Data collection methods
Data | Data collection method | Time period covered | Comments |
---|---|---|---|
6 interviews | Semi-structured interviews | 2008–2019 | |
2 project time plans | Archival data from pilot project time plans | 2009–2012 | Details regarding pilot projects and implementation plans |
9 project reports | Archival data with reports issued during the project | 2008–2019 | Reports continuously issued over 2008–2019 |
3 Annual reports | Publicly available annual reports from 2010 to 2012 | 2010–2012 | Financial measures and comments from top management |
10 planning and follow-up meetings | Archival data with presentations, agendas, and decision protocols | 2008–2013 | Details regarding logistics strategy content, pilot projects and implementation plans |
7 instructional documents | Archival data with instructions for site managers, purchasing, delivery planners etc. | 2010–2013 | Descriptions of logistics processes aimed at different organizational members |
2 pilot project kick-off/start up meetings | Researcher observation and notetaking | 2011–2014 | Observational participation during full day meetings with representation from all main participants for pilot project 2 and 3, respectively |
3 site visits | Researcher observation, unstructured interviews and notetaking | 2010–2016 | Planned site visits at pilot project 1, 2 and 3, respectively. Unstructured interviews with site managers, foremen, project participants and site personnel. Walk around at site and full day observation of site activities |
3 student theses | Master thesis projects/reports covering pilot project 1, 2 and 3, respectively | 2010–2015 | Containing information on pilot project 1, 2 and 3, with thesis 3 covering the full-scale implementation of the final logistics strategy outlined in the main project report in 2013 |
Influencing factors on the logistics strategy process outcomes
Identified logistics strategy components | Expected outcomes | Realized outcome | Identified constraints towards strategy implementation (data source within parentheses: D = documentation, LM = logistics manager, PM = project manager, LD = logistics Developer) |
---|---|---|---|
Centralized logistics | Centralized development of logistics operations platform | Existed between 2016 and 2019 | New purchasing manager left (started in 2016) (LM), Top management did not understand the strategy (PM), Logistics was part of the purchasing organization (D, LM, PM, LD) |
Regional planning units | Aggregation of materials and distribution planning (MTS materials) | Not realized | Top management did not understand the strategy (PM), Regional managers were not committed to change current way of working (LM) |
ERP-system | Connecting central/regional and project planning levels | Not realized | Central organization was reluctant to carry initial investment costs (LM, PM), Top management did not understand the strategy (PM) |
Distribution terminals | Inventory buffers of MTS materials in each region to increase flexibility, minimize number of deliveries, achieve economies of scale | Not realized | Site managers only experienced the incurred cost of distribution terminals (PM), Central organization was reluctant to carry initial investment costs (LM, PM) |
Design and engineering | Routines to improve planning, supplier selection and accuracy of information | Not realized | Top management did not understand the strategy (PM), Low degree of standardization in design and engineering solutions (D, LM) |
Site logistics | Site disposition plan, roles and responsibilities, delivery planning, goods reception | Not realized | Material handling on site was not considered logistics (PM), Purchasers were not aware of material flow problems on site (LM, PM) |
Marking and labelling of goods | Ensure correct and informative packaging labels | Not realized | Site managers only experienced the purchasing cost but not the savings of labelling goods (PM), Lack of scale perceived by suppliers (PM) |
Delivery planning and transports | Increased control of delivery times and reduce disturbances on production activities | Not realized | Logistics was part of the purchasing organization (D, LM, PM), transport costs were not visible to project purchasers (included in purchasing costs) (D, LM) |
Supplier development policies | Continuous improvements to supply logistics | Not realized | Insufficient logistics capabilities within purchasing organization (D, LM, PM), Long-term supply agreements were not used by project purchasers (PM), Purchasing organization's incentives drove focus on purchasing costs over total costs (D, LM, PM), Logistics was part of the purchasing organization (D, LM, PM) |
Implications for logistics strategy fit
Contextual factors and logistics strategy components | Description | Literature findings | Case study findings | ||
---|---|---|---|---|---|
Implications for fit | Key references | Realized outcome | Implications for fit | ||
Demand characteristics | Number, size, knowledge, behaviour and heterogeneity among clients | Determines suitable degree of product standardization and pre-engineering through competitive priorities | (2022), . (2015) | Remained unchanged. Projects were of local character with a high heterogeneity among clients | Products and productions system were adaptable to each client's requirements and the company mainly competes with smaller local actors |
Degree of pre-engineering | No. product variants, BOM structure complexity (depth and breadth), and amount of engineering work performed prior to customer order impacting production and supply variability | IP requirements are generated from the late design changes | . (2019), (2022), , , | Low use of standardized products and pre-engineered components. BOM structure changes from project to project | High level of IP requirements due to low amount of information possessed prior to task execution (DTO: low degree of pre-engineering) |
Production system | Degree of off-site assembly (CM&SA, PF&SA, PF&PA or MB) impacting production and supply variability | IP requirements are generated from production variability (process time and flow variability) | (2022), . (2019), , , | Mainly CM&SA production systems with high levels of production variability in projects | High level of IP requirements due to due to low amount of information possessed prior to task execution (high level of production variability) |
Organizational structure | Determines level of IP capacity of logistics organization during task performance | , , , . (1995), | High level of IP capacity generated from decentralized organizational structure. IP requirements reduced due to reduced division of labour | ||
Supply chain structure | Number of suppliers and supplier relationships impacting delivery reliability and quality | IP requirements are generated from supply variability | , , | Mainly arms-length relationships with local suppliers of building materials. Direct deliveries to construction sites from materials suppliers | High level of IP requirements generated from short-term, market-based supplier relationships. Direct deliveries from many suppliers to construction sites |
Administrative processes | Formalized procedures for information processing, coordination and control activities, e.g.: demand management, inventory and order management, order processing, distribution and transportation planning | Determines level of IP requirements generated from level of formalization | Formalized logistics processes were never implemented, and logistics tasks were handled in a problem-solving manner. Administrative processes were seldom considered by site management | High level of IP requirements due to low amount of information possessed prior to task execution (lack of administrative routines and information system) | |
Operational processes | Formalized procedures for physical activities, e.g.: on-site material handling, transportation, warehouse operations | Determines level of IP requirements generated from level of formalization | Formalized logistics processes were never implemented, and logistics tasks were handled in a problem-solving manner. Construction workers and supervisor typically carried out goods reception and material handling | High level of IP requirements due to low amount of information possessed prior to task execution (absence of established material handling and goods reception procedures) |
Aben , T.A. , Van Der Valk , W. , Roehrich , J.K. and Selviaridis , K. ( 2021 ), “ Managing information asymmetry in public–private relationships undergoing a digital transformation: the role of contractual and relational governance ”, International Journal of Operations and Production Management , Vol. 41 No. 7 , pp. 1145 - 1191 .
Bankvall , L. , Bygballe , L.E. , Dubois , A. and Jahre , M. ( 2010 ), “ Interdependence in supply chains and projects in construction ”, Supply Chain Management , Vol. 15 , pp. 385 - 393 .
Bildsten , L. ( 2014 ), “ Buyer-supplier relationships in industrialized building ”, Construction Management and Economics , Vol. 32 , pp. 146 - 159 .
Bowen , G.A. ( 2009 ), “ Document analysis as a qualitative research method ”, Qualitative Research Journal , Vol. 9 No. 2 , pp. 27 - 40 .
Busse , C. , Meinlschmidt , J. and Foerstl , K. ( 2017 ), “ Managing information processing needs in global supply chains: a prerequisite to sustainable supply chain management ”, Journal of Supply Chain Management , Vol. 53 , pp. 87 - 113 .
Cannas , V.G. , Gosling , J. , Pero , M. and Rossi , T. ( 2019 ), “ Engineering and production decoupling configurations: an empirical study in the machinery industry ”, International Journal of Production Economics , Vol. 216 , pp. 173 - 189 .
Chandler , J.A.D. ( 1962 ), Strategy and Structure: Chapters in the History of the American Industrial Enterprise , MIT Press , Cambridge, MA .
Child , J. ( 1972 ), “ Organizational structure, environment and performance: the role of strategic choice ”, Sociology , Vol. 6 , pp. 1 - 22 .
Chow , G. , Heaver , T.D. and Henriksson , L.E. ( 1995 ), “ Strategy, structure and performance: a framework for logistics research ”, Logistics and Transportation Review , Vol. 31 , p. 285 .
Christopher , M. ( 1986 ), “ Implementing logistics strategy ”, International Journal of Physical Distribution and Materials Management , Vol. 16 , pp. 52 - 62 .
Danese , P. , Molinaro , M. and Romano , P. ( 2020 ), “ Investigating fit in supply chain integration: a systematic literature review on context, practices, performance links ”, Journal of Purchasing and Supply Management , Vol. 26 , 100634 .
Doering , T. , Suresh , N.C. and Krumwiede , D. ( 2019 ), “ Measuring the effects of time: repeated cross-sectional research in operations and supply chain management ”, Supply Chain Management: An International Journal , Vol. 25 No. 1 , pp. 122 - 138 .
Donaldson , L. ( 1987 ), “ Strategy and structural adjustment to regain fit and performance: in defence of contingency theory ”, Journal of Management Studies , Vol. 24 , pp. 1 - 24 .
Dubois , A. and Gadde , L.-E. ( 2002 ), “ The construction industry as a loosely coupled system: implications for productivity and innovation ”, Construction Management and Economics , Vol. 20 , pp. 621 - 631 .
Dubois , A. , Hulthén , K. and Sundquist , V. ( 2019 ), “ Organising logistics and transport activities in construction ”, The International Journal of Logistics Management , Vol. 30 , pp. 320 - 340 .
Eisenhardt , K.M. ( 1989 ), “ Building theories from case study research ”, Academy of Management Review , Vol. 14 , pp. 532 - 550 .
Elfving , J.A. ( 2021 ), “ A decade of lessons learned: deployment of lean at a large general contractor ”, Construction Management and Economics , Vol. 40 , pp. 548 - 561 .
Farjoun , M. and Fiss , P.C. ( 2022 ), “ Thriving on contradiction: toward a dialectical alternative to fit-based models in strategy (and beyond) ”, Strategic Management Journal , Vol. 43 , pp. 340 - 369 .
Feizabadi , J. , Gligor , D. and Alibakhshi , S. ( 2021 ), “ Strategic supply chains: a configurational perspective ”, The International Journal of Logistics Management , Vol. 32 , pp. 1093 - 1123 .
Flick , U. ( 2018 ), An Introduction to Qualitative Research , Sage , London .
Flynn , B.B. and Flynn , E.J. ( 1999 ), “ Information‐processing alternatives for coping with manufacturing environment complexity ”, Decision Sciences , Vol. 30 , pp. 1021 - 1052 .
Flyvbjerg , B. ( 2006 ), “ Five misunderstandings about case-study research ”, Qualitative Inquiry , Vol. 12 , pp. 219 - 245 .
Galbraith , J.R. ( 1974 ), “ Organization design: an information processing view ”, Interfaces , Vol. 4 , pp. 28 - 36 .
Galunic , D.C. and Eisenhardt , K.M. ( 1994 ), “ Renewing the strategy-structure-performance paradigm ”, Research in Organizational Behavior , Vol. 16 , p. 215 .
Gligor , D. ( 2017 ), “ Re‐examining supply chain fit: an assessment of moderating factors ”, Journal of Business Logistics , Vol. 38 , pp. 253 - 265 .
Hallavo , V. ( 2015 ), “ Superior performance through supply chain fit: a synthesis ”, Supply Chain Management: An International Journal , Vol. 20 No. 1 , pp. 71 - 82 .
Howard , M. , Lewis , M. , Miemczyk , J. and Brandon‐Jones , A. ( 2007 ), “ Implementing supply practice at Bridgend engine plant: the influence of institutional and strategic choice perspectives ”, International Journal of Operations and Production Management , Vol. 27 , pp. 754 - 776 .
Janné , M. and Fredriksson , A. ( 2022 ), “ Construction logistics in urban development projects–learning from, or repeating, past mistakes of city logistics? ”, The International Journal of Logistics Management , Vol. 33 , pp. 49 - 68 .
Janné , M. and Rudberg , M. ( 2022 ), “ Effects of employing third-party logistics arrangements in construction projects ”, Production Planning and Control , Vol. 33 , pp. 71 - 83 .
Jonsson , H. and Rudberg , M. ( 2015 ), “ Production system classification matrix: matching product standardization and production-system design ”, Journal of Construction Engineering and Management , Vol. 141 , 05015004 .
Ketokivi , M. and Choi , T. ( 2014 ), “ Renaissance of case research as a scientific method ”, Journal of Operations Management , Vol. 32 , pp. 232 - 240 .
Klaas , T. and Delfmann , W. ( 2005 ), “ Notes on the study of configurations in logistics research and supply chain design ”, Supply Chain Management: European Perspectives , Vol. 11 , pp. 12 - 36 .
Koskela , L. and Ballard , G. ( 2012 ), “ Is production outside management? ”, Building Research and Information , Vol. 40 , pp. 724 - 737 .
Langley , A. ( 1999 ), “ Strategies for theorizing from process data ”, Academy of Management Review , Vol. 24 , pp. 691 - 710 .
Luo , B.N. and Donaldson , L. ( 2013 ), “ Misfits in organization design: information processing as a compensatory mechanism ”, Journal of Organization Design , Vol. 2 , pp. 2 - 10 .
Luo , B.N. and Yu , K. ( 2016 ), “ Fits and misfits of supply chain flexibility to environmental uncertainty: two types of asymmetric effects on performance ”, The International Journal of Logistics Management , Vol. 27 No. 3 , pp. 862 - 885 .
Marchesini , M.M.P. and Alcântara , R.L.C. ( 2016 ), “ Logistics activities in supply chain business process: a conceptual framework to guide their implementation ”, The International Journal of Logistics Management , Vol. 27 , pp. 6 - 30 .
Maylor , H. , Turner , N. and Murray-Webster , R. ( 2015 ), “ It worked for manufacturing…!”: operations strategy in project-based operations ”, International Journal of Project Management , Vol. 33 , pp. 103 - 115 .
Meyer , A.D. , Tsui , A.S. and Hinings , C.R. ( 1993 ), “ Configurational approaches to organizational analysis ”, Academy of Management Journal , Vol. 36 , pp. 1175 - 1195 .
Miles , R.E. , Snow , C.C. , Meyer , A.D. and Coleman , H.J. Jr. ( 1978 ), “ Organizational strategy, structure, and process ”, Academy of Management Review , Vol. 3 , pp. 546 - 562 .
Mintzberg , H. ( 1979 ), The Structure of Organizations: A Synthesis of the Research , Prentice-Hall , Eaglewoods Cliff, New Jersey .
Mirzaei , N.E. , Fredriksson , A. and Winroth , M. ( 2016 ), “ Strategic consensus on manufacturing strategy content: including the operators' perceptions ”, International Journal of Operations and Production Management , Vol. 36 , pp. 429 - 466 .
Miterev , M. , Mancini , M. and Turner , R. ( 2017 ), “ Towards a design for the project-based organization ”, International Journal of Project Management , Vol. 35 , pp. 479 - 491 .
Montanari , J.R. ( 1978 ), “ Managerial discretion: an expanded model of organization choice ”, Academy of Management Review , Vol. 3 , pp. 231 - 241 .
Nakano , M. ( 2015 ), “ Exploratory analysis on the relationship between strategy and structure/processes in supply chains: using the strategy-structure-processes-performance paradigm ”, The International Journal of Logistics Management , Vol. 26 , pp. 381 - 400 .
Pfohl , H.C. and Zöllner , W. ( 1997 ), “ Organization for logistics: the contingency approach ”, International Journal of Physical Distribution and Logistics Management , Vol. 27 , pp. 306 - 320 .
Ruffini , F.A. , Boer , H. and Van Riemsdijk , M.J. ( 2000 ), “ Organisation design in operations management ”, International Journal of Operations and Production Management , Vol. 20 , pp. 860 - 879 .
Sabri , Y. ( 2019 ), “ In pursuit of supply chain fit ”, The International Journal of Logistics Management , Vol. 30 , pp. 821 - 844 .
Sandberg , E. ( 2017 ), “ Introducing the paradox theory in logistics and SCM research–examples from a global sourcing context ”, International Journal of Logistics Research and Applications , Vol. 20 , pp. 459 - 474 .
Sezer , A.A. and Fredriksson , A. ( 2021 ), “ Paving the path towards efficient construction logistics by revealing the current practice and issues ”, Logistics , Vol. 5 , p. 53 .
Shurrab , H. , Jonsson , P. and Johansson , M.I. ( 2022 ), “ A tactical demand-supply planning framework to manage complexity in engineer-to-order environments: insights from an in-depth case study ”, Production Planning and Control , Vol. 33 No. 5 , pp. 462 - 479 .
Siggelkow , N. ( 2002 ), “ Evolution toward fit ”, Administrative Science Quarterly , Vol. 47 , pp. 125 - 159 .
Silvestre , B.S. , Silva , M.E. , Cormack , A. and Thome , A.M.T. ( 2020 ), “ Supply chain sustainability trajectories: learning through sustainability initiatives ”, International Journal of Operations and Production Management , Vol. 40 No. 9 , pp. 1301 - 1337 .
Sousa , R. and Voss , C.A. ( 2008 ), “ Contingency research in operations management practices ”, Journal of Operations Management , Vol. 26 , pp. 697 - 713 .
Thunberg , M. and Fredriksson , A. ( 2018 ), “ Bringing planning back into the picture–How can supply chain planning aid in dealing with supply chain-related problems in construction? ”, Construction Management and Economics , Vol. 36 , pp. 425 - 442 .
Thunberg , M. , Rudberg , M. and Karrbom Gustavsson , T. ( 2017 ), “ Categorising on-site problems: a supply chain management perspective on construction projects ”, Construction Innovation , Vol. 17 , pp. 90 - 111 .
Turkulainen , V. ( 2022 ), “ Contingency theory and the information processing view ”, in Handbook of Theories for Purchasing, Supply Chain and Management Research , Edward Elgar Publishing , pp. 248 - 266 .
Van De Ven , A.H. ( 1992 ), “ Suggestions for studying strategy process: a research note ”, Strategic Management Journal , Vol. 13 , pp. 169 - 188 .
Van De Ven , A.H. , Ganco , M. and Hinings , C.R. ( 2013 ), “ Returning to the Frontier of contingency theory of organizational and institutional designs ”, Academy of Management Annals , Vol. 7 , pp. 393 - 440 .
Venkatraman , N. and Camillus , J.C. ( 1984 ), “ Exploring the concept of ‘fit’ in strategic management ”, Academy of Management Review , Vol. 9 , pp. 513 - 525 .
Voordijk , H. , Meijboom , B. and De Haan , J. ( 2006 ), “ Modularity in supply chains: a multiple case study in the construction industry ”, International Journal of Operations and Production Management , Vol. 26 , pp. 600 - 618 .
Voss , C. , Tsikriktsis , N. and Frohlich , M. ( 2002 ), “ Case research in operations management ”, International Journal of Operations and Production Management , Vol. 22 , pp. 195 - 219 .
Wikner , J. and Rudberg , M. ( 2005 ), “ Integrating production and engineering perspectives on the customer order decoupling point ”, International Journal of Operations and Production Management , Vol. 25 , pp. 623 - 641 .
Yin , R.K. ( 2018 ), Case Study Research: Design and Methods , 6 ed. , SAGE , Thousand Oaks, California .
Zajac , E.J. , Kraatz , M.S. and Bresser , R.K. ( 2000 ), “ Modeling the dynamics of strategic fit: a normative approach to strategic change ”, Strategic Management Journal , Vol. 21 , pp. 429 - 453 .
This research was supported by The Development Fund of the Swedish Construction Industry (SBUF), under grant 13843, and The Lars Erik Lundberg Foundation for Research and Education. The authors would like to thank the case company and the key informants, for sharing data, experience and documents on the case study. We also appreciate the constructive feedback we got from the anonymous reviewers and the editor. Their comments greatly improved the manuscript.
Related articles, all feedback is valuable.
Please share your general feedback
Contact Customer Support
An official website of the United States government
The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.
The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.
Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .
Lynn calman.
1 University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK
Alex molassiotis.
2 Hong Kong Polytechnic University, Hung Hom, Hong Kong
Longitudinal qualitative methods are becoming increasingly used in the health service research, but the method and challenges particular to health care settings are not well described in the literature.We reflect on the strategies used in a longitudinal qualitative study to explore the experience of symptoms in cancer patients and their carers, following participants from diagnosis for twelve months; we highlight ethical, practical, theoretical and methodological issues that need to be considered and addressed from the outset of a longitudinal qualitative study.
Key considerations in undertaking longitudinal qualitative projects in health research, include the use of theory, utilizing multiple methods of analysis and giving consideration to the practical and ethical issues at an early stage. These can include issues of time and timing; data collection processes; changing the topic guide over time; recruitment considerations; retention of staff; issues around confidentiality; effects of project on staff and patients, and analyzing data within and across time.
As longitudinal qualitative methods are becoming increasingly used in health services research, the methodological and practical challenges particular to health care settings need more robust approaches and conceptual improvement. We provide recommendations for the use of such designs. We have a particular focus on cancer patients, so this paper will have particular relevance for researchers interested in chronic and life limiting conditions.
Longitudinal qualitative research (LQR) has been an emerging methodology over the last decade with methodological discussion and debate taking place within social research [ 1 ]. Longitudinal qualitative research is distinguished from other qualitative approaches by the way in which time is designed into the research process, making change a key focus for analysis [ 1 ]. LQR answers qualitative questions about the lived experience of change, or sometimes stability, over time. Findings can establish the processes by which this experience is created and illuminates the causes and consequences of change. Qualitative research is about why and how health care is experienced and LQR focuses on how and why these experiences change over time. In contrast to longitudinal quantitative methodologies LQR focuses on individual narratives and trajectories and can capture critical moments and processes involved in change. LQR is also particularly helpful in capturing “transitions” in care; for example, while researchers are beginning to more clearly map the cancer journey or pathway [ 2 ] we less clearly understand the processes involved in the experience of transition along this pathway whether that be to long term survivor or living with active or advanced disease. Saldana [ 3 ] identifies the principles that underpin LQR as duration, time and change and emphasizes that time and change are contextual and may transform during the course of a study.
Holland [ 4 ] identifies four methodological models of LQR.
• Mixed methods approaches. LQR may be imbedded within case studies, ethnographies and within quantitative longitudinal studies such as cohort studies and randomized controlled trials. Mixed methods studies are the context of most LQR studies in healthcare [ 5 ].
• Planned prospective longitudinal studies. Where the analysis can be the individual or the family or an organization.
• Follow-up studies, where an original study of participants are followed up after a period of time.
• Evaluation studies, for policy evaluation.
LQR methodologies can be particularly useful in assessing interventions. LQR studies embedded within randomized controlled trials or evaluation studies, of often complex interventions, are used as part of process evaluation. This can help us to understand not just whether an intervention may work but the mechanisms through which it works and if it is feasible and acceptable to the population under study [ 6 ].
LQR is becoming more frequently used in health research. LQR has been used, for example, to explore the prospect of dying [ 7 ], journeys to the diagnosis of cancer [ 8 ] and living with haemodialysis [ 9 ]. Published papers report mainly interview based studies, sometimes called serial interviews [ 10 , 11 ] to explore change over time, although other data collection methods are used. Different approaches have been taken to collection and analysis of data, for example, the use of longitudinal data to fully develop theoretical saturation of a category in a grounded theory study [ 12 , 13 ]. Data is not presented as a longitudinal narrative but as contributing to the properties of a category.
There are limitations in the published literature. Analysis is complex and multidimensional and can be tackled both cross-sectionally at each time point to allow analysis between individuals at the same time as well as longitudinally capturing each individual’s narrative. Thematic analysis is widely used [ 13 - 15 ] but can lead to cross-sectional descriptive accounts (what is happening at this time point) rather than focusing on causes and consequences of change. Research founded on explicit theoretical perspectives can move beyond descriptive analysis to further explore the complexities of experience over time [ 16 ]. LQR generates a rich source of data which has been used successfully for secondary analysis of data [ 11 , 17 ].
How analysis with this multidimensional data can be integrated is a particular challenge and is not well described or reported in the literature [ 4 ]. Papers tend to focus on either the cross-sectional or longitudinal (narrative) data. This means that the longitudinal aspects of the study, time and change, are often poorly captured. In particular the reporting of cross-sectional data alone can lead to descriptions of each time point rather than focusing on the changes between time points. Studies may have the explicit aim to focus on one or other aspect of analysis and this will achieve different analysis and reporting. The addition of a theoretical framework can help to guide researchers during analysis to move beyond description.
The purpose of this paper is to reflect on the strategies used in an LQR programme and highlight ethical, practical, theoretical and methodological issues that need to be considered and addressed from the outset of a study, giving researchers in the field some direction and raising the debate and discussion among researchers on ways to develop and carry out LQR projects.
We have carried out over the past six years a large LQR programme of research about experiences of symptoms in cancer patients [ 18 - 25 ]. This included interviews with patients from eight cancer diagnostic groups (and their caregivers) from diagnosis to three, six and 12 months later. As researchers working for the first time with longitudinal qualitative data we developed our research design and analysis strategy iteratively throughout the project. We have a particular focus on cancer patients, so this paper will have particular relevance for researchers interested in chronic and life limiting conditions.
As we were completing the analysis and dissemination of this large programme of research we wished to reflect on our experience of a health services research LQR project. As members of the core research team we felt that we had developed a great deal of experience in the development and management of such a project. We felt that if we pooled our knowledge we could suggest some important lessons learned from our experience. The authors met at regular intervals to identify the key aspects of the researchers’ experience of conducting this LQR project that we considered were not well addressed within the current literature. Issues were identified through brainstorming sessions among the investigators and consideration of past formal discussions (recorded or not) during the project duration. A final complete list was presented and discussed in an open meeting with a group of qualitative researchers from a supportive care research team and further discussions took place. Common issues that are relevant to any qualitative research and for which there is significant literature where left out, and only issues that were closely linked with LQR remained in the list for further discussion. Alongide our experience and consultation with experienced qualitative researchers, we have also searched the literature to find out if there is any clear information on each issues/topic. Recommendations, thus, were both experience-based and literature based, although due to lack of or limited literature around some of the issues discussed, experience-based recommendations were more common. This paper was developed to give examples of how specific ethical and practical issues in the project were tackled so they might stimulate debate and discussion amongst LQR researchers.
We present the results of our discussions and suggested solutions below and these are summarized in Table Table1 1 .
Summary of themes and suggested solutions
Ethical issues: participant | Recruitment shortly after significant diagnosis | Treating doctor assessed participant prior to approach by researcher. |
Approached participants sensitively in order to build trust and develop relationships over long term | ||
Blurring of boundaries as relationships develop | Agreed plans to manage participant initiated contact about e.g. their treatment or health status (researchers did not give advice but referred participant to relevant health professional) | |
Potential for patients to become unwell or die during study | Written distress policy for participants and the research team in place | |
Ongoing consent recorded over the life of the project | ||
Ethical issues: researcher | Developing relationships over time | Prepared researchers to manage difficult topics and emotions during the interview, and how management might change as relationships deepen |
Closure of relationships | ||
Developed a supportive network for researchers (e.g. debriefing sessions post interview) | ||
Confidentiality – and sharing data over large research teams | Written procedures for managing ad-hoc or informal contacts with participants. | |
Developed clear data transfer and management plans | ||
Management of participant fatigue in interviews | Ensure as the interview schedule changes due to new emerging topics that it is not over burdensome. Find new ways to ask questions to avoid repetition (do not merely add more questions) | |
Involvement of service users in study design | ||
Recruitment and retention of participants | Some groups of patients had high levels of attrition due to natural history of disease | Checked health status of participants before contacting them prior to next interview to ensure this was done sensitively |
Careful thought should be given to heterogeneity of the sample. The time points at which data is collected may have to be managed differently for sub-groups | ||
Time | At what time points should data be collected? | We made a pragmatic decision about this and time points were the same for all participants. |
It may be more relevant to identify time points by key transitions in the patient’s journey or by consideration of previous literature or informed by theory | ||
Time should be explicitly included in the interview – to include changing illness perceptions | Looking forwards and backwards in interviews moves away from linear notions of time | |
Encourage reflexivity in the participant as well as the researcher | ||
Asking participants to reflect on their experience from the previous interview | ||
Data collection and management of resources | Management of time and resources – when working with a large data set | Ensure adequate time is included in project plans for project management and communication with participants |
Funding for LQR | Work with the funding bodies to consider LQR | |
Research focus and topic guide evolves over time | Flexibility, openness and responsiveness to the data and emerging analysis and interpretation is a key skill for the LQR researcher | |
Ask for advice about how to manage this from an ethics committee | ||
Analyzing data | LQR data sets are large and complex and can be analyzed in multiple ways from different perspectives | Ensure adequate time to analyze data between interviews – even if analysis is preliminary |
Consider analysis of data within each case and as comparison between cases | ||
Consider if and how subgroups should be analysed – is there a strong theoretical or practical reason why some groups should be analysed separately? | ||
Consider the contribution of a number of different analysis strategies to the data and their strengths and weaknesses | ||
Consider analysing data in a number of different ways, to add alternative understandings of longitudinal data |
Patients with cancer may be vulnerable, with a high symptom burden and poor prognosis, but patients still value being able to contribute their views [ 10 , 26 ]. Longitudinal research with this patient group is important but some ethical issues are amplified by collecting in-depth data from the same participants over time. Particular issues have been identified as intrusion (into people’s lives), distortion (of experience due to repeated contact, personal involvement and closure of relationships) and dependency [ 4 ].
We wished to interview patients shortly after diagnosis, which is a critical point in the patient pathway. Sensitive recruitment of participants soon after a life changing diagnosis, such as cancer, is important in building relationships and establishing a long term commitment to a study. Although building relationships and developing trust is essential this adds complexity to the role of the researcher involved in longitudinal research. Both the researcher and the researched can be affected by their involvement over time [ 27 ]. We found that on occasion patients did contact the research team for advice or information relating to their diagnosis. It is important that a research team have plans in place to manage this sort of situation without detriment to the relationship with the participant. There was a clear written distress policy for interviews and participants were given information about local support in case they wanted this after the interview.
There was a significant risk in our research that patients would become too unwell to participate or die between interviews. We sought consent from participants to access medical records and were able to check the health status of participants prior to contacting the participants to make arrangements for the next interview to ensure this was done sensitively. Consent was an ongoing process and was given in writing prior to the first interview and consent was checked verbally prior to each subsequent interview and also during the interview if a participant became upset or was talking about a particularly sensitive issue. The participant would be reminded that the tape recorder could be switched off at any time and the interview could be terminated at any time. If upset the participant would be given time to recover before the researcher asked if it was acceptable to continue with the interview. These procedures were built into the study protocol and the application for ethical approval.
Researchers too can be affected by their role [ 27 ]. Despite good training and support protocols for researchers qualitative research can be emotionally challenging [ 27 ]. Building a relationship over time, hearing about distressing situations and the impact that diagnosis can have on everyday life and relationships is hard. Information may be disclosed to the researcher that has not been discussed with anyone else; this builds a bond between those involved. Researchers may see participants deteriorate and die. The research team needs to build a supportive network and procedures to ensure that researchers are well supported in their role. In our study we used debriefing for very stressful events and researchers had regular supervision with the study team. Peer support within the research team also proved important on a day to day basis. It has been suggested that professional counseling is made available for researchers for whom debriefing is not sufficient support [ 27 ].
Staff retention may be an issue over time. There is a tension between the need to build relationships with participants in difficult circumstances and researcher burn out. It is ideal that one researcher builds a relationship with a participant over time but due to staff turnover or sickness this may not always be possible. Changes in staffing on LQR projects need to be well managed; the participant should be made aware that a different researcher will interview them and the researcher should read through previous transcripts so that participants feel there is some continuity and they do not have to repeat their story.
“Escaping the field” [ 4 ] or closure of relationships that have been built over time requires thought. Participants in our studies were prepared for the longitudinal element and the closure of the relationships. Study information was clear so participants knew that they were going to be interviewed 4 times over the year, and researchers prepared participants for the last interview: when ringing to arrange last interview participants were reminded that it was the final visit. At the end of the last interview we asked participants how they had found the process of being involved in research and had an informal “debriefing” session with them. If patients died whilst on the study a card would be sent on behalf of the research team to offer condolences.
It is important to ensure the confidentiality is maintained throughout the project as personal details, such as addresses, may be kept for longer than in studies with a single data collection point. Any ad hoc correspondence, phone messages or emails, for example, from participants to update researchers on their condition, should be handled in line with ethical approval requirements. As data is collected over time and experiences may be bound in particular circumstances and contexts ensuring that participants are not identifiable becomes more pertinent. The “blurred boundaries” for example taking your “emotional work” home with you [ 27 ] may also need special attention in LQR. Wray et al. [ 27 ] report, in their study, taking telephone calls from participants at home and ensuring women got evidence based care. These are complex, grey areas in LQR and it may become harder to separate, or manage ethically, empathy as a human being and a wish to help people who are suffering, with the role of a researcher when relationships deepen over time. These issues may have implications for the confidentiality of participants’ identities and data.
Data may have to be shared across large teams; this may mean that the core research team loses control of the data set and it is important to ensure that all team members are working to the ethical principles agreed with the relevant ethics committee. Large volumes of data may be generated from LQR and consideration should be given to how this data is archived and stored for the required length of time stipulated by the university, hospital or other regulatory body. LQR data is a valuable resource for archiving, data sharing and secondary data analysis, and may be a requirement of some funding bodies. To date this has been more common for large qualitative population data sets and is a specialist service offered by some Universities. The correct ethical approval, and participant consent to this, should be sought at the outset.
It is important to consider how researchers will deal with participant fatigue; within quantitative studies much thought is given to the burden of lengthy repeated questionnaires, the same consideration should be made for LQR, particularly as new topics of interest may emerge during the course of the study and it is tempting just to add a few more questions to the interview. Focusing on the purpose of the research, finding different ways to ask questions can avoid repetition and participants anticipating questions and giving the “right” response [ 28 ]. It is also wise to involve patients or service users in the design of the research and ongoing management to get the participants’ perspective of burden and balance research interest with participants’ well being.
We were successful in the recruitment of participants to the study. Patients were identified by the clinical team at the research site and then approached by a member of the research team to give information about the study. Once participants were recruited to the study retention was satisfactory. Recruitment and retention are important in all longitudinal studies. In qualitative studies sufficient participants are required at the last time point to ensure data saturation particularly if any new themes become evident at this point. We also wished to interview carers and this created a significant number of interviews at follow-up. We eventually made the decision not to interview some carers at follow-up as data was saturated. This created some difficulty with carer participants who valued this ongoing opportunity to ventilate feelings. The oversampling at the beginning (in order to have an adequate number of subjects at the last interview) was not a successful technique and overstretched the researchers and the data collection process unnecessarily.
There were two groups of patients where attrition was particularly poor: lung cancer patients (where 18 were recruited and four finished the study) and brain cancer patients (where 11 started and only one patient completed the fourth interview). For both of these groups there was a significant drop off after the third time point at six months. These attrition rates were not unexpected and almost all of these participants withdrew because they were too unwell or had died; this type of attrition may be unavoidable in some patient groups. All breast and gynecology patients completed all four interviews. Hence, a more selective approach to over-recruitment at the beginning of a LQR project is advocated, basing such decision on the outlook of participants over the timeline of the project. In some LQR studies it might be appropriate to develop newsletters or a web site with news of the study for participants to sustain interest. Good researcher communication skills are required to develop trust and convey the importance of the project to participants in the initial stages of the project. We have field notes that suggest that participants found participation in the study beneficial and this may also have contributed to our successful retention rates in populations with better health and survival.
The attrition in the sample highlights the complexity of having a heterogeneous sample in longitudinal research. We were well aware at the outset of the different disease trajectories of the tumor groups but for the purposes of analysis we designed the data collection points to be the same for all patients. In retrospect this was not entirely appropriate as there were different disease and treatment trajectories within each diagnostic group. In future research we would think differently about timing of interviews and link it to, for example, critical incidents rather than having set time points. Careful thought should be given to heterogeneity of the sample; by sampling over a number of cancer diagnostic groups we complicated our analysis making it difficult to draw together the experiences of patients with different disease trajectories. It may have been a better strategy to sample for heterogeneity within, for example, patients with advanced cancer. While heterogeneity in qualitative research is a desirable sampling feature, in LQR it is the “change” in events that is of more importance, and depicting change in very heterogeneous populations may not be so meaningful. Hence, defining clearly what an appropriate sample is for a given LQR study and understanding the trajectory of this sample over time are highly important considerations.
Issues of time and timing are of importance. Longitudinal research often focuses on change: how does coping or experience change? or how do participants manage change over time? [ 1 ]. Quantitative longitudinal research, such as cohort studies, assumes linearity of experiences and that people may experience time in the same way. However, the notion of time in a disease trajectory is complex. The difference between clock time and embodied time (or the experience of time) of the cancer patient has been recently illustrated in lung cancer, and this research highlights the lack of relationship between these two conceptualizations of time [ 29 ]. The differences between research time and biographical time have been explored elsewhere too [ 1 ]. Thus, consideration needs to be given to how time is defined in the study by the participants and by the research team.
One of the central issues we faced in this study was about the nature of time. As discussed above we identified set time points for data collection at the outset. However, we discovered that it is important to balance the pragmatics of a research design with flexible notions of time. We had significant attrition after the data collection point at six months and in retrospect we had not factored in the short disease trajectories of some patients or that some patients may have different notions of time. It may have been more useful to identify potential turning points or defining moments, from initial interviews, previously published research or clinical understanding of disease and focus on those rather than identifying set time points. For example, we know that the end of treatment, be that palliative or curative, is a significant time for patients [ 30 , 31 ] but treatment duration may not fall neatly into the first three months after diagnosis. That said, the focus of interviews should not be about “concrete events, practices, relationships and transitions which can be measured in precise ways, but with the agency of individuals in crafting these processes [ 32 ], p 192.” However, defining moments do often lead to change, in experience, coping or relationships and are useful points to tap into participants’ experiences. However, on a practical level, it would have been very difficult with our large data set to keep track of these critical incidents for every participant and to be able to organize researcher appointments to conduct interviews.
Issues of time need to be explicitly placed within the interview, an aspect we could have strengthened in our study. Looking both forwards and backwards in time moves away from linear notions of time as discussed above, asking participants to reflect on the content of their previous interviews. One way of doing this may be to encourage participants to approach the interview with reflexivity [ 33 ], a concept we are familiar with as researchers but in longitudinal research may be as important for the participant. For example, an issue that seems important for participants in the short term may not prove to be as important in the long term with the benefit of hindsight or increased understanding of the context [ 34 ]. This tentative or provisional, often contradictory, understanding makes analysis complex. As researchers we must endeavour to understand these complexities and make sense of them.
McLeod [ 33 ] suggests that reflexivity within the interview did not work for all of her research participants (in a study of school children) and is a point worth pursuing as we further develop our understanding of this methodology with patients. Reflexivity on a health state is complex for patients and it has been suggested that interviewing the ill may pose particular difficulties for the researcher [ 35 , 36 ], [a]s sick people, participants are unfamiliar with their everyday worlds, and they are often incapable of describing their condition and perceptions, so that researchers have difficulty in obtaining data to comprehend, interpret and generally conduct their research. … When researching participants who are sick, these methodological problems result in decisions about the timing of data collection, challenges to validity and reliability, and debates about who should be conducting the research [ 35 ], p 538.
Longitudinal qualitative research may in some way solve some of these issues as researchers will have the chance to incorporate changing illness perceptions into data collection and analysis. Patients whose illness has a long term impact will develop vocabulary and a way of expressing their illness experience in a way that patients with an acute episode will not. These changing perceptions, often moving from a lay perspective to one of the patients managing and controlling their illness [ 37 ], needs to be factored into analysis.
One of the main difficulties with LQR is the time and resources that are required to undertake a study. Dealing with a large data set can bring logistical challenges and there is a significant amount of time spent on project management, keeping up to date with participants, sending reminders and checking on a patient’s status. Analysis between interviews, across the participants and longitudinally within the individual narrative, can be a significant challenge in LQR.
There are no guidelines about how long a longitudinal study should be (although at least 2 points are necessary to examine change [ 3 ]) or how often data needs to be collected; this should be determined by the processes and population under investigation and the research question. Many health/patient related studies are short in duration, one to two years, in comparison to LQR in the social sciences where issues, such as transitions in identity from child to adult, are investigated over decades. This may of course be because of differences in the issues/processes under investigation but may also reflect research funding in health care which is often limited to a fixed duration. This poses problems for a research team who wish to follow a population for a number of years and requires ongoing generation of funds to complete the research.
The topic guide and the focus of the interview may change over time, this may prove challenging when seeking ethical approval for a study. Ethics committees usually ask for all documentation including topic guides prior to giving an opinion. Our interview schedule had broad questions both to comply with ethical approval procedures and to allow participants to talk about what is important for them at the time of each interview. Example opening questions include “How have you been feeling physically this past month” or “How have you been feeling emotionally this past month”. Developing a relationship with an ethics committee and seeking guidance about how to approach this with the committee is advisable.
LQR is a prospective approach and therefore can give a different perspective on processes. Issues that seem very important at one time point may change with the perspective of time and processes may change the way experiences are viewed. One off qualitative interviews rely on recall, for example, asking about symptom experience at diagnosis when a patient is several months away from that point. There will always be some element of retrospective discussion in an LQR interview but with a focus on change over time, this can be aided by summarizing or reflecting on the previous interview. As data is collected prospectively, causation, the temporality of cause and effect, and the processes or conditions by which this happens can also be explored in the data [ 4 ].
As we describe below, the richness of the interview content and overwhelming amount of data made it difficult to analyze in-depth each interview before the next one, an issue also been reported in other studies [ 27 ]. When this is the case we would propose that a preliminary analysis and summary of the interview is made so that the next interview can commence with a recap of what was previously discussed. Subsequent interviews could start by the interviewer providing a short summary of themes they have identified from the last interview and asking the participant to reflect on this summary of experiences before moving on to ask how the participant is feeling now and what has changed for them since the last interview. This more selective interview approach in subsequent interviews may also decrease the amount of data collected, easing the analysis and making the data collected more focused and less overwhelming for the researcher. Indeed we have noticed that often subsequent interviews tended to be shorter than the initial one. This helps the researcher and participant to keep the focus on longitudinal elements, what has changed since last time, why has this happened? Preliminary analysis will also highlight emerging themes to be further pursued in later interviews.
Using LQR researchers can respond to a change in focus and interviews can be adapted to the individual narratives. This is particularly useful as at the outset it is often not clear what the important processes are over time. Thus much data collected in the initial stages may not be relevant in the emerging processes over time, and data collection necessarily will become more focused at later time points. Flexibility and responsiveness to the data and emerging analysis and interpretation is a key skill for the LQR researcher.
Longitudinal qualitative data analysis is complex and time consuming. A longitudinal analysis occurs within each case and as comparison between cases. The focus is not on snapshots across time (a cross-sectional design will achieve this) but “to ground the interviews in an exploration of processes and changes which look both backwards and forwards in time [ 32 ], p194.”
Holland [ 4 ] synthesizes two approaches to analyzing data and suggests some questions to guide analysis. Firstly, framing questions focus on the contexts and conditions that influence changes over time, she gives the example, “what contextual and intervening conditions appear to influence and affect participant changes over time? [ 4 ].” Descriptive questions generate descriptive information about what kinds of changes occur, for example, “what increases or emerges through time? [ 4 ].” These two types of questions move the researcher forward to develop deeper levels of analysis and interpretation.
Data collection and analysis should be informed by the research question, data collection methods and theoretical perspective, if one is being used from the outset. It may be possible to anticipate whether cross-sectional or longitudinal analysis would be the most helpful method of answering the research question. Considering these issues at the outset may allow the researcher to be alert to themes in the data during analysis whilst keeping an open mind to emerging issues.
As described above we planned to analyze each interview before moving onto the next interview with each participant to allow reflexivity of the researcher and participant and to focus on “processes and changes” rather than snapshots. Due to the volume of data it was not always possible to do this and this is certainly a limitation of our work and may reflect the predominance of cross-sectional data in our reporting of the studies.
We decided to analyze each tumor group separately rather than across the whole sample as it was clear that there were significant differences in these populations due to different disease trajectories and symptom experience. There was a different analysis and theoretical perspective taken in each analysis reflecting that data from each tumor group. McLeod [ 33 ] suggests that the nature of longitudinal data means that multiple theoretical frameworks may be useful to analyses and interpretation and the use of different paradigms may lead to new insights and interpretations.
Interpretative Phenomenological Analysis was used in lung cancer analysis [ 21 ], Interpretative Description with lymphoma data [ 20 ], content or thematic analysis using Leventhal’s self-regulation theory, the theoretical framework for the study, was used for gynecological, brain, and head and neck cancer data analysis [ 18 , 22 , 23 ], and thematic narrative analysis for breast cancer patients, The above approach took into consideration the data analysis experience of the researchers involved or the type of information collected through the interviews. For example, the analysis of breast cancer patients’ accounts [ 25 ] lead itself to narrative analysis because the women expressed their feelings much more than other groups and we analysed the data through patient stories about their cancer journey; this fitted well with the approach to data generation and Frank’s [ 38 ] concept of the cancer journey was used as the theoretical lens though which data were analyzed. In data from other diagnostic groups the unit of analysis was often the whole interview, as in the case of patients with head and neck cancer, where coding units in the first interview were assessed for presence and information in subsequent interviews. This captured well some experiences over time, such as the continuous nature of fatigue and tiredness over time, or the attempts for maintaining normality which were evident only after T2, increasing in complexity at T3 and T4 [ 22 ]. Detailed practical examples are presented in the respective papers [ 18 - 25 ] and a summary of the themes alongside other qualitative research related to symptom experience of cancer patients is presented in a meta-synthesis of these data [ 39 ].
Our analyses have highlighted new insights into the symptom experiences of patients with cancer. Utilizing multiple analysis strategies and theoretical perspectives has its strengths and allows comparison and gives direction for reanalysis and further interpretation of this important research resource.
Through reflecting on and describing our experiences we have identified broad recommendations for undertaking LQR projects in health research which we hope will stimulate debate amongst qualitative researchers.
• We would recommend incorporating a theoretical perspective (if appropriate to the methodology), that encompasses concepts such as time or the experience of change. This may help researchers keep the analysis “alive” to longitudinal aspects of analysis and move beyond descriptions of experience at each time point to explore change between time points.
• Qualitative researchers are familiar with complex ethical issues involved in being in the field. However, there are some ethical issues that are amplified whilst undertaking LQR, and require careful consideration and planning, such as how relationships are built and sustained over time whilst adhering to ethical practices, how relationships are ended, maintaining confidentiality over time and managing distress in participant and researchers.
• Good project management is essential when working with large data sets. Ensure adequate time is included in project plans for project management and communication with participants.
• Developing good team working is important; there are advantages to working with large teams which may be an unfamiliar way of working for qualitative researchers. Different perspectives can be brought to bear on the analysis making it richer and generating new insights. Communication is particularly important when analysis is undertaken by researchers who have not been involved in collecting data.
• We would encourage researchers to consider multiple methods of analysis and secondary analysis within the same data set to explore the rich data that is generated.
• We have clearly identified that longitudinal research with patients with a poor prognosis and experiencing long term challenges is worthwhile. However, thought needs to be given to the timing of data collection and the heterogeneity of the sample. Support for participants and researchers, and any additional ethical considerations, should be built into protocols as there is an increased burden for all involved in LQR.
• We recommend that from the outset the research team should consider how the volume of data can be managed and consider practical issues such as timing of interviews so data can be transcribed and analyzed in time for the next round of interviews. This early analysis may help keep the focus on change and transitions rather than description of events.
•Funders of research may be unfamiliar to funding longitudinal qualitative research and recommend that a strong case for the added value of this method should be made.
This paper has explored our experience of LQR and highlighted areas where we have learned a great deal about the methodology. During this longitudinal project we developed expertise in managing practical and ethical issues, tried different analysis strategies to look for alternative ways of examining data and understanding the experience of participants. There have been successes in the strategies we have used and areas in retrospect that we could have worked differently. For example, ensuring sensitivity during initial recruitment and subsequent contacts, putting procedures in place from the outset of the study to manage issues such as patient distress during interviews and patient initiated contact regarding health issues during data collection all helped the researchers to build trusting relationships with participants. These factors, together with researcher continuity, were important in helping to maintain good recruitment rates for participants with better health and survival rates throughout the study.
It is important to note that findings were generated from one particular study and issues highlighted here reflect the conduct of this study. There are other methodological issues that may be illustrated better through other examples of LQR research and we would encourage researchers to publish methodological issues highlighted by their studies to strengthen debate in this area. Although we consider that there are general lessons to be learned from our experience, which can be usefully considered by other researchers, we acknowledge that there may be aspects of the study, particularly the heath status of the participants that will not necessarily be broadly relevant. For this reason we do consider that this paper will have particular relevance for researchers interested in chronic and life limiting conditions.
We found that when seeking guidance for the project published literature was limited in highlighting debates about LQR focusing on the reporting of findings rather than developing debate about this emerging methodology. Much of the methodological literature cited in this paper comes from the social science literature where there is a long standing tradition of LQR and where debates about LQR with schoolchildren or other healthy populations in society are well rehearsed. There is little literature that examines the methodology in the context of health services research and whether there are particular issues about following participants through the trajectory of their illness to recovery, living with impairments or death. This paper has started to highlight some of the areas where further methodological exploration would be valuable.
One of the ongoing debates in qualitative methodology is how quality and credibility are evaluated [ 40 , 41 ]. There is little debate about whether LQR poses additional questions about quality. We have highlighted where, for example, there may be heightened concerns about ethical conduct, and using multiple methods of analysis. Longitudinal analysis is complex and is often reported a-theoretically and descriptively [ 13 - 15 ] and this also has implications for the quality and credibility of LQR. It may be that established guidance for the evaluation of qualitative research can be utilised with LQR but little exploration of this can be found in the published literature. Summaries of the researcher’s interpretation of a data collected in a previous interview when discussed with participants at a subsequent interview can enhance the credibility of the data. We have highlighted some ways in which these aspects of LQR can be enhanced, and by providing a record of our experiences it can help to start standardising a process by which QLR can be conducted which can enhance the credibility of research and quality of data collected.
LQR is an increasingly utilised methodology in health services research, for example in the development and evaluation of complex health interventions or to study transitions in recovery or long term illness. The findings presented in this paper are important as they begin to identify areas of LQR where there is potential for debate and multiple perspectives on these would be valuable.
Additional research and inquiry is also essential to further develop the methodology. There is little published work about rigour in LQR, and it would be worth investigating whether additional elements should be added to accepted conceptualizations of the quality of qualitative research so judgments can be made about the rigour of research. Research to explore participants’ perspectives of being in a longitudinal study would be valuable as there may be additional burden to the participant, emotional and practical, of being involved in LQR. Eliciting participants’ insights into their experiences of participation may give us greater insight into the method itself.
This paper has highlighted specific methodological, practical and ethical issues identified in an LQR programme of research about experiences of symptoms in cancer patients in the first year after diagnosis. The study itself has highlighted useful insights into these experiences and allowed examination of data from multiple perspectives, but importantly has been an important learning opportunity of the research team. Next steps may include agreement among the qualitative research community about standardization of the process, identification of LQR research questions that would be distinct from what can be achieved from cross-sectional work, and influencing funders for the value and uniqueness of this methodological approach.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
Conception of paper: AM, LC. Acquisition of original data: AM, LB. Interpretation of data: All authors. Drafting paper: LC. Critical revisions: AM, LB. Final approval: all authors.
The pre-publication history for this paper can be accessed here:
http://www.biomedcentral.com/1471-2288/13/14/prepub
IMAGES
COMMENTS
This paper examines a longitudinal case study to show the challenges that project managers face when assessing project risks and benefits.
Based on an in-depth longitudinal case study, we provide detailed descriptions of how a project management team worked with its stakeholder relationships. Applying a practice approach, we explore how stakeholder management practices emerged and evolved as embedded actions and interpretations related to perceptions of each stakeholder's harm and ...
Method Review the methodological literature on longitudinal case study. Define the LCCS and demonstrate the development and application of the LCCS research strategy to the investigation of Project C, a software development project at IBM Hursley Park.
We conducted a longitudinal case study in a growing large-scale agile organization, focusing on how external and internal changes impact coordination over time.
Management Information Systems researchers rely on longitudinal case studies to investigate a variety of phenomena such as systems development, system implementation, and information systems ...
Finally, since I report on a longitudinal case study of a public service organization's entire innovation project my study contributes with it's empirical usage to organizational studies (Rashman, Withers, & Hartley, 2009). The study proceeds as follows.
Section 3 describes the design of the longitudinal explanatory case study, while Section 4 provides a rich description of the programme organization and the findings on coordination for each phase. Section 5 presents coordination in the phases and develops five propositions to answer the research question (shown in Table 10 ).
11.1 INTRODUCTION This chapter reports the experiences of the third author as he undertook two longitudinal case studies of software projects at IBM Hursley Park, as part of his PhD research. The two projects are referred to respectively as Project B and Project C to retain consistent identifiers with previous publications [144-147, 152, 154, 155] on these case studies.
Request PDF | The longitudinal, chronological case study research strategy: A definition, and an example from IBM Hursley Park | Context: There is surprisingly little empirical software ...
Objective: To examine the use of the longitudinal, chronological case study (LCCS) as a research strategy for investigating the rich, fine-grained behaviour of phenomena over time using qualitative and quantitative data. Method: Review the methodological literature on longitudinal case study.
This chapter contains sections titled: Introduction Background to the Research Project Case Study Design and Planning Data Collection Data Analysis Reporting Lessons Learned
Longitudinal vs cross-sectional studies The opposite of a longitudinal study is a cross-sectional study. While longitudinal studies repeatedly observe the same participants over a period of time, cross-sectional studies examine different samples (or a "cross-section") of the population at one point in time. They can be used to provide a snapshot of a group or society at a specific moment.
We discuss the insights gained and lessons learned from applying a longitudinal qualitative approach to an empirical case study of a software development project in a large multi-national ...
From the Editors Introducing Teaching Case Studies in ProjectFrom the Editors Introdu. and Management, Université du Québec à Montréal, CanadaProject Management Journal® is an academic journal dedicated to publishing research relevan. to researchers, reflective practitioners, and organizations. In this regard, as scholars, we have a double ...
Originality/value This paper adopts a longitudinal case design to study the fit between the logistics context and strategy, adding to the body of knowledge on organisational design and strategy in logistics and supply chain management.
To address this gap the longitudinal case-study project is generating up-to-date and in-depth data concerning researchers' use and experience of five mainstream CAQDAS packages subsequent to initial introductory training.
This paper presents the methodology and findings of a longitudinal-grounded case study of the ambitious implementation of a PMIS within the public works organization of the HKG SAR. It has provided an opportunity for practical experimentation through the quantitative measurement of 'before' and 'after' effects arising from a change in management techniques. These were substantially ...
Method: Review the methodological literature on longitudinal case study. Define the LCCS and demonstrate the development and application of the LCCS research strategy to the investigation of Project C, a software development project at IBM Hursley Park.
In this report, we describe an application of longitudinal multiple case study to evaluate a complex public health initiative over 16 months. The benefits of this design include the ability to capture the interventions over time, which is ideal to document the complex processes of policy adoption and implementation.
Our case studies collection highlights how organizations are implementing project management practices and using PMI products or services to fulfill strategic initiatives and overcome challenges.
Longitudinal qualitative methods are becoming increasingly used in the health service research, but the method and challenges particular to health care settings are not well described in the literature.We reflect on the strategies used in a longitudinal ...
It then examines--using a longitudinal analysis--a six-year (1998-2003) benchmarking study performed by one project management consulting company, a study involving 550 worldwide organizations and 2,5
A qualitative longitudinal case study is conducted in a Tunisian leading bank as part of its process of implementing a Global Banking System divided into three phases.