qualitative research framework

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Chapter 4: Theoretical frameworks for qualitative research

Tess Tsindos

Learning outcomes

Upon completion of this chapter, you should be able to:

• Describe qualitative frameworks.
• Explain why frameworks are used in qualitative research.
• Identify various frameworks used in qualitative research.

What is a Framework?

A framework is a set of broad concepts or principles used to guide research.  As described by Varpio and colleagues 1 , a framework is a logically developed and connected set of concepts and premises – developed from one or more theories – that a researcher uses as a scaffold for their study. The researcher must define any concepts and theories that will provide the grounding for the research and link them through logical connections, and must relate these concepts to the study that is being carried out. In using a particular theory to guide their study, the researcher needs to ensure that the theoretical framework is reflected in the work in which they are engaged.

It is important to acknowledge that the terms ‘theories’ ( see Chapter 3 ), ‘frameworks’ and ‘paradigms’ are sometimes used interchangeably. However, there are differences between these concepts. To complicate matters further, theoretical frameworks and conceptual frameworks are also used. In addition, quantitative and qualitative researchers usually start from different standpoints in terms of theories and frameworks.

A diagram by Varpio and colleagues demonstrates the similarities and differences between theories and frameworks, and how they influence research approaches. 1(p991) The diagram displays the objectivist or deductive approach to research on the left-hand side. Note how the conceptual framework is first finalised before any research is commenced, and it involves the articulation of hypotheses that are to be tested using the data collected. This is often referred to as a top-down approach and/or a general (theory or framework) to a specific (data) approach.

The diagram displays the subjectivist or inductive approach to research on the right-hand side. Note how data is collected first, and through data analysis, a tentative framework is proposed. The framework is then firmed up as new insights are gained from the data analysis. This is referred to as a specific (data) to general (theory and framework) approach .

Why d o w e u se f rameworks?

A framework helps guide the questions used to elicit your data collection. A framework is not prescriptive, but it needs to be suitable for the research question(s), setting and participants. Therefore, the researcher might use different frameworks to guide different research studies.

A framework informs the study’s recruitment and sampling, and informs, guides or structures how data is collected and analysed. For example, a framework concerned with health systems will assist the researcher to analyse the data in a certain way, while a framework concerned with psychological development will have very different ways of approaching the analysis of data. This is due to the differences underpinning the concepts and premises concerned with investigating health systems, compared to the study of psychological development. The framework adopted also guides emerging interpretations of the data and helps in comparing and contrasting data across participants, cases and studies.

Some examples of foundational frameworks used to guide qualitative research in health services and public health:

• The Behaviour Change Wheel 2
• Consolidated Framework for Implementation Research (CFIR) 3
• Theoretical framework of acceptability 4
• Normalization Process Theory 5
• Candidacy Framework 6
• Aboriginal social determinants of health 7(p8)
• Social determinants of health 8
• Social model of health 9,10
• Systems theory 11
• Biopsychosocial model 12
• Discipline-specific models
• Disease-specific frameworks

E xamples of f rameworks

In Table 4.1, citations of published papers are included to demonstrate how the particular framework helps to ‘frame’ the research question and the interpretation of results.

Table 4.1. Frameworks and references

As discussed in Chapter 3, qualitative research is not an absolute science. While not all research may need a framework or theory (particularly descriptive studies, outlined in Chapter 5), the use of a framework or theory can help to position the research questions, research processes and conclusions and implications within the relevant research paradigm. Theories and frameworks also help to bring to focus areas of the research problem that may not have been considered.

• Varpio L, Paradis E, Uijtdehaage S, Young M. The distinctions between theory, theoretical framework, and conceptual framework. Acad Med . 2020;95(7):989-994. doi:10.1097/ACM.0000000000003075
• Michie S, van Stralen MM, West R. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci .  2011;6:42. doi:10.1186/1748-5908-6-42
• CFIR Research Team. Consolidated Framework for Implementation Research (CFIR). Center for Clinical Management Research. 2023. Accessed February 15, 2023. https://cfirguide.org/
• Sekhon M, Cartwright M, Francis JJ. Acceptability of healthcare interventions: an overview of reviews and development of a theoretical framework. BMC Health Serv Res . 2017;17:88. doi:10.1186/s12913-017-2031-8
• Murray E, Treweek S, Pope C, et al. Normalisation process theory: a framework for developing, evaluating and implementing complex interventions. BMC Med .  2010;8:63. doi:10.1186/1741-7015-8-63
• Tookey S, Renzi C, Waller J, von Wagner C, Whitaker KL. Using the candidacy framework to understand how doctor-patient interactions influence perceived eligibility to seek help for cancer alarm symptoms: a qualitative interview study. BMC Health Serv Res . 2018;18(1):937. doi:10.1186/s12913-018-3730-5
• Lyon P. Aboriginal Health in Aboriginal Hands: Community-Controlled Comprehensive Primary Health Care @ Central Australian Aboriginal Congress; 2016. Accessed February 15, 2023. https://nacchocommunique.com/wp-content/uploads/2017/09/cphc-congress-final-report.pdf
• Solar O., Irwin A. A Conceptual Framework for Action on the Social Determinants of Health:   Social Determinants of Health Discussion Paper 2 (Policy and Practice); 2010. Accessed February 22, 2023. https://www.who.int/publications/i/item/9789241500852
• Yuill C, Crinson I, Duncan E. Key Concepts in Health Studies . SAGE Publications; 2010.
• Germov J. Imagining health problems as social issues. In: Germov J, ed. Second Opinion: An Introduction to Health Sociology . Oxford University Press; 2014.
• Laszlo A, Krippner S. Systems theories: their origins, foundations, and development. In: Jordan JS, ed. Advances in Psychology . Science Direct; 1998:47-74.
• Engel GL. From biomedical to biopsychosocial: being scientific in the human domain. Psychosomatics . 1997;38(6):521-528. doi:10.1016/S0033-3182(97)71396-3
• Schmidtke KA, Drinkwater KG. A cross-sectional survey assessing the influence of theoretically informed behavioural factors on hand hygiene across seven countries during the COVID-19 pandemic. BMC Public Health . 2021;21:1432. doi:10.1186/s12889-021-11491-4
• Graham-Wisener L, Nelson A, Byrne A, et al. Understanding public attitudes to death talk and advance care planning in Northern Ireland using health behaviour change theory: a qualitative study. BMC Public Health . 2022;22:906. doi:10.1186/s12889-022-13319-1
• Walker R, Quong S, Olivier P, Wu L, Xie J, Boyle J. Empowerment for behaviour change through social connections: a qualitative exploration of women’s preferences in preconception health promotion in the state of Victoria, Australia. BMC Public Health . 2022;22:1642. doi:10.1186/s12889-022-14028-5
• Ayton DR, Barker AL, Morello RT, et al. Barriers and enablers to the implementation of the 6-PACK falls prevention program: a pre-implementation study in hospitals participating in a cluster randomised controlled trial. PLOS ONE . 2017;12(2):e0171932. doi:10.1371/journal.pone.0171932
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• Bossert J, Mahler C, Boltenhagen U, et al. Protocol for the process evaluation of a counselling intervention designed to educate cancer patients on complementary and integrative health care and promote interprofessional collaboration in this area (the CCC-Integrativ study). PLOS ONE . 2022;17(5):e0268091. doi:10.1371/journal.pone.0268091
• Lwin KS, Bhandari AKC, Nguyen PT, et al. Factors influencing implementation of health-promoting interventions at workplaces: protocol for a scoping review. PLOS ONE . 2022;17(10):e0275887. doi:10.1371/journal.pone.0275887
• Wilhelm AK, Schwedhelm M, Bigelow M, et al. Evaluation of a school-based participatory intervention to improve school environments using the Consolidated Framework for Implementation Research. BMC Public Health . 2021;21:1615. doi:10.1186/s12889-021-11644-5
• Timm L, Annerstedt KS, Ahlgren JÁ, et al. Application of the Theoretical Framework of Acceptability to assess a telephone-facilitated health coaching intervention for the prevention and management of type 2 diabetes. PLOS ONE . 2022;17(10):e0275576. doi:10.1371/journal.pone.0275576
• Laing L, Salema N-E, Jeffries M, et al. Understanding factors that could influence patient acceptability of the use of the PINCER intervention in primary care: a qualitative exploration using the Theoretical Framework of Acceptability. PLOS ONE . 2022;17(10):e0275633. doi:10.1371/journal.pone.0275633
• Renko E, Knittle K, Palsola M, Lintunen T, Hankonen N. Acceptability, reach and implementation of a training to enhance teachers’ skills in physical activity promotion. BMC Public Health . 2020;20:1568. doi:10.1186/s12889-020-09653-x
• Alexander SM, Agaba A, Campbell JI, et al. A qualitative study of the acceptability of remote electronic bednet use monitoring in Uganda. BMC Public Health . 2022;22:1010. doi:10.1186/s12889-022-13393
• May C, Rapley T, Mair FS, et al. Normalization Process Theory On-line Users’ Manual, Toolkit and NoMAD instrument. 2015. Accessed February 15, 2023. https://normalization-process-theory.northumbria.ac.uk/
• Davis S. Ready for prime time? Using Normalization Process Theory to evaluate implementation success of personal health records designed for decision making. Front Digit  Health . 2020;2:575951. doi:10.3389/fdgth.2020.575951
• Durand M-A, Lamouroux A, Redmond NM, et al. Impact of a health literacy intervention combining general practitioner training and a consumer facing intervention to improve colorectal cancer screening in underserved areas: protocol for a multicentric cluster randomized controlled trial. BMC Public Health . 2021;21:1684. doi:10.1186/s12889-021-11565
• Jones SE, Hamilton S, Bell R, Araújo-Soares V, White M. Acceptability of a cessation intervention for pregnant smokers: a qualitative study guided by Normalization Process Theory. BMC Public Health . 2020;20:1512. doi:10.1186/s12889-020-09608-2
• Ziegler E, Valaitis R, Yost J, Carter N, Risdon C. “Primary care is primary care”: use of Normalization Process Theory to explore the implementation of primary care services for transgender individuals in Ontario. PLOS ONE . 2019;14(4):e0215873. doi:10.1371/journal.pone.0215873
• Mackenzie M, Conway E, Hastings A, Munro M, O’Donnell C. Is ‘candidacy’ a useful concept for understanding journeys through public services? A critical interpretive literature synthesis. Soc Policy Adm . 2013;47(7):806-825. doi:10.1111/j.1467-9515.2012.00864.x
• Adeagbo O, Herbst C, Blandford A, et al. Exploring people’s candidacy for mobile health–supported HIV testing and care services in rural KwaZulu-Natal, South Africa: qualitative study. J Med Internet Res . 2019;21(11):e15681. doi:10.2196/15681
• Mackenzie M, Turner F, Platt S, et al. What is the ‘problem’ that outreach work seeks to address and how might it be tackled? Seeking theory in a primary health prevention programme. BMC Health Serv Res . 2011;11:350. doi:10.1186/1472-6963-11-350
• Liberati E, Richards N, Parker J, et al. Qualitative study of candidacy and access to secondary mental health services during the COVID-19 pandemic. Soc Sci Med. 2022;296:114711. doi:10.1016/j.socscimed.2022.114711
• Pearson O, Schwartzkopff K, Dawson A, et al. Aboriginal community controlled health organisations address health equity through action on the social determinants of health of Aboriginal and Torres Strait Islander peoples in Australia. BMC Public Health . 2020;20:1859. doi:10.1186/s12889-020-09943-4
• Freeman T, Baum F, Lawless A, et al. Revisiting the ability of Australian primary healthcare services to respond to health inequity. Aust J Prim  Health . 2016;22(4):332-338. doi:10.1071/PY14180
• Couzos S. Towards a National Primary Health Care Strategy: Fulfilling Aboriginal Peoples Aspirations to Close the Gap . National Aboriginal Community Controlled Health Organisation. 2009. Accessed February 15, 2023. https://researchonline.jcu.edu.au/35080/
• Napier AD, Ancarno C, Butler B, et al. Culture and health. Lancet . 2014;384(9954):1607-1639. doi:10.1016/S0140-6736(14)61603-2
• WHO. COVID-19 and the Social Determinants of Health and Health Equity: Evidence Brief . 2021. Accessed February 15, 2023. https://www.who.int/publications/i/item/9789240038387
• WHO. Social Determinants of Health . 2023. Accessed February 15, 2023. https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1
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Qualitative Research – a practical guide for health and social care researchers and practitioners Copyright © 2023 by Tess Tsindos is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License , except where otherwise noted.

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Methodology

• What Is Qualitative Research? | Methods & Examples

What Is Qualitative Research? | Methods & Examples

Published on June 19, 2020 by Pritha Bhandari . Revised on June 22, 2023.

Qualitative research involves collecting and analyzing non-numerical data (e.g., text, video, or audio) to understand concepts, opinions, or experiences. It can be used to gather in-depth insights into a problem or generate new ideas for research.

Qualitative research is the opposite of quantitative research , which involves collecting and analyzing numerical data for statistical analysis.

Qualitative research is commonly used in the humanities and social sciences, in subjects such as anthropology, sociology, education, health sciences, history, etc.

• How does social media shape body image in teenagers?
• How do children and adults interpret healthy eating in the UK?
• What factors influence employee retention in a large organization?
• How is anxiety experienced around the world?
• How can teachers integrate social issues into science curriculums?

Table of contents

Approaches to qualitative research, qualitative research methods, qualitative data analysis, advantages of qualitative research, disadvantages of qualitative research, other interesting articles, frequently asked questions about qualitative research.

Qualitative research is used to understand how people experience the world. While there are many approaches to qualitative research, they tend to be flexible and focus on retaining rich meaning when interpreting data.

Common approaches include grounded theory, ethnography , action research , phenomenological research, and narrative research. They share some similarities, but emphasize different aims and perspectives.

Note that qualitative research is at risk for certain research biases including the Hawthorne effect , observer bias , recall bias , and social desirability bias . While not always totally avoidable, awareness of potential biases as you collect and analyze your data can prevent them from impacting your work too much.

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Each of the research approaches involve using one or more data collection methods . These are some of the most common qualitative methods:

• Observations: recording what you have seen, heard, or encountered in detailed field notes.
• Interviews:  personally asking people questions in one-on-one conversations.
• Focus groups: asking questions and generating discussion among a group of people.
• Surveys : distributing questionnaires with open-ended questions.
• Secondary research: collecting existing data in the form of texts, images, audio or video recordings, etc.
• You take field notes with observations and reflect on your own experiences of the company culture.
• You distribute open-ended surveys to employees across all the company’s offices by email to find out if the culture varies across locations.
• You conduct in-depth interviews with employees in your office to learn about their experiences and perspectives in greater detail.

Qualitative researchers often consider themselves “instruments” in research because all observations, interpretations and analyses are filtered through their own personal lens.

For this reason, when writing up your methodology for qualitative research, it’s important to reflect on your approach and to thoroughly explain the choices you made in collecting and analyzing the data.

Qualitative data can take the form of texts, photos, videos and audio. For example, you might be working with interview transcripts, survey responses, fieldnotes, or recordings from natural settings.

Most types of qualitative data analysis share the same five steps:

• Prepare and organize your data. This may mean transcribing interviews or typing up fieldnotes.
• Review and explore your data. Examine the data for patterns or repeated ideas that emerge.
• Develop a data coding system. Based on your initial ideas, establish a set of codes that you can apply to categorize your data.
• Assign codes to the data. For example, in qualitative survey analysis, this may mean going through each participant’s responses and tagging them with codes in a spreadsheet. As you go through your data, you can create new codes to add to your system if necessary.
• Identify recurring themes. Link codes together into cohesive, overarching themes.

There are several specific approaches to analyzing qualitative data. Although these methods share similar processes, they emphasize different concepts.

Qualitative research often tries to preserve the voice and perspective of participants and can be adjusted as new research questions arise. Qualitative research is good for:

• Flexibility

The data collection and analysis process can be adapted as new ideas or patterns emerge. They are not rigidly decided beforehand.

• Natural settings

Data collection occurs in real-world contexts or in naturalistic ways.

• Meaningful insights

Detailed descriptions of people’s experiences, feelings and perceptions can be used in designing, testing or improving systems or products.

• Generation of new ideas

Open-ended responses mean that researchers can uncover novel problems or opportunities that they wouldn’t have thought of otherwise.

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Researchers must consider practical and theoretical limitations in analyzing and interpreting their data. Qualitative research suffers from:

• Unreliability

The real-world setting often makes qualitative research unreliable because of uncontrolled factors that affect the data.

• Subjectivity

Due to the researcher’s primary role in analyzing and interpreting data, qualitative research cannot be replicated . The researcher decides what is important and what is irrelevant in data analysis, so interpretations of the same data can vary greatly.

• Limited generalizability

Small samples are often used to gather detailed data about specific contexts. Despite rigorous analysis procedures, it is difficult to draw generalizable conclusions because the data may be biased and unrepresentative of the wider population .

• Labor-intensive

Although software can be used to manage and record large amounts of text, data analysis often has to be checked or performed manually.

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.

• Chi square goodness of fit test
• Degrees of freedom
• Null hypothesis
• Discourse analysis
• Control groups
• Mixed methods research
• Non-probability sampling
• Quantitative research
• Inclusion and exclusion criteria

Research bias

• Rosenthal effect
• Implicit bias
• Cognitive bias
• Selection bias
• Negativity bias
• Status quo bias

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.

There are five common approaches to qualitative research :

• Grounded theory involves collecting data in order to develop new theories.
• Ethnography involves immersing yourself in a group or organization to understand its culture.
• Narrative research involves interpreting stories to understand how people make sense of their experiences and perceptions.
• Phenomenological research involves investigating phenomena through people’s lived experiences.
• Action research links theory and practice in several cycles to drive innovative changes.

Data collection is the systematic process by which observations or measurements are gathered in research. It is used in many different contexts by academics, governments, businesses, and other organizations.

There are various approaches to qualitative data analysis , but they all share five steps in common:

• Prepare and organize your data.
• Review and explore your data.
• Develop a data coding system.
• Assign codes to the data.
• Identify recurring themes.

The specifics of each step depend on the focus of the analysis. Some common approaches include textual analysis , thematic analysis , and discourse analysis .

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