Elsevier

Midwifery

Volume 22, Issue 2, June 2006, Pages 108-119
Midwifery

Appraising the quality of qualitative research

https://doi.org/10.1016/j.midw.2005.05.004Get rights and content

Summary

In the process of undertaking a meta-synthesis of qualitative studies of free-standing midwife-led units, the authors of this paper encountered a number of methodologically and epistemologically unresolved issues. One of these related to the assessment of the quality of qualitative research. In an iterative approach to scoping this issue, we identified eight existing checklists and summary frameworks. Some of these publications were opinion based, and some involved a synthesis of pre-existing frameworks. None of them provide a clear map of the criteria used in all their reviewed papers, and of the commonalities and differences between them. We critically review these frameworks and conclude that, although they are epistemologically and theoretically dense, they are excessively detailed for most uses. In order to reach a workable solution to the problem of the quality assessment of qualitative research, the findings from these frameworks and checklists were mapped together. Using a technique we have termed a ‘redundancy approach’ to eliminate non-essential criteria, we developed our own summary framework. The final synthesis was achieved through reflexive debate and discussion. Aspects of this discussion are detailed here. The synthesis is clearly rooted in a subjectivist epistemology, which views knowledge as constructed and hermeneutic in intent, encompassing individual, cultural and structural representations of reality.

Section snippets

Background

Narratives of womens’ experiences of midwifery care have been published since at least the 1960s (Kitzinger, 1962); however, the first explicitly research-based account of the nature of English midwifery practice was not completed until 1983 (Kirkham, 1983). Over the past 2 decades, qualitative research in maternity care has gained increasing exposure and credibility. This reflects a growing interest in this paradigm in the health services, as it sheds light on the environment and culture of

Literature review

In the process of scoping this issue, we came across a number of checklists for appraising qualitative research. This occurred through an iterative process akin to Bates’ (1989) ‘berrypicking’ model, rather than through a systematic search of the literature. This approach reflects ‘real world’ search patterns, where the retrieval of one paper leads to others. Four different checklists were found in journals (Popay and Rogers, 1998; Mays and Pope, 2000; Yardley, 2000; Cesario et al., 2002).

Discussion

The utility of qualitative research has been the subject of considerable debate. The tenor of this debate has frequently touched on the struggle to measure up to positivist constructs of what constitutes good research. For example, Sandelowski and Barroso (2002) note the apologetic stance some authors of qualitative studies take when describing small sample size as a limitation to the applicability of their findings. However, a preoccupation with generalisability, and thus with the quality

Conclusion

Within health circles, interest in qualitative research is increasing. The trend is driven by the acknowledged complexity of many health-care interventions, the emphasis on client experience, and the focus on changing clinicians’ practice. As the interest is translated into funding more studies, concern is being expressed about how to appraise these studies and, ultimately, what their findings mean for health-care practice. Although the literature on appraisal of qualitative research is

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