As surgery being the primary mode of treatment for most of the cancers (e.g. breast cancer), surgeons play an important role in referring those patients to oncologists. This study examine decision making process of surgeons.

Methods: A qualitative study, grounded theory. In-depth, semi structured interviews. Interviews of 34 surgeons, audio taped and transcribed. It is filled by the process of coding and analyzing.

Decisions related to (neo)adjuvant treatment are somehow related to patient factors (e.g., functional status/comorbidities, life expectancy, and risk of disease recurrence), surgeon factors (e.g., level of training/specialization, personal beliefs [52,83]), considerations of treatment benefits and risks, and the broader health system in which they operate.

Qualitative data “document the world from the point of view of the people studied”. Grounded theory is “grounded” in the sense that findings tend to be inductively derived from the data and the participants themselves.

Theory building is entirely inductive (or deductive); instead, theory building occurs in an ongoing dialogue between pre-existing theory and new observations/insights generated from empirical research. The Penchanksy and Thomas model for open ended questions. (continues..)

Colbourne et al: The culture of cancer and  the therapeutic impact of qualitative research interviews..

Aim: to investigate the experience of men during and after receiving potentially curative treatment for testicular or prostate cancer , and the corresponding experience of their spouse/partner.

Study design:  Qualitative, longitudinal, case study, two recruitment arms,(prospective and retrospective)

Therapeutic interview : personal change
Q I :  to know the experience

Characteristics of Therapeutic  Interviews:
Case study
Open mode of interview
Temporal dimension
Multiple layer of meaning of dream
Investigation of pathology

Remembrance of the past is very important. Sometimes environment carries negative emotions. Interview provide emotional expression.

Hutchison et al 1994 suggest that human interaction provide a positive, therapeutic component to the research interview,

Potential outcome of human interaction:
Catharsis
Altruism
Self-acknowledgement
Sense of purpose
Empowerment healing

Through qualitative interviews, we can understand particular relationship.

Negative metaphor of diseases???—Oh cancer is like death sentence…

Sometimes, cancer patietns walk a tightrope of thoughts and emotions. Few people hid their diagnosis.

If you are professional and  indulge in taking interviews , it is defficult to hide professional knowledge and  it is not wise to hide it as well. In such cases, balanced approach is important.

This study like  designs involve serial interviews…

Verheoff et al (2002)

Randomized controlled trials (RCTs) have an important place in the assessment of the efficacy of complementary and alternative medicine (CAM). However, they address only one, limited, question, namely whether an intervention has-statistically-an effect. They do not address why the intervention works, how participants are experiencing the intervention, and/or how they give meaning to these experiences. Therefore, we argue that the addition of qualitative research methods to RCTs can greatly enhance understanding of CAM interventions. Qualitative research can assist in understanding the meaning of an intervention to patients as well as patients’ beliefs about the treatment and expectations of the outcome. Qualitative research also assists in understanding the impact of the context and the process of the intervention. Finally, qualitative research is helpful in developing appropriate outcome measures for CAM interventions. Greater understanding of CAM interventions has the potential to improve health care delivery.

The field of public health is full of puzzling questions, complicated relationships, and slowly evolving events– phenomena leaving gaps in understanding that invite qualitative methods to fill

(Rubin and Rubin 1995, p.51)

Probe..

Qualitative research is a tool to better understanding of the human condition.

Qualitative research is more about hearing, listening and interpreting.

How and why… Ask them..

Qualitative researchers seek answers to their questions in the real world. They gather what they see, hear, and read from people and places and from events and activities .. Their purpose is to learn about some aspects of the social world and to generate new understandings that an be used by that social  world.

the first step of grounded theory is start with open mind…

In grounded theory, you should understand contradictory statements.

Research is not a clinical or academic ct, it is human interaction on a very personal level.

I had to be a partner and a listener in the human act of research.

How you position yourself on continuum will ultimately influence the kind of research you conduct.

Positivist

Interpretivist

Feminist

FUNNY VIDEO

I can understand numbers, hence I think I am not bad with quantitative data. But what about qualitative? I am novice,  I need to develop this skills.

Last year, our professor, just gave snapshot to we students, and believe me, it somehow made me curious to learn more of it. Because of medical journalism, my interest multiplied by two( double). My career logic model has objective of doing MBA in future, that made my further extended my interest.

* In depth Interviews…wow.. i love this part. Now million dollar question: I have been working on asking questions, how will I make it happen?

* Ground theory… i do not know why it is ground.. but remember conversation with my instructor. it is to do something with complete open kind, means(you do not have any opinion), Categorizations of variables…

*Few softwares line NIVIVO , Dedoose..bla bla bla..I came across Dedoose when I attended presentation by one of doctoral students at APHA. I downloaded the program on my mac and played with it foolishly, like child play with video game. But i found it very interesting. You pick up any line from the conversation and code it.

* I think qualitative analysis is more challenging than quantitative. Qualitative is highly researcher-based. I think it is very important tool in marketing. Agreed that logistic regression from quantitative methods can predicts the stock market, but qualitative market can give the real picture what consumer thinks of the product.

*Qualitative is so vast……I met yesterday one of my best friends whose husband is Anthropologist. I had chat with him and came to know the importance of qualitative methods in anthropology.

Now, I am at the final step of finishing MPH, I think I didn’t achieve much what i wanted to. Still i am lacking something.

Anyway, I am starting blog for qualitative studies, for myself. Life i learning process!!!! And when you get “L’ out, it becomes earning…