Health Psychology. Michael Murray
for their own behaviour or thoughts. This approach has been used to explore the character of patient talk and the character of doctor–patient interactions. There is a particular preference for naturally occurring conversations, e.g., mealtime talk (Wiggins et al., 2001). Locke and Horton-Salway (2010) analysed how class leaders talked to antenatal class members about pregnancy, childbirth and infant care in ‘golden age’ or ‘bad old days’ stories variably to contrast the practices of the past with current practices. The second type of discourse analysis, Foucauldian discourse analysis (FDA), was developed by Ian Parker (1997) and others because they criticized the previous approach as evading issues of power and politics. FDA aims to identify the broader discursive resources that people in a particular culture draw upon in their everyday lives. This approach has been used to explore such issues as smoking (Gillies and Willig, 1997) and masculine identity (Tyler and Williams, 2014).
Double-blind Control
A double-blind control is used in randomized controlled trials to prevent bias: both the investigator and the participant (subject) are prevented from knowing whether they are in the treatment or control condition. A single-blind is when only the participant is unaware of the condition they have been allocated to.
Effect Size
An effect size is the strength of the association between study variables and outcome as measured by an observed difference or correlation. Cohen’s d and Person’s r are the most popular indices of effect size in psychological studies. The effect size is a measure of the importance of an effect rather than its statistical significance. Effect sizes are used in meta-analysis as a means of measuring the magnitude of the results obtained over different studies. Effect size is related to the power of a study to detect a difference that really exists. A weak study cannot detect a real difference because it has samples that are too small relative to the magnitude of the difference that exists, a common problem in psychology. It is estimated that 60–70% of published studies in psychology journals lack sufficient power to obtain statistical significance.
Ethical Approval
This is a necessary requirement before any research can be started. Ethics boards and research review panels in all research institutions and universities have been established for this purpose. Any research project must present before a panel of experts on ethical issues, and have the panel’s explicit approval of: the full details of the aims, the design, the participants and how they will be chosen; the information provided to the participants; the method of consent used; the methods of data analysis; the nature and timing of debriefing of participants; and the methods of dissemination. Funding and publication are normally contingent on ethical approval being obtained.
Ethnographic Methods
Ethnographic methods seek to build a systematic understanding of a culture from the viewpoint of the insider. Ethnographic methods are multiple attempts to describe the shared beliefs, practices, artefacts, knowledge and behaviours of an intact cultural group. They attempt to represent the totality of a phenomenon in its complete, naturalistic setting. Detailed observation is an important part of ethnographic fieldwork. Ethnography can provide greater ecological validity. The processes of transformation can be observed and documented, including how the culture becomes embodied in participants, alongside the recording of their narratives. It is more labour-intensive, but combining ethnography with narrative interviews can produce richer information than qualitative interviews alone (Paulson, 2011).
The observation can be either overt or covert. In the overt case, the researcher does not attempt to disguise his/her identity, but rather is unobtrusive so that the phenomenon under investigation is not disturbed. In this case, the researcher can take detailed notes, in either a prearranged or discursive format. In certain cases, the researcher may decide that his/her presence may disturb the field. In this case, two forms of covert observation may be used. In one form, the focus of observation is not aware at all of the presence of the researcher. An alternative approach is when the person observed may be aware of the researcher’s presence but is unaware that he/she is a researcher. In both of these forms the researcher needs to consider whether such covert surveillance is ethically justified. A form of participant observation that is not covert is when the researcher accompanies the person but tries not to interfere with the performance of everyday tasks. Priest (2007) combined grounded theory and ethnography to explore members’ experience of a mental health day service walking group, including the psychological benefits of the physical activity, the outdoor environment and the social setting. Stolte and Hodgetts (2015) used ethnographic methods to study the tactics employed by a homeless man in Central Auckland, New Zealand, to maintain his health and help him to gain respite while living on the streets, an unhealthy place.
Focus Groups
Focus groups comprise one or more group discussions in which participants ‘focus’ collectively upon a topic or issue that is usually presented to them as a series of questions, although sometimes as a film, a collection of advertisements, cards to sort, a game to play, or a vignette to discuss. The distinctive feature of the focus group method is its generation of interactive data (Wilkinson, 1998). Focus groups were initially used in marketing research. As its title implied, they had a focus that was to clarify the participants’ views on a particular product. Thus, from the outset the researcher had set the parameters of the discussion and as it proceeded he/she deliberately guided the discussion so that its focus remained limited. More recent use of the focus group has been much more expansive. In many cases, the term ‘discussion group’ is preferred to give an indication of this greater latitude. The role of the researcher in the focus group is to act as the moderator for the discussion. The researcher can follow similar guidelines to those for an interview by using a guide, except the discussion should be allowed to flow freely and not be constrained too much by the investigator’s agenda. The researcher needs to ensure that all the group participants have an opportunity to express their viewpoints. The method is often combined with interviews and questionnaires.
Although it is usual for the moderator to introduce some themes for discussion, this can be supplemented with a short video extract or pictures relevant to the topic being investigated. As the discussion proceeds, the researcher can often take a background role, while ensuring that the discussion does not deviate too far from the focus of the research and that all the participants have an opportunity to express their views. An assistant can help in completing consent forms, providing name-tags, organizing refreshments, keeping notes on who is talking (this is useful for transcription), and monitoring the recording equipment. The focus group recording should be transcribed as soon as possible afterwards since it is often difficult to distinguish speakers. Here are a few examples: Jones et al. (2014b) carried out a focus group and telephone interviews with patients in rural areas to examine the management of diabetes in a rural area; Liimakka (2014) drew upon focus group discussions to explore how young Finnish university students viewed the cultural ideals of health and appearance; Griffiths et al. (2015) used pre- and post-intervention focus groups to test a website, Realshare, for young oncology patients in the south-west of England; and Bogart (2015) examined the social experiences of 10 adolescents aged 12–17 years with Moebius Syndrome, a rare condition involving congenital facial paralysis.
Grounded Theory Analysis
Grounded theory analysis is a term used to describe a set of guidelines for conducting qualitative data analysis. It was originally developed by Glaser and Strauss (1967) and has subsequently gone through various revisions. In its original form, qualitative researchers were asked to dispense with theoretical assumptions when they began their research. Rather, they were encouraged to adopt a stance of disciplined naïvety. As the research progresses, certain theoretical concepts are discovered and then tested in an iterative fashion. In the case of the qualitative interview, the researcher is encouraged to begin the analysis at a very early stage, even as the interview is progressing. Through a process of abduction, the researcher begins to develop certain theoretical hypotheses.