There’s a lot more qualitative research being produced by physiotherapists today, which is gratifying because for a long time it looked like the profession might be stuck in an endless loop of clinical trials on hamstring stretching, and the last thing the profession needs right now is more trials on hamstring stretching.
But there’s still a dire need for more qualitative research in physiotherapy, and especially good quality research, which can sometimes be in short supply.
How many times have you read a piece of qualitative research and thought that the authors were just telling you what you already knew? You know the kind of thing I mean: an interview-based study of people’s experience of pain, with a thematic analysis that concludes that pain is unpleasant, disruptive, and that people learn to cope with it. Well, actually, I knew that already, and if you didn’t know that, you’re probably in the wrong profession.
I once read a qualitative study of people’s experience of breathlessness that concluded that people with COPD thought that not being able to breathe was frightening. Seriously! That was their principal conclusion! I spent half-an-hour reading that paper, and at the end I wanted to visit the authors and give them an experience of acute breathlessness.
Lest you become concerned for my mental health, I can reassure you that my motives are noble, even if they are also quite selfish. There’s just too much information saturating our daily lives today, and too much good research out there, to waste time with research that only serves to state the bleeding obvious.
So I thought it might be useful to offer up some blog posts tackling some of the aspects of qualitative research that physiotherapists seem to frequently misunderstand, if only to save myself from having to read another qualitative study that tells me it’s hard living with multiple sclerosis.
There’s no suitable point of entry here. My experience is that physiotherapists come to qualitative research with all kinds of past experiences, so the best thing is probably to tackle issues as they arise and see where it leads. Hopefully some of these posts will be informative, others will be entertaining, others will fail miserably and they’ll only tell you things you already knew. Which at least will be ironic.
Topic 1: Is qualitative research ‘Simply talking trivialities in high sounding language?’¹
There’s a chapter in Denzin and Lincoln’s 2005 Handbook of Qualitative Research titled ‘Cultural Poesis: The Generativity of Emergent Things.’ The opening paragraph reads:
What follows is a piece of imaginative writing grounded in an intense attention to the poesis, or creativity, of ordinary things. This is an ethnographic attention, but it is one that is loosened from any certain prefabricated knowledge of its object. Instead, it tracks a moving object in an effort (a) to somehow record the state of emergence that animates things cultural and (b) to track some of the effects of this state of things – the proliferation of everyday practices that arise in the effort to know what is happening or to be part of it, for instance, or the haunting or exciting presence of traces, remainders, and excesses uncultured by claiming meaning (p.1027).
This kind of writing represents, to my mind, an image of what most physiotherapists think qualitative research is all about: sludgy, vague and ridiculously wordy, saying nothing of interest or relevance; the kind of reading you only have to do if you’re studying a PG research paper and your tutor makes you read it; a form of punishment for evils performed in a past life.
But qualitative researchers don’t hold a monopoly on unreadable research. Look at the title of this paper from the latest edition of the American Journal of Physiology: ‘Hydrogen sulfide decreases β-adrenergic agonist stimulated lung liquid clearance by inhibiting ENaC-mediated transepithelial sodium absorption’. And, just to be fair, here’s the start of the abstract:
In pulmonary epithelia, β-adrenergic agonists regulate the membrane abundance of the epithelial sodium channel (ENaC) and thereby control the rate of transepithelial electrolyte absorption. This is a crucial regulatory mechanism for lung liquid clearance at birth and thereafter. This study investigated the influence of the gaseous signalling molecule hydrogen sulfide (H2S) on β-adrenergic agonist regulated pulmonary sodium and liquid absorption…
You get the idea. It’s hardly George Orwell.
Clearly, both papers have their merits (the Stewart chapter is actually very interesting!) but they both require a bit of work. More than anything, they ask us to spend a bit of time in unfamiliar surroundings, with language and concepts that may be new or challenging to us. It’s only when we read things that are beyond the limits of our familiar world view that we engage in real learning after all. So my first plea is that we can have less of the kinds of research that tells me that incontinence is unpleasant, and more of the kinds of things that make me say “I have absolutely no idea what you’re talking about, but I’m keen to find out more.”
Agné, A.M., Baldin, J-P, Benjamin, A.R. et al (2015). Hydrogen sulfide decreases β-adrenergic agonist stimulated lung liquid clearance by inhibiting ENaC-mediated transepithelial sodium absorption. American Journal of Physiology – Regulatory, Integrative and Comparative Physiology. DOI: 10.1152/ajpregu.00489.2014.
Stewart, K. (2005). Cultural Poesis: The Generatively of Emergent Things. In, Norman K. Denzin, & Yvonna S. Lincoln. The SAGE handbook of qualitative research (3rd ed.). Thousand Oaks, CA, pp.1027-1042.
¹ This comes from the title of this article by Julianne Cheek (1998). Postmodern theory and nursing: Simply talking trivialities in high sounding language? In H. Keleher & F. McInerney (Eds.), Nursing matters: Critical sociological perspectives. Sydney: Churchill Livinsgtone.