Thematic Analysis: From Study Design to Write-Up (L4Rema)
Introduction to Thematic Analysis
Definition: Thematic analysis (TA) is described as an accessible, flexible, and increasingly popular method of qualitative data analysis.
Purpose: It is a method for systematically identifying, organizing, and offering insight into patterns of meaning (themes) across a data set (Braun and Clarke 2012).
Braun and Clarke (2006/2012) Approach:
Developed a standardized 6-phase framework for researchers.
Emphasized the flexibility of the approach, allowing it to be adapted to various research contexts.
Provides a useful structure for studies involving multiple researchers.
Foundational principle: "The analysis produces the answer to a question."
Constructing the Research Question
Research Problem: There must be a identified GAP in existing research and a corresponding NEED to conduct the new study.
Research Question Definition: The question should aim specifically to address the research gap to help fulfill the identified need.
Quantitative Framework (PICO): A method primarily for formulating strong quantitative research questions.
P: Population
I: Intervention
C: Control
O: Outcomes
Example Question: "(P) In school-age children (I) what is the effect of a school-based physical activity program (O) on a reduction in the incidence of childhood obesity (C) compared with no intervention?"
Qualitative Framework (PEO): Often differs from quantitative approaches by focusing on exploration.
P: Patient, Population, or Problem (The disease, condition, and demographic).
E: Exposure (Exposure to a condition, risk factor, screening, rehabilitation, or service).
O: Outcome or Themes (Experiences, attitudes, feelings, quality of life).
Example Question: "Experiences of using steam inhalation in patients with chronic sinusitis."
Mixed Methods Framework (SPIDER): Designed for qualitative and mixed-methods research.
S: Sample (The group of people being studied).
PI: Phenomenon of Interest (Topic of the research, such as an intervention).
D: Design (Techniques used for data gathering: focus groups, interviews, observations).
E: Evaluation (The outcome of the study).
R: Research Type (Qualitative methodology: Phenomenology, Ethnography, Grounded Theory, Case Study).
Example Question: "What are the barriers experienced by clinicians that lead to the reluctance to recommend CBT in practice? A qualitative interview study."
Sampling and Qualitative Methodology
Sampling Techniques:
Purposive Sampling: Selecting participants based on specific required characteristics (e.g., women, over age 40, registered at a specific GP practice, with no history of CVD).
Convenience Sampling: Selecting participants based on accessibility and availability (e.g., students current present in a lecture).
Data Collection Methods: Interviews, focus groups, etc.
Interview Guide: Quality data requires a strong guide consisting of open-ended questions.
Structure of Interview Questions:
Question 1: Should be open and easy to answer to get the participant talking (e.g., "Can you tell me how you first realised you may be diagnosed with…?").
All questions should include prompts to encourage deeper responses.
Final Question: Always ask if there is anything else the participant wishes to add.
The 6 Phases of Thematic Analysis (Braun and Clarke)
Inductive vs. Deductive: TA is typically inductive (themes are generated directly from the data). Deductive analysis involves testing an existing theory, which is not the standard application for TA.
Phase 1: Familiarizing Yourself With the Data
Goal: Immerse yourself in the data.
Activities: Reading and re-reading transcripts, listening to audio recordings, watching videos of interviews/focus groups, and taking initial notes.
Phase 2: Generating Initial Codes
Definition: The systematic analysis of data through coding.
Every "meaningful" section of text is assigned a code.
Crucial Rule: Not every piece of text needs to be coded. If it does not relate to the research question, it is ignored.
Phrases used for codes can be refined (e.g., changing "Happy" to "Happiness at diagnosis").
Example: For the text "New colleagues… might be needing to look at it more," an initial code might be "New staff."
Phase 3: Searching for Themes
Goal: Shift from individual codes to broader themes.
A theme captures something important about the data relative to the research question.
Codes are grouped into meaningful clusters; occasionally, one code may become an overarching theme.
Example Structure:
Theme: Usefulness of prompts.
Subthemes: Useful for inexperienced practitioners; Support for decision; A reminder tool.
Phase 4: Reviewing Potential Themes
Goal: Themes are reviewed against the coded data and the entire data set.
Researchers ask:
Is there another way codes could be grouped?
Do themes adequately answer the research question?
Are the quotes representative of each code/theme?
Example: Mapping "Friendly staff" under the theme "Satisfaction with clinic."
Phase 5: Defining and Naming Themes
Goal: Clearly state what is unique and specific about each theme.
Criteria for Good Themes:
Singular focus (they do not try to do too much).
Related but non-overlapping (no repetition).
Directly address the research question.
Example: A subtheme titled "Assistance in persuading patients" describes how GPs use prompts to help explain to patients why antibiotics may not be necessary.
Phase 6: Producing the Report
Goal: Create a journal article or dissertation that Tells a "compelling story."
Order matters: Themes should connect logically. Researchers should rearrange themes to ensure a meaningful flow.
Example Revision: Changing the order from "Use of therapy -> Experiences of trauma -> Receiving diagnosis" to "Experiences of trauma -> Receiving diagnosis -> Use of therapy."
Writing up a Qualitative Research Paper
Introduction:
Identify the research problem and the specific need/gap.
State the research question clearly.
Methods:
Participants: Provide exhaustive detail.
Procedure: Explain the sampling technique and why it was chosen.
Materials: Describe tools like the interview guide and its development.
Analysis: Detail the stages used (e.g., citing Braun and Clarke).
Results:
Present an overview of themes and subthemes.
Provide descriptions for each theme and support them with verbatim quotes.
Note: Do not discuss implications or refer to previous evidence in this section.
Discussion:
Summarize key findings and relate them to the research question.
Highlight the most important and prevalent themes.
Compare findings to previous literature, discuss implications, note limitations, and reach a conclusion.
Worked Example: McDermott et al. (2010)
Study Title: "Developing a computer delivered, theory based intervention for guideline implementation in general practice."
Research Problem:
Need: GPs are not adhering to guidelines for Respiratory Tract Infections (RTI) and stroke prevention.
Gap: Electronic prompts can help, but they have varying success and the use of behavior change theory in their design is a missing element.
Methods:
33 face-to-face interviews with GPs in South England and London.
Prompts were presented to GPs during semi-structured interviews.
Overarching Question: "What factors may be involved in GPs' decision to use electronic prompts for RTI and stroke prevention guidelines during a consultation?"
Key Themes Identified:
Perceptions of role of prompts: GPs rejected "enforcement" but accepted "choice/control."
Patient outcomes: Assistance in persuading patients.
Prescriber differences: Usefulness for inexperienced staff.
Accessibility: Usability and information presentation.
Acceptability: Credibility of sources.
Conclusion: Acceptability of computer-delivered prompts is higher when practitioners view them as valuable tools that support rather than mandate their practice.