Qualitative Research 39
Strategy:
1. Read the clinical problem: ‘Infant feeding in the east end of London’
2. Read the article:
• Hoddinott P, Pill R. ‘Qualitative study of decisions about infant feeding among women in east
end of London.’ BMJ 1999; 318: 30-34
3. Read the background articles:
• Greenhalgh T, Taylor R. ‘Papers that go beyond numbers (qualitative research).’ BMJ
1997;315:740-3
• Critical Appraisal Checklist for an article on qualitative research.
Evidence-Based Child Health Network of Materials
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Qualitative Research 39
Consider the following scenario:
You are a member of the midwifery team of a busy city-based district general hospital. The results
of a recent audit by one of your team has shown that the proportion of your first-time mothers who
breast-feed is only 55%.
Determined to improve this uptake of breast-feeding you decide to undertake a literature search.
You are specifically interested in recent publications that have examined the beliefs of first-time
mothers about breast feeding. You find a qualitative study recently published in the BMJ that
looks as if it might be useful.
After reading the paper, answer the following questions:
Does this paper contribute to your understanding about the beliefs of first-time mothers to
breast feeding.
Would you recommend the adoption of a programme of antenatal apprenticeship to firsttime mothers going through your unit?
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Critical appraisal checklist for an article on qualitative research
This checklist is based on a number of sources, including the work of Dr Rod Jackson, Dr Nicky Britten and
Dr Trisha Greenhalgh
1. Did the article describe an important clinical problem addressed via a clearly formulated question?
2. Was a qualitative approach appropriate?
3. Was the sampling strategy clearly defined and justified? In particular,
a) Has the method of sampling (for both the participants and the setting) been adequately described?
b) Have the investigators studied the most useful or productive range of individuals and settings relevant to
their question?
c) Have the characteristics of the participants been defined?
4. What was the researcher’s perspective, and has the researcher critically examined his or her own role,
potential bias and influence?
5. What methods did the researcher use for collecting data? In particular,
a) Have appropriate data sources been studied?
b) Have the methods used for data collection been described in enough detail?
c) Was more than one method of data collection used?
d) Were the methods used reliable and independently verifiable (e.g. audiotape, videotape, fieldnotes)?
e) Were observations taken in a range of circumstances (e.g. at different times?)
6. What methods did the researcher use to analyse the data, and what quality control measures were
implemented? In particular,
a) How were the themes and concepts derived from the data?
b) Did more than one researcher perform the analysis, and what method was used to resolve differences of
interpretation?
7. What are the results, and do they address they research question?
8. Are the results credible? For example,
a) Have sequences from the original data been included in the paper (e.g. direct quotation)?
b) Is it possible to determine the sources of data presented (by numbering of extracts)?
c) How much of the information collected is available for independent assessment?
d) Are the explanations presented plausible and coherent?
9. What conclusions were drawn, and are they justified by the results? In particular, have alternative
explanations for the results been explored and discounted?
10. To what extent are the findings of the study transferable to other clinical settings?
a) Were the participants in the study similar in important respects to your own patients?
b) Is the context similar to your own practice?
Evidence-Based Child Health Network of Materials
Produced by Centre for Evidence-Based Child Health