Taking qualitative research to its logical conclusion

I have been doing qualitative research most of my working life and I enjoy it immensely. There is something very satisfying about capturing people’s views about a topic – often an issue of some importance to them – in their own words. Most of my paid work has focused on experiences of the health service, such as patients’ views about their treatment and care for coronary heart disease, cancer, diabetes and so forth. Some has concerned experiences of social care, such as parents’ views about the appropriate future care of their adult sons or daughters with learning disabilities. Such research may not answer statistical questions, but it gets to the heart of how people feel.

The writing-up of qualitative research traditionally involves some explication of the issues by the researcher and some quotations from those interviewed, to show how they expressed themselves in their own words. Over the years, I became interested in exploring whether one could omit the researcher almost entirely and allow those interviewed to tell their stories – and explain the issues – themselves. Much too often, it was their words which were most alive or moving and the researcher simply paraphrased them for explanation, but without a great gain in understanding. My reports became increasingly quotation-based, with some tentative analysis offered by myself. Whether this was a style that was seen to be better or worse than a more traditional one I never knew.

Over twenty years ago, I took this position to its logical conclusion. Having interviewed 21 men and women with HIV and AIDS, I wrote a book, Wise Before their Time: People with HIV and AIDS Talk about their Lives, which set out their views with only minor interjections from myself. This was a time when there was little treatment for AIDS and most were dying, so their experiences were very moving. Sir Ian McKellan wrote a short Foreword in which he said ‘This collection of true stories is as powerful as any classic of fiction.’ It was published by Harper Collins (1992), aimed at a popular audience, and sold quite well, around 7,000 copies.

About seven years ago, I repeated the exercise with people who worked in hospice care. I was interested in understanding how it felt to go to work every day to work with dying people ­– and interviewed 31 staff in two hospices, including health care assistants, doctors, nurses, managers and even one chef. Again, I pared down my contribution to a minimum, so that the reader essentially ‘heard from’ the people involved. The book, Life in a Hospice: Reflections on Caring for the Dying, was published by Radcliffe (2007), had a Foreword by Tony Benn and was ‘highly commended’ by the British Medical Association. Again, it was aimed at a popular audience, but it was read primarily by a professional one. Commercially, it did not do well at all. I found that most people do not share my fascination with dying.

And now, I have tried again but on a subject of even less social policy interest (albeit growing), namely grandmothers. Called CelebratingGrandmothers: Grandmothers Talk about their Lives, it is in its very early days. It explores a wide range of issues of concern to grandmothers, such as the pleasures of revisiting childcare, how they cope with offering advice to their children, how it affects their feelings about themselves and the considerable pain experienced when they are unable to see their grandchildren due to distance or strained family relationships. Again, the voices in this book are very much those of the grandmothers themselves, with my interjections kept at a minimum.

What does one gain by omitting the researcher? One answer is that one gains time and space, allowing the people interviewed to be quoted at greater length (although there is much to be said for being as spare as possible). It enables them to tell a story or develop the complexities of an argument for which there is less space in a more conventional report. Perhaps it will help to provide some examples. All of these are taken from my recent book on grandmothers.

Here is one grandmother explaining how she saw the role of grandmother at the outset:

I was 50 and kind of astonished to find myself being a grandmother. One doesn’t see oneself in that role, really. I went out and bought myself a suit and when I got home, I realised in the back of my mind that it was a suit that grandmothers would wear. I was never able to wear it. It was a kind of heather-coloured tweed. And it immediately ‘grandmothered’ me.

Then I thought, no, no, I don’t have to do this! I hung on to the suit for quite a time, because it was quite nice, but every time I put it on, it felt completely wrong – I didn’t feel I was that person. Of course, I hadn’t changed, I was still the person I was, so there was no need to change the way I thought about clothes. I expect it went to Oxfam eventually and some other grandmother picked it up.

And here is another describing the sheer joy of being with her grandchildren:

They stay with me a lot and like to sleep with me. I love it. When they are lying in bed with me in the morning – that’s the happiest time. We’ll talk about anything, what should we do, what we are having for breakfast. But what makes me so happy is that they are sharing their time with me. One is lying on my leg, one is lying on my hair, one is putting the fingers on my head – it’s like a joyful current going all around my body. You can’t buy that happiness anywhere.

The book is riddled with the complexities of family relationships. Here is one grandmother explaining how her status created problems with her son:

My relationship with my son has become more distant since his second child was born. It feels sad. This could be that in order to be close to his wife, he has to be distant from me, because she seems to feel there’s some rivalry between us, which I think creates rivalry between us. I think he found it very stressful doing his job and becoming a father. His wife had enormous expectations of sharing the children with him, she felt he wasn’t doing enough.

I detected some bitterness towards me. I don’t know whether that was, ‘You didn’t mother me like this’ or ‘I’m finding this role really difficult, trying to be a good father and my partner’s expecting far too much of me and I can’t do it.’ If he hadn’t had children, I think I would be closer to him. I’m valued as a grandmother, but I think the mother-son relationship has suffered.

And finally, here is one thinking about her own life:

Both becoming a grandmother and retiring – the two things at different times – each time you question the fragility of your life. You feel you are moving up, passing on. It makes you question things about life and how long you have to live. There’s another generation that has come up – and you belong to the one who would have to leave to make room. And you think, am I going to see them as adults? I’m not eternal. I’d just like to see what’s going to happen.

Now, PSSRU – where I am a Visiting Fellow – is an academic institution and you might be wondering whether such books come under the heading of ‘academic research’. I tend to argue that they don’t, because I don’t want to be criticised for pretending to do something I am not. On the one hand, they are all presented in a logical, analytical fashion – they are not simply a set of stories in no particular order. The research has been undertaken as rigorously as any academic study. But, on the other, I do not try to fit the findings into the existing literature in their respective fields. Nor do I offer a clear analysis of what kind of people have what kind of view, i.e. are people’s views different if they are a young grandmother or an impoverished grandmother or a Jewish grandmother, although all are represented among those interviewed. What a reader comes away with, I hope, is a strong sense of what it feels like to be a grandmother (or, in the other books, what it feels like to have HIV or to work in a hospice). It puts the reader into the texture of their lives – what the issues are for them, the considerations they take into account when addressing such issues and some of the different ways they respond. In sum, all such studies should progress understanding. They are clearly a kind of research, but is it academic? I do not know, but it is a lot of fun to do.

This was originally posted in a blog of the Personal Social Services Research Unit at the London School of Economics, where I was a Visiting Fellow       http://blogs.lse.ac.uk/healthandsocialcare/2014/10/28/taking-qualitative-research-to-its-logical-conclusion/

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