This blog is written by Dr Analisa Smythe, Research Matron, Birmingham and Solihull Mental Health Trust, The Royal Wolverhampton NHS Trust (analisa.smythe@nhs.net) and Dr Catharine Jenkins, Associate Professor, Dementia Care, Birmingham City University (catharine.jenkins@bcu.ac.uk ).
Introduction
Qualitative research is key to understanding participants’ experiences and insights, usually collected through focus groups and interviews, which then support arguments for change and innovation. Our research has focused mainly on the experiences of nurses and family carers involved in the care of people living with dementia. For nurses, understanding how we approach our roles, how service-users experience care, what feels significant in our experiences of providing care, and how we manage the barriers to high quality care and work together better are all key areas open to study through qualitative methods. However, it is not easy; in this blog we discuss some of the considerations from our own experiences.
Securing funding
The Chief Nursing Officer for England’s strategic plan (1) for research highlights the value of nurse led research and the need for a clear research career pathway. The NIHR have developed a framework for clinical academic careers and offers a range of awards, from pre-doctoral to advanced fellowships (2). The NIHR also offer larger grants, which are highly competitive. Qualitative researchers may have more success with charitable funders such as the Burdett Charitable Trust for Nursing and the General Nursing Council, which have calls specifically for nurses.
Identifying the relevant team
The team should include a patient or carer as Patient and Public involvement (PPIE) (3). The research team should have a mix of skills, the role of each person in the team should be clear and they should be able to demonstrate a track record appropriate to their proposed roles. Previous research and papers in peer reviewed journals, and relationships between the various organisations should also be clearly defined (4). A conversation at an early stage regarding assigning first and corresponding author is key as this might cause conflict later.
Approvals
Ethical approval is essential. Researchers should refer to the HRA decision making tool, designed to support decision-making around whether the study is research as defined by the UK Policy Framework for Health and Social Care Research (HRA) (5). Approvals will also be required from the sponsor. Obtaining sponsorship from host organisations can be time consuming, so researchers need to be prepared for this.
Resources and Pragmatics
Recruitment, data analysis and write-up often take longer than planned (4). Dictaphones should be password protected and tested in advance. Transcriptions, whether by an agency or online/AI resource, should be checked for accuracy.
Planning
Decisions about data collection should be guided by the research aims and objectives (5). Personal, or sensitive questions are probably best addressed individually (in interviews), but a focus group conversation between participants may build greater insights. It is hard to craft non-leading questions; they will be drawn from the authors’ understanding of the literature and perhaps their own concerns too.
Recruitment
Recruitment requires flexibility and preparation, as participants are busy. The agreed time, place, or mode (e.g., online) for an interview or focus group may not work on the day. The obvious answer is to ‘phone in advance. It is useful to have attractive refreshments and be able to offer a gift-token as an acknowledgement of someone’s time and participation. If only a couple of people arrive for a focus group, it might be prudent to continue anyway as participants are often late, (have participant information and consent sheets ready) and later an informal ‘snowballing effect’ can encourage others to come forward.
Communication skills
If a participant gives one-word answers an empathetic ‘interesting, can you tell me more?’ can encourage more detail. (‘Why’ can paradoxically make people clam up). Sometimes research is emotionally fraught, but this can provide an opportunity for participants to feel heard and validated. Personally, we feel it is not harmful if participants become tearful, so long as they are supported and reassured and there are safeguards in place for managing the impact of this both on the participants and on the research. Participants can be signposted to further support. If participants raise concerns about safety or poor practice, then safeguarding procedures must be followed.
Recognition
While it is important to acknowledge participants with genuine thanks, a gift-token is a concrete sign of recognition. It is also the researchers’ duty to share findings in a final report.
Writing-up
Word limits can be tight. With marvelous quotes arranged in themes, it is hard to edit out a pointed statement or an emotionally moving turn of phrase. The key is to reflect, and be ruthless. Publications reject overlong papers, so a risk is that a project could potentially remain unpublished, and voices unheard. Steps should be taken to ensure the trustworthiness and integrity within the data analysis process, for example by checking with participants that the researchers interpreted their statements correctly (member checking) and by keeping a reflexive journal (6). Research exploring workplace difficulties can result in contentious findings. Once trust is established participants often share detailed, exposing reflections on their professional troubles, but this transparency can result in justification for change. All information provided should be treated with confidentiality and handled in accordance with due processes which are clearly communicated to participants as part of an informed consent process.
Conclusion
Although there are barriers and challenges to qualitative research, it enables researchers to collect the perspectives, insights and wisdom of people whose understanding is drawn directly from their experiences. Their experiences are valuable and as researchers we can share them with wider, even international, audiences of fellow practitioners facing similar struggles and addressing similar goals. Qualitative research facilitates nurses learning from each other, which for nurse researchers, is immensely rewarding.
References
1. NHS England and NHS Improvement (2021) Making research matter Chief Nursing Officer for England’s strategic plan for research. Available from https://www.england.nhs.uk/wp-content/uploads/2021/11/B0880-cno-for-englands-strategic-plan-fo-research.pdf.
2. NIHR (2025) Research career development funding programme. Available from https://www.nihr.ac.uk/career-development/research-career-funding-programmes
3. NIHR. (2019) Patient and public Involvement Resources for applicants to NIHR research 2019 [Available from: https://www.nihr.ac.uk/documents/PPIE-patient-and-public-involvement-resources-for-applicants-to-nihr-research-programmes/23437.]
4. Siverio, s., Hall, J., Sandall, J. (2020). Time and qualitative research: Principles, Pitfalls and Perils. Conference: Quality Research Symposium. Bath. Available: https//www.researchgate.net/publication/338902281.
5. Health Research Authority. (2023). UK Policy Framework for health and Social Care Research. Available; https//www.hra.nhs.uk/planning and improving research/policies standards legislation/uk policy framework health social care research.
6. Johnson J et al (2020). A Review of the Quality Indicators of Rigor in Qualitative Research, American Journal of Pharmaceutical Education, Volume 84, Issue 1, 7120,ISSN 0002-945. https://doi.org/10.5688/ajpe7120.