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European Journal of General Practice

ISSN: 1381-4788 (Print) 1751-1402 (Online) Journal homepage: https://www.tandfonline.com/loi/igen20

Series: Practical guidance to qualitative research.Part 3: Sampling, data collection and analysis

Albine Moser & Irene Korstjens

To cite this article: Albine Moser & Irene Korstjens (2018) Series: Practical guidance to qualitativeresearch. Part 3: Sampling, data collection and analysis, European Journal of General Practice,24:1, 9-18, DOI: 10.1080/13814788.2017.1375091

To link to this article: https://doi.org/10.1080/13814788.2017.1375091

© 2018 The Author(s). Published by InformaUK Limited, trading as Taylor & FrancisGroup.

Published online: 04 Dec 2017.

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METHODOLOGICAL PAPER

Series: Practical guidance to qualitative research. Part 3: Sampling, datacollection and analysis

Albine Mosera,b and Irene Korstjensc

aFaculty of Health Care, Research Centre Autonomy and Participation of Chronically Ill People, Zuyd University of Applied Sciences,Heerlen, The Netherlands; bFaculty of Health, Medicine and Life Sciences, Department of Family Medicine, Maastricht University,Maastricht, The Netherlands; cFaculty of Health Care, Research Centre for Midwifery Science, Zuyd University of Applied Sciences,Maastricht, The Netherlands

KEY POINTS ON SAMPLING, DATA COLLECTION AND ANALYSIS

� The data collection plan needs to be broadly defined and open during data collection.� Sampling strategies should be chosen in such a way that they yield rich information and are consistent

with the methodological approach used.� Data saturation determines sample size and is different for each study.� The most commonly used data collection methods are participant observation, face-to-face in-depth inter-

views and focus group discussions.� Analyses of ethnographic, phenomenological, grounded theory, and content analysis studies yield different

narrative findings: a detailed description of a culture, the essence of the lived experience, a theory or adescriptive summary, respectively.

ABSTRACTIn the course of our supervisory work over the years, we have noticed that qualitative researchtends to evoke a lot of questions and worries, so-called frequently asked questions (FAQs). Thisseries of four articles intends to provide novice researchers with practical guidance for conduct-ing high-quality qualitative research in primary care. By ‘novice’ we mean Master’s students andjunior researchers, as well as experienced quantitative researchers who are engaging in qualita-tive research for the first time. This series addresses their questions and provides researchers,readers, reviewers and editors with references to criteria and tools for judging the quality ofqualitative research papers. The second article focused on context, research questions anddesigns, and referred to publications for further reading. This third article addresses FAQs aboutsampling, data collection and analysis. The data collection plan needs to be broadly defined andopen at first, and become flexible during data collection. Sampling strategies should be chosenin such a way that they yield rich information and are consistent with the methodologicalapproach used. Data saturation determines sample size and will be different for each study. Themost commonly used data collection methods are participant observation, face-to-face in-depthinterviews and focus group discussions. Analyses in ethnographic, phenomenological, groundedtheory, and content analysis studies yield different narrative findings: a detailed description of aculture, the essence of the lived experience, a theory, and a descriptive summary, respectively.The fourth and final article will focus on trustworthiness and publishing qualitative research.

ARTICLE HISTORYReceived 18 December 2016Revised 7 August 2017Accepted 9 August 2017

KEYWORDSGeneral practice/familymedicine; generalqualitative designs andmethods; sampling; datacollection; analysis

Introduction

This article is the third paper in a series of fourarticles aiming to provide practical guidance to quali-tative research. In an introductory paper, we havedescribed the objective, nature and outline of the

Series [1]. Part 2 of the series focused on context,research questions and design of qualitative research[2]. In this paper, Part 3, we address frequently askedquestions (FAQs) about sampling, data collection andanalysis.

CONTACT Irene Korstjens im.korstjens@av-m.nl Zuyd University of Applied Sciences, Faculty of Health Care, Research Centre for MidwiferyScience, PO Box 1256, 6201 BG, Maastricht, The Netherlands� 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unre-stricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

EUROPEAN JOURNAL OF GENERAL PRACTICE, 2018VOL. 24, NO. 1, 9–18https://doi.org/10.1080/13814788.2017.1375091

Sampling

What is a sampling plan?

A sampling plan is a formal plan specifying a samplingmethod, a sample size, and procedure for recruitingparticipants (Box 1) [3]. A qualitative sampling plandescribes how many observations, interviews, focus-group discussions or cases are needed to ensure thatthe findings will contribute rich data. In quantitativestudies, the sampling plan, including sample size, isdetermined in detail in beforehand but qualitativeresearch projects start with a broadly defined samplingplan. This plan enables you to include a variety of set-tings and situations and a variety of participants,including negative cases or extreme cases to obtainrich data. The key features of a qualitative samplingplan are as follows. First, participants are alwayssampled deliberately. Second, sample size differs foreach study and is small. Third, the sample will emergeduring the study: based on further questions raised inthe process of data collection and analysis, inclusionand exclusion criteria might be altered, or the sam-pling sites might be changed. Finally, the sample isdetermined by conceptual requirements and not pri-marily by representativeness. You, therefore, need toprovide a description of and rationale for your choicesin the sampling plan. The sampling plan is appropriatewhen the selected participants and settings are suffi-cient to provide the information needed for a fullunderstanding of the phenomenon under study.

Some practicalities: a critical first step is to selectsettings and situations where you have access topotential participants. Subsequently, the best strategyto apply is to recruit participants who can provide therichest information. Such participants have to beknowledgeable on the phenomenon and can articulateand reflect, and are motivated to communicate atlength and in depth with you. Finally, you should

review the sampling plan regularly and adapt whennecessary.

What sampling strategies can I use?

Sampling is the process of selecting or searching forsituations, context and/or participants who providerich data of the phenomenon of interest [3]. In qualita-tive research, you sample deliberately, not at random.The most commonly used deliberate sampling strat-egies are purposive sampling, criterion sampling, the-oretical sampling, convenience sampling and snowballsampling. Occasionally, the ‘maximum variation,’‘typical cases’ and ‘confirming and disconfirming’ sam-pling strategies are used. Key informants need to becarefully chosen. Key informants hold special andexpert knowledge about the phenomenon to bestudied and are willing to share information andinsights with you as the researcher [3]. They also helpto gain access to participants, especially when groupsare studied. In addition, as researcher, you can validateyour ideas and perceptions with those of the keyinformants.

What is the connection between sampling typesand qualitative designs?

The ‘big three’ approaches of ethnography, phenom-enology, and grounded theory use different types ofsampling.

In ethnography, the main strategy is purposive sam-pling of a variety of key informants, who are mostknowledgeable about a culture and are able and will-ing to act as representatives in revealing and interpret-ing the culture. For example, an ethnographic studyon the cultural influences of communication in mater-nity care will recruit key informants from among a var-iety of parents-to-be, midwives and obstetricians inmidwifery care practices and hospitals.

Box 1. Sampling strategies in qualitative research. Based on Polit & Beck [3].

Sampling Definition

Purposive sampling Selection of participants based on the researchers’ judgement about what potential par-ticipants will be most informative.

Criterion sampling Selection of participants who meet pre-determined criteria of importance.Theoretical sampling Selection of participants based on the emerging findings to ensure adequate representa-

tion of theoretical concepts.Convenience sampling Selection of participants who are easily available.Snowball sampling Selection of participants through referrals by previously selected participants or persons

who have access to potential participants.Maximum variation sampling Selection of participants based on a wide range of variation in backgrounds.Extreme case sampling Purposeful selection of the most unusual cases.Typical case sampling Selection of the most typical or average participants.Confirming and disconfirming sampling Confirming and disconfirming cases sampling supports checking or challenging emerging

trends or patterns in the data.

10 A. MOSER AND I. KORSTJENS

Phenomenology uses criterion sampling, in whichparticipants meet predefined criteria. The most prom-inent criterion is the participant’s experience with thephenomenon under study. The researchers look forparticipants who have shared an experience, but varyin characteristics and in their individual experiences.For example, a phenomenological study on the livedexperiences of pregnant women with psychosocialsupport from primary care midwives will recruit preg-nant women varying in age, parity and educationallevel in primary midwifery practices.

Grounded theory usually starts with purposivesampling and later uses theoretical sampling to selectparticipants who can best contribute to the develop-ing theory. As theory construction takes place concur-rently with data collection and analyses, thetheoretical sampling of new participants also occursalong with the emerging theoretical concepts. Forexample, one grounded theory study tested severaltheoretical constructs to build a theory on autonomyin diabetes patients [4]. In developing the theory, theresearchers started by purposefully sampling partici-pants with diabetes differing in age, onset of dia-betes and social roles, for example, employees,housewives, and retired people. After the first ana-lysis, researchers continued with theoretically sam-pling, for example, participants who differed in thetreatment they received, with different degrees ofcare dependency, and participants who receive carefrom a general practitioner (GP), at a hospital or froma specialist nurse, etc.

In addition to the ‘big three’ approaches, contentanalysis is frequently applied in primary care research,and very often uses purposive, convenience, or snow-ball sampling. For instance, a study on peoples’ choiceof a hospital for elective orthopaedic surgery usedsnowball sampling [5]. One elderly person in the pri-vate network of one researcher personally approachedpotential respondents in her social network by meansof personal invitations (including letters). In turn,respondents were asked to pass on the invitation toother eligible candidates.

Sampling is also dependent on the characteristicsof the setting, e.g., access, time, vulnerability of partici-pants, and different types of stakeholders. The setting,where sampling is carried out, is described in detail toprovide thick description of the context, thereby, ena-bling the reader to make a transferability judgement(see Part 3: transferability). Sampling also affects thedata analysis, where you continue decision-makingabout whom or what situations to sample next. This isbased on what you consider as still missing to get thenecessary information for rich findings (see Part 1:

emergent design). Another point of attention is thesampling of ‘invisible groups’ or vulnerable people.Sampling of these participants would require applyingmultiple sampling strategies, and more time calculatedin the project planning stage for sampling and recruit-ment [6].

How do sample size and data saturation interact?

A guiding principle in qualitative research is to sampleonly until data saturation has been achieved. Data sat-uration means the collection of qualitative data to thepoint where a sense of closure is attained becausenew data yield redundant information [3].

Data saturation is reached when no new analyticalinformation arises anymore, and the study providesmaximum information on the phenomenon. In quanti-tative research, by contrast, the sample size is deter-mined by a power calculation. The usually smallsample size in qualitative research depends on theinformation richness of the data, the variety of partici-pants (or other units), the broadness of the researchquestion and the phenomenon, the data collectionmethod (e.g., individual or group interviews) and thetype of sampling strategy. Mostly, you and yourresearch team will jointly decide when data saturationhas been reached, and hence whether the samplingcan be ended and the sample size is sufficient. Themost important criterion is the availability of enoughin-depth data showing the patterns, categories andvariety of the phenomenon under study. You reviewthe analysis, findings, and the quality of the participantquotes you have collected, and then decide whethersampling might be ended because of data saturation.In many cases, you will choose to carry out two orthree more observations or interviews or an additionalfocus group discussion to confirm that data saturationhas been reached.

When designing a qualitative sampling plan, we(the authors) work with estimates. We estimate thatethnographic research should require 25–50 interviewsand observations, including about four-to-six focusgroup discussions, while phenomenological studiesrequire fewer than 10 interviews, grounded theorystudies 20–30 interviews and content analysis 15–20interviews or three-to-four focus group discussions.However, these numbers are very tentative and shouldbe very carefully considered before using them.Furthermore, qualitative designs do not always meansmall sample numbers. Bigger sample sizes mightoccur, for example, in content analysis, employingrapid qualitative approaches, and in large or longitu-dinal qualitative studies.

EUROPEAN JOURNAL OF GENERAL PRACTICE 11

Data collection

What methods of data collection are appropriate?

The most frequently used data collection methods areparticipant observation, interviews, and focus groupdiscussions. Participant observation is a method ofdata collection through the participation in and obser-vation of a group or individuals over an extendedperiod of time [3]. Interviews are another data collec-tion method in which an interviewer asks the respond-ents questions [6], face-to-face, by telephone or online.The qualitative research interview seeks to describethe meanings of central themes in the life world ofthe participants. The main task in interviewing is tounderstand the meaning of what participants say [5].Focus group discussions are a data collection methodwith a small group of people to discuss a given topic,usually guided by a moderator using a questioning-route [8]. It is common in qualitative research to com-bine more than one data collection method in onestudy. You should always choose your data collectionmethod wisely. Data collection in qualitative researchis unstructured and flexible. You often make decisionson data collection while engaging in fieldwork, theguiding questions being with whom, what, when,where and how. The most basic or ‘light’ version ofqualitative data collection is that of open questions insurveys. Box 2 provides an overview of the ‘big three’qualitative approaches and their most commonly useddata collection methods.

What role should I adopt when conductingparticipant observations?

What is important is to immerse yourself in theresearch setting, to enable you to study it from theinside. There are four types of researcher involvementin observations, and in your qualitative study, you mayapply all four. In the first type, as ‘complete partic-ipant’, you become part of the setting and play aninsider role, just as you do in your own work setting.This role might be appropriate when studying personswho are difficult to access. The second type is ‘activeparticipation’. You have gained access to a particularsetting and observed the group under study. You canmove around at will and can observe in detail anddepth and in different situations. The third role is‘moderate participation’. You do not actually work inthe setting you wish to study but are located there asa researcher. You might adopt this role when you arenot affiliated to the care setting you wish to study.The fourth role is that of the ‘complete observer’, inwhich you merely observe (bystander role) and do notparticipate in the setting at all. However, you cannotperform any observations without access to the caresetting. Such access might be easily obtained whenyou collect data by observations in your own primarycare setting. In some cases, you might observe othercare settings, which are relevant to primary care, forinstance observing the discharge procedure for vulner-able elderly people from hospital to primary care.

Box 2. Qualitative data collection methods.

Definition AimEthno-graphy

Pheno-menology

Groundedtheory

Contentanalysis

Participants ofobservations

Participation in andobservation of peopleor groups.

To obtain a close andintimate familiarity witha given group of indi-viduals and their practi-ces through intensiveinvolvement with peo-ple in their environ-ment, usually over anextended period.

Suitable Very rare Sometimes

Face-to-face in-depthsInterviews

A conversation wherethe researcher posesquestions and theparticipants provideanswers face-to-face,by telephone or viamail.

To elicit the participant’sexperiences, percep-tions, thoughts andfeelings.

Suitable Suitable Suitable Suitable

Focus groupdiscussion

Interview with a groupof participants toanswer questions ona specific topic face-to-face or via mail;people who partici-pate interact witheach other.

To examine differentexperiences, percep-tions, thoughts andfeelings among variousparticipants or parties.

Suitable Sometimes Suitable

12 A. MOSER AND I. KORSTJENS

How do I perform observations?

It is important to decide what to focus on in each indi-vidual observation. The focus of observations isimportant because you can never observe everything,and you can only observe each situation once. Yourfocus might differ between observations. Each obser-vation should provide you with answers regarding‘Who do you observe?’, ‘What do you observe’, ‘Wheredoes the observation take place?’, ‘When does it takeplace?’, ‘How does it happen?’, and ‘Why does it hap-pen as it happens?’ Observations are not static butproceed in three stages: descriptive, focused, andselective. Descriptive means that you observe, on thebasis of general questions, everything that goes on inthe setting. Focused observation means that youobserve certain situations for some time, with someareas becoming more prominent. Selective means thatyou observe highly specific issues only. For example, ifyou want to observe the discharge procedure for vul-nerable elderly people from hospitals to general prac-tice, you might begin with broad observations to getto know the general procedure. This might involveobserving several different patient situations. Youmight find that the involvement of primary care nursesdeserves special attention, so you might then focus onthe roles of hospital staff and primary care nurses, andtheir interactions. Finally, you might want to observeonly the specific situations where hospital staff andprimary care nurses exchange information. You takefield notes from all these observations and add yourown reflections on the situations you observed. Youjot down words, whole sentences or parts of situa-tions, and your reflections on a piece of paper. Afterthe observations, the field notes need to be workedout and transcribed immediately to be able to includedetailed descriptions.

What are the general features of an interview?

Interviews involve interactions between the inter-viewer(s) and the respondent(s) based on interviewquestions. Individual, or face-to-face, interviews shouldbe distinguished from focus group discussions. Theinterview questions are written down in an interviewguide [7] for individual interviews or a questioningroute [8] for focus group discussions, with questionsfocusing on the phenomenon under study. Thesequence of the questions is pre-determined. In indi-vidual interviews, the sequence depends on therespondents and how the interviews unfold. Duringthe interview, as the conversation evolves, you goback and forth through the sequence of questions. It

should be a dialogue, not a strict question–answerinterview. In a focus group discussion, the sequence isintended to facilitate the interaction between the par-ticipants, and you might adapt the sequence depend-ing on how their discussion evolves. Working with aninterview guide or questioning route enables you tocollect information on specific topics from all partici-pants. You are in control in the sense that you givedirection to the interview, while the participants are incontrol of their answers. However, you need to beopen-minded to recognize that some relevant topicsfor participants may not have been covered in yourinterview guide or questioning route, and need to beadded. During the data collection process, youdevelop the interview guide or questioning route fur-ther and revise it based on the analysis.

The interview guide and questioning route mightinclude open and general as well as subordinate ordetailed questions, probes and prompts. Probes areexploratory questions, for example, ‘Can you tell memore about this?’ or ‘Then what happened?’ Promptsare words and signs to encourage participants to tellmore. Examples of stimulating prompts are eye con-tact, leaning forward and open body language.

What is a face-to-face interview?

A face-to-face interview is an individual interview, thatis, a conversation between participant and interviewer.Interviews can focus on past or present situations, andon personal issues. Most qualitative studies start withopen interviews to get a broad ‘picture’ of what isgoing on. You should not provide a great deal of guid-ance and avoid influencing the answers to fit ‘your’point of view, as you want to obtain the participant’sown experiences, perceptions, thoughts, and feelings.You should encourage the participants to speak freely.As the interview evolves, your subsequent major andsubordinate questions become more focused. A face-to-face or individual interview might last between 30and 90min.

Most interviews are semi-structured [3]. To preparean interview guide to enhance that a set of topics willbe covered by every participant, you might use aframework for constructing a semi-structured interviewguide [10]: (1) identify the prerequisites to use a semi-structured interview and evaluate if a semi-structuredinterview is the appropriate data collection method;(2) retrieve and utilize previous knowledge to gain acomprehensive and adequate understanding of thephenomenon under study; (3) formulate a preliminaryinterview guide by operationalizing the previousknowledge; (4) pilot-test the preliminary interview

EUROPEAN JOURNAL OF GENERAL PRACTICE 13

guide to confirm the coverage and relevance of thecontent and to identify the need for reformulation ofquestions; (5) complete the interview guide to collectrich data with a clear and logical guide.

The first few minutes of an interview are decisive.The participant wants to feel at ease before sharinghis or her experiences. In a semi-structured interview,you would start with open questions related to thetopic, which invite the participant to talk freely. Thequestions aim to encourage participants to tell theirpersonal experiences, including feelings and emotionsand often focus on a particular experience or specificevents. As you want to get as much detail as possible,you also ask follow-up questions or encourage tellingmore details by using probes and prompts or keepinga short period of silence [6]. You first ask what andwhy questions and then how questions.

You need to be prepared for handling problemsyou might encounter, such as gaining access, dealingwith multiple formal and informal gatekeepers, negoti-ating space and privacy for recording data, sociallydesirable answers from participants, reluctance of par-ticipants to tell their story, deciding on the appropriaterole (emotional involvement), and exiting from field-work prematurely.

What is a focus group discussion and when can Iuse it?

A focus group discussion is a way to gather togetherpeople to discuss a specific topic of interest. The peo-ple participating in the focus group discussion sharecertain characteristics, e.g., professional background, orshare similar experiences, e.g., having diabetes. Youuse their interaction to collect the information youneed on a particular topic. To what depth of informa-tion the discussion goes depends on the extent towhich focus group participants can stimulate eachother in discussing and sharing their views and experi-ences. Focus group participants respond to you and toeach other. Focus group discussions are often used toexplore patients’ experiences of their condition andinteractions with health professionals, to evaluate pro-grammes and treatment, to gain an understanding ofhealth professionals’ roles and identities, to examinethe perception of professional education, or to obtainperspectives on primary care issues. A focus group dis-cussion usually lasts 90–120 mins.

You might use guidelines for developing a ques-tioning route [9]: (1) brainstorm about possible topicsyou want to cover; (2) sequence the questioning:arrange general questions first, and then, more specificquestions, and ask positive questions before negative

questions; (3) phrase the questions: use open-endedquestions, ask participants to think back and reflect ontheir personal experiences, avoid asking ‘why’ ques-tions, keep questions simple and make your questionssound conversational, be careful about giving exam-ples; (4) estimate the time for each question and con-sider: the complexity of the question, the category ofthe question, level of participant’s expertise, the sizeof the focus group discussion, and the amount of dis-cussion you want related to the question; (5) obtainfeedback from others (peers); (6) revise the questionsbased on the feedback; and (7) test the questions bydoing a mock focus group discussion. All questionsneed to provide an answer to the phenomenon understudy.

You need to be prepared to manage difficulties asthey arise, for example, dominant participants duringthe discussion, little or no interaction and discussionbetween participants, participants who have difficultiessharing their real feelings about sensitive topics withothers, and participants who behave differently whenthey are observed.

How should I compose a focus group and howmany participants are needed?

The purpose of the focus group discussion determinesthe composition. Smaller groups might be more suit-able for complex (and sometimes controversial) topics.Also, smaller focus groups give the participants moretime to voice their views and provide more detailedinformation, while participants in larger focus groupsmight generate greater variety of information. In com-posing a smaller or larger focus group, you need toensure that the participants are likely to have differentviewpoints that stimulate the discussion. For example,if you want to discuss the management of obesity in aprimary care district, you might want to have a groupcomposed of professionals who work with thesepatients but also have a variety of backgrounds, e.g.GPs, community nurses, practice nurses in generalpractice, school nurses, midwives or dieticians.

Focus groups generally consist of 6–12 participants.Careful time management is important, since you haveto determine how much time you want to devote toanswering each question, and how much time is avail-able for each individual participant. For example, ifyou have planned a focus group discussion lasting90min. with eight participants, you might need15min. for the introduction and the concluding sum-mary. This means you have 75min. for asking ques-tions, and if you have four questions, this allows atotal of 18min. of speaking time for each question. If

14 A. MOSER AND I. KORSTJENS

all eight respondents participate in the discussion, thisboils down to about two minutes of speaking time perrespondent per question.

How can I use new media to collect qualitativedata?

New media are increasingly used for collecting qualita-tive data, for example, through online observations,online interviews and focus group discussions, and inanalysis of online sources. Data can be collected syn-chronously or asynchronously, with text messaging,video conferences, video calls or immersive virtualworlds or games, etcetera. Qualitative research movesfrom ‘virtual’ to ‘digital’. Virtual means thoseapproaches that import traditional data collectionmethods into the online environment and digitalmeans those approaches take advantage of the uniquecharacteristics and capabilities of the Internet forresearch [10]. New media can also be applied. SeeBox 3 for further reading on interview and focus groupdiscussion.

Analysis

Can I wait with my analysis until all data havebeen collected?

You cannot wait with the analysis, because an iterativeapproach and emerging design are at the heart ofqualitative research. This involves a process wherebyyou move back and forth between sampling, data col-lection and data analysis to accumulate rich data andinteresting findings. The principle is that what emergesfrom data analysis will shape subsequent samplingdecisions. Immediately after the very first observation,interview or focus group discussion, you have to startthe analysis and prepare your field notes.

Why is a good transcript so important?

First, transcripts of audiotaped interviews and focusgroup discussions and your field notes constitute your

major data sources. Trained and well-instructed tran-scribers preferably make transcripts. Usually, e.g., inethnography, phenomenology, grounded theory, andcontent analysis, data are transcribed verbatim, whichmeans that recordings are fully typed out, and thetranscripts are accurate and reflect the interview orfocus group discussion experience. Most importantaspects of transcribing are the focus on the partic-ipants’ words, transcribing all parts of the audiotape,and carefully revisiting the tape and rereading thetranscript. In conversation analysis non-verbal actionssuch as coughing, the lengths of pausing and empha-sizing, tone of voice need to be described in detailusing a formal transcription system (best known are G.Jefferson’s symbols).

To facilitate analysis, it is essential that you ensureand check that transcripts are accurate and reflect thetotality of the interview, including pauses, punctuationand non-verbal data. To be able to make sense ofqualitative data, you need to immerse yourself in thedata and ‘live’ the data. In this process of incubation,you search the transcripts for meaning and essentialpatterns, and you try to collect legitimate and insight-ful findings. You familiarize yourself with the data byreading and rereading transcripts carefully and con-scientiously, in search for deeper understanding.

Are there differences between the analyses inethnography, phenomenology, grounded theory,and content analysis?

Ethnography, phenomenology, and grounded theoryeach have different analytical approaches, and youshould be aware that each of these approaches hasdifferent schools of thought, which may also haveintegrated the analytical methods from other schools(Box 4). When you opt for a particular approach, it isbest to use a handbook describing its analytical meth-ods, as it is better to use one approach consistentlythan to ‘mix up’ different schools.

In general, qualitative analysis begins with organiz-ing data. Large amounts of data need to be stored in

Box 3. Further reading on interviews and focus group discussion.

Face-to-face interviews � Brinkmann S, Kvale S. Interviews. Learning the craft of qualitative research interviewing.3rd ed. Sage: London; 2014.Rubin HJ, Rubin IS. Qualitative interviewing: The art of hearing data. 2nd ed. Sage:Thousand Oaks (CA); 1995.

Online interviews � Salmons J. Qualitative online interviews. 2nd ed. Sage: London; 2015.Focus group discussion � Barbour RS, Kitzinger J. Developing focus group research. Politics, theory and practice.

1st ed. Sage: London; 1999.Kruger R, Casey M. Focus groups: A practical guide for applied research. Sage: ThousandOaks (CA); 2015.

EUROPEAN JOURNAL OF GENERAL PRACTICE 15

smaller and manageable units, which can be retrievedand reviewed easily. To obtain a sense of the whole,analysis starts with reading and rereading the data,looking at themes, emotions and the unexpected, tak-ing into account the overall picture. You immerseyourself in the data. The most widely used procedureis to develop an inductive coding scheme based onactual data [11]. This is a process of open coding, cre-ating categories and abstraction. In most cases, you donot start with a predefined coding scheme. Youdescribe what is going on in the data. You ask your-self, what is this? What does it stand for? What else islike this? What is this distinct from? Based on thisclose examination of what emerges from the data youmake as many labels as needed. Then, you make acoding sheet, in which you collect the labels and,based on your interpretation, cluster them in prelimin-ary categories. The next step is to order similar or dis-similar categories into broader higher order categories.Each category is named using content-characteristicwords. Then, you use abstraction by formulating ageneral description of the phenomenon under study:subcategories with similar events and information aregrouped together as categories and categories aregrouped as main categories. During the analysis pro-cess, you identify ‘missing analytical information’ andyou continue data collection. You reread, recode, re-analyse and re-collect data until your findings providebreadth and depth.

Throughout the qualitative study, you reflect onwhat you see or do not see in the data. It is commonto write ‘analytic memos’ [3], write-ups or mini-analy-ses about what you think you are learning during the

course of your study, from designing to publishing.They can be a few sentences or pages, whatever isneeded to reflect upon: open codes, categories, con-cepts, and patterns that might be emerging in thedata. Memos can contain summaries of major findingsand comments and reflections on particular aspects.

In ethnography, analysis begins from the momentthat the researcher sets foot in the field. The analysisinvolves continually looking for patterns in the behav-iours and thoughts of the participants in everyday life,in order to obtain an understanding of the cultureunder study. When comparing one pattern withanother and analysing many patterns simultaneously,you may use maps, flow charts, organizational chartsand matrices to illustrate the comparisons graphically.The outcome of an ethnographic study is a narrativedescription of a culture.

In phenomenology, analysis aims to describe andinterpret the meaning of an experience, often by iden-tifying essential subordinate and major themes. Yousearch for common themes featuring within an inter-view and across interviews, sometimes involving thestudy participants or other experts in the analysis pro-cess. The outcome of a phenomenological study is adetailed description of themes that capture the essen-tial meaning of a ‘lived’ experience.

Grounded theory generates a theory that explainshow a basic social problem that emerged from the datais processed in a social setting. Grounded theory usesthe ‘constant comparison’ method, which involves com-paring elements that are present in one data source(e.g., an interview) with elements in another source, toidentify commonalities. The steps in the analysis are

Box 4. Qualitative data analysis.

Ethnography Phenomenology Grounded theory Content analysis

Transcripts mainly from Observations, face-to-faceand focus group discus-sions, field notes.

Face-to-face in- depthInterviews.

Face-to-face in- depthinterviews; rarely obser-vations and sometimesfocus groupdiscussions.

Face-to-face and onlinein-depth interviews andfocus group discus-sions; sometimesobservations.

Reading, notesand memos

Reading through tran-scripts, classifying intooverarching themes,adding marginal notes,assigning preliminarycodes.

Reading through tran-scripts, adding marginalnotes, defining firstcodes.

Reading through tran-scripts, writing memos,assigning preliminarycodes.

Reading through tran-scripts, adding marginalnotes, assigning prelim-inary codes.

Describing Social setting, actors,events.

Personal experience. Open codes. Initial codes.

Ordering Themes, patterns andregularities.

Major and subordinatestatements.

Units of meaning.

Axial coding.Selective coding.

Descriptive categories andsubcategories.

Interpreting How the culture works. Development of theessence.

Storyline about socialprocess.

Main categories, some-times exploratory.

Findings Narrative offering detaileddescription of a culture.

Narrative showing theessence of the livedexperience.

Description of a theory,often using a visualmodel.

Narrative summary ofmain findings.

16 A. MOSER AND I. KORSTJENS

known as open, axial and selective coding. Throughoutthe analysis, you document your ideas about the datain methodological and theoretical memos. The out-come of a grounded theory study is a theory.

Descriptive generic qualitative research is defined asresearch designed to produce a low inference descrip-tion of a phenomenon [12]. Although Sandelowskimaintains that all research involves interpretation, shehas also suggested that qualitative description attemptsto minimize inferences made in order to remain ‘closer’to the original data [12]. Descriptive generic qualitativeresearch often applies content analysis. Descriptive con-tent analysis studies are not based on a specific qualita-tive tradition and are varied in their methods ofanalysis. The analysis of the content aims to identifythemes, and patterns within and among these themes.An inductive content analysis [11] involves breakingdown the data into smaller units, coding and namingthe units according to the content they present, andgrouping the coded material based on shared concepts.They can be represented by clustering in treelike dia-grams. A deductive content analysis [11] uses a theory,theoretical framework or conceptual model to analysethe data by operationalizing them in a coding matrix.An inductive content analysis might use several techni-ques from grounded theory, such as open and axialcoding and constant comparison. However, note thatyour findings are merely a summary of categories, not agrounded theory.

Analysis software can support you to manage yourdata, for example by helping to store, annotate andretrieve texts, to locate words, phrases and segments ofdata, to name and label, to sort and organize, to identifydata units, to prepare diagrams and to extract quotes.Still, as a researcher you would do the analytical workby looking at what is in the data, and making decisionsabout assigning codes, and identifying categories,

concepts and patterns. The computer assisted qualita-tive data analysis (CAQDAS) website provides supportto make informed choices between analytical softwareand courses: http://www.surrey.ac.uk/sociology/research/researchcentres/caqdas/support/choosing. SeeBox 5 for further reading on qualitative analysis.

The next and final article in this series, Part 4, willfocus on trustworthiness and publishing qualitativeresearch [13].

Acknowledgements

The authors thank the following junior researchers who havebeen participating for the last few years in the so-called‘Think tank on qualitative research’ project, a collaborativeproject between Zuyd University of Applied Sciences andMaastricht University, for their pertinent questions: EricaBaarends, Jerome van Dongen, Jolanda Friesen-Storms, SteffyLenzen, Ankie Hoefnagels, Barbara Piskur, Claudia vanPutten-Gamel, Wilma Savelberg, Steffy Stans, and AnitaStevens. The authors are grateful to Isabel van Helmond,Joyce Molenaar and Darcy Ummels for proofreading ourmanuscripts and providing valuable feedback from the‘novice perspective’.

Disclosure statement

The authors report no conflicts of interest. The authors aloneare responsible for the content and writing of the paper.

ORCID

Irene Korstjens http://orcid.org/0000-0003-4814-468X

References

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Box 5. Further reading on qualitative analysis.

Ethnography � Atkinson P, Coffey A, Delamount S, Lofland J, Lofmand L. Handbook of ethnography. Sage:Thousand Oaks (CA); 2001.

� Spradley J. The ethnographic interview. Holt Rinehart & Winston: New York (NY); 1979.� Spradley J. Participant observation. Holt Rinehart & Winston: New York (NY); 1980.

Phenomenology � Colaizzi PF. Psychological research as the phenomenologist views it. In: Valle R, King M, editors.Essential phenomenological alternative for psychology. New York (NY): Oxford UniversityPress; 1978. p. 41-78.

� Smith J.A, Flowers P, Larkin M. Interpretative phenomenological analysis. Theory, method andresearch. Sage: London; 2010.

Grounded theory � Charmaz K. Constructing grounded theory. 2nd ed. Sage: Thousand Oaks (CA); 2014.� Corbin J, Strauss A. Basics of qualitative research. Techniques and procedures for developing

grounded theory. Sage: Los Angeles (CA); 2008.Content analysis � Elo S, K€a€ari€ainen M, Kanste O, P€olkki T, Utriainen K, Kyng€as H. Qualitative Content Analysis: a

focus on trustworthiness. Sage Open 2014: 1–10. DOI: 10.1177/2158244014522633.� Elo S. Kyng€as A. The qualitative content analysis process. J Adv Nurs. 2008; 62: 107–115.� Hsieh HF. Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;

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[13] Korstjens I, Moser A. Series: Practical guidance toqualitative research. Part 4: Trustworthiness and pub-lishing. Eur J Gen Pract. 2018;24. DOI:10.1080/13814788.2017.1375092

18 A. MOSER AND I. KORSTJENS