Qualitative Health Research - A guide for the perplexed

Part 7 - Philosophy and the place of research methods

Now we get to the heart of one of the most contentious issues in QHR.

If you’ve followed the series so far, we’ve covered a lot of ground: sampling, generalisability, voice, and the ‘emic’ perspective, but we’re mining the motherlode now when we talk about the place of philosophy and methods in QHR.

So let’s be clear from the outset, QHR places far too much emphasis on research methods and nowhere near enough on philosophy.

Anchoring a qualitative study in philosophy is perhaps the most valuable thing you can do to a research study. Firstly, it guides every step of the process - every aim, and every question you pose of the data - and it ‘lifts’ your analysis above the obvious and mundane.

It is the key to saying something new and surprising, and does more than anything to prevent you from presenting your findings as if they somehow spoke objectively for themselves.

To begin with, philosophy helps you situate yourself. It helps you focus your question and your analysis.

People drawn to hermeneutic phenomenology are going to undertake a very different study to people who are critical theorists, and they’ll find very different things in the data.

For example, phenomenology is very concerned with what it means to besomeone. So a phenomenologist would be very interested in what it means to live with cerebral palsy. Critical theorists are more interested in the way power operates in society, and would be interested in the ways people and institutions subtly discriminate against disabled people.

The phenomenologist’s study demands a very different approach to the critical theorist’s, but the methods they use really aren’t what matters here. Beyond talking to people, observing things, and reading texts, there aren’t many complexities to qualitative research methods, but this is often where QHR goes wrong.

Concerned to mirror the granular control quantitative researchers need to hold over every step in their methods, qualitative health researchers have developed all sorts of ways to regulate, define, and standardise data collection and analysis methods. Using digital transcript-analysis tools and member checking, for example, are evidence of the researcher attempting to bring standardisation to data that really shouldn’t be standardised.

The point of QHR is to reflect the uniqueness of each event; each non-standard, perspective-laden, contextual nuance of health and healthcare. So how on earth do you find meaning in all of this complexity?

Philosophy.

No matter what your question, I would guarantee that someone has thought about the issue you are exploring before you. More than this though, the great philosophers have woven this question into a deeper search for the meaning of life, and with their help you might just be able find something in your data that transforms the way we all think.

Physiotherapists often baulk at the idea of reading philosophy. It’s not something they’re familiar or comfortable with. Quantitative research mostly brushes over its underlying philosophy, especially in health research. So most physios look at philosophy in the same way they might look at a plate of food they don’t like. (And most are happy just to go hungry).

Unfortunately this has also been an option for a lot of qualitative health researchers in recent years, as guidance to qualitative health researchers has come to look increasingly like quantitative-lite.

Elizabeth St Pierre Adams has been resisting this trend for years now, writing about a kind of QHR that returns to the discipline’s early promise, arguing against the over-emphasis on methods and formulae (Pierre 2013, 2014).

She doesn’t deny that philosophy is hard. But then so is physiology, anatomy, clinical decision-making, ethics, and professionalism, and none of us would practice without these. So we should not let qualitative health researchers get away with making rigid claims about their research methods as a substitute for philosophically-informed thinking.

References

Pierre, E. A. S. (2013). The posts continue: becoming. International Journal of Qualitative Studies in Education, 26(6), 646-657. doi:10.1080/09518398.2013.788754

Pierre, E. S. (2014). A Brief and Personal History of Post Qualitative Research: Toward Post Inquiry. Journal of Curriculum Theorizing, 30(2). Retrieved from Google Scholar