A review of participation of young persons with disabilities - a critical analysis of qualitative studies.

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A review of participation of young persons with disabilities - a critical analysis of qualitative studies. Truls I. Juritzen, Postdoc, CHARM Eivind Engebretsen, Professor, Dept. of Health Sciences, University of Oslo 29 October 2014

Background young people with disabilities effective rehabilitation services participation and community integration knowledge about rehabilitation strategies targeting this group is generally limited most of the studies we find when searching in scientific indexing databases are quantitative.

Aim identify and critically assess how qualitative research is presented in peer reviewed articles available in scientific indexing databases.

Qualitative research interpretative how people make sense of social world meanings of actions, events, decisions, beliefs, values.. provide understanding of people's experiences, processes of actions and events contextual settings

Research questions: What kind of knowledge is provided through the studies? In what way do the studies confine with qualitative principals in terms of studying individual processes and experiences and by opening up new areas of research by exploring new hypothesis? To what extent do the reports live up to their own stated principles? Are the knowledge objectives stated in the introductions of the articles, followed up throughout the presentation of methods, results and discussion of findings?

Background reviews, comparisons and synthesis of qualitative research more frequent Hannes, K., & Macaitis, K. (2012).

Heterogeneity both quantitative and qualitative reviews and synthesis need to address the problem of heterogeneity In qualitative meta-studies this is principally challenging Researching individuality The particular The concrete context Lived experience

Challenge: How to summarize qualitative studies without violating its character Need for meta-studies sensitive to the specific character of knowledge provided by qualitative research

Analytic approach to review the literature in a way that confine with qualitative principals not as pieces of knowledge content considered as knowledge processes understood and described on their own individual terms. characteristics of each paper's creation of knowledge

analytic approach individual processes of meaning making rather than general characteristics how the papers create knowledge than what they create knowledge about a critical approach focusing on both the explicit and implicit message of the articles relation between the qualitative knowledge principles the authors adhere to and the knowledge they actually present through their papers

This review: meta-epistemological analyzing the knowledge production of the research papers rather than the knowledge content

Systematic search OVID MEDLINE, EMBASE,CINAHL, PsycINFO, Web of Knowledge Social Sciences Index. Publications from January 2000 to August 2013 Original publications in English language - full text Subjects between 18 and 26 years, multidisciplinary intervention and objective or outcome targeting participation. Out of the 112 publications meeting the inclusion criteria only 12 were qualitative.

Analyses phase 1 The 12 qualitative studies reviewed independently by two of the authors 1) presentation of aims and research questions, 2) presentation of methods 3) presentation of results.

Analyses phase 2 - more detailed scrutinizing 1. the qualitative ideals and principals expressed through the aims / research questions 2. how ideals and principals are followed up trough the choice of methods, presentation of results and conclusion

Example 1 Skill development in an employmenttraining program for adolescents with disabilities» Sally Lindsay, Tracey Adams, Carolyn McDougall & Robyn Sanford Disability & Rehabilitation, 2012; 34(3): 228 237

Aim: to explore youth s experiences in an employment-training program for adolescents with disabilities (Lindsay 2012). describe gained skills and experiences give the participants the opportunity to suggest improvements to the employment training program they have attended.

Presentation of methods: descriptive qualitative methodology in-depth interviews brief questionnaire and a chart review to exploring new phenomena or questions. ( ) individuals lived experience and ( ) explore in-depth perspectives and processes. (p. 229)

Presentation of results presented and ordered under headings highlighting central themes from the data analysis. (.) Most of the participants» «most youth...» «Several participants» «Many of the younger participants» «The majority of the participants». ( ) This study is limited in that the findings are suggestive rather than generalizable due to the small qualitative sample. (p. 236)

Example 2 "Patients' experience of return to work rehabilitation following traumatic brain injury: a phenomenological study J. Marian Hooson, R. Coetzer, G. Stew & A.Moore "Neuropsychological Rehabilitation 23(1): 19-44.

Aim: to increase the understanding of what might be assistive in RTW rehabilitation when individuals have multiple impairments and disabilities as a result of TBI (Hooson et al. 2013, s. 20).

Presentation of methods: Phenomenological methodology Informed by a constructivist-interpretivist perspective accepting the existence of multiple realities and truths. Semi-structured interviews were used in the data collection from 8 participants. Data analysed using an interpretative phenomenological analysis (IPA) Aiming to give voice to both the individual and more generalised aspects of the narratives (p. 25).

Presentation of results: Demographics and other relevant data of the 8 participants are presented in 4 tables findings from the interviews are grouped into master themes and sub-themes illustrated by quotations from the interviews Number of participants supporting each statement: Most of the participants (9 out of10),, A subset of participants (6 out of 10), All participants etc.

Questions / discussion: Is it a tendency to adjust to ideals and quality criteria which are closer to the quantitative research tradition than the qualitative tradition? Is this leading to a ambivalent position between quantitative and qualitative research ideals and possibilities? Is the unique in-depth knowledge characteristic of qualitative research methods more true or valid when supported by a higher number of informants