Epistemology and Ontology in Qualitative Data Research

DATA INTERPRETATION ASSIGNMENT

INTRODUCTION:

Qualitative research is a method of study, designed to capture, analyse and interpret data, relevant to people’s concepts and experiences of their social world (Murphy et al., 1998). Here the emphasis is on viewing the actions, norms, and values of the study population from a holistic standpoint. The aim is to uncover meanings that are not ordinarily revealed in quantitative studies (Bryman, 2008). Qualitative research depends largely on the richness of people’s testimonies and the amount of data that can be gotten without replication (Wilkinson, 2000). The method is underpinned by the principles of Ontology and Epistemology. Ontology considers the nature of the acclaimed meanings/realities in relation to the existence of objective reality (Kavanagh et al., 1994); while Epistemology looks at how knowledge is construed and what is accepted as valid evidence in qualitative research; which is seen as being largely dependent on the study design and the quality of collected information (Braun and Clarke, 2013).

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Due to the descriptive and interpretative nature of qualitative research, it can be used to give voice to the marginalised groups and patients, as they are rarely heard; it can be used to create an understanding of what influences peoples values and experiences; It is possible to generate acceptable theory that explains people’s behaviour and experiences; and also, be used to create an understanding of how a person’s social and/cultural constructs can influence their health (Elliot and Timulak, 2005). The developed knowledge could in turn, help decision makers (for instance), to develop clear methods on how best to address/tackle identified issues (Edwards and Elwyn, 2009). In the same vein, the data excerpts to be interpreted in this project, further illustrate how qualitative research methods have been applied to explore the participants’ own opinions, experiences, and knowledge of healthy eating.

The researchers overall question of “What kinds of foods are healthy/good for you?” also demonstrate the exploratory/investigatory nature of this research method; allowing subjects to use own terms to express their own realities. Despite the attributed benefits of qualitative research methods, there are some disadvantages associated with it. One major pitfall of qualitative research is the researcher’s likely tendency of introducing bias; influencing the findings to reflect what they want it to be, or even to give relevance to their study. However, bias in qualitative research can be reduced by adopting appropriate analytical processes, such as Trustworthiness. The criteria’s for ensuring trustworthiness are – Credibility, Transferability, Dependability, and Confirmability (Lincoln and Guba, 1985). To extract relevant information from the transcripts, appropriate frameworks will be used to analyse, structure and interpret key findings transparently. This process is vital, to guarantee the reliability of the findings of this project (Creswell, 2014).

DATA ANALYSIS PROCESS AND JUSTIFICATION:

Due to the exploratory nature of the primary research, Thematic Analysis process (inductive strategy) will be adapted in the analysis and interpretation of the transcribed data. Thematic analysis is a qualitative method that is used “for identifying, analysing and reporting patterns within data” (Braun and Clarke, 2006, p. 79). For this assignment, it was used to explore the gap in health beliefs and folk models of diabetes in British Bangladeshis by concentrating on, and deriving themes from the responses of the research participants which will give understanding of the phenomenon under study (Fielden, Sillence and Little, 2011). Themes has been defined as “something important about the data in relation to the assignment aim and represents some level of patterned response or meaning within the data set” (Braun and Clarke, 2006, p.82). Being a methodological tool, thematic analysis seeks to identify recurring patterns found within the data. This type of analysis provides not only a rich data but also an interpretation of the research aims and objectives, by deriving recurring patterns and salient themes. By doing so, a rich thematic description of the data can assist to extract “the predominant and important themes” (Blacker, 2009, p.83). Unlike pragmatism, thematic analysis does not depend on a particular epistemological position, paradigm fit, or theoretical position but rather it “matches what the researcher wants to know” (Braun and Clarke, 2006, p.80), which therefore makes it a flexible research tool that can used of within various theoretical frameworks. Hence, this allows patterns or themes within thematic analysis to be identified in either a deductive or inductive way. This project did not make use of hypotheses as it is not set out to test a theory or theories, rather it seeks to examine possible ideas, concepts, beliefs and reasons that the British-Bangladesh may have about foods that are healthy/good.

CODING AND ANALYSIS OF THE TRANSCRIPT:

An adapted version of Silverman’s Syntax of conversation analysis as put together by Gubrium and Holstein (2002) was employed to code and analyse the data transcript. Making use a more complex system of coding could be difficult to read and understand (Gubrium and Holstein, 2002). Due to its flexibility, thematic analysis lacks a specific set of guidelines to follow but it does entail the transcript contains necessary information in verbatim, which must be true to the original transcript (Braun and Clark, 2006). This project therefore aim to provide a “rich thematic description” (Braun and Clark, 2006, p.83) of the data in order that readers will be able to identify and understand important themes that mattered to the participants of the study. The six-phase model as outlined below by Braun and Clark (2006) was used to analyse the transcript.

Step 1: Data Familiarisation: This entails that the researcher reads and re-read the data in order to become familiar with it, and pay particular attention to any possible occurring patterns.

Step 2: Initial Code Generation: Coding specify information which seemed interesting to the researcher, which may form the foundation of analysing repeated themes across the data set. Systematic coding of interesting points relevant to the research aim and objectives across all data sets was carried out. The coding was conducted manually.

Step 3: Theme Search: This have to do with collating codes into themes and identifying all data relevant to a particular theme. Themes were developed when similar ideas are repeated in the data: for example, the ‘vegetables, fish, meat, chicken, eggs’ or ‘they are good for our health’. Here, the researcher began to identify and gather some possible themes which was noted down. All codes that were well-thought-out relevant to the research aim were included (See Appendix 1 and 2) for this evidence.

Step 4: Reviewing of themes: At this phase, themes need to be checked in order to ensure that they correspond to the idea or perception given by participants, and also to ensure that they are proper for coded extracts. Thematic process for analysis was adapted. At this point different themes were combined as one theme. A second reading of the data set was done to in order to know whether each theme suited each idea that was expressed, and also to accommodate any data that might be left out.  

Step 5: Naming and Definition of themes: It was necessary that each theme should be clearly named and defined for the purpose of giving a quick meaning of each theme.

Step 6: Report Production: This was done by gathering the extract to illustrate the derived themes.

REPORT ON ANALYSIS OF THE DATA:

This section gives a summary of the thematic analysis from both daughter and mother groups. Following the coding of the data from the interview transcript, major themes emerged showing the factual information the participants hold about the kinds of foods that they considered healthy/good. Themes that were developed from the transcripts were so similar that they were categorised under similar headings. The over-arching themes that was derived from mother’s participatory groups, follow by the over-arching themes that came from daughter participatory groups are presented below.

Mothers: Main themes that came from the mother’s participatory group related to:

1. Awareness/knowledge of healthy/good food
2. Social/environmental factors

Daughters: Main themes that came from the daughter’s participatory group were related to:

1. Awareness/knowledge of healthy/good food

All of the main themes consisted of sub-themes (see fig. 1 for the schematic representation of the main and sub-themes for both daughter and mother on what constitutes healthy/good food).

KEYS:

              Represents main themes and sub-themes for Mothers

               Represents the topic under investigation

               Represents main theme and sub-themes for daughters

Kinds of healthy/good food

Figure 1: Schematic Representation of the main and sub-themes for both daughters and mothers on what constitutes healthy/good food.

Through these three themes mentioned above, foods considered healthy/good is explored by using direct quotations extracted from the transcripts to support and reaffirm the points as constructed by the research participants. Quotes were applied according to their appropriateness to the theme under discussion. The role of the schematic representation of the main themes and sub-themes is to show how they all function to influence participant’s food choices.

MOTHERS:

Main Theme 1: Awareness/knowledge of healthy/good food

This phase of the analysis explores mothers’ awareness/knowledge of healthy/good food towards uncovering its consequences on their ability to practice healthy eating. As shown in figure 1, awareness/knowledge drivers dictating kinds of foods that are considered healthy/good by participants are: good for health, nutritional practices, exercise, age, medication, and worsening health condition and doctor’s advice.

Sub-theme: Good for Health

This phase of the analysis explores ‘good for health’ as it influences mothers’ practices towards healthy food choices. Regarding healthy food, the participants reported fish, vegetables, fruits, milk, rice as some of the food that they considered to be healthy for the body. Below are responses from the participants about such decisions/choices.

“It’s good to eat vegetables and boiled food, brown rice etc is good for health” (M006).

“Our fish, vegetables, fruits, milk, these are good for them” (M008).

“well, things that contain fat are bad for you; you shouldn’t eat meat and cut down on things like butter. You should have food containing less fat” (M009).

Similarly, another participant has this to say: “I think for us, we should eat rice, fish, fruit and vegetables. Take regular walks, have good sleep routine. As an uneducated person, this is that I think. I think they are good. I think fish is better than eating meat, chips etc” (M011).

On further probing on why she thinks these are good food -  In her word:

“(Laughs) I don’t like meat, chicken etc. I feel that rather than meat, burger etc, fish is better. There’s a lot of fat in the others that is harmful for the body. After I came to this country, after two years I kept on putting weight. I only ate rice and fish and fruits but I kept on getting bigger. Even to this day I only eat rice and fish. When the children get takeaway from outside, I don’t eat that. But I still keep on putting on weight. But although I was big, I didn’t have any illness or problems. Not a single day over 9 years I didn’t even have to take a paracetamol. I was very well and healthy. I didn’t have any headache or temperature. Then suddenly I was diagnosed with diabetes and high blood pressure. Since then …I think to myself I don’t eat meat, chicken or takeaways, use little oil in cooking, why am I getting bigger and why am I ill now? The doctor said you don’t need oil for high blood pressure. If people are healthy, they could still have blood pressure. Then I was relieved. After that I was diagnosed with diabetes and cholesterol” (M011).

It was also revealed that some of the participants were not bothered about which food was healthy/good, as some of them ate just anything that was available.

 One of the participants in her words has this to say:

“I’m not fussy; I would eat whatever is available and whatever I can cook. You know, the cooking I do doesn’t always taste nice so my daughters will come and cook. Yes, they are ok, they are eating everything. They are eating good and bad foods (laughing), they are at ‘new’ (young) age so they need to look after themselves. Somethings they will not eat” (M020).

From the extracts of the theme-good for health it is obvious that most of the participants are knowledgeable about the kinds of food that are healthy/good for their health and the ones that are detrimental to health. Foods associated with healthy/good foods from the perspective of the mothers have presented. Vegetables, boiled food, brown rice, fish, fruits, milk and eggs.

Sub-theme: Age and ill health

 Interestingly, age and ill health were the reasons why mothers were practising health eating. This may be because as people age, they become more susceptible to disease and disability. It is also a common knowledge that much burden of ill health among older people can be reduced or prevented by addressing their nutritional needs. The mothers expressed their views as presented below.

“For older people, you should have milk, fruits, you should have fresh food, less rice, fruits are best and you should have things like eggs” (M009).

“you should eat less. The machine (body) starts losing power, can’t digest food like before” (M014).

“you start eating less anyway as you get older. I can’t eat like I used to eat before. Now I have diabetes so I have to be careful with what I eat” (M018).

Age and ill health as the impact on food choices from the perspective of the mothers’ have been presented.

Sub-theme: Doctor’s Advice on food healthy/good foods

Three participants reported that they were advised by doctors on food that were healthy/good for health. Below are foods advised by doctors for the mothers eat and the ones to cut down from eating.

“There are people who say what is good to eat. The place I go to exercise, the people there also say it. community centre. People come. People from health also come there” (M021).

On further questioning M021 has this to say:

“If I say something then they provide the information accordingly and try to make it relevant. They say the fish is good. If I say vegetables then they say it is good. Spinach and vegetables, we have talked about the other day” (M021).

Another participant explained:

“If you go to the doctor, they would say these things are good for your health. Yes, fruit and milk. We eat rice and curry every day” (M025).

“The doctor does say not to eat this and that. Even if I don’t eat it my illness isn’t going away. Cholesterol. Always high. even if I don’t eat. I eat rice once a day. There are always things that are made of butter…. I don’t eat things either” (M037).

On further probing the participants continued to explain:

“Rice and curry. I eat fish and that. I don’t eat meat and chicken. Even then if it is not coming down so I don’t know what to do anymore (laughs). I showed doctors in Bangladesh, they also said that it hasn’t come down. They say eat less rice. I say I eat very little rice and the doctor says try to cut down more” (M037).

Considering the comments of the mothers, it could be said that most of the participants know about foods and practices of what good foods are. Having presented data on the awareness and knowledge of healthy/good foods, I now follow up with the next main theme which consists of findings on social/environmental factors.

Main Theme 2: social/environmental Factors

This phase of the analysis explores social/environmental factors that can impact on mothers’ food choices. Widespread of available unhealthy food and less availability of healthy food are core reasons people of different ages and backgrounds explained for eating habits which is perceived as unhealthy. The category here associated with social/environmental factors include less oil.

Sub-Theme: Less oil in Bangladesh

Analysis of the narratives indicatives that mothers cooked with less oil during their time in Bangladesh.

“Less in Bangladesh. Yes, a bit more here. More because it looks good and tastes good. That’s why we end up putting it in everything” (M006).

Another participant has this to say:

“After I came to this country, after two years I kept on putting weight. I only ate rice and fish and fruits but I kept on getting bigger. Even to this day I only eat rice and fish. When the children get takeaway from outside, I don’t eat that. But I still keep on putting on weight” (M011).

Having presented data on Less oil as kinds of foods that is healthy/good for the body from the perspective of the mothers, I now present the next main theme which consists of findings on kinds of foods that are healthy/good for you from the daughters.

DAUGHTERS:

Main Theme 1: Awareness/knowledge of healthy/good food

The participants reported various foods that they considered to being healthy/good for the body. The categories here associated with awareness/knowledge of healthy/good foods included kinds of foods good for the body, doctor’s advice, and nutritional practices/ill-health.  Below are participant’s responses.

Sub-Theme: Kinds of Foods Good for the Body

In the same manner, daughters reported that cooked fish, vegetables, eggs, tomato, cucumber, milk, sardines, mackerel and red onions as healthy/good foods.

“Vegetables mostly. I cook fish, you know. I always have one curry, which is fish, made with fish and then, um, meat, obviously, I have, and vegetables definitely” (D008).

On further questioning why, these foods are considered healthy/good, the participant has this to say.

“Er, good growth, really, isn’t it, for kids” (D008).

“Vegetables and fish. More vegetable and fish, and less meat and chicken” (D011)

Sub-Theme: Doctors ADVICE

Healthy food was some time associated with idealised ways, often standards set by others, such as doctors, nurses, community health workers, and reading them online. This is reiterated in the comments below:

“Because, um, I have been told by my nurse [at the GP surgery] that the trouble is, you know we should take vegetable everyday” (D011).

“No, not really our doctor normally tells us about healthy diet because our Indian diet is very spicy” (D009).

Sub-Theme: Nutritional Practices/Ill Health

The analysis of the sub-theme- nutritional practices/ill health showed a wide range of reasons why people associate with healthy/good foods. The interviewees reported cutting down on oil and salt as a way of preventing diseases such as stroke and high level of cholesterol. Below the extracts of some of the participant’s responses to this theme.

“I have cut down on oil and salt compared to my mum. Because my friend came down the other day and she said oh that’s a lot of oil and I said well they say the colour looks nice when you give oil and salt and then you think well this person has to cook.  But she said I only put two tablespoons and I actually measured the tablespoon it was nothing, but I did it the next day I did it with a tiny bit of salt and it was a bit bland, but I think I could get used to it. Then my husband said ‘oh salt-it’s not very nice’ but I said well got to do it because these days everyone got cholesterol. I have always seen my dad and uncles, they have all had strokes and heart disease and it worries you. And if you do- practise it now your children will learn whereas because we were always fed rice and curry twice a day by our mum and dad that’s what stayed with us, whereas if we change things now then our kids will remember that they will change their lifestyle” (D006).

Another participant has this to say:

“Food, um, the things I think are good, but nowadays I don’t seem to cook much of them, vegetable bhajis, ah, because you don’t need to put much spice in them, but you do need to put a bit of oil, so I tend to get olive oil for bhajis most of the time. And, um, fishes, and I also think, mackerel, tinned mackerel and sardines are really good, as well, because I read it lowers blood pressure, and cholesterol. So that is the reason I got into that, because my mother-in-law has got blood pressure and cholesterol, so I tried to cool things like that for her when I was living with her, and I kept the habit up, really” (D018).

CONCLUSION:

This study focused on recognising the influence of qualitative research upon how people interpret/associate with healthy eating. The data transcript and analysis showed a wide range of findings that people associate with healthy/good foods. Participants in the study discussed healthy eating in relation to different kinds of food (e.g., fruits, vegetables, milk, brown rice and eggs). The interviewees also described healthy in terms of nutrients (e.g., fat, carbohydrates). Healthy food was also discussed in terms of how they are cooked (e.g., food made at home, cutting down in salt and oil). Interviewees’ discussions about healthy food also involved ways of eating (e.g., have salad with meals, no lamb). The participants at some point, related healthy food to consequences that arise from eating in more or less healthy ways. Their perceptions of physical consequences included energy, weight, disease avoidance and disease management. Healthy food was also associated with idealised ways, that is, standards set by others, such as doctors, nurses, community health workers, and reading them online. Some of the participants attempted to achieve the official, idealised way, whereas others intentionally rejected official advices (i.e., “I’m not fussy; I would eat whatever is available and whenever I can cook”).

A major finding in this interpretation was the wide range of ways people’s perceptions what they think constitutes healthy food and eating. The review showed that people’s perception about healthy/good food are not simply a set of beliefs that can be arbitrated as right or wrong giving the ways scientists discuss healthy eating.

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