Qualitative Research Methodology in Health

This critical analysis focuses on three qualitative research articles that explore different aspects of suicidal ideations. The research design and methodology of each article are critiqued and evaluated. The limitations of each study are discussed, and the need for further research in this area is emphasized.

Running head: CRITICAL ANALYSIS
Qualitative Research Methodology in Health
Name of the Student
Name of the University
Author Note

1CRITICAL ANALYSIS
Table of Contents
Introduction:...............................................................................................................................2
Article 1......................................................................................................................................2
Article 2:.....................................................................................................................................4
Article 3:.....................................................................................................................................6
Conclusion:................................................................................................................................7
References:.................................................................................................................................8

2CRITICAL ANALYSIS
Introduction:
Suicidal ideations, commonly referred to as suicidal thoughts refer to the planning or
thinking about suicides (Testa et al., 2017). Some of the frequent causes that lead to suicidal
ideations are anxiety, depression, schizophrenia, substance abuse and eating disorders like
anorexia nervosa. Furthermore, individuals with a family history of mental disorders are at an
increased likelihood of facing such ideations. People who experience suicidal thoughts report
feelings of being trapped and a persistent sense of hopelessness, emotional pain, mood
swings, guilt feelings, and changes in personality (Kleiman et al., 2017). Qualitative research
is exploratory in design and are primarily conducted for gaining a deeper insight into the
opinions, motivations and reasons behind a phenomenon. This assignment will critique the
research design and methodology of three qualitative articles that focus on different aspects
of suicidal ideations.
Article 1
Player, M. J., Proudfoot, J., Fogarty, A., Whittle, E., Spurrier, M., Shand, F., ... & Wilhelm,
K. (2015). What interrupts suicide attempts in men: a qualitative study. PLoS One, 10(6),
e0128180. doi:10.1371/journal. pone.0128180
The article by Player et al., (2015) was aimed at investigating the underlying factors
that either assist, complicate or inhibit different interventions for males, who are at an
increased risk for suicidal acts. The authors were correct in identifying the fact that suicide
rates, although quite high among females, are significantly larger among their male
counterparts. This was directly attributed to the fact that males have been found to cope with
their distress and depression in a different manner, than females (Rotenstein et al., 2016). The
authors recruited participants from all territory and state of Australia using the purposive
sampling method. This is a form of non-probability sampling that depends on the

3CRITICAL ANALYSIS
characteristics of the entire population being investigated. Also referred to as selective
sampling, some of the advantages of this technique employed by the researchers are that this
is one of the most time-effective and cost-effective sample recruitment methods (Palinkas et
al., 2015). Furthermore, this might be considered as the only accurate method in presence of
limited sources of primary data. However, some of the drawbacks of the way by which the
participants were recruited are related to the inability of purposive sampling to generalize the
findings of the research to a larger population, reduced levels of reliability, increased level of
bias, and vulnerability to researcher judgment errors (Merriam & Tisdell, 2015). Data
collection was conducted via questionnaires namely, the Patient Health Questionnaire-9
(PHQ-9), Male Depression Risk Scale (MDRS), and the Generalized Anxiety Disorder 7-
item (GAD-7). This was followed by development of an interview schedule. The authors
clearly indicated the process of data collection and provided a justification for the same
(Player et al., 2015).
In the next step, the authors conducted an interview for which the scheduling was
based on a literature review and it was then piloted and adjusted based on the feedback that is
collected from the participants (Player et al., 2015). The final schedule of the interview
explored different factors that contribute to making a suicide attempt, along with the factors
that prevent or interrupt from making any such attempt including the supportive factors of
family and friends that help in preventing future attempt. Klonsky, May and Saffer, (2016)
have opined that suicide or the tendency to commit suicide is stemmed from a complex mind-
set, no two people suffering from such self-harming mental instability will have similar mind-
set or triggers facilitating or accelerating the tendencies. Hence, it is very important for the
research studies to focus on capturing the unique perspective of the different target groups
and be able to address those issues adequately. The authors in this case have utilized the
technique of qualitative interviews which is extremely helpful and advantageous to achieve

4CRITICAL ANALYSIS
the goal of the research question (Player et al., 2015). As discussed by Wolgemuth et al.,
(2015), qualitative interviews help the researchers to observe or capture the unique
perspective of the different subjects and understand the exact experience of the subject and
how it relates to the issue. In order to minimize the bias, all of the 35 interviews were
conducted by the same research officer within 8 focus groups, and the participant consent had
been taken before commencing with the interview. However, the only limitation of this study
design can be the cost, time, and the quality of the data collection by the interviewer (Player
et al., 2015).
Article 2:
Li, H., Tucker, J., Holroyd, E., Zhang, J., & Jiang, B. (2017). Suicidal ideation, resilience,
and healthcare implications for newly diagnosed HIV-positive men who have sex with men
in China: a qualitative study. Archives of sexual behavior, 46(4), 1025-1034. Doi:
10.1007/s10508-016-0894-0
The next article by Li, Tucker, Holroyd, Zhang and Jiang, (2017) is based on the
conundrum of HIV diagnosis and the impact of the same on the suicidal intention and
behaviour. On a more elaborative note, the HIV positive diagnosis generally leads to terror
and confusion on the patient, especially for the culturally diverse populations. On a more
elaborative, for a conventional Confucian culture like the Chinese culture, the risk and
resilience associated with suicidal ideation is associated with cultural influences such as
marriage obligations, obligation for parenthood and continuing the family name, providing
financial support to families, and lastly protecting the family reputation. Hence, it has been
hypothesized that the impact of a delimiting diagnosis such as HIV will have a far more
deleterious impact on the psyche and will accumulate a stronger suicidal ideation for these
target groups. This study has aimed to focus on the socially disadvantaged group of men who
have sex with men or MSM in China and explore the psychosocial context immediately

5CRITICAL ANALYSIS
following a HIV diagnosis and explore coping and resilience among this group. Researchers
are of the opinion that the MSM is a socially disadvantaged group that has higher chance of
acquiring HIV and along with that they also are subjected to extreme social isolation and
discrimination as well and hence the risk of suicidal ideation is also extremely high (Frye et
al., 2015). Hence, the research question is valid and also relevant to the present public health
issues. The research had been conducted in Shenzhen in China in the year of 2010 which had
at least 100000 to 200000 MSMs and repeated in depth interviews have been conducted in a
three month interval setting by taking the collaborative aid of a local nongovernment
organization or NGO. The data collection process followed a semi structured interview
process based on a life profile approach which takes into consideration the background
research, lengthy interviews, and close collaborations with participants. As discussed by
Kendall (2014), the life profile approach is excellent technique for understanding the exact
impact of a life impact on the mind-set, psyche and behavioural patterns of the individuals.
The life profiling approach to qualitative research allows the researchers to ensure that the
testimonies have accurately reflected the depth of the life-world or the social themes and have
a focussed approach to the individual life narratives.
The sampling had been purposeful, which is a selective and non-probability sampling
that is reported to be the most time saving and cost effective sampling technique that takes
into consideration into the entire population that is being studied (Benoot, Hannes & Bilsen,
2016). The data collection was initiated by ethics approval followed by the nominated NGO
contacting the potential participants conducting the interview which was digitally recorded
and then transcribed verbatim and in the data analysis was based on the emerging themes.
The advantages of this approach is accurate screening, capturing both verbal and nonverbal
cues, keeping focus and capturing emotions and behaviours, hence the choice is
commendable (Powney & Watts, 2018). The only limitation had been unintended

6CRITICAL ANALYSIS
intervention effect, recruitment bias, lack of standardized scales to measure suicidal ideation
and the participants not opening up due to use of digital recorders.
Article 3:
Foggin, E., McDonnell, S., Cordingley, L., Kapur, N., Shaw, J., & Chew-Graham, C. A.
(2016). GPs’ experiences of dealing with parents bereaved by suicide: a qualitative study. Br
J Gen Pract, bjgpoct-2016. Doi: 10.3399/bjgp16X686605
This research study by Foggin et al. (2016) have attempted to explore the experience
of the general practitioners dealing with the parents suffering from bereavement of the
suicide. It has to be mentioned that even though, many research studies have focussed on the
risk factors of suicide but there is very limited knowledge and understanding of the impact of
suicide on parents of the suicide victim, how the GPs handle these grief stricken parents and
how it impacts the GPs. Hence, it can be mentioned that this a very important area of concern
and the research aim is valid and relevant.
The research follows a qualitative interview based research technique involving 13
general physicians or GPs. Sampling was based on coroners’ reports, poster advertisements,
newspaper articles, and suicide bereavement self-help groups and all the parents and then the
parents were interviewed and then approached for their GPs to be contacted. The data
collection was based on semi-structured interviews which incorporated individual
perspectives of the patients to be incorporated into the data which enhances the quality and
diversity of the data, the data collected had been analysed thematically (McIntosh & Morse,
2015).
The limitations of this study include participation bias which was although reduced to
some extent due to the recruitment via bereaved parents, but for the general physicians that
were extremely uncomfortable of their experience with the bereaved parents and could have

7CRITICAL ANALYSIS
been less likely to participate. Along with that GPs selected represented a very small sample
size which might not have incorporated all of the GPs in practice with a variety of different
issues.
Conclusion:
Suicidal thoughts can most commonly range from detailed and comprehensive plans
to transitory considerations. These thoughts are extremely common and most people report
experiencing them during periods of mental distress and/or stress. Such events often increase
the vulnerability of such individuals to attempt suicide for ending their life. These three
articles have been successful in understanding the extent of suicidal ideation and how it
develops however there have been considerable drawbacks in all of the studies. For the first
article, the limitation had been time, cost and the originality or quality of the data collected as
the interviewer had been the same. For the second article the drawbacks had been unintended
intervention effect, recruitment bias, lack of standardized scales to measure suicidal ideation
and the participants not opening up due to use of digital recorders which could have affected
the nature or quality of the data collected. The third and final article had been limited by
small sampling and participation bias. Hence, these drawbacks limit the generalizability of
these studies and there is need for further research in this area with emphasis to address these
limitations.

8CRITICAL ANALYSIS
References:
Benoot, C., Hannes, K., & Bilsen, J. (2016). The use of purposeful sampling in a qualitative
evidence synthesis: A worked example on sexual adjustment to a cancer
trajectory. BMC medical research methodology, 16(1), 21. Doi: 10.1186/s12874-016-
0114-6
Foggin, E., McDonnell, S., Cordingley, L., Kapur, N., Shaw, J., & Chew-Graham, C. A.
(2016). GPs’ experiences of dealing with parents bereaved by suicide: a qualitative
study. Br J Gen Pract, bjgpoct-2016. Doi: 10.3399/bjgp16X686605
Frye, V., Nandi, V., Egan, J., Cerda, M., Greene, E., Van Tieu, H., ... & Koblin, B. A. (2015).
Sexual orientation-and race-based discrimination and sexual HIV risk behavior
among urban MSM. AIDS and Behavior, 19(2), 257-269. Doi: 10.1007/s10461-014-
0937-2
Kendall, L. (2014). The conduct of qualitative interviews: Research questions,
methodological issues, and researching online. In Handbook of research on new
literacies (pp. 151-168). Routledge. Retrieved from
https://www.taylorfrancis.com/books/e/9781136650864/chapters/10.4324%2F978141
0618894-13
Kleiman, E. M., Turner, B. J., Fedor, S., Beale, E. E., Huffman, J. C., & Nock, M. K. (2017).
Examination of real-time fluctuations in suicidal ideation and its risk factors: Results
from two ecological momentary assessment studies. Journal of abnormal
psychology, 126(6), 726. Doi: 10.1037/abn0000273

9CRITICAL ANALYSIS
Klonsky, E. D., May, A. M., & Saffer, B. Y. (2016). Suicide, suicide attempts, and suicidal
ideation. Annual review of clinical psychology, 12, 307-330. Doi: 10.1146/annurev-
clinpsy-021815-093204
Li, H., Tucker, J., Holroyd, E., Zhang, J., & Jiang, B. (2017). Suicidal ideation, resilience,
and healthcare implications for newly diagnosed HIV-positive men who have sex
with men in China: a qualitative study. Archives of sexual behavior, 46(4), 1025-
1034. Doi: 10.1007/s10508-016-0894-0
McIntosh, M. J., & Morse, J. M. (2015). Situating and constructing diversity in semi-
structured interviews. Global qualitative nursing research, 2, 2333393615597674.
Doi: 10.1177/2333393615597674
Merriam, S. B., & Tisdell, E. J. (2015). Qualitative research: A guide to design and
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Palinkas, L. A., Horwitz, S. M., Green, C. A., Wisdom, J. P., Duan, N., & Hoagwood, K.
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K. (2015). What interrupts suicide attempts in men: a qualitative study. PLoS
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10CRITICAL ANALYSIS
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Rotenstein, L. S., Ramos, M. A., Torre, M., Segal, J. B., Peluso, M. J., Guille, C., ... & Mata,
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