Applying a new concept of embedding qualitative research: an example from a quantitative study of carers of people in later stage dementia

Abstract

Background Qualitative methods are increasingly included in larger studies to provide a richer understanding of people’s experience. This paper explores the potential of using a novel approach to embedded qualitative design as part of an observational study examining the effectiveness of home support for people in later stage dementia in England. The method involved collecting and analysing unsolicited conversational comments made by participants as they completed standardised measures. An evaluation of the method is presented using the voices of participants to illustrate its potential. Methods The conversations of 17 carers recruited to an observational study were audio recorded to gather commentary made while completing a structured interview. Data were interrogated using thematic analysis to investigate the feasibility of conducting an embedded qualitative study, the potential richness of the material and participants’ reactions to formal questioning and participating in research. Results The findings revealed that qualitative data were available from this approach. Analysis generated three themes from carers: conflicting carer emotions; the importance of maintaining normality and agency within day-to-day life; and tensions between these desires and making use of formal services. Important issues for carers were revealed establishing the benefit of using the method. The advantages of exploiting unsolicited conversation included enhancing understanding of people’s lived experience, reducing participant burden in research and easing the process of data collection. In addition, it provided an opportunity to evaluate individuals’ experience of the research process. Conclusions The findings demonstrate how unsolicited comments during structured interviews may appear incidental but can reveal important aspects of living with dementia. The method also emphasised methodological challenges for research in dementia, including the influence and impact of the research context. Further research is required to evaluate the method with other groups including people with dementia themselves. Electronic supplementary material The online version of this article (10.1186/s12877-019-1240-x) contains supplementary material, which is available to authorized users.

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“…Ethnographic approaches have commonly relied on sustained fieldwork, where a researcher takes part in a group's practices while observing them, so as to rigorously interpret how people make sense of their everyday lives and social systems (Hammersely and Atkinson, 2007). The ethnographic approach used in this study drew on recent multidisciplinary research in trials to design a study "embedded" within a broader based research programme (Aazh, 2016;Abendstern et al 2019;Clark et al, 2013;Eborall et al, 2007;Fairbrother et al, 2013;Lewis and Russell, 2011;Mekki et al, 2017;Wenborn et al, 2016) to collect focused (Knoblauch, 2005;Pink and Morgan, 2013) observational data on situated practices of people with dementia and their caregivers when using ATT in their everyday lives. We used this data to construct in-depth extended cases of how people with dementia and caregivers used (or chose not to use) these technologies, to help explain how and how far specific technologies for supporting people with dementia may be relevant in the context of their everyday situation and interactions in home and community settings.…”