Method (e.g. interview technique, method of analysis, etc)
This single case study will be conducted using a qualitative research method. This method is appropriate for this research project as it enables researchers to develop ideas and gain an understanding of society through ‘studying the way that people make sense of their world as subjective individuals’. Silverman (2001) discusses qualitative research stating, “the methods used by qualitative researchers exemplify a common belief that they can provide a ‘deeper’ understanding of social phenomena than would be obtained from purely quantitative data”.
A method needs to be chosen for data gathering, which is done in accordance with the type of research required. An interview is necessary for this research project as a questionnaire previously failed to provide sufficient information. There are various types of interviews, which Grebenik and Moser (1962, cited by Bell, 1999) believe to be placed on what they refer to as a ‘continuum of formality’. At one end of this continuum we find the ‘formalised interview’, also known as a structured interview that uses a format such as a questionnaire. At the other end we find the ‘informal interview’, also known as the unstructured interview, which is “determined by individual respondents”.
For the purpose of this research project the interview is to be conducted using the semi-structured interview technique. A semi-structured interview, which Bell (1999) refers to as the ‘guided or focused interview’, encourages “freedom to allow the respondent to talk about what is of central significance to him or her”, but still maintains “some loose structure to ensure all topics which are considered crucial to the study are covered”. (Bell, 1999) Bell furthers this comment by saying that the structure is “established by selecting topics around which the interview is guided”. Therefore it is necessary to consider the specific information required and develop some sort of structure. A structure devised in relation to the topic being researched also avoids collecting a mass of information that has to be worked through, which actually has no relevance to the topic being researched.
An interview structure or schedule consists of the questions that have been formulated from the topic(s) being researched. (refer to appendix 2) These questions also include prompts or probes to assist the interviewer should they wish to develop an area that the interviewee may have problems discussing. However, these prompts are only examples of questions that may be used. Often is the case that questions must be improvised in accordance with the interviewee’s answers. This occurs as the interviewer may wish to question the respondent about a topic mentioned, enabling the expansion and development of answers and ideas being discussed.
It is important to remember that upon conducting the interview permission must be granted from the respondent stating that they understand how the data is to be used, and that they consent to the use of this data. (refer to appendix 3) It is also advisable to devise a list entitled ‘interview preparation’, to ensure that all important factors are completed before proceeding with the interview. (refer to appendix 4)
Bias
When conducting an interview it is important for the interviewer to remain objective toward the topic being researched. However, this can be difficult sometimes as Sellitz et al (1962, cited by Bell, 1999) recognises, “interviewers are human beings and not machines”. Bell (1999) continues that therefore, ”their manner may have an effect on the respondents”, which may bias their opinions and answers.
Bias can be a particular problem within a single case study as it may go unnoticed. This is unlikely to occur within a team of interviewers, as the data analysis would highlight any consistencies that appear bias. It can be very easy for an interviewer to ‘lead’ an interview, as just by asking a question with “a different emphasis and in a different tone of voice can produce very different responses”. (Bell, 1999) If an interviewer does feel that they have a particular opinion upon a topic being researched within the interview they must ensure that they are aware of this bias and apply self-control to avoid affecting the respondents answers.
Reliability
Bell (1999) describes reliability as, “the extent to which a test or procedure produces similar results under constant conditions on all occasions”. Were this applied to a research project conducted by several interviewers then the reliability of the data could be recognised from the consistency of answers. As this is a single case study no comparisons can be made to check the reliability of answers. However, this study asks for the opinions of the respondent and “questions which ask for opinions may produce different answers for a whole range of reasons”. (Bell, 1999) The interviewee may be affected by something they had previously seen on T.V. or read in a newspaper, or the surroundings may affect the answers given. For this reason the reliability of answers may be doubted.
Validity
Clarke and Oxman (2003) describe validity as, “The degree to which a result (of measurement or study) is likely to be true and free of bias (systematic errors)”, therefore stating that a valid measure is one that measures what it claims to and not something else.
The application of External validity is most appropriate for this study as defined, “external validity concerns making generalisations about your results”. This observes “how well the conclusions of your study apply to other people in other places at other times”. This is the aim of the study to answer a question and yet be able to apply it to the population.
Validity and reliability are closely linked and through the improvement of external validity we can also improve the reliability of the information collected. Trochim (2000) suggests three ways that external validity can be improved: draw a good sample from the population, show data about similarities between various groups of people, places and times, and replicate the study to produce stronger results. Again not all of these can be applied to a single case study, but they would be valuable aspects to remember for future reference in studies involving several respondents.
Analysis method
The interview will be analysed using Glaser and Strauss’ method of ‘grounded theory’, also known as ‘open-coding’.
Silverman (2001) provides a simplified model of Glaser and Strauss’s grounded theory, which involves these stages:
- “an initial attempt to develop categories which illuminate the data.
- an attempt to ‘saturate’ these categories with many appropriate cases in order to demonstrate their relevance
- developing these categories into more general analytic frameworks with relevance outside the setting.”
Glaser and Strauss’s grounded theory refers to “theory that was derived from data, systematically gathered and analysed through the research process”. (Strauss and Corbin, 1998) It is the process of data collection, which is completed through the use of a semi-structured interview within this research project, analysis, using the method of open coding, and finally the development of a theory, which for this study is to provide an answer to the relevant question. (refer to section entitled ‘question’)
Grounded theory is apt for a single case study as the data collated, when analysed, will “offer insight, enhance understanding, and provide a meaningful guide” to the topic being studied. (Strauss and Corbin, 1998)
Open coding enables a researcher to build theories through “defining categories, and developing categories in terms of their properties and then later relating categories through statements of relationships”. (Strauss and Corbin, 1998) The development of these categories enables the researcher to reduce data into more manageable amounts, so that patterns can emerge, thus structuring the theory.
Findings/results
Through analysis of the results several reoccurring themes were identified. These themes were highlighted within the passages and then placed into categories in accordance with Glaser and Strauss’s method of ‘grounded theory’. As stated by Strauss and Corbin (1998), grounded theory, also known as open coding, provides the researcher with the technique to “aptly name categories, make comparisons, and extract an innovative, integrated, realistic scheme, from the raw data”.
The analysis of the data emphasised four main categories that can be identified. These are the role of the therapist, the standard and convenience of treatment received, and the patient’s belief in the therapy.
These are be discussed in-depth, with relation to the results collated from the semi-structured interview:
The role of the therapist.
This is an interesting factor to consider as the client does actually contradict herself at one point.
Upon asking if the relationship plays a role she adamantly remarks, ‘No, I don’t think it does’. If we refer to the question put to her in paragraph 7 and then the answer in paragraph 8 (page 5), we see the contradiction she makes.
Immediately after commenting about being put at ease she states that the therapist does not have a role in aiding her relaxation. Reading further into the transcript though we observe that this is not so, as she makes several references to the importance of the role of the therapist. She refers to positive aspects of complementary therapy sessions when highlighting the therapists attitude, and in comparison to her G.P’s attitude, reflects upon how she was put at ease with the approach that the therapist took. (page 6, paragraph 9)
The importance of the role of the therapist is emphasised further when the development of the relationship between therapist and client advances. Paragraph 1 (page 7) provides sufficient evidence that the attitude and the relationship formed within the therapy sessions is actually an important factor to the client’s therapy. It enables the client to develop trust, which is an essential aspect to the healing within such a relationship, although the client may not be consciously aware just how essential it actually is.
The standard and convenience of treatment received.
The respondent commented that prior to the recommendation of the complementary therapy she had tried almost all of the orthodox treatments available. However, these treatments caused many problems, such as drowsiness, which were inconvenient to her lifestyle, and also only ‘abated the symptoms for a few hours at a time’. (pg 2, paragraph 5)
Upon trying the complementary therapy though she found an almost immediate response. This is discussed within paragraph 7 (page 2), where she comments that after just two visits she began to feel the benefits of the treatment. This is quite remarkable when compared to the continuous inconvenience she had suffered for several years from the treatments supplied by her G.P.
The complementary therapy sessions last just twenty minutes and cause minimal inconvenience to the client. The treatment has no side effects and the respondent commented that since her first treatments she has only returned on two occasions. It must be emphasised though that the reason for not returning is purely because the therapy cured the health problem after just three sessions, whereas orthodox medicines failed over a period of several years.
Belief in the therapy
The recommendation, and prior knowledge that a complementary therapy works, is an important factor in relation to believing in a therapy. The study provides evidence that doubts about the therapy do arise within a client, especially if they are receiving treatment for the first time.
The respondent within this study disclosed that she was quite dubious about the treatment and also doubted the technique. Interestingly though she is adamant that she entered the therapy with an open mind, and it would appear that many of her doubts are as she confesses because she, ‘just couldn’t see how it could work not having to take any medicine’. (page 3, paragraph 5)
The doubts and tension surrounding the therapy are eased though, due to the recommendation of the complementary therapy through a friend. It appears that knowing that someone had successfully received complementary therapy helped to relieve the doubt in her mind. The interviewee remarked that she no longer has any qualms with regards to the therapy, and believes in the therapy so much so that she recommends the treatment to others. (page 4, paragraph 7)
Conclusion
The overall opinion seems be that the individual uses a complementary therapy for the maintenance of health for several reasons. The reasons identified within this study are that orthodox treatment has failed the client previously, and therefore recommendations have been made to use a complementary therapy, which it must be hastened add was by friends or colleagues rather than a G.P. Upon using the therapy recommended the client found the results to be very successful, and have therefore continued their treatment when it has been necessary.
The attitude of the therapist toward the client also appears to have an impact. A relationship that involves trust is developed, which sequentially assists the ability to make the client feel relaxed and at ease. If a client builds a relationship that includes respect and trust, therefore leading to a sense of relaxation and ease, this will also be beneficial to the clients healing process. The state of mind is also important, as both body and mind are a whole; therefore relaxation of the mind will play a role in the client’s recovery.
The respondent commented upon an issue that is extremely valid when she said, ‘peoples G.P’s are still failing them’. Many aspects of orthodox treatment do not present a cure to some peoples health problems, as is documented within the data taken from the subject involved in this study.
Complementary therapies can however help a proportion of the population, and the sample interviewee used within the semi-structured interview of this project, is representative of this factor.
G.P’s do not readily recommend complementary therapy treatment for on-going illnesses and from the data collated within this study it is suggested that patients are finding out about these treatments through recommendations from others. However, the study also suggests that upon following these recommendations they discover a treatment that is suitable, convenient, relaxing and friendly. The client will therefore persist with the treatment and, as did the subject of the single case study, will discard of the orthodox and stereotypical thinking that pharmaceuticals and operations are the only means to maintaining a persons health.
Bibliography
Bell, J (1999) Doing your research project (3rd ed.) Open University Press, London
Clarke M, Oxman AD (2003). Cochrane Reviewers' Handbook 4.1.6. Validity. (viewed March 2003).
Parker-Eames, M (1997) Research methods and healing [Videorecording]. - Tape 2 : Introduction to qualitative research. - University of Derby
Silverman, D (2001) Interpreting Qualitative Data. (2nd ed.) Sage publications, London
Strauss, A and Corbin, J (1998) Basics of Qualitative research: Techniques and Procedures for developing grounded theory. Sage Publications, London
Trochim, W.M.K (2000) External Validity [WWW] (viewed March, 2003)
Trochim, W.M.K (2000) Sampling Terminology [WWW] (viewed March, 2003)
