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Chapter 3: Theory in qualitative research

Tess Tsindos

Learning outcomes

Upon completion of this chapter, you should be able to:

• Define theory.
• Describe foundational qualitative theories.
• Examine theories for qualitative research.
• Explain why theories are used in qualitative research.
• Identify various theories used in qualitative research.

What is a theory?

In essence, ‘a theory is a big idea that organises many other ideas with a high degree of explanatory power’. 1(p2) Theory has also been defined as ‘an organised, coherent, and systematic articulation of a set of issues that are communicated as a meaningful whole’. 2(p633) Consider the various theories in you may have encountered. These might include scientific theories, philosophical theories, systems theories, psychological theories, conspiracy theories and many more. Each one of these theories enables the person who embodies that theory to ‘explain’ their worldview. Qualitative theories are no different, in that the theory that is adopted in qualitative research enables the researcher to organise their ideas and explain their results. Qualitative theories are usually concerned with explaining the ‘why’ of the complex social world. This is noticeable when examining the locus of control theory, which informs the research question(s), data collection and interpretation. Results from researchers who adhere to this theory are presented within this meaningful whole that revolves around having control over the outcomes of one’s life in some form.

Qualitative t heories

This chapter investigates the foundational theories that have come to be associated with qualitative research methods. In Chapter 2, paradigms and, in particular, the interpretivist/constructivist paradigm, were discussed. The interpretivist paradigm is a worldview that uses participants’ perceptions and experiences of the phenomenon that is being investigated to be analysed. It also acknowledges the researcher’s own experiences and background, in terms of how these influence their interpretations and meanings of data.

Reeves and colleagues 2 discuss how theory can be used to describe how societies work, how organisations operate and why people interact in certain ways. They state that ‘theories give researchers different ‘lenses’ through which to look at complicated problems and social issues, focusing their attention on different aspects of the data and providing a framework within which to conduct their analysis’. 2(p631) Below we describe

There are three levels of theory.

• Grand theories are broad universal and societal level theories that include many different domains and concepts. 3 There are many grand theories and many theorists. Examples include Karl Marx, Friedrich Engels, Max Weber, Emily Durkheim and Michel Foucault. Sylvia IV applied Foucault’s theory of biopolitics to analyse how governments managed populations via technology to enforce social distancing measures to prevent the spread of COVID-19. 4
• Middle-range theories are narrower in scope when compared to grand theories, have fewer concepts and are applied at a local level. 3 In healthcare improvement, two examples of middle-range theories include diffusions of innovation, 5 how an idea or product gains momentum and spreads through a system, and normalisation process theory, how a practice or program becomes embedded within a context. 3,6 McEvoy and colleagues applied normalisation process theory to analyse the ‘le vers and barriers to the implementation of community participation in primary health care in Ireland.’ 7(para10)  They conducted an instrumental case study (read more about case studies in Chapter 8) which consisted of two qualitative studies incorporating semi-structured interviews (n=44), focus groups (total number of participants across focus groups was 27) and document analysis (17 documents). 7  
• Micro-level theories are at the individual level and look at relationships and interactions. 2 Phenomenology is an example of a micro-level theory as the focus is on the individual lifeworld (see Chapter 5). For example, symbolic interactionism explores how social groups and social interactions explain larger social meanings and norms. 8 The social care article by Basic (2022) 9(p1) applies symbolic interactionism in their study which aims ‘t o identify and analyse power relations that contribute to the shaping of young people’s identities and repertoires of action via stigmatisations and social comparisons with different reference groups’ . The research demonstrates that ‘narratives about war, escaping war, and post-war life in Sweden, constructing and reconstructing an image of a series of interactive rituals that are both influenced by and influence the power dynamic between the actors’. 9(p1)

Below, three different theories are applied to a qualitative research topic to provide an example of how these different theories can inform the exploration of experiences in qualitative research.

Exploring loneliness and health status of Chinese and Anglo-Australian Manningham Seniors 10 through three different theor ies

Phenomenology A researcher using a phenomenological approach would study older persons’ perceptions of loneliness by exploring how individuals make sense of their personal and health experiences. The researcher would seek to understand, describe and interpret human behaviour and the meanings the older persons make of their experiences. The approach would be to understand what is being experienced and how it was experienced. This would be done by examining participants’ own statements in the interviews. For example, what is the experience of loneliness and the impact of that experience on an older person’s health? And, what does it mean for older persons to be lonely? The goal is to understand the meanings that the older persons attached to their experiences of loneliness and health.

Interactionism A researcher using interactionist theory would approach the study of older persons’ perceptions of loneliness and health by seeking to understand how the meanings that daily interactions produced. The goal would be to identify and explore the different interactions that contributed to the understanding of loneliness and health in older persons’ daily lives. Thus, the researcher might examine the differences between participants’ experiences (interactions) with family and with friends. Is there a difference and how is that difference manifested?

Critical theory A researcher using critical theory would approach the study of older persons’ interactions by examining power and its relationship to the older persons’ characteristics, such as cultural background or gender identity. For example, critical race theory 11 states that institutions such as health systems have laws or procedures that are inherently racist because they lead to different outcomes based on racial factors. The researcher would proceed along the specific critical theoretical lens selected to help them understand how social conceptions of race and ethnicity operate through older persons’ interactions with the health system. Is there a difference between how Chinese and Anglo-Australian seniors are treated within health systems and are these differences due to factors such as ageism or cultural background?

Many theories inform qualitative research, and those presented in this chapter are limited examples. Theories have been developed and modified over many years and have influenced each other’s changes over time. The theories mentioned in this chapter are those that you are likely to encounter in the health domain. Other important theories in the social sciences and humanities, are also used in health-related research, and include (but are not limited to) Marxism and its descendants, feminism, hermeneutics and the post-modernist family of theories.

Willis and colleagues explore theories in their paper The essential role of social theory in qualitative public health research . 8 They posit that social theory assists researchers to generalise results beyond their particular research group, and that ‘theories provide structured interpretations or models for investigating and understanding a problem’. 8(p439)   Table 1: Types of social theory 8(p439) provides excellent examples of theorists such as Marx, Durkheim, Foucault and de Beauvoir, along with their key concepts. To provide clarity around the types of social theories, we have included links below to examples of readings that use the social theory type discussed in Willis’ table.

Conflict theory – Campbell B. Social justice and sociological theory . Society . 2021:58:355-364. doi:10.1007/s12115-021-00625-4 12

Structural functionalism – Adhikari SR. Manu Smriti as the protection of female in Hindu philosophy: in the dimension of structural-functionalism . Philosophy Study . 2020;10(11):706-712. doi:10.17265/2159-5313/2020.11.005 13

Symbolic interactionism – Basic G. Symbolic interaction, power, and war: narratives of unaccompanied young refugees with war experiences in institutional care in Sweden . Societies . 2022;12(3):90. doi: 10.3390/soc12030090 9

Sociology of knowledge – Messina CB. 2022. Breaking the silence on femicide: how women challenge epistemic injustice and male violence . Br J Sociol . 2022;73(4):859-884. doi:10.1111/1468-4446.12968 15

Feminist theory – Lazarus S, Button M, Kapend R. Exploring the value of feminist theory in understanding digital crimes: gender and cybercrime types . The Howard Journal of Crime and Justice . 2022; 61(3) 381-398. doi:10.1111/hojo.12485 16

This chapter has presented examples of studies using phenomenology, interactionism and critical theory. However, there are many other theories used in qualitative research in health, including queer, intersectionality and colonialism theories. Dr Brene Brown is a grounded theory researcher (more about grounded theory in chapter 10) who writes and presents about how she engages with theory in her work. In the video entitled The anatomy of trust she talks about how her research starts from personal experience with a story about trust, then she investigates the research data she has collected for ideas about trust and engages with theory from John Gottman, who has worked on trust and betrayal. This process is described from about minutes 7–20. The entire presentation illustrates the interplay between research data and theory.

It is important to remember that qualitative research is not an absolute science and that there is no right or wrong theory or framework to guide research. Every researcher has a different worldview and a different perspective to explore; however, all research needs to be guided by a paradigm, theory and/or framework, to ensure full exploration of the experiences of participants.

• Collins CS, Stockton CM. The central role of theory in qualitative research. Int J Qual  Methods . 2018;17:1-10. doi: 10.1177/1609406918797475
• Reeves S, Albert M, Kuper A, Hodges BD. Why use theories in qualitative research? BMJ . 2008;337(7670):631-634. doi:10.1136/bmj.a949
• Davidoff F, Dixon-Woods M, Leviton L, Michie S. Demystifying theory and its use in improvement. BMJ Qual Saf . Mar 2015;24(3):228-238. doi:10.1136/bmjqs-2014-003627
• Sylvia JJI. The Biopolitics of Social Distancing. Soc Media Soc . 2020;6(3):2056305120947661. doi:10.1177/2056305120947661
• Dearing JW. Applying Diffusion of Innovation Theory to Intervention Development. Res Soc Work Pract . 2009;19(5):503-518. doi:10.1177/1049731509335569
• May CR, Cummings A, Girling M, et al. Using Normalization Process Theory in feasibility studies and process evaluations of complex healthcare interventions: a systematic review. Implement Sci . 2018;13(1):80. doi:10.1186/s13012-018-0758-1
• McEvoy R, Tierney E, MacFarlane A. ‘Participation is integral’: understanding the levers and barriers to the implementation of community participation in primary healthcare: a qualitative study using normalisation process theory. BMC Health Serv Res . 2019;19(1):515. doi:10.1186/s12913-019-4331-7
• Willis K, Daly J, Kealy M, et al. The essential role of social theory in qualitative public health research. Aust N Z J Public Health . 2007;31(5):438-443. doi:10.1111/j.1753-6405.2007.00115.x
• Basic G. Symbolic interaction, power, and war: narratives of unaccompanied young refugees with war experiences in institutional care in Sweden. Societies . 2022;12(3):90. doi: 10.3390/soc12030090
• Tsindos T. Loneliness and Health Status of Chinese and Anglo-Australian Manningham Seniors . Dissertation (PhD). Monash University; 2014.
• Ansell A. Critical race theory. In: Schaefer R, ed. Encyclopedia of Race, Ethnicity, and Society Volume 1 . SAGE Publications Inc.; 2008:344-346.
• Campbell B. Social justice and sociological theory. Society . 2021:58:355-364. doi:10.1007/s12115-021-00625-4
• Adhikari SR. Manu Smriti as the protection of female in Hindu philosophy: in the dimension of structural-functionalism. Philosophy Study . 2020;10(11):706-712. doi:10.17265/2159-5313/2020.11.005
• Messina CB. 2022. Breaking the silence on femicide: how women challenge epistemic injustice and male violence. Br J Sociol . 2022;73(4):859-884. doi:10.1111/1468-4446.12968
• Lazarus S, Button M, Kapend R. Exploring the value of feminist theory in understanding digital crimes: gender and cybercrime types. The Howard Journal of Crime and Justice . 2022; 61(3) 381-398. doi:10.1111/hojo.12485

Qualitative Research – a practical guide for health and social care researchers and practitioners Copyright © 2023 by Tess Tsindos is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License , except where otherwise noted.

What is a Qualitative Narrative Inquiry Design?

Tips for using narrative inquiry in a dissertation, summary of the elements of a qualitative narrative inquiry design, sampling and data collection, resource videos.

• SAGE Research Methods
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Narrative inquiry is relatively new among the qualitative research designs compared to qualitative case study, phenomenology, ethnography, and grounded theory. What distinguishes narrative inquiry is it beings with the biographical aspect of C. Wright Mills’ trilogy of ‘biography, history, and society’(O’Tolle, 2018). The primary purpose for a narrative inquiry study is participants provide the researcher with their life experiences through thick rich stories. Narrative inquiry was first used by Connelly and Calandinin as a research design to explore the perceptions and personal stories of teachers (Connelly & Clandinin, 1990). As the seminal authors, Connelly & Clandinin (1990), posited:

Although narrative inquiry has a long intellectual history both in and out of education, it is increasingly used in studies of educational experience. One theory in educational research holds that humans are storytelling organisms who, individually and socially, lead storied lives. Thus, the study of narrative is the study of the ways humans experience the world. This general concept is refined into the view that education and educational research is the construction and reconstruction of personal and social stories; learners, teachers, and researchers are storytellers and characters in their own and other's stories. In this paper we briefly survey forms of narrative inquiry in educational studies and outline certain criteria, methods, and writing forms, which we describe in terms of beginning the story, living the story, and selecting stories to construct and reconstruct narrative plots. 

Attribution: Reprint Policy for Educational Researcher: No written or oral permission is necessary to reproduce a tale, a figure, or an excerpt fewer that 500 words from this journal, or to make photocopies for classroom use. Copyright (1990) by the American Educational Research Association; reproduced with permission from the publisher. 

The popularity of narrative inquiry in education is increasing as a circular and pedagogical strategy that lends itself to the practical application of research (Kim, 2016). Keep in mind that by and large practical and professional benefits that arise from a narrative inquiry study revolve around exploring the lived experiences of educators, education administrators, students, and parents or guardians. According to Dunne (2003), 

Research into teaching is best served by narrative modes of inquiry since to understand the teacher’s practice (on his or her own part or on the part of an observer) is to find an illuminating story (or stories) to tell of what they have been involved with their student” (p. 367).

• Temporality – the time of the experiences and how the experiences could influence the future;
• Sociality – cultural and personal influences of the experiences; and;
• Spatiality – the environmental surroundings during the experiences and their influence on the experiences. 

From Haydon and van der Riet (2017)

• Narrative researchers collect stories from individuals retelling of their life experiences to a particular phenomenon. 
• Narrative stories may explore personal characteristics or identities of individuals and how they view themselves in a personal or larger context.
• Chronology is often important in narrative studies, as it allows participants to recall specific places, situations, or changes within their life history.

Sampling and Sample Size

• Purposive sampling is the most often used in narrative inquiry studies. Participants must meet a form of requirement that fits the purpose, problem, and objective of the study
• There is no rule for the sample size for narrative inquiry study. For a dissertation the normal sample size is between 6-10 participants. The reason for this is sampling should be terminated when no new information is forthcoming, which is a common strategy in qualitative studies known as sampling to the point of redundancy.

Data Collection (Methodology)

• Participant and researcher collaborate through the research process to ensure the story told and the story align.
• Extensive “time in the field” (can use Zoom) is spent with participant(s) to gather stories through multiple types of information including, field notes, observations, photos, artifacts, etc.
• Field Test is strongly recommended. The purpose of a field study is to have a panel of experts in the profession of the study review the research protocol and interview questions to ensure they align to the purpose statement and research questions.
• Member Checking is recommended. The trustworthiness of results is the bedrock of high-quality qualitative research. Member checking, also known as participant or respondent validation, is a technique for exploring the credibility of results. Data or results are returned to participants to check for accuracy and resonance with their experiences. Member checking is often mentioned as one in a list of validation techniques (Birt, et al., 2016).

Narrative Data Collection Essentials

• Restorying is the process of gathering stories, analyzing themes for key elements (e.g., time, place, plot, and environment) and then rewriting the stories to place them within a chronological sequence (Ollerenshaw & Creswell, 2002).
• Narrative thinking is critical in a narrative inquiry study. According to Kim (2016), the premise of narrative thinking comprises of three components, the storyteller’s narrative schema, his or her prior knowledge and experience, and cognitive strategies-yields a story that facilitates an understanding of the others and oneself in relation to others.

Instrumentation

• In qualitative research the researcher is the primary instrument.
• In-depth, semi-structured interviews are the norm. Because of the rigor that is required for a narrative inquiry study, it is recommended that two interviews with the same participant be conducted. The primary interview and a follow-up interview to address any additional questions that may arise from the interview transcriptions and/or member checking.

Birt, L., Scott, S., Cavers, D., Campbell, C., & Walter, F. (2016). Member checking: A tool to enhance trustworthiness or merely a nod to validation? Qualitative Health Research, 26 (13), 1802-1811. http://dx.doi.org./10.1177/1049732316654870

Cline, J. M. (2020). Collaborative learning for students with learning disabilities in inclusive classrooms: A qualitative narrative inquiry study (Order No. 28263106). Available from ProQuest Dissertations & Theses Global. (2503473076). 

Connelly, F. M., & Clandinin, D. J. (1990). Stories of Experience and Narrative Inquiry. Educational Researcher, 19 (5), 2–14. https://doi.org/10.1080/03323315.2018.1465839

Dunne, J. (2003). Arguing for teaching as a practice: A reply to Alasdair Macintyre. Journal of Philosophy of Education . https://doi.org/10.1111/1467-9752.00331 

Haydon, G., & der Riet, P. van. (2017). Narrative inquiry: A relational research methodology suitable to explore narratives of health and illness. Nordic Journal of Nursing Research , 37(2), 85–89. https://doi.org/10.1177/2057158516675217

Kim, J. H. (2016). Understanding Narrative Inquiry: The crafting and analysis of stories as research. Sage Publications. 

Kim J. H. (2017). Jeong-Hee Kim discusses narrative methods [Video]. SAGE Research Methods Video https://www-doi-org.proxy1.ncu.edu/10.4135/9781473985179

O’ Toole, J. (2018). Institutional storytelling and personal narratives: reflecting on the value of narrative inquiry. Institutional Educational Studies, 37 (2), 175-189. https://doi.org/10.1080/03323315.2018.1465839

Ollerenshaw, J. A., & Creswell, J. W. (2002). Narrative research: A comparison of two restorying data analysis approaches. Qualitative Inquiry, 8 (3), 329–347. 

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An Introduction to Qualitative Research

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CHAPTER 3 QUALITATIVE RESEARCH

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