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The Qualitative Report 2022 Volume 27, Number 4, 1040-1057
https://doi.org/10.46743/2160-3715/2022.5249
Qualitative Data Analysis for Health Research:
A Step-by-Step Example of Phenomenological Interpretation
Sue Monaro
1, 2
, Janice Gullick
2
, and Sandra West
2
1
Department of Vascular Surgery, Concord Repatriation General Hospital, Sydney, Australia
2
Susan Wakil School of Nursing & Midwifery, Faculty of Medicine and Health,
University of Sydney, Australia
Phenomenological studies have been critiqued when analytic activities and
intersection with the underpinning philosophy lack clarity. This methodological
discussion paper describes data analysis in hermeneutic interpretive
phenomenology. Data management strategies (transcript preparation, coding,
philosophy application, tabling/concept maps, and Microsoft Word) and data
analysis processes (reduction, display, and conclusion drawing/verification) are
illustrated. Deconstruction, reconstruction, and reorganisation of
themes/subthemes using hierarchical heading styles to populate the navigation
pane and philosophical tenets acted as analytic hooks. This paper has outlined
data analysis in hermeneutic interpretive phenomenology, including the use of
MS Word and its functionality, which was supported by other data display
strategies to enhance data visualisation and verification. Techniques described
are transferrable to other qualitative methodologies.
Keywords: qualitative research, phenomenological interpretation,
hermeneutics, rigour
Aim
This paper aims to provide examples of data analysis strategies in hermeneutic
interpretive phenomenological research to inform clinical knowledge and practice. There are
few published examples of step-by-step analytical processes within the methodological
literature for interpretative phenomenology. The described examples are grounded in concepts
shared across qualitative methodologies yet are focussed on activities and assumptions
congruent with the phenomenological tradition.
Background
Clinical researchers are increasingly using qualitative research as a way to access
understanding of complex illness experiences. There is an expanding range of qualitative
methodologies with variation in their techniques, complexities, and acceptability. These
methodologies typically generate large volumes of data and researchers often struggle to
describe the granular detail of their data analysis. The process and reporting of data analysis
must be rigorous if findings are to be publishable and considered a trustworthy basis for clinical
practice/systems improvement. The overarching methodological approaches to primary
qualitative research continue to be distinguishable as either descriptive or interpretative.
Descriptive qualitative research, where the research is not necessarily grounded within
a particular philosophy or prescriptive methodology, includes both thematic analysis (e.g.,
Miles & Huberman, 1984), and qualitative content analysis (e.g., Elo & Kyngäs, 2008). While
Sue Monaro, Janice Gullick, and Sandra West 1041
it is necessary to give an account of the analytic lens used to examine the data (Caelli et al.,
2003), for example, detailing the theoretical or discipline-based assumptions about the
phenomenon of interest that may be drawn from literature (Sandelowski, 2010), the researcher
then tends to stay closer to the data (Sandelowski, 2000) using lower inference interpretation
to describe common experiences. However, even in thematic description some level of
abstraction is required to establish such themes, along with a need to describe the personal
positioning of the researcher (their personal history, presuppositions and motives) that may
influence interpretation (Jootun et al., 2009).
Interpretative qualitative research (including the theory-building methodology of
Grounded Theory) uses methodologies that harness a theory or philosophy congruent with the
research paradigm to provide a vehicle for the abstraction of data; for example, the application
of symbolic interactionism within Grounded Theory or the existential philosophies of Merleau-
Ponty (1945/1962) or Heidegger (1927/1996) within phenomenology. Given that a theoretical
or philosophical lens establishes assumptions about how a phenomenon will be explored and
influences the types of questions we ask of participants, theory and philosophy are ideally
incorporated at the outset of a study. As analytical tools, philosophy and theory can also be
used as either a deductive analytic framework (Gullick et al., 2020) or to refine and reframe
the understanding of inductively derived themes (Gullick, Monaro, & Stewart, 2016; Sheils,
Mason, & Gullick, 2019) and can even be employed retrospectively to help the researcher
explain patterns emerging from data.
The debate about phenomenological research persists to some extent because of the
frequently weak published descriptions of the analytical approach used in phenomenology and
the often-cursory attention paid to the philosophical lens claimed by authors (Gullick & West,
2019, Paley, 2005, 2018). To assist, scholars such as Benner (1994) and van Manen (2016)
have suggested steps in the interpretive phenomenological research process. Both offer
simplified structures of philosophical thought in their seminal texts; for example, Benner
(1994) republished Victoria Leonard’s 1989 “Heideggerian phenomenological perspective on
the concept of a person” to provide a simplified overview, while van Manen’s existential
domains of corporeality, spatiality, temporality, and relationality capture and simplify
important elements of existentialist thought. Benner suggests identification of a “paradigm
case” where a strong example of a certain way of being-in-the-world is identified, then used as
a comparator to other cases through a thematic analysis. These methods have the benefit of
practicality for novice researchers yet their application in nursing research is often reductionist.
Smith et al. (2009) also provide a six-step approach to the method known as IPA (Interpretive
Phenomenological Analysis), but this has been vigorously criticised in scholarly discourse,
refuting its place as an interpretative/hermeneutic method (Giorgi, 2011; Paley, 2016). One
critique is that Smith et al.’s work seeks a psychological understanding of a particular person’s
life experiences, and so differs vastly from the existential analysis that philosophically-based
interpretive phenomenology offers in understanding the fundamental nature of human
situations (van Manen, 2018).
Philosophy forms the basis for sound interpretive phenomenology and ideally, the
philosopher is chosen to align to the research problem. Heidegger (1927/1996), for example,
explores one’s embeddedness in-the-world alongside others and his temporal understanding of
the world is framed by a sense of finitude. Merleau-Ponty (1962) offers an analysis of
experience as “embodied” and so is useful to researchers of illness and injury. Gadamer (1960)
“Truth and Method,” is another frequently used framing for phenomenology with a focus on
language as a means to cocreate meaning in a fusion of horizons between the researcher and
the researched. Published descriptions of the techniques and strategies needed to conduct and
analyse interpretive phenomenology are often lacking in granular detail – perhaps because
specific strategies are frequently shaped by the particulars of a project and its data. Core
1042 The Qualitative Report 2022
concepts in phenomenological nursing research have been well illustrated (Tuohy et al., 2013).
Mackey (2005) established the importance of the philosophical and methodological
foundations on which the method is built. Others have explored the ties between the operational
elements of an interpretive phenomenological study and the philosophical tradition (Frechette
et al. 2020).
As interpretive phenomenology is widely used but difficult to learn and teach, the aim
of this methodological discussion paper is to describe one research team’s application of
interpretive phenomenology using an existential philosophical lens. Papers such as this, which
provide more detailed descriptions of analytical processes, may assist clinical researchers using
phenomenology in finding a way through the analytic maze to become more systematic and
transparent about their methods.
Method
This methodological discussion, used as a vehicle in an interpretive phenomenological
project that explored patient and family experiences of decision-making in the face of major
amputation; a complex phenomenological analysis of a large data set reported within a doctoral
thesis (Monaro, 2018). The authors have clinical backgrounds in acute care nursing. The
doctoral student and advanced practice nurse (SM) and nurse academic supervisors (SW and
JG) have expertise in the application of qualitative methods, and more specifically interpretive
phenomenology, to understand the lived experience of illness. They have a particular interest
in progressing the practical application of Heideggerian phenomenology to health research in
ways that promote both philosophical and methodological integrity.
The granular techniques developed are not the only possible approach but provide some
strategies to tackle phenomenological analysis. While the research steps within a qualitative
project should be driven by the methodology, ethical considerations and the practicalities of
generating data about a phenomenon, Miles and Huberman’s “concurrent flows of activity”
provide a useful structure for the organisation of our discussion of methods in this paper (1984,
p. 21). Their seminal text describes process domains of data reduction, data display, and
conclusion drawing/verification that can be applied across a range of qualitative methodologies
and collectively contribute to a researcher’s analytic choices. While later versions of this text
have been published (Miles et al., 2014, 2019) and expand on thematic analytic method, these
were not used pre-emptively as an analytic tool for this phenomenological study. The original
1984 version provided a simple organising structure as a vehicle for this present discussion.
An overview of these “concurrent flows of activity” applicable to all qualitative methods
provide a foundation for our later granular explanation.
Concurrent flows of activity in all qualitative research
Data reduction
Data reduction is a continuous process extending from establishing the research design
(i.e., deciding what framework to use and what research questions to ask), through to the
transformation of findings into publication. Data reduction processes include determining
which chunks of data to code through initial allocation of a label to organise data, identifying
and choosing to explore patterns between data elements, and processes of simplifying,
summarising, and focussing interrogations of the data. These multiple reductive processes
support the emerging development and critical interrogation of themes that contribute to
understanding (Miles & Huberman, 1984).
Sue Monaro, Janice Gullick, and Sandra West 1043
Data display
Data display refers to the ways in which data are organised into forms that are more
compact and accessible so the researcher can see patterns in the data and then can either draw
clear, justifiable conclusions or be guided by the data display towards further analytic steps
(Miles & Huberman, 1984). Data display, which may take the form of coding trees, mind maps
(paper-based or digital), cardboard index cards, tables, diagrams, and/or text with headings and
subheadings, is understood as a key element and indeed a cornerstone to rigorous analysis.
Qualitative research software programmes are designed to support analyses by
providing tools for data organisation and display. Software packages offer benefits (e.g., easy
filing and coding of large data sets and storage of references and memos), yet there are also
limitations for phenomenology (Goble et al., 2012). There has long been concern that when
using software, researchers may be seduced by the prioritisation of coding and conflate
achieving a fully-coded data set with completion of analysis (Bong, 2002; Goble et al., 2012).
The use of software should therefore be guided by the research questions and the chosen
theoretical/philosophical framework (Jackson & Bazely, 2019). Similarly, it should be
recognised that not all methodologies follow the same analytic patterns, which necessarily
shape researcher interaction with the data (Atherton & Elsmore, 2007). Additionally, in
interpretive qualitative methods where analytical uncertainty is a necessary stage of researcher
reflexivity, the lure of a simplified structuring of data may provide a false certainty about
interpretation.
Methodologies with highly systematic analytic processes such as Grounded Theory
may lend themselves to data management software. However, in approaches such as
interpretive phenomenology, it may de-emphasise the importance of writing and rewriting as a
priority for a developing philosophical explanation (van Manen, 2003). There is also a danger
of software fragmenting the data and increasing the risk of data elements being concealed so
that possible links with other data elements are hidden during phenomenological interpretation
(Goble et al. 2012). We argue here though, that there may be advantages to using simple data
display technologies that allow a methodical way of organising and visualising emerging ideas,
particularly for large, complex data sets.
Conclusion drawing and Verification
Conclusion drawing includes determination of early conclusions (hopefully held lightly
and sceptically) that are then either refuted or developed into increasingly explicit and
grounded understandings (Miles & Huberman, 1984). These conclusions may lead to further
reframing/sampling, changing direction in analytic thinking, or, finally, proposing a rich and
thick (Dibley, 2011) comprehensive description or interpretation of findings.
Verification may take the form of revisiting field notes/interview transcripts to check a
point made, through to lengthy review between colleagues to argue for or against elements of
the interpretation (Miles & Huberman, 1984). Member checking (where conclusions are
presented to participants to confirm the validity of findings) is a feature of some methodologies
for example, Collaizi’s descriptive phenomenology (Collaizi, 1978, p. 6), but has been
challenged as both impractical and problematic if a participant does not recognise their
individual experience in an abstracted, theorised synthesis of participant experiences (Morse,
2015). Member checking is not a feature of interpretive phenomenology, although in a
longitudinal study there is an opportunity to seek clarification or accuracy of wording within a
transcript from an individual participant or explore how a developing understanding of the
experiences of others resonates with an individual participant. This need to consider the fit of
member checking with the study’s epistemological stance is important (Birt et al., 2016), and
1044 The Qualitative Report 2022
its application to synthesised, analysed data in interpretive phenomenology is argued to be
redundant and inconsistent with, for example, Heideggerian philosophy (McConnell-Henry et
al., 2011).
Most qualitative approaches have published criteria for rigour that guide method-
specific strategies for data verification – for example, Elo et al.’s (2014) “Focus on
trustworthiness” in qualitative content analysis, or the de Witt and Ploeg (2006) framework for
rigour in interpretive phenomenological nursing research.
Analysing a hermeneutic phenomenological study: An example of an analytical process
Hermeneutics is a method and theory of interpretation of written records that can be
traced back to the writings of Aristotle. Hermeneutic interpretation was fleshed out in the early
1800s by Ast (Dilthey, 1976) as an iterative movement between the “parts” (e.g., small
segments of data, or elements relating to an individual) and the “whole” (e.g., data from across
a whole sample or elements of greater context such as one’s society and culture).
The hermeneutic phenomenological study that provides the vehicle for this paper
explored 19 cases of critical limb-threatening ischaemia (CLTI) by analysing semi-structured
interview data from 14 people with CLTI and 13 family members who were making decisions
about major amputation (Monaro, 2018; Monaro, Gullick, & West, 2019; Monaro, West, &
Gullick, 2021)). Heidegger’s (1927/1996) articulation of the “parts” and the “whole” from an
existential philosophical perspective requires application of his existentials; moving back and
forth between a person’s Being (for example, being-with-others, spatiality, temporality, being-
towards death) and what is being asked about Being (e.g., our study of an illness experience).
The use of these existential philosophical domains in providing “analytic hooks” in
phenomenology have been described in detail (Gullick & West, 2019; Gullick et al., 2020).
Due to Heidegger’s relative neglect of the body (Aho, 2010), the philosophy of
Heidegger (1927/1996) (exploring one’s being-in-the-world) was complemented by the
philosophy of Merleau-Ponty (1968) (exploring the intertwining physical and existential body),
which provided a different analytic lens to uncover the embodied disruption of CLTI (Monaro,
Gullick, & West, 2019). The developing interpretation then explored the making of decisions
about amputation in a changed body and the subsequent relationship to “Being,” situated in a
familial, relational, social, and cultural context.
We have used Miles and Huberman’s (1984) concurrent flows of activity: data
reduction, data visualisation, drawing conclusions, and verification in the following sections,
where we attempt to describe these mechanics of analysis in detail. We note that, in reality, the
steps described sometimes cross these artificial boundaries and the activities are iterative in
nature and commonly grow in complexity over the life of the study.
Reducing Data
The research problem, identified through practical experience and a critical review of
the literature, initially encompassed broader patient experiences of CLTI but directed the
inquiry towards making subsequent decisions about amputation. Decisions were made about
inclusion/exclusion criteria to guide purposive sampling of patients and their significant others
and the timing of and rationale for longitudinal interviews. An interview guide focused on these
conversational style encounters to elicit narratives that unveiled an ontological understanding
of the body with CLTI in the face of its tasks.
Data analysis commenced with reading and screening verbatim transcripts that had been
formatted for data tracking (Table 1), and immediate ideas about small parts of data were
captured by highlighting any words, phrases, and sentences of interest with handwritten notes.
Sue Monaro, Janice Gullick, and Sandra West 1045
Data were reduced by collecting text with similar initial codes and clumping these using early
category and subcategory labels. All data considered in any way relevant were coded, while
parts of the story that were unrelated to the experience and its broader context were put aside
(for example, initial ice-breaking conversations about the weather). Data were then cleaned,
with repetitions and mis-starts removed without changing the meaning/nuance of the data.
Superior exemplars were selected, duplicate quotes deleted, and a narrative style interpretation
woven through to include interpretive philosophical touchpoints. A version of the initial coded
data was retained so that a sense of “saturation” of themes could be revisited and reported.
Table 1
Data Management - *Transcript preparation
1. Verbatim transcription of digital voice file to a Microsoft Word file with transcript marked by
line numbers and participant responses designated by individual codes to link participant to
exemplar
2. Transcript checked against the digital voice file for accuracy and notation of non-verbal
communication, which was inserted in parentheses
3. Where the subject had referred to an object or concept by “it” or “thing,” the object or concept
was specified in parentheses
4. Where the subject had referred to another person as “they” or “them” or had used the person’s
name, the person was specified by inserting their relationship to the subject in parentheses
5. Gender-specific references, e.g., “her” and “she” to surgeons, changed to masculine because of
the possibility of identification of individual surgeons due to the low number of female vascular
surgeons
6. Redundant or repeated words and phrases deleted if they did not add meaning or emphasis, e.g.,
“um”, “you know,” “ah.”
Much of this early data coding was clinically oriented (reflecting the naïve
understanding of the novice clinician-researcher), and an effort was then made to use language
more relevant to the philosophical touchpoints and the patient and family experience. Van
Manen’s (1997) four domains of corporeality, temporality, relationality and spatiality were
useful as an entree to philosophical thinking. They functioned as deductive analytical “hooks,”
allowing initial inductively coded data to be more selectively organised into data blocks. The
main document containing blocks of data was separated into four Word files, one for each of
van Manen’s domains, making these sections less unwieldly to work with.
As the doctoral student became increasingly sensitised to this phenomenological
theming, Victoria Leonard's (1989) work: “A Heideggerian phenomenological perspective on
the concept of the person,” was used to assist with deeper conceptual application and language
for a novice philosophical researcher. The data was further reduced using this framework which
loosely organises substantive Heideggerian concepts.
As the researchers began to immerse themselves into the primary philosophical texts of
Merleau-Ponty and Heidegger and their understanding grew, the further reduction of the
existentially-derived data blocks (see van Manen, 2003, then Leonard, 1989) were rescreened
by reviewing words, phrases and quotes as the specificity of the philosophical lens was
increased. This allowed additional reduction into philosophically-derived foci that captured
and targeted both Merleau-Ponty’s (1945/1962, 1968) and Heidegger’s (1927/1996) important
philosophical ideas.
The work of analytic reduction therefore involved a backwards and forwards approach
that saw both a deconstruction of the texts and their situated meanings and then reconstruction
through a philosophically-derived interpretation that reflected the lived experience of the
individual against a larger, contextual historical/cultural perspective (Rescher, 1997). The list
1046 The Qualitative Report 2022
of philosophically-derived themes was continually interrogated, extended, collapsed and
intellectually challenged until they were reduced to a refined yet cohesive and interlinked set
of explanatory themes. Table 2 provides a detailed outline of these steps illustrated by examples
from the study and linking of the analysis process with de Witt and Ploeg’s (2006) criteria for
rigour. In the final phase of data reduction, we decided which findings would be included in
the thesis and which might sit outside of that dissertation for separate publication.
Table 2
Data Analysis - Interpretative processes and steps
Process
Steps and Examples from study
Stage 1: Initial data reduction of individual transcripts
A.
Coding prepared transcripts
for points of immediate
interest.
Label identified points in transcript with “sticky”/
handwritten notes.
B.
Collating early meanings
with attention to individual
contexts (conclusion
drawing & data
verification).
Separate Word file with exemplars of early inductive
meanings cut & pasted under category headings.
Exemplars labelled with participant code & line
number to ensure traceability (verification).
C.
Document early analytical
thinking (conclusion
drawing).
Writing a description of initial analytical thinking
using explanatory text to provide both context &
background for exemplars (conclusion drawing).
Stage 2: Initial application of the philosophical lens
A.
Seeking ways to organise &
visualise data categorised
under philosophical concepts
of interest (data reduction
& display).
Began constructing a table of analytical ideas from all
transcripts & aligning with Merleau-Ponty (MP) &
Heideggerian (H) concepts. Large data volume was
difficult to manage & the table approach was
discontinued.
Use of qualitative software considered but decided
against due to concern about fragmentation & loss of
visibility of the large volume of data.
B.
Organise selected data by
analytical “hooks”
(philosophically derived
foci) (data reduction &
data display).
Create a separate Word file for each the van Manen’s
(1997) four existentials as these capture important
philosophical ideas/domains of MP & H:
Corporeality, temporality, relationality, spatiality
(analytic hooks).
C.
Use the conceptual framing
of Victoria Leonard (1989)
as an entrée to Heideggerian
philosophy.
Rework data using the framework: The person as
having a world / The person as a being for whom
things have significance & value / The person as self-
interpreting / The person as embodied /The person in
time.
D.
Use of specific MP or H
philosophical lenses to
rescreen within the above
data blocks (data reduction
& verification).
Review words, phrases & quotes using an MP & H
philosophical lens – Data associated with changes to
the body were explored through MP, while the
remainder of data were explored through an H lens.
Stage 3: Emergence & extension of an analytical structure
A.
Use multiple hierarchical
levels of headings of Word
navigation pane tool to
develop a philosophically
guided sense &
The emergence of nine parts of the experience:
Creeping decay (MP), Unclear boundaries of the body
(MP), Changed boundaries of the body (MP) & space
for living (H), Being towards death (H), No choice
(H), Delay as a deficient mode of concern (H),
Sue Monaro, Janice Gullick, and Sandra West 1047
understanding of the whole
& parts of the data (see
Figure 1) (data display).
Turning point/clearing (H), Difficulty with open
conversations (H), & Being alongside (H) in a world
of amputation.
B.
Re-check of all transcripts
using new key ideas to locate
any overlooked data (data
verification).
Overlooked data assigned to part(s).
C.
Develop a written narrative
to (a) explain, expand &
refine each area identified &
(b) establish concreteness of
emerging findings (De Witt
& Ploeg 2006) (conclusion
drawing & data reduction).
(a) Word file with the navigation pane selected from
the “View” tab allowed data visualisation of themes
(headings) & sub themes (levels of subheadings) to
organise meaningful units of analysis in the findings
section.
(b) Include participant’s context (e.g., significant
other, living environment, disease trajectory) at the
start of each participant exemplar as part of the
“whole” against which an exemplar (a part) could be
examined (Figure 1).
Stage 4: Challenging analytical thinking & data organisation
A
Support the criterion of
openness (de Witt & Ploeg
2006) by using mind
mapping of areas to
challenge current thinking &
explore analytical links
between key thematic blocks
(data display).
Hand drawn mind maps and schematics make visible
the important stages of thinking & analysis (Figure 3).
Process
Steps and examples from the study
B.
Reorganise initial ordering of
data according to philosopher
etc., re-order & regroup data
to enhance linkages & allow
a more
temporally/chronologically
coherent narrative (data
reduction, conclusion
drawing). Sections may
either expand or collapse,
changing the number of
themes.
Reduced data into seven sections: The body with
CLTI, Being-towards-death, Talking about CLTI,
Making decisions about CLTI, Being alongside, The
changed body & space for living, & The chaos of
hospitalisation.
Further development of the narrative to connect the
philosophical interpretation to exemplars &
participant contexts.
C
Link related areas to form
consolidated blocks (data
reduction).
Consolidation of the experience of CLTI: including:
1. The body with CLTI & Being-towards-death.
2. Dealing with CLTI: including Talking about CLTI
& Making decisions about CLTI.
3. The experience of major amputation: including
Being alongside, The changed body & space for
living & The chaos of hospitalisation.
D.
Compare original analysis
document against refined
analysis to ensure no loss or
overlooking of key findings
during data reduction (data
verification).
Returned to original analysis document that used van
Manen’s four existential concepts & checked against
the subheadings (in navigation plan) to re-check for
any unintentionally omitted data.
Stage 5: Deeper refinement of analysis
1048 The Qualitative Report 2022
A.
Extract/separate findings
outside of current decision-
making interests (a
phenomenon of interest &
focus of research problem).
Parts extracted for possible later publication: (1)
Recovery & rehabilitation (2) Chaos of
hospitalisation.
B.
Look for negative cases &/or
outliers across themes, an
established criterion for
rigour (Benner) (data
verification).
To acknowledge the multiple truths accepted within
an interpretive paradigm & to draw links between the
contexts that underpin diverse cases.
C.
Linking of thematic parts,
i.e., extremes of diverse
findings that may exist along
a continuum (conclusion
drawing).
Linking of parts, e.g., talking about CLTI versus
retreating to silence.
D.
Reorganising & re-titling
parts (data reduction).
The final four parts related to decision-making: (1)
Embodied CLTI (2) Being towards death (3) Being-
with (4) Turning – these became separate findings
chapters in the thesis.
Stage 6: Preparing final documentation of the research for dissemination
A.
De-identification (data
display).
Linking: 1) Pseudonyms (linked patient & family
participants allocated pseudonyms paired with
matching letters to assist the reader (e.g., Mel &
Michael). Unique stories that could reveal participant
identity considered.
B.
Final rewriting & analysis
(data reduction, display &
conclusion drawing).
Simultaneously using the navigation pane to view
parts against the whole. Automatically generated table
of contents (using heading function in Word) to view
the whole.
C.
Congruence with further
criteria for rigour in
interpretive phenomenology
(de Witt & Ploeg (2006), see
Table 3)
(data verification)
Consolidated criteria for
Reporting Qualitative
research (COREQ) used to
report in thesis and other
publications (data
verification).
Activities informed by De Witt & Ploeg (2006) -
rereading to ensure a balance between the
philosophical interpretation & the participants’
voices. The interweaving of the philosophy with the
findings: Provision of verbatim quotes from the
existential philosophical texts (MP & H) supported
the interpretation. Further grounding of the
interpretation through carefully paraphrased concepts
from the philosophical texts to make the ideas
accessible to readers who are not conversant with the
dense philosophies used. This paraphrasing also
challenges the researcher to question the depth of
their understanding. Ensuring upon final reading by
the research team, that all interpretative meanings
generated resonates & is supported by exemplars.
COREQ (Tong et al., 2007) – Specific criteria within
the domains of Research team & reflexivity; Study
design; and Analysis and findings either reported or
exclusions justified with references. COREQ
Checklist appended to thesis.
D
Actualisation – looking for
further realisation of the
resonance of the study
findings (data verification).
Dissemination of findings through conferences &
research publications: feedback from conference
attendees & peer-reviewers of manuscripts compels
the researcher to re-examine & make further
Sue Monaro, Janice Gullick, and Sandra West 1049
refinements to the interpretation before publication
&/or thesis examination.
Displaying Data
Seeking ways to organise and display data categorised under philosophical concepts of
interest, we began to visualise data by constructing a table in Microsoft Word. However, due
to the volume of textual data from the study’s 42 interviews, this tabling became a difficult
format to manage and was aborted. The possibility of using qualitative software was considered
but not pursued due to concerns about fragmentation and the loss of visibility of the large
volume of data.
A Microsoft Word (.docx) document with the navigation pane selected (from the “View”
tab) allowed data visualisation of themes and subthemes (previously formatted using the
heading function in “Styles”), so they appeared in hierarchical order in the navigation pane
(Figure 1). The document contained multiple headings within hierarchical levels. For example,
heading one was a theme and heading two a subtheme. Further breakdown of the parts meant
that within some themes, there might have been subthemes down to level five or six. This data
display allowed organisation of the data through visual clumping under these early theme
headings (common ideas from raw data grouped under subheadings) that displayed on the left
of the screen as a table of hierarchical content. 198 pages of themed participant quotes resulted.
Figure 1
Microsoft Word Navigation pane: Parts versus the whole (Monaro, 2018)
This visual format of the navigation pane facilitated seamless movement across a large
document to, for example, quickly paste new data into an existing theme by simply clicking
that heading in the navigation pane. It also facilitated the easy moving of whole sections of text
to different parts of the document by dragging a subheading in the navigation plane to a new
placement. As data analysis became more sophisticated, visualising the heading structures
enabled a philosophically guided sense and understanding of the “whole” (tabulated thematic
1050 The Qualitative Report 2022
list) and “parts” of the data (see Figure 1). This visualisation revealed that a restructure of the
ideas was required to clarify the chronology and temporality of the CLTI experience. This
provided context and ensured that the reconfiguration of sections was congruent with the parts
against the whole. An early philosophical interpretation was then progressed between
researchers using the “Insert Comment” function under the “Review” tab in Word to visualise
emerging philosophical codes/rationale.
To assist the application of Leonard's (1989) summary of Heideggerian ideas, her
conceptual work as it related to this themed data set was developed as a figure (Figure 2): the
person as having a world; the person as a being for whom things have significance and value;
the person as self-interpreting; the person as embodied; and the person in time.
Figure 2
Superimposing Leonard’s (1989) “Heideggerian concepts of the person” on the experience
of CLTI ) (Monaro, 2018)
Mind mapping was employed to draw out and connect ideas, challenge thinking, and explore
analytical links between key thematic blocks (data display). These hand-drawn mind maps
made visible the important stages of thinking and analysis: Figure 3 illustrates a representation
of the temporality of disease progression. The process of mind mapping initiated thinking
which linked the text (data) to the guiding framework for philosophical sensitivity. These mind
maps were included in the methods section of the thesis.
Sue Monaro, Janice Gullick, and Sandra West 1051
Figure 3
Temporality of disease progression and making treatment decisions (Monaro, 2018)
Drawing (Tentative) Conclusions
The process of conclusion-drawing was tentative and iterative and required thorough
immersion in both the language and stories generated by the participants. Conclusion drawing
spanned the life cycle of analysis – it began during transcription and then continued with
repeated listening to recorded interviews while reading the transcripts. Such immersion
required not only data familiarity but also a philosophically-informed response to the semantics
(the meaning and intentions of participants words) and the syntax (the way words were
arranged) (Gullick et al., 2017).
The analysis document containing the organised quotes (supported by the navigation
pane) (Figure 1) was further developed by inserting initial descriptive analytic thinking using
explanatory text to provide context and background to participant exemplars. This became
richer and more nuanced as the staged theorising progressed (informed by van Manen, then
Leonard, then Merleau-Ponty and Heidegger, enabled by mind-mapping).
The process of working with the “parts” and the “whole” supported early conclusion
drawing as individual words were considered against the context of a sentence, then parts of a
participant’s interview were interpreted against the whole of their interview. As part of the
“whole” against which an exemplar (a part) could be examined, each participant’s exemplar
was preceded by relevant context (e.g., significant other, living environment, disease
trajectory). The whole of the participant’s interview was then interpreted against what was
understood about the individual’s health condition, their family, and their social world and
culture.
Each interview was also considered against the whole of the other participants’
aggregated data. Thus, the parts and the whole of the data were entered and re-entered to
interpret the person and their family's experience. Collecting data at two references points: soon
after the possibility of amputation had been raised (an interim understanding), and six months
after it had been experienced (a more comprehensive temporal understanding), also facilitated
further consideration of the “parts” and the “whole” relevant to this experience.
1052 The Qualitative Report 2022
A structure for philosophically-informed conclusion drawing emerged from this
process of moving between the parts and whole. Figure 4 illustrates this for two sections of the
analysis by showing how hermeneutic interpretation moves between the embodied disruption
of CLTI and Heidegger’s philosophical structures of Being-with; a temporal sense of being
already situated in the world, among others, with a sense of projected Being-towards (for
example, the Heideggerian concept of Being-towards-death) (Monaro et al., 2021).
Figure 4
Analysis of Dasein with CLTI and Being-towards death (adapted (Monaro et al., 2021 and
reproduced with permission).
An Application of Data Verification to Support Rigour
Processes for verification also spanned the cycle of analysis, ensuring the credibility of
the research process. The initial, pre-reflexive ideas arising out of the data through early coding
were initially generated independently by the group and consolidated by consensus. Data
exemplars that had been cut and pasted from transcripts were labelled with the participant code
and line number to ensure traceability. Pseudonyms were allocated to enhance the humanistic
tone of the text and we used pseudonyms beginning with the same letter for linked participants
(e.g., Michael and Mel) to make family connections easier to recognise.
After key concepts were themed, several iterations of document comparison occurred
to capture any overlooked data/findings during data reduction: raw transcripts against original
analysis, original analysis document against refined analysis (using the search function in
word), and analysis using Van Manen’s four existential concepts against the thematic structure
in the final navigation pane.
In a further expression of data verification, the 32-item Consolidated criteria for
Reporting Qualitative research (COREQ) reporting checklist (Tong et al. 2007) allowed
reflection on elements of rigour expected for publication. However, not all points were relevant
to phenomenological research, and these were thoughtfully rebutted.
Finally, a methods-specific framework provided the final structure to verification, as
we sought congruence with de Witt and Ploeg’s (2006) criteria for trustworthiness in
interpretive phenomenological nursing research. These criteria and their application are
detailed in Table 3.
Sue Monaro, Janice Gullick, and Sandra West 1053
Table 3
Criteria for rigour (de Witt & Ploeg, 2006)
Criteria
Demonstration
Balanced
integration
The balance between the philosophical interpretation and the participants’ voices;
further grounding of the interpretation through carefully paraphrasing concepts
from the philosophical texts to make the ideas accessible to readers who are not
conversant with the dense philosophies. This paraphrasing also challenged the
researcher to question the depth of their understanding.
Openness
Every time a research-related decision was made (e.g., data collection, changes to
the analytical process, emerging ethical issues), they were documented in an audit
trail. The developing philosophical understanding and the processes for getting
there were exhaustively described in the thesis and subsequent publications,
including the use of mind maps.
Concreteness
The data was considered in a way that was useful to practice – (the philosophical
lens did not obliterate the clinicians apriori understanding and communication of
the world of amputation). Enough context was provided to allow an informed
reading of the data by others.
Resonance
The wording of themes allowed an intuitive grasp of the embodied meaning of
something (for example, “creeping decay” to describe the impact of deteriorating
peripheral ischaemia on the fleshiness of the body).
Actualisation
We looked for further realisation of the resonance of the interpretation through
preliminary dissemination. We used feedback from conference attendees and
peer-reviewers of manuscripts which compelled us to re-examine and refine the
interpretation before final publication and/or thesis examination.
Discussion
The work of Miles and Huberman (1984) provided a useful framing for this paper and
supported the idea that there is more that unites strong qualitative approaches than divides. It
allowed us to explain the reduction of data from initial narrowing of the research interest to a
research problem and articulating the sampling strategy, through to refinement of final themes
and decisions about what and how to publish. It provided the opportunity to communicate the
value of visual aids in displaying data to share ideas and enabled an explanation of the
navigation pane as a simple but effective analytic tool for high-level analysis of a large and
complex data set. Many of our verification strategies were common to other qualitative
approaches and are described in qualitative reporting guidelines. The doctoral work that
provided the vehicle for this paper started with the intentional use of Heideggerian philosophy,
which required an eventual deep familiarity. This can be challenging for novice researchers
who are simultaneously developing an understanding of general methodological rigour. In this
case, a gradual introduction to philosophical thinking using the work of van Manen (2017) and
Leonard (1989) provided an early establishment of assumptions, philosophical sensitivity, and
a gentle immersion into these complex ideas. Growing expertise in applying Heidegger’s
(1927/1996) and Merleau-Ponty’s (1945/1962, 1968) philosophies then provided analytical
hooks on which to frame a nuanced philosophical interpretation. It is recommended that
researchers who are new to interpretive phenomenology seek supervision and support from
philosophical/methodological experts.
1054 The Qualitative Report 2022
Implications for Practice
Research into complex illness experiences using philosophically-based, interpretative
qualitative methods is challenging to novice clinical researchers. Phenomenology has specific
considerations related to the philosophical framework which underpins interpretation. Clear
and detailed articulations of such processes have been explained. Our use of Microsoft Word
and the functionalities of the navigation pane generated by hierarchical heading styles,
comments, and search functions provided techniques to manage and interpret large volumes of
complex and diverse data. Mind maps are particularly useful data visualisation devices which
increase the transparency of the analytic process. We have confirmed the value of Miles and
Huberman’s (1984) seminal text and have applied it to describe our analytical techniques and,
in so doing, have provided granular guidance to clinicians commencing research using
interpretive qualitative methodologies. Given the subjective, context-bound nature of
qualitative research (acknowledged as a strength), the importance of a clear and extensive
description of the research activities and processes of analysis is vital to help readers determine
the strength and trustworthiness of their work to inform clinical practice. Many of the
approaches described here are transferrable to a range of descriptive and interpretative
qualitative methods. Establishing the specific criteria for rigour within one’s chosen
methodology and wrestling in a supportive manner with the underpinning philosophy or theory
allows rigour to be fully realised.
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Sue Monaro, Janice Gullick, and Sandra West 1057
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Author Note
The authors, Sue Monaro (https://orcid.org/my-orcid?orcid=0000-0002-4172-4932),
Janice Gullick, and Sandra West, work in the Susan Wakil School of Nursing and Midwifery
in the Faculty of Medicine and Health at the University of Sydney, Australia. This body of
work arises from a PhD that used phenomenology to explore the patient and family experience
of chronic limb-threatening ischaemia. The research team has collaborated on other projects
and have created a community of practice for qualitative research in clinical settings.
Correspondence concerning this article should be addressed to Sue Monaro, Level 3
West Cardiovascular Ambulatory Care, Concord Repatriation General Hospital, Concord, New
South Wales, 2138, Australia. Email: sue.monaro@health.nsw.gov.au
Copyright 2022: Sue Monaro, Janice Gullick, Sandra West, and Nova Southeastern
University.
Article Citation
Monaro, S., Gullick, J., & West, S. (2022). Qualitative data analysis for health research: A
step-by-step example of phenomenological interpretation. The Qualitative Report,
27(4), 1040-1057. https://doi.org/10.46743/2160-3715/2022.5249
