Informing Client-Centred Practice through Qualitative Inquiry: Evaluating the Quality of Qualitative Research

Although qualitative research methods have only recently been included in occupational therapy curricula, they are being embraced by those researchers who recognise both their utility in exploring many of the issues that are of relevance and importance to clients and the profession and their congruence with client-centred philosophy (Hammell 2001). If qualitative research is to provide convincing evidence on which to base practice, it must be capable of withstanding critical scrutiny regarding the quality and relevance of the researcher’ s work (Kuzel and Engel 2001). Agencies that fund health-related research require guidance on how to evaluate qualitative research (Devers 1999) and practitioners need sufficient information from which to evaluate the strength and plausibility of the evidence reported, yet little explicit guidance has been provided within the occupational therapy literature to assist in this process of evaluation. Further, it has been proposed that because occupational therapists espouse a client-centred orientation to practice (College of Occupational Therapists [COT] 2000), the research base that informs practice should itself reflect a client-centred orientation, demonstrating efforts to include clients as collaborators throughout the research process (Hammell 2001). The procedure for critiquing qualitative research is not one of judging a rigid adherence to rules or specific prescriptive criteria (Hasselkus 1995) but is a process of weighing the various elements of the research in an effort to determine their appropriateness given the purpose and context of the study (Hasselkus 1991). Although qualitative research entails an inherently creative process, this cannot preclude the rigour of both research process and reporting. Whilst radical postmodernists argue that evaluative criteria reflect a form of academic oppression and a desire to impose conformity on diversity (Rosenau 1992), occupational therapy research is undertaken for the benefit of clients and with the goal of informing theory and improving practice. It is therefore incumbent upon the profession to evaluate all inquiry with attention to how dependably it might achieve these goals (Kuzel and Engel 2001). Popay and Williams (1998) outlined several ways in which qualitative research could contribute to the pursuit of evidence-based health care: probing ‘taken for granted’ practices, exploring organisational culture, evaluating complex policy initiatives, understanding client or provider behaviours and exploring client experiences and perspectives. This paper examines a framework of general guidelines with which to evaluate the quality of those forms of qualitative inquiry undertaken to explore client perspectives and experiences, advocating for research to be undertaken and reported according to principles that are Occupational therapists are increasingly embracing qualitative research methods yet little published advice exists in the occupational therapy literature to enable readers to gauge the quality and relevance of researchers’ work. If qualitative research is to provide convincing evidence with which to inform theory and practice, it must be capable of withstanding critical scrutiny and practitioners must be given sufficient information with which to evaluate the strength and plausibility of the evidence reported. The process of undertaking qualitative research and of writing and critiquing subsequent reports is not about assessing adherence to rigid rules but of ensuring the appropriateness and thoroughness of data collection, analysis and reporting, given the nature and context of the issue. The espousal of a client-centred ethic also demands consideration of research relevance and usefulness to clients and the degree of consumer involvement throughout the research process. This paper examines an evaluative framework that may be used to assess the quality of qualitative evidence as this is both researched and reported. Recourse to a set of general strategies ± used where appropriate ± will serve to enhance the quality of qualitative research and assert its potential to inform the client-centred, evidence-based practice of occupational therapy.