talk with participants in person, over the phone, or via video conferencing.

Step 5: Conduct your interviews

As you conduct your interviews, be very careful that all conditions remain as constant as possible.

• Ask your questions in the same order, and try to moderate your tone of voice and any responses to participants as much as you can.
• Pay special attention to your body language (e.g., nodding, raising eyebrows), as this can bias responses.

After you’re finished conducting your interviews, it’s time to analyse your results.

• Assign each of your participants a number or pseudonym for organizational purposes.
• Transcribe the recordings manually or with the help of transcription software.
• Conduct a content or thematic analysis to look for categories or patterns of responses. In most cases, it’s also possible to conduct a statistical analysis to test your hypotheses .

Transcribing interviews

If you have audio-recorded your interviews, you will likely have to transcribe them prior to conducting your analysis. In some cases, your supervisor might ask you to add the transcriptions in the appendix of your paper.

First, you will have to decide whether to conduct verbatim transcription or intelligent verbatim transcription. Do pauses, laughter, or filler words like ‘umm’ or ‘like’ affect your analysis and research conclusions?

• If so, conduct verbatim transcription and include them.
• If not, conduct intelligent verbatim transcription, which excludes fillers and fixes any grammar issues, and is often easier to analyse.

The transcription process is a great opportunity for you to clean your data as well, spotting and resolving any inconsistencies or errors that come up as you listen.

Coding and analysing structured interviews

After transcribing, it’s time to conduct your thematic or content analysis . This often involves ‘coding’ words, patterns, or themes, separating them into categories for more robust analysis.

Due to the closed-ended nature of many structured interviews, you will most likely be conducting content analysis, rather than thematic analysis.

• You quantify the categories you chose in the coding stage by counting the occurrence of the words, phrases, subjects, or concepts you selected.
• After coding, you can organise and summarise the data using descriptive statistics .
• Next, inferential statistics allows you to come to conclusions about your hypotheses and make predictions for future research. 

When conducting content analysis, you can take an inductive or a deductive approach. With an inductive approach, you allow the data to determine your themes. A deductive approach is the opposite: it involves investigating whether your data confirm preconceived themes or ideas.

Content analysis has a systematic procedure that can easily be replicated , yielding high reliability to your results. However, keep in mind that while this approach reduces bias, it doesn’t eliminate it. Be vigilant about remaining objective here, even if your analysis does not confirm your hypotheses .

After your data analysis, the next step is to combine your findings into a research paper .

• Your methodology section describes how you collected the data (in this case, describing your structured interview process) and explains how you justify or conceptualise your analysis.
• Your discussion and results sections usually address each of your coded categories, describing each in turn, as well as how often they occurred.

If you conducted inferential statistics in addition to descriptive statistics, you would generally report the test statistic , p value , and effect size in your results section. These values explain whether your results justify rejecting your null hypothesis and whether the result is practically significant .

You can then conclude with the main takeaways and avenues for further research.

Example of interview methodology for a research paper

Let’s say you are interested in healthcare on your campus. You study abroad in the US with a lot of international students, and you think there may be a difference in perceptions based on country of origin.

Specifically, you hypothesise that students coming from countries with single-payer or socialised healthcare will find US options less satisfying.

There is a large body of research available on this topic, so you decide to conduct structured interviews of your peers to see if there’s a difference between international students and local students.

You are a member of a large campus club that brings together international students and local students, and you send a message to the club to ask for volunteers.

Here are some questions you could ask:

• Do you find healthcare options on campus to be: excellent; good; fair; average; poor?
• Does your home country have socialised healthcare? Yes/No
• Are you on the campus healthcare plan? Yes/No
• Have you ever worried about your health insurance? Yes/No
• Have you ever had a serious health condition that insurance did not cover? Yes/No
• Have you ever been surprised or shocked by a medical bill? Yes/No

After conducting your interviews and transcribing your data, you can then conduct content analysis, coding responses into different categories. Since you began your research with the theory that international students may find US healthcare lacking, you would use the deductive approach to see if your hypotheses seem to hold true.

A structured interview is a data collection method that relies on asking questions in a set order to collect data on a topic. They are often quantitative in nature. Structured interviews are best used when:

• You already have a very clear understanding of your topic. Perhaps significant research has already been conducted, or you have done some prior research yourself, but you already possess a baseline for designing strong structured questions.
• You are constrained in terms of time or resources and need to analyse your data quickly and efficiently

More flexible interview options include semi-structured interviews , unstructured interviews , and focus groups .

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.

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.

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BMC Health Services Research volume  24 , Article number:  465 ( 2024 ) Cite this article

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Early access to care for carpal tunnel syndrome (CTS) can avoid higher rates of surgery and permanent harm yet is often delayed, particularly for populations more likely to underutilise care.

We sought to explore patient experiences and perspectives of health service access for CTS to inform an equity-focussed co-design of a health service for improving early care access.

In this Normalisation Process Theory (NPT)-informed qualitative study we conducted semistructured in-depth interviews with 19 adults with experience of CTS. Recruitment prioritised New Zealand Māori, Pasifika, low-income, and rural populations. Data were analysed using deductive then inductive thematic analysis.

We identified five major themes: (1) the ‘Significant Impact of CTS’ of the sense-making and relational work to understand the condition, deciding when to get care, compelling clinicians to provide care, and garnering help from others; (2) ‘Waiting and Paying for Care’– the enacting, relational, and appraising work to avoid long wait times unless paying privately, particularly where quality of care was low, employment relations poor, or injury compensation processes faltered; (3) circumstances of ‘Occupation and CTS Onset’ whereby the burden of proof to relate onset of CT symptoms to occupation created excessive relational and enacting work; (4) the ‘Information Scarcity’ of good information about CTS and the high relational and appraising work associated with using online resources; (5) ‘Negotiating Telehealth Perspectives’ where telehealth was valued if it meant earlier access for all despite the challenges it held for many.

Quality, culturally and linguistically responsive information and communication from clinicians and health services will improve equitable early access to CTS care including realising the potential of telehealth modes of care. Policy changes that reduce individual burden of proof in injury compensation claims processes, enable time off work to attend health appointments, and increase public funding for surgical resources would improve early access to CTS care particularly for Māori and Pacific populations and those in small and rural workplaces. NPT is valuable for understanding where opportunities lie to reduce inequitable delays to accessing care including the impact of racism, particularly for populations more likely to underutilise care.

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Introduction

Carpal tunnel syndrome (CTS) is a common musculoskeletal problem for which there is a good consensus on treatment, including the importance of accessing early care [ 1 , 2 ]. Affecting around one in ten people at some point over their lifetime [ 3 ], CTS involves compression of the median nerve at the wrist, causing sensory loss, pain, and functional impairment including lost work days and sleep disturbance [ 1 , 2 , 3 , 4 ]. Education, advice, and splinting can be effective where symptom duration is less than 1 year [ 1 , 2 ]; surgical decompression is recommended where symptoms become severe or do not improve [ 2 , 3 ].

In the New Zealand healthcare system, access to timely care can be difficult; care for musculoskeletal conditions such as CTS is under-resourced [ 5 ], in common with many countries [ 6 , 7 ]. People with CTS must negotiate accessing care that straddles complex public-private interfaces. Although New Zealand has a universal secondary-level public health system with a smaller private system, general practice (GP) is accessed on a subsidised user-pays basis [ 8 ] and most allied health (AH) primary care services have no subsidy. Therefore, both primary and second tier services can be out of reach for those unable to pay [ 9 ]. Where CTS can be attributed to occupation, the publicly funded Accident Compensation Corporation (ACC) subsidises AH, specialist, and GP care. However, the ACC acceptance rate for CTS is extremely low– only about 25% of claims submitted are recognised, lower for indigenous Māori (23%) and Pacific peoples (people of Pacific ethnicity) (22%) compared with European (28%) ethnicity (ACC, e-mail communication, February 2021).

In addition to access, inequitable outcomes for CTS are also a problem. Māori and Pacific peoples suffer worse outcomes and lower rates of access across musculoskeletal conditions [ 10 , 11 , 12 ]. These populations are more likely to be in manual work [ 13 ], a risk factor for CTS [ 3 ]. Additionally, people with diabetes are five times more likely to develop CTS [ 14 ]– and diabetes is nearly three times more common in Māori [ 15 ] and four times more common in Pacific peoples [ 16 ] than in the general population. Low socioeconomic status, poor access to transport or telecommunications, service cost, and distance are associated with reduced access to health services overall [ 12 , 17 , 18 ]. In New Zealand, there is an obligation that new and existing models of care help eliminate health inequities, including identifying where inequities exist [ 19 ].

HealthPathways is a New Zealand-based tool designed to support better quality care through improved integration across primary and secondary services by making expert clinical knowledge, relevant to the local context, available to primary care clinicians using a digital platform [ 20 , 21 ]. However, outcomes of HealthPathways have seldom been evaluated at the patient level [ 22 , 23 ] and their impact on inequity is not well understood [ 23 ]. Another tool with potential to improve care access for musculoskeletal conditions including CTS [ 24 ] is telehealth. Defined here as synchronous telephone or video consultation, telehealth has become widely available since the Covid pandemic. It is likely to remain part of health delivery [ 25 ], although concerns persist about its deployment as a panacea for limited health resources [ 26 ] and about risk for exacerbating existing health inequities [ 27 ]. In developing a local CTS HealthPathway that could optionally incorporate telehealth tools in the south of New Zealand, we undertook a co-design process [ 28 , 29 ]. This prioritised those more likely to underuse health services to gain an understanding of inequities in access, experience, and outcomes for CTS from the patient perspective. The overarching aim was to develop health services that would be more likely to help eliminate inequities.

To this end, in the early patient story-gathering phase, we employed an implementation science framework, Normalisation Process Theory (NPT) [ 30 ] to help guide the interview schedule and interpretation. A robust mid-range theory, NPT seeks to explain and guide implementation processes, including consideration of how existing or future aspects of a service are likely to impact equity [ 31 , 32 ], by asking questions about the labour involved, in this case for patients seeking and engaging care, in terms of: (1) sense-making, (2) relationships, (3) taking action, and (4) appraising [ 30 ] (Fig.  1 ). An extension of NPT, the Burden of Treatment Theory [ 31 ], was also applied to help understand how patients navigate this work. It examines the interaction between patients’ capacity for action, including the material and cognitive resources at their disposal, and the work that healthcare systems pass on to them.

This study aimed to explore patient experiences and perspectives of health services for CTS using NPT and the Burden of Treatment Theory to inform the care pathway co-design.

The full co-design process and an evaluation of the resulting care pathway will be reported elsewhere.

Normalisation process theory domains and constructs [ 30 ]

This participatory qualitative study was undertaken within a co-design approach oriented to “working with patients and focussing on experiences” [ 33 ]. Ethical approval was obtained from the University of Otago Human Ethics Committee (Health), reference H21/026. Māori consultation was completed with the Ngāi Tahu Research Consultation Committee. All participants provided informed written consent.

We conducted semistructured in-depth individual interviews with 19 adults with experience of CTS. The pilot-tested interview schedule covered eight fields of interest (Fig.  2 and Supplemental 1 ). Interview questions were generated from existing quality of care evaluation instruments [ 34 , 35 ]. The New Zealand Māori holistic health framework of Te Whare Tapa Whā [four-pillared house] [ 36 ], represented by a locally developed visual tool [ 37 ] was offered to invite participants to reflect on their CTS story and its impact across four pillars of health: physical, spiritual, thoughts and feelings, and family/community.

Study methods: interview schedule development, process of thematic analysis, and relationship with co-design process

A minimum of five participants from each of the following key demographic characteristics were sought: Māori ethnicity; Pacific ethnicity; Low-income (using ‘fixed line measure’ [ 38 ]), seasonal, zero hours, or out of work; rural domicile [ 39 ]. A minimum of five with each of the following care characteristics were sought: CT surgery in the past 12 months; not sought or received care beyond GP consultation with or without medication. Those who received non-pharmacological, non-surgical care completed the total number of participants.

Participants were purposefully recruited from health and non-health settings in the Otago and Southland districts of New Zealand, including GPs, procedure- and wait-lists, Community Health Council, trade unions, marae-based networks, and Pasifika networks, by clinician invitation and paper- or social media-based advertisement. Inclusion and exclusion criteria are outlined in Table  1 .

One researcher (MB), a clinician of 20 years of European descent with qualitative research training, conducted 40-60-minute interviews in person in local service or health settings, in the participant’s home or workplace, or in two cases by telephone. For three interviews, one or more family members were present. The interviewing researcher has strong connections and experience of the cultures of Māori and Pacific peoples in New Zealand and those with low and insecure income, through family, social, and occupational networks, including marae and the trade union movement. Her knowledge of the health system helped participants to make sense of the clinician workgroup outputs and recommendations. The researcher kept a diary and regularly talked with co-researchers to maintain a balanced viewpoint.

Interviews were audio-recorded and transcribed by the interviewing researcher in three cases and by a contracted transcription service (Pacific Transcription, Auckland NZ) for the remaining interviews. Field notes were made during and after the interview. Transcribed data were entered in NVivo data management software (NVivo 12– QSR International Pty Ltd, Melbourne) and subjected to deductive then inductive analysis by MB, using a systematic method of thematic analysis (Fig.  2 ) [ 40 ]. At intervals, coding, categorisation, and interpretation were discussed and reflected on with co-researchers. Participants were sent a 2-page summary of study findings and a 3-page detailed description of the themes and supporting quotes (step 8. of thematic analysis in Fig.  2 ). Permission was sought for the use of individual quotes, and feedback and comments invited on the themes and summary. Permission was declined for one quote regarding social position being an advantage in being offered an appointment. No further changes were suggested. Three responses commented on the strength of the findings and the value of patients being heard in the design process. A sub-group of four participants were subsequently involved in a series of consultation activities for how findings from the present study would be integrated in the HealthPathway development (reported in future work– Fig.  2 ).

Demographic and disease characteristics were collected using a tailored questionnaire. Participants completed self-report measures for symptom status and function (Boston Carpal Tunnel Questionnaire– BCTQ [ 41 ]). Although the BCTQ has been validated for a wide range of ages and nationalities, including Chinese, Korean, and Greek [ 42 ], the ethnicity(s) of the North American population in which it was developed [ 41 ] and that of a UK study [ 43 ] were undefined. The questionnaire therefore may have limited validity in the present study population. BCTQ scores were categorised by severity [ 44 ].

Participants were reimbursed for expenses incurred in participating in the study with a $25 petrol or grocery voucher. All names are pseudonyms.

Data were collected May to July 2021. Participant demographic and health characteristics are reported in Table  2 .

Thematic analysis

Five major themes were identified: Significant Impact of CTS, Waiting and Paying for Care, Occupation and CTS Onset, CTS Information Scarcity, and Negotiating Telehealth Perspectives. Interpretation using NPT identified participant experiences relating to each of the four domains (Fig.  3 ).

The work that patients do: overview of NPT analysis

1) The theme of ‘Significant Impact of CTS’ was characterised by the severity of symptoms, waking at night, worry about what will happen, yet finding it hard to be taken seriously. Participants found CTS to be a condition for which it was hard to make sense of the symptoms– if these would be temporary or lead to permanent harm, and how bad these might get. It was therefore often not evident that care should be sought early, yet also a cause for alarm about the future in terms of livelihood and the degree of impairment. Charlene was a 54-year-old shop owner who had experienced CTS for over 30 years since being pregnant with her first son. Although she had seen her GP many times, as well as other health providers, she remained uncertain about what was going on in her hands. Over the past year, symptoms had worsened: her hands were numb all of the time and pain kept her awake half the night, yet referral for care required multiple GP visits. There were financial and social impacts of having to employ someone to do part of her job and enlisting help from whānau [family], but it was her declining physical state and symptom severity that concerned her most.

“What's going to happen, are they just going to shrivel up and fall off?”

Viewed using the NPT domains, two types of work: sense-making (Coherence)– trying to understand the condition and deciding when to get care, as well as relational (Cognitive Participation)– compelling clinicians to provide care and to garner help from others, were seen to be high.

2) ‘Waiting and Paying for care’ refers to the delays to care associated with under resourcing in the public system, costs, poor quality of care, employment precarity, and burdensome ACC processes, in contrast to quicker, easier access when paying privately or through private health insurance.

“[6 months ago]… he [GP] said well “you’ll never get an appointment at the hospital”. I don’t have um life insurance or medical insurance… you’re solely reliant on the public system…, like well I can’t sleep at night. I can’t lift, you know my hands are, one of them’s absolutely shot. Give us a hand here!” Female < 65y.

Knowledge of how long the wait might be was important for reducing the added burden of trying to manage life in anticipation of care, and for making decisions about whether to pay– although for several participants private care was out of reach.

Poor quality care including racism, was another cause for delays and extra work by participants. Tui-Helen , a Māori participant living in a rural setting, described the extra effort she put in to avoid delays which she predicted might occur based on past experiences of seeking care in which racism was implicit.

“…at the end of the day I’m not having them throw the excuse at me “you never came” because that seems to be the kaupapa [theme] that “…nobody turns up to the appointments”, or “you make an appointment they don’t come”, and I thought well no I made my appointment, I’m going! You know,…e mana-aki [show respect, generosity], just you know be humble, and a lot a karakia [prayer].” Female, < 65yr.

Tui-Helen compensated for the unjust presumption made on the part of a health provider that she would be non-adherent or irresponsible, by making extra appointments, attending early, essentially engaging in what was being required of her by the health care providers to legitimate and speed up the route to access care.

Gloria , a 39-year-old manual worker from a rural setting, also experienced poor provider responses. She had symptoms of 3 years that were now interfering with her work and sleep.

“I said to my doctor, over the years on several occasions, "Oh I've got this problem… I’ve got this problem" and she's keep fobbing me off "Oh we'll keep an eye on it, keep an eye on it".”

These experiences reflect the NPT domains of Cognitive Participation (Enrolment, Activation, and Legitimation)and Collective Action (Relational integration and Contextual integration– the resourcing of time and consultation fees) to compel clinicians and health services to provide care, as well as Reflexive Monitoring to appraise the quality of care.

For Trina, a 38-year-old mum and part-time labourer, it was precarious employment that led her to decline referral for investigation and delay her care.

“If I actually knew for myself that it is or it isn’t carpal tunnel and then if it is, I mean, job prospects aside, I’d better deal with it before it gets sore again. I know what I’m doing [declining investigation and diagnosis] is not the right choice but life is busy and things are hard.”

Difficult ACC processes were another reason for long delays. The onus of responsibility on the participant to get the ‘proof’ [that symptom onset was work-related] was particularly fraught for those in small or unsupportive employment environments.

“I’ve got a form from a doctor to go through ACC and he’s got [date 18 months ago]… I have to send them on to… whoever is I’ve been working for to fill out. And then the person at ACC said to me “oh we’ll probably reject them"… he [GP] said “oh if they reject them we’ll just apply again“… in all honesty I need to take these forms up to get them sorted… I just been so busy,… the [employer] and I don’t get on…” Female < 65yr.

In contrast, a supportive work environment and strong relationships with and between health providers moderated participants’ work to compel ACC or other health services to provide care. Joseph , a 63-year-old who works in a meat processing plant with an active union presence and health providers onsite described his positive experience accessing care:

“It was that letter [health provider] wrote, it was clear evidence the length that I went because the carpal tunnel... the beauty of this, [health provider] knows the surgeon. [Health provider] knows the doctor and he write them… the help they need [to give me].”

3) ‘Occupation and CTS Onset’ identified symptoms that were associated with current or previous work in a wide range of industries, yet little acceptance of this by ACC. Melanie , a 25-year-old Māori participant from a rural town, described her onset of symptoms as the intensity of her work in cleaning and kitchen handing increased.

Social position could also bring advantage, for example Celia , a 54-year-old health professional in a rural town noted that she was lucky because her position as a health sector worker probably contributed to her being offered an appointment (in the private sector) reasonably quickly.

“It was from working. I was working one job, doing cleaning and then I started another secondary job, washing dishes and that's when it started, when I was doing both jobs.”

That ACC processes were “too difficult” was a common reason given by participants for either them or their health provider deciding not to lodge a claim. Participants also shared stories of family and friends who had ‘fought’ with ACC and the enormous effort involved, which informed participants’ own experiences and choices.

“[My brother] had surgery when he was about 21. Yes, he had to wait quite a long time to get that surgery. He had to fight a lot for it, because no one would take responsibility for it. So, they were trying to get it under ACC, because of been working in the McDonalds. That didn’t work out. So, he had to go through public… he had to wait on a very, very long waiting list.” Female, < 65yr.

“I have heard of another case, a friend, she was a fish filleter and she got it and then her claim was turned down, but she had to fight for it.” Male, < 65yr.

Claims were declined because of insufficient evidence that the occupation has caused the problem… to prove that occupation directly contributed to the problem is incredibly difficult with something of a gradual onset nature. The substantial relational work– Initiation, Enrolment, Legitimation, in addition to Enacting work involved in engaging with ACC was beyond the capacity of most participants.

4) ‘CTS Information Scarcity’ describes how good information about CTS is hard to find and rarely offered unless in the context of an extended private specialist appointment.

Julie-Anne, a 53-year-old mum and small farmlet operator, reflected that over her 10-year history of CTS including one surgery 7 years ago and a second more recently, no one had asked her about the chain sawing and heavy impact work she regularly did, or discussed how this might relate to her condition.

“I think yeah, if I had done that [activity modification and splint] earlier on... At that point, you could have information about what causes it and the things you can do to help yourself.”

Participants were unanimous in their desire for information about CT and its management. However, some who searched online found that the information often lacked relevance.

“A lot of the times the American websites come up and you think, I put New Zealand in, and still American sites come up. You’re this and… I don’t know, I don’t know.” Female, < 65yr.

Going online introduced additional relational and sense-making work– avoiding unsolicited notifications or advertising and judging what was accurate versus inaccurate information. On the other hand, social media was emphasised to be a highly valued source of health information by the participant from a Pacific community, because of language accessibility, communicative style, and trust in the community.

5) ‘Negotiating Telehealth Perspectives’ captured a range of views in which the role of telehealth in a future pathway was generally viewed positively and capable of serving the communication purpose, although it was highlighted that this may not work for some such as older relatives or kaumātua (elders) or those with connection difficulties.

“That would work! That would absolutely work… But the kaumātua need to be seen. Kanohi-ki-te-kanohi [face-to-face], and not put on the devices” Female < 65yr.

On the other hand, it was seen as a complete “cop-out” by a few. Several rural participants preferred to drive several hundred kilometres rather than use telehealth for a specialist assessment, although this also reflected their desperation to get something done.

In-person appointment was preferred by most, in part due to concerns about a virtual consultation being inadequate in the context of a physical problem and a sense that personal validation and important communication may be lost.

“So, if you do that one, if the surgeon will do that one through video, I can fake it or I can how can he touch my… hands?” Male < 65yr.

“A lot of decisions are made on body language and how you fold your arms or shut yourself off or something. So, that’s the things to take into account when you’re talking not face-to-face visits.” Male < 65yr.

Yet all except one participant would use telehealth if it reduced the wait and improved access for all. Financial assistance was pointed out as necessary for telehealth to be accessible– this was available from Work and Income New Zealand (social welfare) for a television but not yet for laptop computers.

The Cognitive Participation (relational work), Collective Action, specifically Interactional workability and Relational integration, and Contextual integration (resourcing) of telehealth requires individual consideration.

A sixth, minor theme, ‘Complexity in Simplicity’ described the incongruency between the simplicity of the surgical procedure (CT release) and the enormous difficulty of accessing the care.

“How bad is this going to get before anyone’s gonna, just snip! You know, like.” Female, < 65yr.

Major themes identified in this study were the wider impact and onset of CTS, delays and extensive waiting for care in the public system ameliorated by paying for private care, lack of information about CTS, and weighing up views on telehealth. NPT interpretation identified that in accessing and engaging care for CTS, those with greater privilege – economic, relational (social capital), or secure and supportive employment conditions, are required to do less work while those with less privilege have substantially more work to do. The latter group often work exceptionally hard and nevertheless may still not get care. These findings add to an existing body of literature that demonstrates how social and economic inequality contributes to inequities in health care access and outcomes, particularly where health services fail to effectively respond to peoples’ circumstances [ 45 , 46 , 47 , 48 ].

This study suggests that even for a relatively simple condition such as CTS, addressing economic as well as provider and system-related factors such as language and communicative styles, values, and beliefs including ethnic bias, is necessary to help eliminate inequity. Moreover, a broad view across the health system, including private care and ACC, is necessary to adequately delineate equity issues. Increasing access to publicly funded CT surgery would reduce the major impact of waiting, particularly for the groups prioritised in this study. Workplaces are key arenas for change– mandated health services in or adjacent to workplaces, leave from work for health appointments, and changes to ACC processes for fairer, quicker access to care. Robust preventive and health promotion programmes could reduce the impact of CT and consequently the need for care.

The potential for telehealth to reduce patient burden in terms of transportation, time, and work interference, as well as the negative impacts of racism by shifting the power imbalance away from clinicians, were valued by participants. However, concerns about remote physical examination, absence of doctors’ hands, and lack of rapport, as previously found [ 49 , 50 ] meant some patients felt they would be more easily dismissed as the extent of their symptoms may not be so evident. A structured, culturally responsive communication approach such as the ‘Hui Process’ [ 51 , 52 ] and explanation of the evidence for telehealth including any known limitations, may address these concerns. Access to technical support, devices, and connectivity is also necessary for equitable access and experience [ 50 , 52 ].

Delays in seeking care associated with perceived low seriousness of CTS is a finding of both the present and previous studies [ 53 , 54 ]. This may be partly explained by the high sense making work, i.e., the difficulty of understanding the impact of occupation and positioning on nerve physiology and the potential long-term consequences. Quality information, clear processes for when and how to seek further care, and clinician time to tailor information to individuals, would reduce this work for patients and improve care access and health outcomes. Clinical decision-making and prioritisation must also account for the incongruency to avoid wrongly denying care.

Strengths and weaknesses of the theory

As a theoretical framework for interrogating the labour involved in seeking health care, NPT usefully identified components of patient ‘work’ as distinct from illness burden and where the differences between the groups relevant to the inequity e.g., lower rates of accessing ACC services for Māori compared to non-Māori [ 10 ] are apparent, helping to explain how inequity operates. The framework helped to make sense of the findings by considering the interrelationship between social and structural constraints and individual agency. In this respect, it aligns with the conceptual framework of health care access developed by Levesque, Harris & Russell (2013) [ 55 ] which seeks to understand the relationships that occur at the interface of health systems and populations. Our NPT analysis prioritises the patient perspective of these relationships and reveals the resulting burden lumbered on patients (Fig.  4 ).

Examples of patient experiences and resulting NPT analysis of patient work (black text) aligned to the Levesque et al. [ 55 ] framework of health care access (blue and white text)

NPT thus gives insight into the dynamics of the health system-population interface, including the impact of its nature, be that bureaucratic, digital, or human, and the influence of other players (such as unions and employers).

The NPT-derived understanding of work that results from experiencing racism is particularly valuable as it recognises the enormous efforts made in seeking care and highlights the need for health services to start meeting patients halfway. Racism is a major driver of unequal access to care across countries, health care indicators, and health care settings [ 56 , 57 ]. Our NPT analysis would suggest that racism operates within the Levesque concept of ‘appropriateness’ of care, as a failure of provider interpersonal quality with flow on effects back to ‘availability’ and ‘acceptability’ (Fig.  4 ).

The findings of this study confirm the importance of interventions proposed by previous studies to support earlier access to care and achieving health equity. These include: additional clinician time and resources [ 58 , 59 ]; culturally safe and responsive communicative skills and tools [ 58 , 60 , 61 ]; patient support with costs and fees [ 47 , 59 , 61 , 62 ], devices and connectivity [ 50 , 59 , 63 ]; tailoring support to individuals [ 61 ]; and preventive programmes [ 58 , 62 ]. Embedding cultural safety training that enables clinicians to acknowledge the inherent power differentials between provider and patient is recommended for addressing clinician bias, particularly ethnic bias [ 56 , 64 ], although training alone is unlikely to address racism entirely due to its structural nature [ 56 ].

The need to go beyond interpersonal relations and change systems, policies, and resourcing has also been emphasised by numerous authors [ 47 , 62 ]. Strengthening employment relations is a more novel recommendation from this study and may have a more wide-reaching impact on health equity, particularly for those with low or insecure income [ 18 ]. The more nuanced understanding of the relative merits of telehealth is another strength.

NPT-informed participatory interview methods are a practical aid for assessing service equity and access and evaluating who is advantaged and how from the patient perspective. This approach warrants further investigation, perhaps integrated within other tools, such as the New Zealand Health Equity Assessment Tool [ 62 ] and the New Zealand Co-design Toolkit [ 33 ].

Strengths and limitations overall

This study was unusual for NPT in that it focussed primarily on the perspectives of patients. While not multi-perspectival in its data gathering, it reinforces the message that the implementation of health interventions in complex health systems owes as much to the work of patients as it does to service providers and other personnel [ 65 ]. The inductive, in addition to deductive analysis allowed for a range of views and issues to be identified, and helped overcome challenges previously associated with the theory around fitting codes and categories solely on a predetermined conceptual framework [ 66 ].

A strength of this study is the focus on populations more likely to underuse health services, including those with low or insecure income, unusual in studies of musculoskeletal care. While recruitment met other predefined demographic and care characteristic targets, only one Pacific participant was recruited. A focus on Pacific peoples is a priority for a future study. This will include Pacific language speakers among the interview team or available as a translation service. Partnering more closely with Pacific community groups will support greater Pacific involvement in the research and service design.

While we have found NPT to be useful in informing health service (and system and policy) design that may potentially contribute to eliminating inequities, whether these elements in fact deliver this, and how they can be implemented and evaluated, are future questions.

Experiences and perspectives of health services for CTS among those more likely to underuse services suggest poorer quality and less timely treatment for those unable to pay for expedited care and extended consultations. Our study findings and NPT analysis suggest a range of interventions that are needed to enable greater health service mitigation of the ongoing impact of wider social and economic inequalities. Racism, conceptualised as a problem of quality of care, is a critical target for reducing inequities in health care access; more work is required to understand and address racism from a structural perspective.

Our use of NPT in patient co-design interviews has been helpful for defining the specific problems to be overcome to achieve equitable early access to care. We recommend NPT for prospective use in future service development.

Data availability

The datasets used and/or analysed during the current study available from the corresponding author on reasonable request.

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Acknowledgements

We thank all participants for their valuable contributions to this research. We thank all those who shared information about this research to enable potential participants to come forward. We thank Southern District Health Board leaders for supporting this research.

This study was funded by a Health Research Council of New Zealand Health Delivery Research Career Development Award [20/913].

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Bűhler, M., Atmore, C., Perry, M. et al. Patient experiences and perspectives of health service access for carpal tunnel syndrome in Aotearoa New Zealand: a normalisation process theory-informed qualitative study. BMC Health Serv Res 24 , 465 (2024). https://doi.org/10.1186/s12913-024-10871-x

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Qualitative Research in Healthcare: Necessity and Characteristics

1 Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea

2 Ulsan Metropolitan City Public Health Policy’s Institute, Ulsan, Korea

3 Department of Nursing, Chung-Ang University, Seoul, Korea

Eun Young Choi

4 College of Nursing, Sungshin Women’s University, Seoul, Korea

Seung Gyeong Jang

5 Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea

Quantitative and qualitative research explore various social phenomena using different methods. However, there has been a tendency to treat quantitative studies using complicated statistical techniques as more scientific and superior, whereas relatively few qualitative studies have been conducted in the medical and healthcare fields. This review aimed to provide a proper understanding of qualitative research. This review examined the characteristics of quantitative and qualitative research to help researchers select the appropriate qualitative research methodology. Qualitative research is applicable in following cases: (1) when an exploratory approach is required on a topic that is not well known, (2) when something cannot be explained fully with quantitative research, (3) when it is necessary to newly present a specific view on a research topic that is difficult to explain with existing views, (4) when it is inappropriate to present the rationale or theoretical proposition for designing hypotheses, as in quantitative research, and (5) when conducting research that requires detailed descriptive writing with literary expressions. Qualitative research is conducted in the following order: (1) selection of a research topic and question, (2) selection of a theoretical framework and methods, (3) literature analysis, (4) selection of the research participants and data collection methods, (5) data analysis and description of findings, and (6) research validation. This review can contribute to the more active use of qualitative research in healthcare, and the findings are expected to instill a proper understanding of qualitative research in researchers who review qualitative research reports and papers.

Graphical abstract

INTRODUCTION

The definition of research varies among studies and scholars, and it is difficult to devise a single definition. The Oxford English Dictionary defines research as “a careful study of a subject, especially in order to discover new facts or information about it” [ 1 ], while Webster’s Dictionary defines research as “studious inquiry or examination - especially: investigation or experimentation aimed at the discovery and interpretation of facts, revision of accepted theories or laws in the light of new facts, or practical application of such new or revised theories or laws” [ 2 ]. Moreover, research is broadly defined as the process of solving unsolved problems to broaden human knowledge [ 3 ]. A more thorough understanding of research can be gained by examining its types and reasons for conducting it.

The reasons for conducting research may include practical goals, such as degree attainment, job promotion, and financial profit. Research may be based on one’s own academic curiosity or aspiration or guided by professors or other supervisors. Academic research aims can be further divided into the following: (1) accurately describing an object or phenomenon, (2) identifying general laws and establishing well-designed theories for understanding and explaining a certain phenomenon, (3) predicting future events based on laws and theories, and (4) manipulating causes and conditions to induce or prevent a phenomenon [ 3 ].

The appropriate type of research must be selected based on the purpose and topic. Basic research has the primary purpose of expanding the existing knowledge base through new discoveries, while applied research aims to solve a real problem. Descriptive research attempts to factually present comparisons and interpretations of findings based on analyses of the characteristics, progression, or relationships of a certain phenomenon by manipulating the variables or controlling the conditions. Experimental or analytical research attempts to identify causal relationships between variables through experiments by arbitrarily manipulating the variables or controlling the conditions [ 3 ]. In addition, research can be quantitative or qualitative, depending on the data collection and analytical methods. Quantitative research relies on statistical analyses of quantitative data obtained primarily through investigation and experiment, while qualitative research uses specific methodologies to analyze qualitative data obtained through participant observations and in-depth interviews. However, as these types of research are not polar opposites and the criteria for classifying research types are unclear, there is some degree of methodological overlap.

What is more important than differentiating types of research is identifying the appropriate type of research to gain a better understanding of specific questions and improve problems encountered by people in life. An appropriate research type or methodology is essential to apply findings reliably. However, quantitative research based on the philosophical ideas of empiricism and positivism has been the mainstay in the field of healthcare, with academic advancement achieved through the application of various statistical techniques to quantitative data [ 4 ]. In particular, there has been a tendency to treat complicated statistical techniques as more scientific and superior, with few qualitative studies in not only clinical medicine, but also primary care and social medicine, which are relatively strongly influenced by the social sciences [ 5 , 6 ].

Quantitative and qualitative research use different ways of exploring various social phenomena. Both research methodologies can be applied individually or in combination based on the research topic, with mixed quantitative and qualitative research methodologies becoming more widespread in recent years [ 7 ]. Applying these 2 methods through a virtuous cycle of integration from a complementary perspective can provide a more accurate understanding of human phenomena and solutions to real-world problems.

This review aimed to provide a proper understanding of qualitative research to assist researchers in selecting the appropriate research methodology. Specifically, this review examined the characteristics of quantitative and qualitative research, the applicability of qualitative research, and the data sources collected and analyzed in qualitative research.

COMPARISON OF QUALITATIVE AND QUANTITATIVE RESEARCH

A clearer understanding of qualitative research can be obtained by comparing qualitative and quantitative research, with which people are generally familiar [ 8 , 9 ]. Quantitative research focuses on testing the validity of hypotheses established by the researcher to identify the causal relationships of a specific phenomenon and discovering laws to predict that phenomenon ( Table 1 ). Therefore, it emphasizes controlling the influence of variables that may interfere with the process of identifying causality and laws. In contrast, qualitative research aims to discover and explore new hypotheses or theories based on a deep understanding of the meaning of a specific phenomenon. As such, qualitative research attempts to accept various environmental factors naturally. In quantitative research, importance is placed on the researcher acting as an outsider to take an objective view by keeping a certain distance from the research subject. In contrast, qualitative research encourages looking inside the research subjects to understand them deeply, while also emphasizing the need for researchers to take an intersubjective view that is formed and shared based on a mutual understanding with the research subjects.

Comparison of methodological characteristics between quantitative research and qualitative research

The data used in quantitative research can be expressed as numerical values, and data accumulated through questionnaire surveys and tests are often used in analyses. In contrast, qualitative research uses narrative data with words and images collected through participant observations, in-depth interviews, and focus group discussions used in the analyses. Quantitative research data are measured repeatedly to enhance their reliability, while the analyses of such data focus on superficial aspects of the phenomenon of interest. Qualitative research instead focuses on obtaining deep and rich data and aims to identify the specific contents, dynamics, and processes inherent within the phenomenon and situation.

There are clear distinctions in the advantages, disadvantages, and goals of quantitative and qualitative research. On one hand, quantitative research has the advantages of reliability and generalizability of the findings, and advances in data collection and analysis methods have increased reliability and generalizability. However, quantitative research presents difficulties with an in-depth analysis of dynamic phenomena that cannot be expressed by numbers alone and interpreting the results analyzed in terms numbers. On the other hand, qualitative research has the advantage of validity, which refers to how accurately or appropriately a phenomenon was measured. However, qualitative research also has the disadvantage of weak generalizability, which determines whether an observed phenomenon applies to other cases.

APPLICATIONS OF QUALITATIVE RESEARCH AND ITS USEFULNESS IN THE HEALTHCARE FIELD

Qualitative research cannot be the solution to all problems. A specific methodology should not be applied to all situations. Therefore, researchers need to have a good understanding of the applicability of qualitative research. Generally, qualitative research is applicable in following cases: (1) when an exploratory approach is required on a topic that is not well known, (2) when something cannot be explained fully with quantitative research, (3) when it is necessary to newly present a specific view on a research topic that is difficult to explain with existing views, (4) when it is inappropriate to present the rationale or theoretical proposition for designing hypotheses, as in quantitative research, and (5) when conducting research that requires detailed descriptive writing with literary expressions [ 7 ]. In particular, qualitative research is useful for opening new fields of research, such as important topics that have not been previously examined or whose significance has not been recognized. Moreover, qualitative research is advantageous for examining known topics from a fresh perspective.

In the healthcare field, qualitative research is conducted on various topics considering its characteristics and strengths. Quantitative research, which focuses on hypothesis validation, such as the superiority of specific treatments or the effectiveness of specific policies, and the generalization of findings, has been the primary research methodology in the field of healthcare. Qualitative research has been mostly applied for studies such as subjective disease experiences and attitudes with respect to health-related patient quality of life [ 10 - 12 ], experiences and perceptions regarding the use of healthcare services [ 13 - 15 ], and assessments of the quality of care [ 16 , 17 ]. Moreover, qualitative research has focused on vulnerable populations, such as the elderly, children, disabled [ 18 - 20 ], minorities, and socially underprivileged with specific experiences [ 21 , 22 ].

For instance, patient safety is considered a pillar of quality of care, which is an aspect of healthcare with increasing international interest. The ultimate goal of patient safety research should be the improvement of patient safety, for which it is necessary to identify the root causes of potential errors and adverse events. In such cases, qualitative rather than quantitative research is often required. It is also important to identify whether there are any barriers when applying measures for enhancing patient safety to clinical practice. To identify such barriers, qualitative research is necessary to observe healthcare workers directly applying the solutions step-by-step during each process, determine whether there are difficulties in applying the solutions to relevant stakeholders, and ask how to improve the process if there are difficulties.

Patient safety is a very broad topic, and patient safety issues could be categorized into preventing, recognizing, and responding to patient safety issues based on related metrics [ 23 ]. Responding to issues that pertain to the handling of patient safety incidents that have already occurred has received relatively less interest than other categories of research on this topic, particularly in Korea. Until 2017, almost no research was conducted on the experiences of and difficulties faced by patients and healthcare workers who have been involved in patient safety incidents. This topic can be investigated using qualitative research.

A study in Korea investigated the physical and mental suffering experienced during the process of accepting disability and medical litigation by a patient who became disabled due to medical malpractice [ 21 ]. Another qualitative case study was conducted with participants who lost a family member due to a medical accident and identified psychological suffering due to the incident, as well as secondary psychological suffering during the medical litigation process, which increased the expandability of qualitative research findings [ 24 ]. A quantitative study based on these findings confirmed that people who experienced patient safety incidents had negative responses after the incidents and a high likelihood of sleep or eating disorders, depending on their responses [ 25 ].

A study that applied the grounded theory to examine the second victim phenomenon, referring to healthcare workers who have experienced patient safety incidents, and presented the response stages experienced by second victims demonstrated the strength of qualitative research [ 26 ]. Subsequently, other studies used questionnaire surveys on physicians and nurses to quantify the physical, mental, and work-related difficulties experienced by second victims [ 27 , 28 ]. As such, qualitative research alone can produce significant findings; however, combining quantitative and qualitative research produces a synergistic effect. In the healthcare field, which remains unfamiliar with qualitative research, combining these 2 methodologies could both enhance the validity of research findings and facilitate open discussions with other researchers [ 29 ].

In addition, qualitative research has been used for diverse sub-topics, including the experiences of patients and guardians with respect to various diseases (such as cancer, myocardial infarction, chronic obstructive pulmonary disease, depression, falls, and dementia), awareness of treatment for diabetes and hypertension, the experiences of physicians and nurses when they come in contact with medical staff, awareness of community health environments, experiences of medical service utilization by the general public in medically vulnerable areas, the general public’s awareness of vaccination policies, the health issues of people with special types of employment (such as delivery and call center workers), and the unmet healthcare needs of persons with vision or hearing impairment.

GENERAL WORKFLOW OF QUALITATIVE RESEARCH

Rather than focusing on deriving objective information, qualitative research aims to discern the quality of a specific phenomenon, obtaining answers to “why” and “how” questions. Qualitative research aims to collect data multi-dimensionally and provide in-depth explanations of the phenomenon being researched. Ultimately, the purpose of qualitative research is set to help researchers gain an understanding of the research topic and reveal the implications of the research findings. Therefore, qualitative research is generally conducted in the following order: (1) selection of a research topic and question, (2) selection of a theoretical framework and methods, (3) literature analysis, (4) selection of the research participants (or participation target) and data collection methods, (5) data analysis and description of findings, and (6) research validation ( Figure 1 ) [ 30 ]. However, unlike quantitative research, in which hypothesis setting and testing take place unidirectionally, a major characteristic of qualitative research is that the process is reversible and research methods can be modified. In other words, the research topic and question could change during the literature analysis process, and theoretical and analytical methods could change during the data collection process.

General workflow of qualitative research.

Selection of a Research Topic and Question

As with any research, the first step in qualitative research is the selection of a research topic and question. Qualitative researchers can select a research topic based on their interests from daily life as a researcher, their interests in issues within the healthcare field, and ideas from the literature, such as academic journals. The research question represents a more specific aspect of the research topic. Before specifically starting to conduct research based on a research topic, the researcher should clarify what is being researched and determine what research would be desirable. When selecting a research topic and question, the research should ask: is the research executable, are the research topic and question worth researching, and is this a research question that a researcher would want to research?

Selection of Theoretical Framework and Methods

A theoretical framework refers to the thoughts or attitudes that a researcher has about the phenomenon being researched. Selecting the theoretical framework first could help qualitative researchers not only in selecting the research purpose and problem, but also in carrying out various processes, including an exploration of the precedent literature and research, selection of the data type to be collected, data analysis, and description of findings. In qualitative research, theoretical frameworks are based on philosophical ideas, which affect the selection of specific qualitative research methods. Representative qualitative research methods include the grounded theory, which is suitable for achieving the goal of developing a theory that can explain the processes involved in the phenomenon being researched; ethnographic study, which is suitable for research topics that attempt to identify and interpret the culture of a specific group; phenomenology, which is suitable for research topics that attempt to identify the nature of research participants’ experiences or the phenomenon being researched; case studies, which aim to gain an in-depth understanding of a case that has unique characteristics and can be differentiated from other cases; action research, which aims to find solutions to problems faced by research participants, with the researchers taking the same position as the participants; and narrative research, which is suitable for research topics that attempt to interpret the entire life or individual experiences contained within the stories of research participants. Other methodologies include photovoice research, consensual qualitative research, and auto-ethnographic research.

Literature Analysis

Literature analysis results can be helpful in specifically selecting the research problem, theoretical framework, and research methods. The literature analysis process compels qualitative researchers to contemplate the new knowledge that their research will add to the academic field. A comprehensive literature analysis is encouraged both in qualitative and quantitative research, and if the prior literature related to the subject to be studied is insufficient, it is sometimes evaluated as having low research potential or research value. Some have claimed that a formal literature review should not be performed before the collection of field data, as it could create bias, thereby interfering with the investigation. However, as the qualitative research process is cyclic rather than unidirectional, the majority believes that a literature review can be performed at any time. Moreover, an ethical review prior to starting the research is a requirement; therefore, the research protocol must be prepared and submitted for review and approval prior to conducting the research. To prepare research protocols, the existing literature must be analyzed at least to a certain degree. Nonetheless, qualitative researchers must keep in mind that their emotions, bias, and expectations may interject themselves during the literature review process and should strive to minimize any bias to ensure the validity of the research.

Selection of the Research Participants and Data Collection Methods

The subjects of qualitative research are not necessarily humans. It is more important to find the research subject(s) from which the most in-depth answers to the research problem can be obtained. However, the subjects in most qualitative studies are humans, as most research question focus on humans. Therefore, it is important to obtain research participants with sufficient knowledge, experience, and attitudes to provide the most appropriate answers to the research question. Quantitative research, which views generalizability as a key research goal, emphasizes the selection of research participants (i.e., the research sample that can represent the study’s population of interest), whereas qualitative research emphasizes finding research participants who can best describe and demonstrate the phenomenon of interest.

In qualitative research, the participant selection method is referred to as purposeful sampling (or purposive sampling), which can be divided into various types. Sampling methods have various advantages, disadvantages, and characteristics. For instance, unique sampling (extreme case sampling) has the advantage of being able to obtain interesting research findings by researching phenomena that have previously received little or no interest, and the disadvantage of deriving research findings that are interesting to only some readers if the research is conducted on an overly unique situation. Maximum variation sampling, also referred to as theoretical sampling, is commonly used in qualitative research based on the grounded theory. Selecting the appropriate participant sampling method that suits the purpose of research is crucial ( Table 2 ).

Sampling methods of selecting research participants in qualitative research

Once the researcher has decided how to select study participants, the data collection methods must be determined. Just as with participant sampling, various data collection methods are available, all of which have various advantages and disadvantages; therefore, the method must be selected based on the research question and circumstances. Unlike quantitative research, which usually uses a single data source and data collection method, the use of multiple data sources and data collection methods is encouraged in qualitative research [ 30 ]. Using a single data source and data collection method could cause data collection to be skewed by researcher bias; therefore, using multiple data sources and data collection methods is ideal. In qualitative research, the following data types are commonly used: (1) interview data obtained through one-on-one in-depth interviews and focus group discussions, (2) observational data from various observation levels, (3) documented data collected from personal or public documents, and (4) image data, such as photographs and videos.

Interview data are the most commonly used data source in qualitative research [ 31 ]. In qualitative research, an interview refers to communication that takes place based on a clear sense of purpose of acquiring certain information, unlike conversations that typically take place in daily life. The level of data acquired through interviews varies significantly depending on the researcher’s personal qualifications and abilities, as well as his or her level of interest and knowledge regarding the research topic. Therefore, interviewers must be trained to go beyond simply identifying the clearly expressed experiences of research participants to exploring their inner experiences and emotions [ 32 ]. Interview data can be classified based on the level of structuralization of the data collection method, sample size, and interview method. The characteristics of each type of interview are given in Table 3 .

Detailed types of interview methods according to the characteristics of in-depth interviews and focus group discussion

Observations, which represent a key data collection method in anthropology, refer to a series of actions taken by the researcher in search of a deep understanding by systematically examining the appearances of research participants that take place in natural situations [ 33 ]. Observations can be categorized as participant and non-participant, insider and outsider, disguised and undisguised, short- and long-term, and structured and unstructured. However, a line cannot be drawn clearly to differentiate these categories, and the degree of each varies along a single spectrum. Therefore, it is necessary for a qualitative researcher to select the appropriate data collection method based on the circumstances and characteristics of the research topic.

Various types of document data can be used in qualitative research. Personal documents include diaries, letters, and autobiographies, while public documents include legal documents, public announcements, and civil documents. Online documents include emails and blog or bulletin board postings, while other documents include graffiti. All these document types may be used as data sources in qualitative research. In addition, image data acquired by the research participant or researcher, such as photographs and videos, serve as useful data sources in qualitative research. Such data sources are relatively objective and easily accessible, while they contain a significant amount of qualitative meaning despite the low acquisition cost. While some data may have been collected for research purposes, other data may not have been originally produced for research. Therefore, the researcher must not distort the original information contained in the data source and must verify the accuracy and authenticity of the data source in advance [ 30 ].

This review examined the characteristics of qualitative research to help researchers select the appropriate qualitative research methodology and identify situations suitable for qualitative research in the healthcare field. In addition, this paper analyzed the selection of the research topic and problem, selection of the theoretical framework and methods, literature analysis, and selection of the research participants and data collection methods. A forthcoming paper will discuss more specific details regarding other qualitative research methodologies, such as data analysis, description of findings, and research validation. This review can contribute to the more active use of qualitative research in the healthcare field, and the findings are expected to instill a proper understanding of qualitative research in researchers who review and judge qualitative research reports and papers.

Ethics Statement

Since this study used secondary data source, we did not seek approval from the institutional review board. We also did not have to ask for the consent of the participants.

Acknowledgments

CONFLICT OF INTEREST

The authors have no conflicts of interest associated with the material presented in this paper.

AUTHOR CONTRIBUTIONS

Conceptualization: Pyo J, Lee W, Choi EY, Jang SG, Ock M. Data curation: Pyo J, Ock M. Formal analysis: Pyo J, Ock M. Funding acquisition: None. Validation: Lee W, Choi EY, Jang SG. Writing - original draft: Pyo J, Ock M. Writing - review & editing: Pyo J, Lee W, Choi EY, Jang SG, Ock M.