How to phrase critical realist interview questions in applied social science research

Brönnimann, Andreas

doi:10.1080/14767430.2021.1966719

Cited by 33 publications

(33 citation statements)

References 53 publications

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“…The study was performed from a critical realist perspective and adopted a general inductive approach to analysis 13,14 . This approach was selected given the need to explicate the complexities of the situational constructs, social hierarchies, organisational cultures and multiple interactions that likely influence health care workers' recognition of deteriorating patients 13 .…”

Section: Methodsmentioning

confidence: 99%

Recognising the deterioration of patients in acute care wards: a qualitative study

Beane

Dondorp

2022

Wellcome Open Res

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Background: Infrastructure, equipment and staff constraints are often cited as barriers to the recognition and rescue of deteriorating patients in resource-limited settings. The impact of health-system organisation, decision-making and organisational culture on recognition of deterioration is however poorly understood. This study explores how health care providers recognise deterioration of patients in acute care in Sri Lanka. Methods: In-depth interviews exploring decision making and care processes related to recognition of deterioration, were conducted with a purposive sample of 23 health care workers recruited from ten wards at a district hospital in Sri Lanka. Interviews were audio-recorded, transcribed and coded thematically, line-by-line, using a general inductive approach. Results: A legacy of initial assessment on admission and inimical organisational culture undermined recognition of deteriorating patients in hospital. Informal triaging at the time of ward admission resulted in patients presenting with red-flag diagnoses and vital sign derangement requiring resuscitation being categorised as "bad". The legacy of this categorisation was a series of decision-making biases anchored in the initial assessment, which remained with the patient throughout their stay. Management for patients categorised as “bad” was prioritised by healthcare workers coupled with a sense of fatalism regarding adverse outcomes. Health care workers were reluctant to deviate from the original plan of care despite changes in patient condition (continuation bias). Organisational culture - vertical hierarchy, siloed working and a reluctance to accept responsibility- resulted in omissions which undermined recognition of deterioration. Fear of blame was a barrier to learning from adverse events. Conclusions: The legacy of admission assessment and hospital organisational culture undermined recognition of deterioration. Opportunities for improving recognition of deterioration in this setting may include establishing formal triage and medical emergency teams to facilitate timely recognition and escalation.

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Section: Methodsmentioning

confidence: 99%

Recognising the deterioration of patients in acute care wards: a qualitative study

Beane

Dondorp

2022

Wellcome Open Res

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“…Interview items were developed based on experiences and challenges of immigrant counselors identified by Kissil et al ( 2013 ). Interview questions reflected a critical realist framework by making use of “Why?” and “How?” style questions and framing questions within the reality of physically moving to a foreign country (Brönnimann, 2022 ). This allowed participants to situate their responses within real experiences (Brönnimann, 2022 ).…”

Section: Methodsmentioning

confidence: 99%

“Treat Me Like a Dumb American”: a Qualitative Exploration of the American Immigrant Counselor Experience

Smith

Martin

2022

Int J Adv Counselling

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This qualitative study addresses the gap in the limited literature on the experiences of American immigrant counselors practicing overseas. Seven American immigrant counselors were interviewed regarding their experience. Interviews were transcribed verbatim and analyzed using inductive Thematic Analysis. Three themes were identified: lack of cultural knowledge as counseling technique, American stereotypes/politics within the counseling session, and issues surrounding lack of counseling regulation and transfer of professional credentials. Implications for American counselor education are discussed.

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“…Up to the time of writing, RE scholars have mostly reflected on the role of individual interview techniques ( Brönnimann, 2022 ; Mukumbang and van Wyk, 2020 ; O’Rourke et al, 2022 ) in theorisation, with focus groups not being mentioned or discussed methodologically as a distinct social research method ( Smeets et al, 2022 ). In the following section, four key lessons are identified to understand how the focus group dynamics influence the process of theory development in the realist approach to evaluation.…”

Section: Focus Groups Merton and Theory-driven Evaluationmentioning

confidence: 99%

Conducting focus groups in realist evaluation

Manzano

2022

Evaluation

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Focus groups are valuable tools for evaluators to help stakeholders to clarify programme theories. In 1987, R.K. Merton, often attributed with the birth of focus groups, wrote about how these were ‘being mercilessly misused’. In the 1940s, his team had conceived focus groups as tools for developing middle-range theory, but through their astonishing success focus groups have metamorphosed and are often an ‘unchallenged’ choice in many evaluation approaches, while their practice seems to provide a philosophically diverse picture. This article examines what knowledge focus group data generate, and how they support theory development. It starts with an overview of the history of focus groups, establishing a relationship between their emergence as a data collection method and the evaluation profession. Practical lessons for conducting groups in realist evaluation are suggested, while exploring how qualitative data can support programme and middle-range theory development using the example of realist evaluation.

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How to phrase critical realist interview questions in applied social science research

Cited by 33 publications

References 53 publications

Recognising the deterioration of patients in acute care wards: a qualitative study

Recognising the deterioration of patients in acute care wards: a qualitative study

“Treat Me Like a Dumb American”: a Qualitative Exploration of the American Immigrant Counselor Experience

Conducting focus groups in realist evaluation

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