Running head: QUALITATIVE RESEARCH METHODS LITERATURE REVIEW 1
Ethnography Qualitative Research Methods Literature Review
Bonnie Marko
University of Regina
Elizabeth Cooper
QUALITATIVE RESEARCH METHODS LITERATURE REVIEW 2
Ethnography
There are many methods of qualitative research that are successful in the analysis and
collection of data. Additionally, these methods enable researchers to become more knowledgeable
by utilizing their specific concerns or inquiries. It also allows researchers to understand individuals,
groups, or populations from the perspective and experiences. Ethnography is an effective way to
collect and gather data in qualitative research. Through my analysis of research articles, some
potential challenges and barriers may be present in some research settings.
Ethnography is a qualitative research method that involves a researcher putting themself
into a social environment for a prolonged period. It analyzes the individual's activities and actions
under the study observed by the researcher. While using ethnographic methods, the terms
"participant observation" and "ethnography" go together (Bryman & Bell, 2019). The role of the
participant observant is essential and necessary for success in ethnography. Additionally, access is
another feature of ethnography that is important and difficult. The researcher has to gain access to
the area that they desire to research.
There are two types of settings for ethnographic research, open and closed. Available
locations include libraries, parks, sidewalks, and secure grounds include firms, schools, and cults.
There may be challenges for a researcher to access both settings, and they may have to incorporate
a covert or overt role to gain access when necessary. Achieving access for a researcher to closed
locations requires planning, dedication, and sometimes luck. Access to open settings can require
assistance because researchers can get sponsors or gatekeepers to help them.
Ethnographers conducting research need to make notes or field notes. Quality fieldnotes
allow them to document events that they may forget later on. This method of note-taking includes
QUALITATIVE RESEARCH METHODS LITERATURE REVIEW 3
mental notes, jotted notes, and full-field notes. There are also analytic memos on all the
observations that reflect initial thoughts on what they may mean. Visual ethnography is every day
by ethnographers, and this involves photographs, video recordings, and visual media. This method
can be used for data collection and enhanced discussion among research participants. For example,
photovoice is a visual ethnography method where participants present photos to other participants
and document their perceptions and views to empower them while doing this activity.
Institutional ethnography is an approach that investigates how an institution influences
people's experiences, and relationships illuminate the power and control within the broader
population. Therefore, ethnographers will interview many individuals in the institution that will
provide any information for their research. Often, snowball sampling is used for the researcher to
identify further contacts and knowledge on the topic of study. This type of sample allows the
researcher to have access to information that is needed.
When researchers conduct ethnography research, their role can shift in the environment.
They can alternate from the complete participant, participant as an observer, observer as a
participant, and complete observer. One of the challenges or setbacks when a researcher immerses
themselves in a study, can forget their role as researchers. Moreover, researchers may have
negative feelings about the settings and situations in ethnographic research, causing biases and
distorting the research findings.
Lastly, ethnographers may have difficulties ending their research as there are no specific
hypotheses for testing. It can cause challenges for lack of a natural end of the research project, and
the researcher may be forced to end the research based on alternate factors. These factors include
stressful situations, exhaustion of funding, or the ethnographer's personal life can interfere. In any
case, the ethnographer has to provide a good reason as to why they ended the research. Ethical
QUALITATIVE RESEARCH METHODS LITERATURE REVIEW 4
considerations should be followed to keep all the individuals and social settings anonymous
(Brymann & Bell).
Underlying Ethnography. Qualitative Health Research, 26(7), 875–876.
https://doi.org/10.1177/1049732316645320
This article showcases and highlights the steps of ethnography and its' strengths and
weaknesses. Ethnography is a useful research method if conducted with the right approach, the
appropriate purpose, and the right environment. The researcher has to devote time to
ethnographic research and multiple data sets. There have been many changes to ethnography
over the years, and technological advances have taken place. There is much versatility in
ethnographic studies, and focus where the methods can change depending on the direction that
the investigation goes. It is a primary method for research in healthcare.
Ethnography in qualitative educational research: AMEE Guide No. 80. 35(8), 1365-e1379,
http://doi.org/ 10.3109/0142159X.2013.804977
This article highlights the methods of ethnographic research, and its benefits to
qualitative data collection. It includes gathering data, interviews, and documentaries in medical
research settings. Ethnography requires extensive periods to collect data and can require high
amounts of resources to sustain. Ethnography investigates different social and cultural groups
and individuals in a particular setting. It also allows the researcher to engage in the social and
environmental atmosphere of the area of research. Ethnography can be historically linked to the
1900s and involved the study of social groups. Some observational tools used in ethnography are
text, photos, videos, interviews, and history for data collection.
QUALITATIVE RESEARCH METHODS LITERATURE REVIEW 5
Moreover, the two main areas of data collection are fieldnotes and the final results. There
are many types of ethnographic studies that have evolved. These include feminist ethnography,
realist ethnography, genre ethnography, rapid ethnography, critical ethnography, online
ethnography, autoethnography, Theoretical discovery, and Theoretical refinement. By using
different ethnological methods by researchers, will improve their future health research quality.
(Reeves, Peller, & Goldman, 2013).
Ethnographic Article Analysis
Children's and Parents' Conceptualization of Quality of Life in Children with Brain Tumors: A
Meta-Ethnographic Exploration. Qualitative Health Research. 2019;29(1):55-68. https://doi-
org.libproxy.uregina.ca/10.1177/1049732318786484
This journal article was about an ethnographic study involving clinicians and parents of
children with brain tumors. This study was conducted to show the quality of life of children and
young people who have brain tumors. Ethical principles were necessary for this study, so
informed consent and debriefing of the survey with participants—the study aimed at looking at
their children's quality of life while dealing with brain tumors. A meta-ethnographic review of
the research determined the children's quality of life with brain tumors internationally from
2007-2016. The researchers used screening methods of peer-reviewed journals and found six
articles that matched the criteria.
Researchers interviewed young patients from four of these studies. In one of the studies
conducted, parents and children were interviewed. In one of the previous research, a parent
represented the deceased child. There are three main ethnography methods: reciprocal
translational, refutational synthesis, and lines of argument synthesis. These methods allowed the
QUALITATIVE RESEARCH METHODS LITERATURE REVIEW 6
researchers to find the main concepts from the previous studies, and critical concepts were put
into data tables. This study's research results determined that the new circumstances of their
illness determined the survivors of brain tumors' quality of life. This study helped identify how
life quality differs from clinicians, parents, and patients with brain tumors. There is no universal
method of understanding quality of life and health-related quality of life for every person with
brain tumors, so the clinicians, parents have to discuss all factors that could influence this as
things could change.
The study showcases the current deficits for quality of life and health quality for brain
tumor patients and families. More recommended ethnographic research needs to follow families
and observe their consultations for how their quality of life changes and the disease progresses.
The researchers' initial review of previous articles lacked clinicians' quality of life understanding
and minimal about parents. There were also discrepancies in the locations of studies, which
impacts the quality of life and healthcare.
Ethnography is an excellent method for this study because the researchers analyzed
previous research and then took vital concepts about the influences of quality of life for brain
tumor patients and determined new normalcy after an illness. In this study, many unanswered
questions are still present, and researchers need more interaction with families, clinicians, and
young brain tumor patients. There is still little knowledge about how each of these groups feels
about the quality of life.
QUALITATIVE RESEARCH METHODS LITERATURE REVIEW 7
Participatory Ethnographic Evaluation and Research: Reflections on the Research Approach
Used to Understand the Complexity of Maternal Health Issues in South Sudan. Qualitative
Health Research. 2017;27(9):1345-1358.
https://doi-org.libproxy.uregina.ca/10.1177/1049732316673975
The study was carried out in Sudanese women for 6 weeks, where 3 in-depth,
conversational interviews with each of 3 of their friends on 3 themes (each interview was based
on 1 theme). The researchers sought ethical consent and participant approval, where 16 women
were recruited initially but 2 discontinued. This study involved the method of participatory
ethnographic evaluation and research (PEER), which is a research method that enables people from
the community to gather information to make a difference in health care policies and procedures.
Most of the PEER researchers did not read and write so they would draw pictures as part of the
questioning process. The data collection in this study was carried out using an inclusive criterion
in women from Sudan who were of reproductive age, married with at least two children, able to
communicate orally in Arabic and not holding a specific position in the village they lived in.
Results were analyzed using the thematic data analysis. The strengths of PEER research in
ethnography is that it eliminates the time and challenge of building relationships with the
population of study for the researchers. Some difficulties that PEER research can cause is not
accurately reporting and verifying of the stories been provided. Moreover, in this study, some of
the participants were illiterates and images were used in interviews which become very subjective
with interpretation. The conclusion reflected the results that were generated in study.
QUALITATIVE RESEARCH METHODS LITERATURE REVIEW 8
Researching Reflexively with Patients and Families: Two Studies Using Video-Reflexive
Ethnography to Collaborate with Patients and Families in Patient Safety Research. Qualitative
Health Research. 2016;26(7):979-993.
https://doi-org.libproxy.uregina.ca/10.1177/1049732315618937
This study was carried out in patients, families, and health care professionals in acute health
care settings. There were 2 studies, study 1 focused on patient safety in end of life care while study
2 focused on infection prevention and control study. The university and health care institution
granted ethics approval for the studies of end of life and infection control in acute care. The study
made use of Video Reflexively ethnography, which uses visual methods to involve patients and
families to the purpose of the study, in this case, patient safety. The researchers worked with
patients, clinicians and families to gather data in this study. An indigenous ethical framework was
used to analyze the data in this study. This framework focuses on participation and the participants
point of view. Video-Reflexively ethnography is described in this study and why it was beneficial
to the researchers. The results/data acquired on video were analyzed by clinicians and researchers.
The strengths of this research method allowed the researchers to build trusting relationships
and understanding of what all the groups perspectives were and how this was impacting their lives.
There were challenges due to ethical concerns and realities of patients, families and clinicians.
There were also difficulties with the researchers being more flexible with the participants and not
having more structured guidelines and this made it difficult for the research goals to be met. I think
that this method was a successful way to collect the desired data, but the researchers should have
incorporated more structured guidelines for participation. The researchers could have offered more
of an incentive if the budget allowed to increase the participation guidelines.
QUALITATIVE RESEARCH METHODS LITERATURE REVIEW 9
Catalyzing Trans disciplinarity: A Systems Ethnography of Cancer–Obesity Comorbidity and
Risk Coincidence. Qualitative Health Research. 27(6), 877-892. https://doi-
org.libproxy.uregina.ca/10.1177/1049732316656162
This research addressed the issues of obesity and cancer and utilized participation from
health care professionals working with cancer or obesity issues. Ethical consideration and
participant consent were acquired. This included data collection from a wide range of primary
informants such as nutritionists, community health educators, survivorship coach, community
screening educator, radiation and surgical oncologists, advocacy director, survivorship coach,
primary care physicians, nurse practitioners and endocrinologists. The researchers observed these
healthcare professionals in their work environments. A combination of purposive and snowball
sampling were used to identify the range of observations. After this period of observation semi
structured interviews were conducted to illuminate barriers present and how professionals work
together to treat obesity and cancer. The data was analyzed using conventional qualitative content
analysis and qualitative modelling.
Although this research highlights some of the causes of the obesity and cancer relationship,
it does not show all the factors that are present to showcase other important causative factors. Some
additional factors would include low-economic status and access to care in the United States. This
use of qualitative modelling is an added effective method that can capture important behavior
patterns and automatically producing descriptions close to personal insights. However, the
limitation to the modelling dwells in its idealization and simplification of reality, which needs to
be sometimes interpreted with caution. The sampling method of snowballing introduces selection
bias and limits the extrapolative and generalization of results. When addressing cancer and obesity
QUALITATIVE RESEARCH METHODS LITERATURE REVIEW 10
it is imperative that practice and protocols focus on collaborative medical care to address all the
factors and concerns involved.
More Than Words: The Use of Video in Ethnographic Research with People with Intellectual
Disabilities. Qualitative Health Research, 29(7), 931–943.
https://doi.org/10.1177/1049732318811704
This study investigates people with intellectual disabilities and beneficial programs for
people in 3 care farm organizations in the United Kingdom. Ethical permission was acquired as
well as consent from participants. Seven case study participants were selected and identified as
having an intellectual disability from the enrollment at the care farm. The study used a case study
design, where two rounds of data collection were performed longitudinally. This study was
conducted over the course of ten months to determine how the care farms effected the case study
participants. The researchers collected data by visiting the care farms and collected field notes as
well as video elicitation interviews, photographic participation and interviews. The research was
conducted through video to get more first-hand participation from the people with intellectual
disabilities as they have very little input into decision making research for programs. The
researchers used video to capture facial expressions, body language and physical interactions from
participants of the study.
Analysis from notes and visual data were analysed using inductive and interpretive approaches.
This was followed by a cross-case analysis. Although, a small sample size limits the power of the
study. The methods of visual ethnography in this study was beneficial and useful. It allowed the
researchers to have contribution of information and opinions from people with intellectual
disabilities in a different form and allows new outlets for data collection that may not have been
QUALITATIVE RESEARCH METHODS LITERATURE REVIEW 11
used before. The researchers identified patterns and differences in the data sets to determine the
final common themes. Some challenges of this study were getting all the participants cooperation
based on their level of disability and cognitive challenges. In addition to this difficulty, secondary
information from caretakers, parents could be non-reflective. There were also varying
communication styles from many of the participants.
Potential Motivations for and Perceived Risks in Research Participation: Ethics in Health
Research. Qualitative Health Research, 23(7), 999–1009.
https://doi.org/10.1177/1049732313490076
This article is an ethnographic study in South Africa, and the research is on sensitive
subjects and gender-based violence. The participants were interested in this study for their
benefit and personal interests and others' use. There was a fear of reporting this study due to the
possible breach of confidentiality and gender biases. There are some risks associated with
working with human participants. The researchers conducted an initial survey and then did
another survey interview 2-3 months later. The first researcher initially introduced himself to the
community, got permission to conduct the study, and lived for three months there. The researcher
stayed in the community and participated in community gatherings, activities, and went out with
people in the community. Eventually, he found two research assistants, which he recruited to help
him select participants.
Potential participants were chosen from many diverse areas to encourage possible diverse
perspectives. The participants were selected based on different characteristics like age and
gender. The interviews were conducted in Zulu and Setswana, and the researcher did 22
interviews. The researcher kept notes during his stay in the community and was included in the
QUALITATIVE RESEARCH METHODS LITERATURE REVIEW 12
analysis. He documented people's feelings about topics and the experiences and emotions he
encountered while interacting with others during the interviews. The video recordings and notes
were transcribed, and all identifying factors of the participants were removed. The gender
dynamics show that more women were available to do interviews, and men were more difficult
to find as they were working.
Sensitive questions were asked of the participants about gender violence, sexual violence.
A grounded theory was employed to analyze data and an inductive analysis performed then
assigned codes were given based on the transcripts. This research's strength is the researcher being
able to be in the community and analyze behaviors and situations from his perspective to address
specific issues reported in the interviews. A weakness of the interviews and data collection would
be the fear of participants to disclose all the information for fear of being judged or scrutinized.
This study could have been conducted differently, as many of the participants were scared
about the confidentiality of the topics and the subject's sensitivity was high. There were many
topics that they felt were sensitive and would be embarrassing to describe. There was positivity
in the research setting, being safe, and offering a chance to speak about these issues for the
participants.
An Auto-Ethnographic Study of the Disembodied Experience of a Novice Researcher Doing
Qualitative Cancer Research. Qualitative Health Research, 26(4), 482–489.
https://doi.org/10.1177/1049732315616625
This research examined illnesses and the effects of difficult work environments that
researchers may encounter. Consent from this research project was given by the researcher’s
current supervisor and the research project team. The study was revised to protect the identities of
the people in the study and consent was obtained from the ethical committee. The researcher used
QUALITATIVE RESEARCH METHODS LITERATURE REVIEW 13
ethnography as the research method to document three situations that happened as a result of
suppression of emotions, traumatization and overidentification with participant. An auto-
ethnography was used, which incorporates evocative or emotional aspects. It reflects how a
researcher can experience different effects when dealing with participants who are in end-stage
diseases like 32 cancer patients that were part of the research. The researcher was assigned to study
these cancer patients who lived alone. She thought she could handle the situation and put her
feelings aside to take on this two-year research endeavor.
Due to the researcher making this research about herself, she has her thoughts and feelings
paired with the experiences of what happened to lead her to anxiety included in the research article.
During the research and the interviews, she was having flash backs to what the participants had
said and how it was affecting her while analyzing the results. She was also over identifying with
the participants which caused her own health and mental health issues. A limitation to this, can be
some sort of bias and skewness since she is assessing herself. The strength of this research method
is that the researcher got to talk about her own experiences doing research and how it caused her
emotional distress and things that need to be addressed for young researchers conducting research
on sensitive subjects in the future. The weakness of this research method is that the researcher is
conducting research on herself so it can be bias or just from her point of view and not geared
towards a larger population. She should have interviewed other researchers that encountered
similar situations. Focusing on support measures for researchers facing emotional distress from
doing sensitive research is imperative. This method of research could have been improved by
incorporating other participants and offering a survey or focus group to gather other thoughts and
feelings in this research setting.
QUALITATIVE RESEARCH METHODS LITERATURE REVIEW 14
The Differences in Antibiotic Decision-making Between Acute Surgical and Acute Medical
Teams: An Ethnographic Study of Culture and Team Dynamics Clinical Infectious Diseases, (69)
1, 12–20. https://doi.org/10.1093/cid/ciy844
This article discusses the use of antibiotics in medical and surgical acute care settings in
the United Kingdom. An ethnographic study was conducted in the London teaching hospital to
look at the Antibiotic Stewardship Program through observations and interviews with informants
within these settings. The results in this study determined that much of the decision making
depends on collaboration from pharmacists, infectious disease specialists and medical
microbiology teams.
Ethics approval was secured and consent from participants acquired. For a 2-year period,
participants were sampled through convenient sampling and data was collected through
observations, face-to-face interviews, and document analysis. The interviews were done prior to
the observations so it would not affect any of the antibiotic decision-making behaviors. Notes were
taken of the observations and other notes were taken of what the observer’s perceptions of the
recordings were. The method of ethnography was a beneficial tool for the researchers to utilize
because they could encounter the process by observation of the healthcare providers in the acute
care setting and analyze those findings compared to what the policies and guidelines are in
comparison. Data were analyzed using ground theory approach, using mainly inductive methods
of enquiry. The conclusion of this study determines that infection diagnosis in the emergency
department in the acute care setting in London determines antibiotic use. Different approaches
need to be addressed further to investigate methods to combat this systemic healthcare dilemma.
QUALITATIVE RESEARCH METHODS LITERATURE REVIEW 15
Navigating Nuances of Language and Meaning: Challenges of Cross-Language Ethnography
Involving Shona Speakers Living with Schizophrenia. Qualitative Health Research, 28(6), 927–
938. https://doi.org/10.1177/1049732318758645
This article shows how ethnography was used to analyze people's experiences living with
Schizophrenia living in Zimbabwe. This research was done by a bilingual mental health nurse to
interact and understand the participants. This ethnography's focus was to focus on this particular
culture and how they specifically are living with a specific illness. There are some ethical
considerations when doing cross-language research, which can reflect some ethical concerns.
The responsibilities that these studies have are different relations according to culture and beliefs
and practices. This study was approved by the University of Tasmania Ethics Committee and the
Zimbabwe Medical Research Council. Access to the participants had to be negotiated through
gatekeepers. The study was explained to the participants in their fluent language, and informed
consent was obtained. Researching people with mental health concerns requires ethical
sensitivity.
Semi-structured interviews were conducted and recorded. After the interview, a
questionnaire was completed to determine the participant's overall quality of life.The data
collection took place from September to November 2015. Semi-structured interviews were used
to collect data as well as recordings. After the interview a questionnaire was used to determine
the participants overall quality of life. Audiotaped interviews were analyzed.
This research's challenges and weaknesses were during language translation and
explaining emotional distress in a different language. Additionally, the researchers could have
cultural biases towards the participants due to the language barriers they encountered. They
could also misinterpret the participants' emotional cues, facial expressions, and opinions due to
QUALITATIVE RESEARCH METHODS LITERATURE REVIEW 16
cultural differences. One strength of this research method is the ability to gather information and
data about living with mental illness in a different culture.
Facilitation of a Person-Centered Approach in Health Assessment of patients with chronic pain:
An Ethnographic Study. Qualitative Health Research, 29(4), 471–483.
https://doi.org/10.1177/1049732318770628
This article is an ethnographic study that focuses on the perception of the patient's chronic
pain from their perspective. The researchers analyzed a documentation tool with nurses and
patients that would gauge the patient's chronic pain and if it works well for the nurses and the
patients. This study focused on holistic patient-centered care and other factors involved with
chronic pain among patients. The limitation of this study is the Hermes tool that the research was
analyzing could be very subjective and not incredibly user friendly. Moreover, the study's
challenges are that this was only done at one rehabilitation facility, and it should have been done
at many facilities. The strength of this data collection method is that the researchers can observe
how the Hermes tool was used and strengthen the format of health documentation and assessment
strategies.
The data was collected through observational methods and semi-structured interviews with
the nurses. The sample size was small in this study, 14 people in total. There were only two men
and 12 women, so this data is skewed and cannot be generalized to men. This method was an
appropriate way to collect the data. However, the researchers could have interviewed more
healthcare workers involved in the care of patients in the rehab facility, increased the sample size,
and ensured that the sample included equal numbers of men and women.
QUALITATIVE RESEARCH METHODS LITERATURE REVIEW 17
Identifying patient safety problems during team rounds: an ethnographic study
BMJ Quality & Safety 2014;23:667-669 http://dx.doi.org.libproxy.uregina.ca/10.1136/bmjqs-
2013-002324
This ethnographic study involves the observational data collection of patient safety
reporting methods collected for the Accreditation Council for Graduate Medical Education from
the academic veterans' affairs medical center. The method for data collection included a
structured data collection form. The patient safety issues were categorized, and the consequences
of each were collected. Descriptive statistics were performed. Eighty-eight patient safety issues
were noted in this study, and the most common patient safety issues were medication accounting
for 20% of cases. The research did not include possible adverse events that did not cause harm.
Ethical approval was granted, and consent was given. This study's limitations were that
most of the observations were done with one observer, and only one institution was used. The
sample size was small, and it would be hard to generalize to the population, and these factors and
variables could cause selection bias. The observational data collection method limitations for this
study are lack of interviews, so data collection would be hard to be observed. The data would be
biased because the information would only be taken from the two observers and no medical
staff's opinions or information. This study found that rounds in the hospital can enhance patient
safety in the hospital setting with education and participation. This method of analysis was
successful in gathering that data.
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Living with pulmonary hypertension: unique insights from an international ethnographic study
BMJ Open 2014; 4:004735. http://dx.doi.org.libproxy.uregina.ca/10.1136/bmjopen-2013-004735
This article represents an ethnographic study done with video footage, field notes, and
patient diaries to capture how pulmonary hypertension impacts patients' lives. The patients were
observed in their homes by the researchers to analyze their everyday life. Patients with pulmonary
arterial hypertension or chronic who were receiving Pulmonary Hypertension specific medication
were recruited through healthcare professionals and patient associations in seven countries across
four continents. 39 patients with pulmonary hypertension 19-91 years old and on specific
medications were selected for this study internationally. However, many of the patients had a poor
understanding of their illness. Patients were given informed consent, and the course was explained
to them before participation. They were also given study information from their health care
providers and patient associations.
This study's strengths are that it is the first ethnographic study that examined patients living
with pulmonary hypertension, which illuminates findings that other qualitative study methods may
not. It also has a broader sample selection and many variables as it focused on an international
demographic. This would be more applicable to a general population and allows for analysis of
disease traits and how patients' location influences the prevalence of the disease. This study's
limitation is that 75% were female, so the study could not be generalized to men.
Data collection for this study was done with observations and discussions to assess these patients'
real-life and experiences. The focus was on watching and listening to the patients, not questioning,
and diaries were given to the patients for their disease perspective. The data collection analysis
was done with footage from the seven countries the data was collected from. The footage was
transcribed into text in English, and critical themes were gathering through coding.
QUALITATIVE RESEARCH METHODS LITERATURE REVIEW 19
Some key themes were medication, social supports, compliance, and therapy. These themes
were compared and to showcase the patient's reported and actual behavior. This method was the
best method to use as it incorporated the patient's quality of life through videos and diaries to
collect data. The study showcased how patients perceive their illness as many patients in the study
is very secretive about the disease. Through the use of ethnography, the researchers could collect
data from seven different countries.
An ethnographic study of tobacco control in hospital settings Tobacco Control 2006; 15:317-322
http://dx.doi.org.libproxy.uregina.ca/10.1136/tc.2005.015388
This article's ethnographic study focuses on tobacco control and smoking cessation help
within by registered nurses. The study was conducted at two different hospitals in British Columbia,
Canada. Ethical approval was given from the University of British Columbia Behavioral Ethics
Board, and each of the two hospitals' ethical review boards. Data collection was done by observing
workplace activities within the hospital and designated smoking areas. There were unstructured
conversations with nurses and collected documents on 16 wards. Informed consent was obtained
from all the participants that talked with the researcher. This study included field notes, hand notes,
conversations, and photographs of the smoking areas.
The results of the findings from this study show the difficulties in managing tobacco use
in hospital settings. Many of the interviewed nurses believed that tobacco use in the hospital setting
was not the primary concern within their workplace priorities, and it smoking cessation is a task
for when the patient is treated and discharged home. Therefore, according to the research in this
study, nurses have a vague understanding of nicotine addiction in the hospital setting. Ethnographic
analysis used a non-linear inductive process that includes coding, sorting, theorizing, and reflecting
QUALITATIVE RESEARCH METHODS LITERATURE REVIEW 20
upon the analytic process. This study's strength is that two hospitals were used to illuminate the
findings and compare the dynamics of both hospitals to make the results more generalizable to a
population. Although not every workplace is the same so further research should explore different
workplace environments.
Causes of intravenous medication errors: an ethnographic study BMJ Quality & Safety, 12, 343-
347. http://dx.doi.org.libproxy.uregina.ca/10.1136/qhc.12.5.343
This article is based on an ethnographic study interested in the findings related to
intravenous medication errors and whether it is based on human error. An observer from this study
followed nurses while they were giving IV drugs on ten different wards in two hospital settings in
the United Kingdom. The human error theory was used to detect the causes of medication errors.
265 Intravenous drug errors were detected in the study. Data for this study was collected on 6-10
days in a row between June -December 1999. The observer made notes of details about what they
saw during IV preparation and administration. The researchers also talked to the staff during the
observations. The study was conducted and presented to the team as research to show common
challenges with the preparation and administration of IV drugs. The researchers obtained
permission to observe from every nurse. Ethics approval was granted from both the hospitals that
were involved in the study. The healthcare staff and pharmacies of the hospital gave permission as
well.
This ethnographic method's strength was using observation in this study as it allowed the
observer to see errors or mistakes that may not have been disclosed when the staff was interviewed.
The weakness is that although the analysis was performed in two hospitals, there should have been
more research done in different hospitals to make the findings more generalized to the healthcare
QUALITATIVE RESEARCH METHODS LITERATURE REVIEW 21
population. Additionally, the observation could affect the results because the healthcare staff is
aware that they are being watched. They could feel pressure and not be able to perform their duties
at work in a natural manner.
This study detected that errors are being made by the nursing staff, but it is an issue of the
whole system. This study could have gathered further information if they interviewed more of the
healthcare team involved in the drug administration process and policies. The researchers could
have observed the pharmacists see how the medication is dispensed to the medical unit.
Creating Spaces in Intensive Care for Safe Communication: A Video-Reflexive Ethnographic
Study BMJ Quality & Safety, 23,1007-1013. http://dx.doi.org.libproxy.uregina.ca/10.1136/bmjqs-
2014-002835
This ethnographic study focuses on enabling a safe environment for healthcare staff to
communicate freely to enhance the workplace within two intensive care units. This study was
conducted in 2011 and included two intensive care units within one hospital in Sydney, Australia.
This study was part of a more significant three-year study, and there were 87 participants involved.
This study used video-reflexive ethnographic methods to determine how healthcare staff
effectively communicated in the fast-paced hospital environment. They did semi-structured
interviews and observations for five weeks with nursing, medical, healthcare staff members, and
administrative staff. They then did focus groups with the participants to discuss possible areas of
concern.
Ethics approvals for this study was granted from the University of Technology and the local
hospitals that participated. The participants had to consent before and after the video clips were
filmed, and they could refuse to be recorded at any time in the observation. It was found in this
QUALITATIVE RESEARCH METHODS LITERATURE REVIEW 22
study that healthcare providers and staff need space to effectively communicate and do their job
correctly, which affects patient safety.
This method of the study's strength reflected through interviews, observations, and focus
groups enabled the healthcare team to devise plans to make the intensive care unit safe for better
quality care. It also allowed the participants to be interactive with how improvements could be
made. This study's limitations are that the research was conducted in only one hospital's two
intensive care units. It makes the study results hard to generalize to other hospital units.
Additionally, there was no follow-up to find out if the solutions that were put in place worked or
did not work.
This study's ethnographic method was suitable because it allowed the individuals' feedback
to encounter private space difficulties in this environment to work on developing ways and
solutions to solve the problem. Further data is still needed to see if these solutions worked, and
more research needs to determine if this was helpful.
Beyond hand hygiene, a qualitative study of the everyday work of preventing cross-
contamination on hospital wards. BMJ Quality & Safety.26,552-558.
http://dx.doi.org.libproxy.uregina.ca/10.1136/bmjqs-2016-005878
This article focuses on an ethnographic study highlighting the risks of cross-contamination
and infection transmission from surfaces and objects within the hospital setting. The study uses
reflexive video methods, including interviews, observation, video recording, and focus groups to
collect data. There were nurses, medical staff, students, administration, and cleaning staff as
participants. The study was part of a three-year project conducted in two hospitals in South Wales,
Australia. Ethics approval was granted from the University of Tasmania and the hospital's research
QUALITATIVE RESEARCH METHODS LITERATURE REVIEW 23
ethics committees. All the participants gave consent for interviews, recording, and observations
and could discontinue the video recording process at any time. The fieldwork was done for three
months in a 16-bed intensive care unit in one hospital in the study.
The remaining fieldwork was done at two other hospitals in two general surgical units.
A limitation of this study is that the methods used may not apply to all sites or hospital settings.
Further comparisons and research would need to be conducted to collect additional data analysis.
This study's strength is that utilizing reflexive video ethnography allows the researcher to collect
data multiple ways and allows the input from the participants to develop solutions to challenges
within their healthcare setting. The spread of infectious diseases in clinical practice is an ongoing
dilemma, and hand hygiene compliance is still not eliminating the problem. It was determined
through this study that moving bodies and objects have to be done in a methodical way to avoid
the spread of infectious diseases within the hospital environment.
Ethnography was the most beneficial method for this study. It is essential for researchers
to observe and get feedback from all different healthcare workers to enable research to influence
solutions and policy changes in infection prevention and the spread of pathogens.
Patients' perceptions of early supported discharge for chronic obstructive pulmonary disease: a
qualitative study. BMJ Quality & Safety,19, 95-98.
http://dx.doi.org.libproxy.uregina.ca/10.1136/qshc.2007.025668
This article is about an ethnographic study that describes patients' opinions about a supported
discharge service for people with chronic obstructive pulmonary disease. This early discharge
service shortens the patient's hospital stay from 3.5 days to 9.5 days with some home care services
in place. The participants selected for this study were 23 older adults with COPD that was
QUALITATIVE RESEARCH METHODS LITERATURE REVIEW 24
exacerbated in 2005. Fourteen patients approved the first discharge service, while 9 of the patients
refused. These patients were from a lower socio-economical setting in England. Men and women
from different ethnic backgrounds were selected. They were invited to participate through a letter
or face-face interviews at their houses. The method for this ethnographic study was audiotaping,
semi-structured interviews, and face-face interviews. Ethics approval was obtained for this study
from the East London Research Ethics Committee. Data was analyzed through a grounded theory
approach from the interviews.
Some limitations of this study are that it was a small study with the participants from the
same England area. Many of the patients approached for the interviews were not available, and
most who did participate were not pleased with their care from the hospital. Their attitudes may
be subjective and, as a result, may create biases in their participation in the study. A limitation in
the hospital program was that many patients did not remember or understand the early discharge
program.
This study's strength is that it did answer the research question about how patients felt
about their care and the program that was offered. It showcases how early discharge programs can
be beneficial to patients and how they can prevent faster recoveries. One other study has looked at
this same topic and patients' perceptions of it. This method of research is beneficial for patients
and healthcare systems. It shows the effectiveness of programs like this. There is a need for further
research on patients' knowledge about the program's goals, consent issues, and how to manage
their chronic conditions at home properly.
QUALITATIVE RESEARCH METHODS LITERATURE REVIEW 25
The frequency of intravenous medication administration errors related to smart infusion pumps: a
multihospital observational study. BMJ Quality & Safety (2017). 26, 131-140.
http://dx.doi.org.libproxy.uregina.ca/10.1136/bmjqs-2015-004465
This article is an ethnographic study about errors in administering intravenous medications
despite the use of smart pump technology. This study was conducted at numerous sites in the USA.
Ten hospitals using the intelligent pumps for IV administration were analyzed, and data was
collected based on the errors associated with their use. Based on the administrations, 60 % had one
or more associated errors.
There was an intensive care unit, surgical intensive care unit, a general surgical unit, and a
medical unit in the ten hospitals. This study was approved by the institutional review boards at all
the selected hospitals. All the personal health information went through a process to de-identify
the data. Two observers, a nurse and a pharmacist at each hospital, would collect data 2-4 days a
week from February to August 2013. The observers would like asses if compliance with the
medication administration policies were being followed. If a critical error were present, the
observer would identify it and let the nurse know immediately.
The study's limitations are that it was geared to point out the prevalence of the occurrence
and included a few observations. Only the administrations that would cause harm were identified
in this study, but the ones that caused harm after the administration were not investigated. The
researchers did realize that the errors that reached the patient were not being documented, so they
did decide to include this information in the study. This study also involves selection biases as the
hospitals were not chosen randomly. Many intravenous medications were not included in this
study; only the researchers and observers observed.
QUALITATIVE RESEARCH METHODS LITERATURE REVIEW 26
The strengths of this study are that the researchers recruited trained observers to analyze
the process of smart pump IV administration. They would be able to detect potential errors
correctly and possible adverse events that could happen. This ethnographic study method research
effectively collected the data, but further research needs to identify the potential effects of IV
medications administered through the smart pump in different randomly selected hospitals.
Elizabeth Cooper - Sat, 14 Nov 2020, 9:24 PM
Bonnie,
Remember to watch the instructions for the assignment. You were to provide the keywords for each article (-5%)
Part 1: I’m not entirely sure what you did here, but you did capture some of the key items that you need for the method. I
would have liked to see a little more about analysis.
Part 2: I am missing the summary of the key points of the articles. Instead, you seem to go directly into the application of the
method. You were able to capture most of the key issues related to ethnography, you identified key analysis features and
strengths/challenges in many cases. I wasn’t always clear on the ethical process or if you believed that other methods would
resonate better to answer the questions posed.
Really good work.
86%-5%=81%
TOTAL: 24.3
QUALITATIVE RESEARCH METHODS LITERATURE REVIEW 27
References
Beecham, E., Langner, R., Hargrave, D., & Bluebond-Langner, M. (2018). Children’s and
Parents’ Conceptualization of Quality of Life in Children with Brain Tumors: A Meta-
Ethnographic Exploration. Qualitative Health Research, 29(1), 55-68.
https://doi.org/10.1177/1049732318786484
Benoot, C., & Bilsen, J. (2015). An Auto-Ethnographic Study of the Disembodied Experience of
a Novice Researcher Doing Qualitative Cancer Research. Qualitative Health
Research, 26(4), 482-489. https://doi.org/10.1177/1049732315616625
Bryman, A., & Bell, E. (2019). Social Research Methods (5th ed., pp. 216-226). Oxford
University Press.
Charani, E., Ahmad, R., Rawson, T., Castro-Sanchèz, E., Tarrant, C., & Holmes, A. (2018). The
Differences in Antibiotic Decision-making Between Acute Surgical and Acute Medical
Teams: An Ethnographic Study of Culture and Team Dynamics. Clinical Infectious
Diseases, 69(1), 12-20. https://doi.org/10.1093/cid/ciy844
Chidarikire, S., Cross, M., Skinner, I., & Cleary, M. (2018). Navigating Nuances of Language
and Meaning: Challenges of Cross-Language Ethnography Involving Shona Speakers
Living with Schizophrenia. Qualitative Health Research, 28(6), 927-938.
https://doi.org/10.1177/1049732318758645
Clarke, A., Sohanpal, R., Wilson, G., & Taylor, S. (2010). Patients' Perceptions of Early
Supported Discharge for Chronic Obstructive Pulmonary Disease: A Qualitative
Study. Quality And Safety In Health Care, 19(2), 95-98.
https://doi.org/10.1136/qshc.2007.025668
QUALITATIVE RESEARCH METHODS LITERATURE REVIEW 28
Collier, A., & Wyer, M. (2015). Researching Reflexively with Patients and Families. Qualitative
Health Research, 26(7), 979-993. https://doi.org/10.1177/1049732315618937
Elmusharaf, K., Byrne, E., Manandhar, M., Hemmings, J., & O’Donovan, D. (2016).
Participatory Ethnographic Evaluation and Research: Reflections on the Research
Approach Used to Understand the Complexity of Maternal Health Issues in South
Sudan. Qualitative Health Research, 27(9), 1345-1358.
https://doi.org/10.1177/1049732316673975
Graham, S., Harley, A., Kessler, M., Roberts, L., DeVasto, D., Card, D, Neuner. J. & Kim, S.
(2016). Catalyzing Transdisciplinarity: A Systems Ethnography of Cancer–Obesity
Comorbidity and Risk Coincidence. Qualitative Health Research, 27(6), 877-892.
https://doi.org/10.1177/1049732316656162
Hor, S., Hooker, C., Iedema, R., Wyer, M., Gilbert, G., Jorm, C., & O'Sullivan, M. (2016).
Beyond Hand Hygiene: A Qualitative Study of The Everyday Work of Preventing Cross-
Contamination on Hospital Wards. BMJ Quality & Safety, 26(7), 552-558.
https://doi.org/10.1136/bmjqs-2016-005878
Hor, S., Iedema, R., & Manias, E. (2014). Creating Spaces in Intensive Care for Safe
Communication: A Video-Reflexive Ethnographic Study: Table 1. BMJ Quality &
Safety, 23(12), 1007-1013. https://doi.org/10.1136/bmjqs-2014-002835
Kaley, A., Hatton, C., & Milligan, C. (2018). More Than Words: The Use of Video in
Ethnographic Research with People with Intellectual Disabilities. Qualitative Health
Research, 29(7), 931-943. https://doi.org/10.1177/1049732318811704
QUALITATIVE RESEARCH METHODS LITERATURE REVIEW 29
Kingman, M., Hinzmann, B., Sweet, O., & Vachiéry, J. (2014). Living with Pulmonary
Hypertension: Unique Insights from An International Ethnographic Study. BMJ
Open, 4(5), e004735. https://doi.org/10.1136/bmjopen-2013-004735
Lamba, A., Linn, K., & Fletcher, K. (2014). Identifying Patient Safety Problems During Team
Rounds: An Ethnographic Study: Table 1. BMJ Quality & Safety, 23(8), 667-669.
https://doi.org/10.1136/bmjqs-2013-002324
Morse, J. (2016). Underlying Ethnography. Qualitative Health Research, 26(7), 875-876.
https://doi.org/10.1177/1049732316645320
Reeves, S., Peller, J., Goldman, J., & Kitto, S. (2013). Ethnography in Qualitative Educational
Research: AMEE Guide No. 80. Medical Teacher, 35(8), e1365-e1379.
https://doi.org/10.3109/0142159x.2013.804977
Schultz ASH, Bottorff JL, Johnson J. (2006). An Ethnographic Study of Tobacco Control in
Hospital Settings Tobacco Control 15(3), 17-322
http://dx.doi.org.libproxy.uregina.ca/10.1136/tc.2005.015388
Schnock, K. O., Dykes, P. C., Albert, J., Ariosto, D., Call, R., Cameron, C., Carroll, D. L., v.
Drucker, A. G., Fang, L., Garcia-Palm, C. A., Husch, M. M., Maddox, R. R., McDonald,
N., McGuire, J., Rafie, S., Robertson, E., Saine, D., Sawyer, M. D., Smith, L. P., …
Bates, D. W. (2017). The Frequency of Intravenous Medication Administration Errors
Related to Smart Infusion Pumps: A Multihospital Observational Study. BMJ Quality and
Safety, 26(2), 131–140. https://doi.org/10.1136/bmjqs-2015-004465
QUALITATIVE RESEARCH METHODS LITERATURE REVIEW 30
Sikweyiya, Y., & Jewkes, R. (2013). Potential Motivations for and Perceived Risks in
Research Participation. Qualitative Health Research, 23(7), 999-1009.
https://doi.org/10.1177/1049732313490076
Taxis K, Barber N. (2003). Causes of Intravenous Medication Errors: An Ethnographic
Study. Quality And Safety In Health Care, 12(5), 343-347.
https://doi.org/10.1136/qhc.12.5.343
Thórarinsdóttir, K., Kristjánsson, K., Gunnarsdóttir, T., & Björnsdóttir, K. (2018). Facilitation of
a Person-Centered Approach in Health Assessment of Patients with Chronic Pain: An
Ethnographic Study. Qualitative Health Research, 29(4), 471-483.
https://doi.org/10.1177/1049732318770628