Why is qualitative research in stroke undeservedly ignored? It remains the basics of the understanding of stroke patients behavior.

Authors: Inna Lutsenko, Aishoola Sultanova
Department of Neurology, Kyrgyz State Medical Academy after I.K. Akhunbaev, Bishkek, Kyrgyzstan.

 Qualitative research is characterised by its aims, which relate to understanding some aspect of social life, and its methods which (in general) generate words, rather than numbers, as data for analysis [1]. The strength of qualitative research is its ability to provide complex textual descriptions of how people experience a given research issue. It provides information about the “human” side of an issue – that is, the often contradictory behaviors, beliefs, opinions, emotions, and relationships of individuals [2], but despite of its effectiveness, qualitative research is undertaken by researchers from a variety of disciplines, and reports may be published in journals not widely read outside the discipline concerned [3].

While quantitative research values control, qualitative research values openness and flexibility. The quantitative researcher maintains an objective and detached stance, but the qualitative researcher is considered to be the key instrument involved closely with the data collection and analysis [4].

Figure 1. The main features that differentiate qualitative research from quantitative research [12].

The three most common qualitative methods are participant observation, in-depth interviews, and focus groups. One advantage of qualitative methods in exploratory research is that use of open-ended questions and probing gives participants the opportunity to respond in their own words, rather than forcing them to choose from fixed responses, as quantitative methods do [2]. It’s crucially important to establish a rapport with the interviewee while gathering the information. The process of establishing rapport is an essential component of the interview and is described in the classic works of Palmer and Douglas [5,6]. Essentially, rapport involves trust and a respect for the interviewee and the information he or she shares. It is also the means of establishing a safe and comfortable environment for sharing the interviewee’s personal experiences and attitudes as they actually occurred [7].

Both qualitative and quantitative data analysis bear their own value and have features that can contribute the research results of each other and enrich the research results. The combined approach involving the both methods is now gaining more and more popularity among the scientists all around the world as it helps to reject the biases and eliminate the breaches of the both approaches [8].

Hence, qualitative research on stroke is considered in the modern time a highly-efficient type of research. Particularly, in patients with stroke, this type of research may contribute to improve the understanding of unknown behavioral models in stroke patients, including reaction to reabilitation and acceptance of the pathology.

Here are some examples of its use in stroke:

S.S.Yoon, and J. Byles carried out a qualitative study to obtain insight into people’s thoughts on stroke, including risk factors, symptoms, treatment, information resources, and prevention. The results were used for the development of an educational strategy for the early recognition of symptoms and for appropriate responses to these in the community, and to the development of an educational programme for people who have had a stroke [9].

Another example is how Maclean et al. in their research explored the beliefs of stroke patients who were identified as having “high” or “low” motivation for rehabilitation and investigated the determinants of their motivation. By using semistructured interviews, they were able to investigate an underresearched topic and to allow patients to explain their beliefs accurately in their own terms. A team of the researcher conducted the serial of bedside interviews, where patients were tested on their confidence about the good recovery, their relationships with professionals. Patient were asked about their roles in recovery participation and about the hopes on the life after the stroke. Results showed that there are more high motivation patients, who believed that they themselves play an important role in rehabilitation and they emphasized the necessity of the learning correct exercises in the manner to bring back the muscle volume and power to affected extremities. High motivation patients also claimed that exactly independence in after stroke life and independence from their relatives brings to their personality the completeness and they underlined the overprotection from the relatives side, which made patients to feel “stupid” and incapable. In addition, one of the interesting findings of research was that some patients cited the desire to leave hospital as quickly as possible as a main motivating factor for doing rehabilitation exercises [11].

Finally, as concluded in a prior systematic review of 95 qualitative studies of stroke, recording the “human” experience of stroke identifies the needs as perceived by patients and their families, as well as differences in priorities between patients and professionals, and barriers to best-quality care. Finding solutions to such problems require improved understanding of the social processes that give rise to them. This can be best achieved through well-designed, conducted, and disseminated qualitative investigations [3].

 

  1. Nouria Brikci, Judith Green. A Guide to Using Qualitative Research Methodology, 2 (2007).
  2. Natasha Mack, Cynthia Woodsong Kathleen M.MacQueen, Greg Guest, Emily Namey. Family Health International. Qualitative Research Methods: A Data Collector’s Field Guide. Module 1: Qualitative Research Methods Overview (2005).
  3. Christopher McKevitt, Judith Redfern, Freda Mold, Charles Wolfe. Qualitative Studies of Stroke: A Systematic Review. Stroke 35,1499–1505 (2004).
  4. Morrow SL, Smith ML. Qualitative research for counseling psychology. In Brown SD, Lent RW, eds. In: Handbook of Counseling Psychology. 3rd ed. New York: Wiley; 2000:199–230
  5. Palmer V. Field Studies in Sociology: a Student’s Manual. Chicago: University of Chicago Press 1928.
  6. Douglas J. Creative Interviewing. Beverly Hills, California: Sage 1985.
  7. Barbara DiCicco-Bloom, Benjamin F Crabtree. The qualitative research interview. Medical Education, 40: 314–321 (2006).
  8. Qualitative data analysis http://www.qualitativedataanalysis.net/qualitative-and-quantitative-data-analysis/
  9. Sung Sug Yoon, Julie Byles. Perceptions of stroke in the general public and patients with stroke: a qualitative study. BMJ VOLUME (2002)
  10. Kaufman SR. Towards a phenomenology of boundaries in medicine: chronic illness experience in the case of stroke. Med Anthropol Q. 1988;2:338–354.
  11. Niall Maclean, Pandora Pound, Charles Wolfe, Anthony Rudd. Qualitative analysis of stroke patients’ motivation for rehabilitation. BMJ, 321(7268): 1051–1054 (2000).
  12. Mary Achebe. The main features that differentiate qualitative research from quantitative research. https://www.tuko.co.ke/287334-difference-qualitative-quantitative-research-methods.html#287334