Book Review: Doing Qualitative Research

Doing Qualitative Research by Benjamin F. Crabtree and William L. Miller (Eds), Sage Publications, London (1992) 276pp. £37.50 HB, £17.95 PB.

The editors of this book are medical/physician anthropologists working in the Department of Family Medicine at the University of Connecticut. The other sixteen contributors to this very readable and informative book are all involved in research and are working in Departments of Family Medicine or in Clinical Epidemiology and Biostatistics. The book itself evolved from a work-shop on qualitative research held in Quebec in May 1989. It was during the 80's that qualitative research methods were developed by family medicine practitioners, and their complementarity to quantitative research methods explored.

Doing Qualitative Research is volume three in a series of books on research methods for primary care. Its aim is to make qualitative research more accessible to primary health care researchers. Its usefulness certainly goes beyond this. The studies described in this book shed light on three important questions. How can health-seeking behaviour be understood?. How do primary health care providers become what they are? What goes on when primary health care seekers encounter clinical providers? As one reads this book and becomes familiar with the methods described, it becomes evident that these research methods can also be applied to other related questions. 'Primary health care' can be replaced with 'mental health care' for example. Thus the scope of this book extends beyond qualitative research methods in Family Medicine.

In this book the editors provide a 'smorgasboard' of qualitative approaches. Clear descriptions of the most important aspects of qualitative research are given. This includes data collection strategies (Chs. 2-4), the specifics for different types of analysis (Chs. 5-10), and reports on completed studies (Chs.11-12). Each of these chapters with the aid of really good concrete examples describes a specific qualitative method, the context in which it is most useful, and how its trustworthiness can be assessed. These eleven chapters are neatly sandwiched between the first chapter, giving an excellent overview of research approaches, and a final reflective chapter that includes a reminder that the 'sciences of the spirit speak to a different part of us than the sciences of nature'.

As a newcomer to qualitative research I found that the first chapter was a very helpful preparation for the richness that follows. The many figures and tables provide helpful summaries that are also useful references for making connections throughout the following chapters. Five different research styles are described in this chapter; experiment; survey, documentary-historical; field and philosophy. The choice of research style depends on many factors including the research aim, the specific research question, the analysis objective and the preferred paradigm. The investigator must clarify what assumptions concerning reality are appropriate for the topic of interest in order to choose the appropriate method.

Qualitative research allows for a wide variety of choice in its methods. This is because these methods derive from many disciplines and traditions. These methods can be organised into two main streams: methods based on human science and methods based on field research. The human science disciplines have led to the development of many qualitative research methods. In the second half of the first chapter quite a number of these traditions and their areas of interest are described. What clearly emerges is that one of the most important characteristics of the qualitative investigator that distinguishes him/her from the quantitative investigator is that of subjectivity. The qualitative investigator is not objective but is an experiencing interpreter who 'brackets' his/her own preconceptions, and attempts to enter into the research participant's world. This is particularly true for the phenomenological and heuristic inquirer. Qualitative research has a proximity of theory and human experience that is not evident in quantitative research.

The methods based on field research offer a wide variety of data collection techniques and four main analytical styles. Analysis of the data collected is seen as an objective/subjective 'dance towards contextual truth'. Each stage of the research is critical, and as understanding and interpretation progress, changes may be made in the sampling, data collection, analysis and even in the research question itself.

As each chapter unfolds one is led further into the mysteries of qualitative research methods. It becomes clear that this type of research is about people, their words, behaviours, attitudes, actions and practices. Information richness is more important than sample size. The relevance of both 'hard' and 'soft' data is emphasised. As the strategies for verifying the credibility and reliability of the findings emerge they confirm that the subjectivity of the researcher is compatible with the trustworthiness of the findings. The completed studies in the latter part of the book emphasise again that research design is a crucial issue and that all qualitative research 'is based on a set of initial and emergent design choices'.

At the end of this book the authors seem sure that they have launched a study research craft. I feel sure that newcomers in particular will, on reading this book, be encouraged to try out this craft and make use of it in their own area of primary care. We may feel unsure and uncertain. The editors assure the reader that qualitative research is best suited for those who are comfortable with uncertainty. Renee O'Sullivan.

Renee O'Sullivan