metaphor analysis of qualitative research

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Using Metaphors to Make Research Findings Meaningful

Rose steele.

1 School of Nursing, Faculty of Health, York University, Toronto, Ontario, Canada

Jennifer Baird

2 Clinical Services Education and Research, Children’s Hospital Los Angeles, Los Angeles, CA, USA

Betty Davies

3 School of Nursing, University of Victoria, Victoria, British Columbia, Canada

4 Department of Family Health Care Nursing at the University of California, San Francisco, USA

Researchers, educators, and funding agencies frequently lament that research is seldom read or put into practice by clinicians. Clinicians, on the other hand, note that they are busy and do not have the time or even the knowledge to read research articles that may be dense and filled with jargon. Traditional ways of disseminating knowledge are often insufficient; therefore, many funding agencies encourage researchers to find innovative ways to help their funded research be applied in practice. The Canadian Institutes of Health Research (CIHR; CIHR, 2012 ), for example, emphasized that varied strategies for knowledge translation, including non-academic modes of communication, are often needed to reach potential knowledge-user audiences beyond the research community. The CIHR encourage researchers to adapt their language of publication to fit target audiences and to present findings in alternative formats. In this column, we propose the use of metaphor as one innovative way to make knowledge useful for application in healthcare settings, so that, as noted by Straus et al. (2011) , findings can be easily understood and capture the attention of the intended users of the knowledge.

As researchers with many years of combined experience and multiple funded studies, we were confident in our abilities to successfully complete a recent study in which we aimed to develop an empirically-grounded and theoretical conceptualization of what makes it possible for some healthcare providers, more than others, to engage in excellent interactions with parents of children with serious illness despite having similar time and other constraints. However, during our concurrent data analysis we realized that the dynamic complexity of what we were finding could not easily be expressed through our usual approaches. Therefore, we sought creative ways to make meaningful sense of the findings so that students, clinicians, educators, and administrators could understand and then use them. As we searched for the most suitable approach, we began to learn more about metaphors and eventually we chose a prairie windmill metaphor to make sense of the findings and bundle them together in the fullness of details ( Davies et al., 2022 ). Our metaphor made the findings clearer and more manageable while also allowing various audiences to make sense of their own experiences of interactions with parents, patients, families, colleagues, and others:

The metaphor shows the whole of interaction, the movement back and forth of the many facets that are important. It captures the mystery of interaction, of the connection that really makes things happen. It's fun to play with because it really makes you think in a different way about excellence in interaction. ([study participant]; Davies et al., 2022 , p. 13)

For many centuries, metaphors have frequently been used to express understanding of complex concepts. For example, as humans we know that when we talk about building bridges between people we are talking about the connections and not actual physical structures. Metaphors are useful for inviting people into worlds that they might not otherwise have seen. They can stimulate imagination, incite feelings, help people to see new meanings, and even lead to change. In qualitative research, metaphors can help simplify complex and/or multidimensional concepts through connecting one familiar concept to another familiar one, resulting in the comparison between the two concepts opening up new possibilities and perspectives ( Schmitt, 2005 ). Metaphors provide structure to data and aid understanding of a familiar process in a new light. Thus, finding the right metaphor can help researchers describe complex findings in ways that others find meaningful.

We knew we had found the right metaphor when clinicians from many settings and disciplines, as well as parents, patients, and other family members, told us that the metaphor spoke to them and that the model made sense:

The windmill is really insightful, much more creative, dynamic, and transformational. I think what's brilliant to me about this model is that there are so many elements and to try to figure out which ones are connected at which level or layer and how they all work, the wholeness of it—I think it's really wonderful. ([study participant]; Davies et al., 2022 , pp. 24–25)

As indicated by the previous quote, metaphors can be transformational and so can effect change. Effective change typically occurs incrementally, so if metaphors are used to tap the imagination and emotions of an audience, then a more evolutionary change may result that is, in the long run, more effective in putting new knowledge into practice. However, while the right metaphor can be extremely useful, it also is important to understand that using metaphors to translate research results is not just a new way of offering information. Rather, it is the comparison process within the use of metaphor that allows the audience to experience and understand one concept in terms of another; the metaphoric structure is what helps facts become interpretable or make sense ( Richardson, 2003 ). We propose that if researchers are serious about helping practitioners and educators use research results, then they must present their findings in such a way that they touch or capture the personal experiences of practitioners and educators so they can find personal meaning in the new knowledge. Metaphors provide one intriguing approach to achieving this aim.

Author Biographies

Rose Steele , RN, PhD, has been a registered nurse for almost 45 years and is an accomplished researcher in pediatric palliative care. She is a Full Professor, York University School of Nursing, Toronto, ON, Canada

Jennifer Baird , RN, MSW, MPH, PhD, is a pediatric nurse scientist, educator, and leader with expertise in the development of interventions to improve the safety and quality of hospital care. She is Director, Clinical Services Education and Research, Children’s Hospital Los Angeles, Los Angeles, CA, USA.

Betty Davies , MSN, PhD, has devoted her career to the field of pediatric palliative care as a practicing nurse, educator, researcher, and author. She is an Adjunct Professor, University of Victoria, Victoria BC, Canada; Professor Emerita, University of California San Francisco, San Francisco, CA, USA.

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Institute of Human Development, Child and Youth Health, (grant number MOP-115009).

ORCID iD: Rose Steele https://orcid.org/0000-0003-2822-0366

Using metaphor as a qualitative analytic approach to understand complexity in primary care research

Affiliation.

• 1 University of Nebraska Medical Center, Omaha, USA.
• PMID: 14658355
• DOI: 10.1177/1049732303255999

Metaphors offer exciting opportunities to identify and explore tacit knowledge and behavior that are embedded in complex organizations and shape health care practices. In this article, the authors explore the theoretical rationale, background, and advantages of using metaphor as an analytic strategy in qualitative health research. They used an analysis of 18 practices in a comparative case study designed to explore office practice strategies for delivering cancer prevention services for illustrations. During the individual and comparative stages of the analysis process, researchers heeded the metaphors that they used in their descriptive language of practices. The authors explore examples showing how metaphors clarify unwritten assumptions, values, and motivators that shape variations in practice behavior.

Publication types

• Research Support, U.S. Gov't, P.H.S.
• Family Practice / organization & administration*
• Health Services Research / methods*
• Organizational Objectives
• Primary Health Care / organization & administration*
• Qualitative Research*

Grants and funding

• 1 RO 1 HS08776/HS/AHRQ HHS/United States

Metaphor and Gender in Business Media Discourse pp 43–63 Cite as

Method: Quantitative and Qualitative Analyses of Metaphor

• Veronika Koller  

133 Accesses

The method section translates the above integrated theoretical framework into a tripartite research paradigm. This combines computer-assisted quantitative analysis with qualitative investigations along the lines of functional grammar in the Hallidayan tradition. Quantitative corpus analysis is here regarded as a valuable starting point, granting a sound empirical basis to subsequent claims about the metaphoric features of the cognition and discourse prevailing in a particular domain. Although quantitative results alone do not provide for sufficient insights, they can, if recontextualized, support qualitative analyses of particular texts (see Koller and Mautner, forthcoming). To integrate those two fundamental methodologies, the present work has been based on machine-readable data. Let us first look at the corpora and then at the two steps in the analysis.

• Conceptual Metaphor
• Text Producer
• British National Corpus
• Metaphoric Expression

These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

I wade through the filth of mighty metaphors, meta, meta, meta by metre. (Einstürzende Neubauten, 1993)

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© 2004 Veronika Koller

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Koller, V. (2004). Method: Quantitative and Qualitative Analyses of Metaphor. In: Metaphor and Gender in Business Media Discourse. Palgrave Macmillan, London. https://doi.org/10.1057/9780230511286_3

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Metaphors for Thinking about Qualitative Researchers’ Roles

The focus for January is on researchers’ roles, including characteristics and skills critical to success. Read the whole series  here .

The roles we take as researchers vary greatly depending on the nature of the study. One pretty clear distinction is between studies where the researcher interacts directly with participants, and studies where the researcher relies on extant data. In Doing Qualitative Research Online I differentiated three types of qualitative data collection as Extant, Elicited, and Enacted.

Extant datawas created for a purpose outside of our research, and collecting it does not entail direct interaction with those who created the images, documents, or datasets. When you start asking questions, you move to elicitation methods. Elicited data is collected when we interview or otherwise engage with consenting participants. Sometimes we go beyond asking questions, and for those highly interactive approaches I use the term enacted research. While I was focused specifically on ways to collect data online, these principles apply more generally.

What roles do researchers take in these three types of qualitative data collection?

One way to think about roles is through the stances taken by the researcher, which I describe metaphorically as the miner, traveler and gardener (Salmons, 2010, 2015, 2016).

According to the metaphors Kvale and Brinkman (Kvale, 2007; Kvale & Brinkman, 2014) devised to explain various roles that interviewers take, the researcher who digs out facts and feelings from research subjects is characterized as a miner . The traveler journeys with the participant to experience and explore the research phenomenon. I introduced the metaphor of the gardener to suggest a nurturing process that is often needed when building rapport with participants online. The metaphor alludes to ways a researcher uses questions or prompts to plant a seed and follow-up or probing questions to cultivate the growth of ideas and shared perceptions. Matching metaphor to methods is not cut-and-dry, and certainly a researcher might take more than one role in a given study. But there are some natural fits.

Extant research is clearly aligned with the metaphor of the miner. The researcher locates potentially rich seams and starts digging. Today’s researchers have many options for using extant resources including historical or contemporary documents, images, or datasets (Salmons, 2019). Researchers might use diary, narrative, or visual or text analysis methods with enacted data. However, since this type of researcher does not influence the substance or nature of the data, using only what has been posted or curated, the researcher may find that the extant data is not adequate to achieve the purpose of the study. In a multimethod study the researcher could add an interview or questionnaire component to the study and elicit explanations from participants to fill in missing pieces of the story.

Elicited research is most appropriately aligned with the gardener metaphor. The researcher may use verbal or written questions to elicit responses to interviews or focus groups. In a study using participant observation, the researcher may elicit data by informally asking questions or conversing with others engaged in the activity under observation. Researchers using these methods may also use images, graphics or media that represent some aspect of the research problem or phenomenon to elicit reactions or answers. Elicitation is flexible and, unlike the researcher using extant data, researchers can draw out detailed replies specific to the phenomena being studied.

Researchers using enacted research approaches fit the metaphor of the traveler. For this kind of study researcher designs and carries out events or activities that require the researcher to be a co-participant. Rather thank thinking about collecting data, data is generated through research events. Creative and arts-based methods, simulations, games, action research or field experiments are some of the highly-interactive methods used. The researcher is highly engaged with the participant(s) throughout multiple stages of the study.

When you think about the type of qualitative study you want to design, think about the roles you prefer to take, and the ways you will relate to participants or materials. How might your preparation change depending on whether you will be a miner, gardener, or traveler? How might you prepare your students or doctoral mentees to take these roles?

Kvale, S. (2007). Doing interviews . Thousand Oaks: SAGE Publications.

Salmons, J. (2015). Qualitative online interviews . Thousand Oaks: SAGE Publications.

Salmons, J. (2016). Doing qualitative research online Doing qualitative research online . London: SAGE Publications.

Salmons, J. (2019). Gather your data online . London: SAGE Publications.

Doing Qualitative Research Online is now available in the SAGE Research Methods database. If your library doesn’t have a subscription, and you would like to access the materials listed here, explore SAGE Research Methods with a  free trial .

Stop, collaborate listen: Gender equality in social data science. Watch the panel discussion now

Passion about research process (not output).

What is Qualitative Research? Definition, Types, Examples, Methods, and Best Practices

By Nick Jain

Published on: June 21, 2023

Table of Content

What is Qualitative Research?

5 key types of qualitative research, examples of qualitative research, qualitative research methods: the top 4 techniques, qualitative research best practices.

Qualitative research is defined as an exploratory metho d that aims to understand complex phenomena, often within their natural settings, by examining subjective experiences, beliefs, attitudes, and behaviors.

Unlike quantitative research , which focuses on numerical measurements and statistical analysis, qualitative research employs a range of data collection methods to gather detailed, non-numerical data that can provide in-depth insights into the research topic.

Here are the key characteristics of Qualitative Research:

• Subjectivity : Qualitative research acknowledges the subjective nature of human experiences and perceptions. It recognizes that individuals interpret and construct meaning based on their unique perspectives, cultural backgrounds, and social contexts. Researchers using qualitative methods aim to capture this subjectivity by engaging in detailed qualitative observations , interviews, and analyses that capture the nuances and complexities of human behavior.
• Contextualization : Qualitative research places a strong emphasis on the context in which social phenomena occur. It seeks to understand the interconnectedness between individuals, their environments, and the broader social structures that shape their experiences. Researchers delve into the specific settings and circumstances that influence the behavior and attitudes of participants, aiming to unravel the intricate relationships between different variables.
• Flexibility : Qualitative research is characterized by its flexibility and adaptability. Researchers have the freedom to modify their research design and methods during the course of the study based on emerging insights and new directions. This flexibility allows for iterative and exploratory research, enabling researchers to delve deeper into the subject matter and capture unexpected findings.
• Interpretation and meaning-making : Qualitative research recognizes that meaning is not fixed but constructed through social interactions and interpretations. Researchers engage in a process of interpretation and meaning-making to make sense of the data collected. This interpretive approach allows researchers to explore multiple perspectives, cultural influences, and social constructions that shape participants’ experiences and behaviors.
• Richness and depth : One of the key strengths of qualitative research is its ability to generate rich and in-depth data. Through methods such as interviews, focus groups , and participant observation, researchers can gather detailed narratives and descriptions that go beyond surface-level information. This depth of data enables a comprehensive understanding of the research topic, including the underlying motivations, emotions, and social dynamics at play.
• Inductive reasoning : Qualitative research often employs an inductive reasoning approach. Instead of starting with preconceived hypotheses or theories, researchers allow patterns and themes to emerge from the data. They engage in iterative cycles of data collection and analysis to develop theories or conceptual frameworks grounded in the empirical evidence gathered. This inductive process allows for new insights and discoveries that may challenge existing theories or offer alternative explanations.
• Naturalistic setting : Qualitative research frequently takes place in naturalistic settings, where participants are observed and studied in their everyday environments. This setting enhances the ecological validity of the research, as it allows researchers to capture authentic behaviors, interactions, and experiences. By observing individuals in their natural contexts, researchers can gain a deeper understanding of how social phenomena unfold in real-world situations.

Learn more: What is Qualitative Observation?

Here are the 5 key qualitative research types that are employed in studies:

1. Phenomenology : This type of research focuses on understanding the essence and meaning of a particular phenomenon or experience as perceived by individuals who have lived through it. It seeks to capture the subjective experiences and perspectives of participants.

2. Ethnography : Ethnographic research involves immersing oneself in a specific cultural or social group to observe and understand its practices, customs, beliefs, and values. Researchers spend extended periods of time within the community to gain a holistic view of its way of life.

3. Grounded Theory: Grounded theory aims to generate new theories or conceptual frameworks based on the analysis of data collected from interviews, observations, or documents. It involves systematically coding and categorizing data to identify patterns and develop theoretical explanations.

4. Case Study : In a case study, researchers conduct an in-depth examination of a single individual, group, or event to gain a detailed understanding of the subject of study. This approach allows for rich contextual information and can be particularly useful in exploring complex and unique cases.

5. Narrative Research: Narrative research focuses on analyzing the stories and personal narratives of individuals to gain insights into their experiences, identities, and sense-making processes. It emphasizes the power of storytelling in constructing meaning.

Example 1. A researcher conducting a phenomenological study might explore the lived experiences of individuals who have survived a natural disaster to understand the psychological and emotional impact of such events.

Example 2. An ethnographer might immerse themselves in a remote indigenous community to study their cultural practices, rituals, and social dynamics.

Example 3. A grounded theory study might investigate the coping mechanisms employed by cancer patients by conducting interviews and analyzing their experiences.

Example 4. A case study could involve examining a specific company’s organizational culture to understand its impact on employee performance and job satisfaction.

Example 5. A narrative research project might analyze the personal narratives of individuals who have experienced significant life transitions, such as migration or career changes, to understand the underlying meaning-making processes.

Learn more: What is Qualitative Market Research?

Here are the best qualitative research methods that offer unique advantages in capturing rich data, facilitating in-depth analysis, and generating comprehensive findings:

1. In-Depth Interviews

One of the most widely used qualitative research techniques is in-depth interviews. This method involves conducting one-on-one interviews with participants to gather rich, detailed information about their experiences, perspectives, and opinions. In-depth interviews allow researchers to explore a participant’s thoughts, emotions, and motivations, providing deep insights into their behavior and decision-making processes. The flexibility of this method allows for the exploration of individual experiences in great detail, making it particularly suitable for sensitive topics or complex phenomena. Through careful probing and open-ended questioning, researchers can develop a comprehensive understanding of the participant’s worldview, uncovering hidden patterns, and generating new hypotheses.

2. Focus Groups

Focus group research involves the gathering of a small group of individuals (typically 6-10) who share common characteristics or experiences. This method encourages participants to engage in open discussions facilitated by a skilled moderator. Focus groups offer a dynamic environment that allows participants to interact, share their perspectives, and build upon each other’s ideas. This method is particularly useful for exploring group dynamics, collective opinions, and societal norms. By observing interactions within the group, researchers can gain valuable insights into how social influences shape individual attitudes and behaviors. Focus groups also allow for the exploration of diverse viewpoints, enabling researchers to identify patterns, contradictions, and shared experiences.

3. Observational Research

Observational research involves systematically observing and documenting participants’ behaviors and interactions within their natural environments. This method provides researchers with a direct window into real-life contexts, allowing for a comprehensive understanding of social interactions, cultural practices, and behavioral patterns. Whether conducted through participant observation or unobtrusive observation, this method eliminates the potential biases associated with self-reporting, as participants’ actions speak louder than words. Observational research is especially valuable in studying nonverbal communication, contextual factors, and complex social systems. It can also provide insights into unarticulated behaviors or experiences that may be difficult to capture through other methods. However, careful planning, ethical considerations, and the need for prolonged engagement are crucial for conducting successful observational research .

4. Case Studies

Case studies involve an in-depth examination of a specific individual, group, organization, or event. Researchers collect data through various sources, such as interviews, observations, documents, and artifacts, to construct a holistic understanding of the case under investigation. This method allows for an exploration of complex social phenomena in their real-life context, uncovering rich, detailed insights that may not be accessible through other methods. Case studies provide an opportunity to examine unique or rare cases, delve into historical contexts, and generate context-specific knowledge. The findings from case studies are often highly detailed and context-bound, offering rich descriptions and contributing to theory development or refinement.

Qualitative research methods offer a range of powerful tools for exploring subjective experiences, meanings, and interpretations. In-depth interviews allow for the exploration of individual perspectives, while focus groups illuminate group dynamics. Observational research provides a direct view of participants’ behaviors, and case studies offer a holistic understanding of specific cases. By leveraging these qualitative methods, researchers can unveil deep insights, capture complex phenomena, and generate context-specific knowledge.

• Clear Research Objectives: Clearly define the qualitative research objectives, questions, or hypotheses that guide the study. This helps maintain focus and ensures that data collection and analysis are aligned with the research goals.
• Sampling Strategy: Select participants or cases that are relevant to the qualitative research questions and provide diverse perspectives. Purposeful sampling techniques, such as maximum variation or snowball sampling, can help ensure the inclusion of a wide range of experiences and viewpoints.
• Data Collection Rigor: Employ rigorous qualitative data collection techniques to ensure the accuracy, credibility, and depth of the findings. This may involve conducting multiple interviews or qualitative observations , using multiple sources of data, and taking detailed field notes.
• Ethical Considerations: Adhere to ethical guidelines and obtain informed consent from participants. Protect the privacy, confidentiality, and anonymity of participants and ensure their voluntary participation throughout the qualitative research process.
• Data Analysis: Utilize systematic and rigorous approaches to analyze qualitative research data. This may involve coding, categorizing, and identifying patterns or themes within the data. Software tools like NVivo or ATLAS.ti can assist in organizing and analyzing large datasets.
• Triangulation: Enhance the validity and reliability of the findings by employing triangulation. Triangulation involves using multiple data sources, methods, or researchers to corroborate and validate the results, reducing the impact of researcher bias.
• Member Checking: Share the preliminary findings with participants to verify the accuracy and interpretation of their data. Member checking allows participants to provide feedback and corrections, enhancing the trustworthiness of the research.
• Reflexive Journaling: Maintain a reflexive journal throughout the research process to record reflections, insights, and decisions made during data collection and analysis. This journal can serve as a valuable tool for ensuring transparency and traceability in the research process.
• Clear and Transparent Reporting: Present the research findings in a clear, coherent, and transparent manner. Clearly describe the research methodology, data collection, and analysis processes. Provide rich and thick descriptions of the findings, supported by direct quotations and examples from the data.

By following these best practices, qualitative researchers can enhance the rigor, credibility, and trustworthiness of their research, leading to valuable and meaningful insights into the complex phenomena under investigation.

Learn more: What is Customer Experience (CX) Research?

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Qualitative analysis of gender differences in heart failure Patient Reported Outcomes (PROs)

CERSI Collaborators: Shannon Dunlay, MD (Mayo Clinic) (PI), Jennifer Ridgeway, PhD (Mayo Clinic), Erica S. Spatz, MD, MHS (Yale)

FDA Collaborators: Fraser Bocell, PhD, Brittany Caldwell, PhD, Anindita Saha, Michelle Tarver, MD, PhD

CERSI Subcontractors: University of Connecticut: Linda Frisman, PhD, Hsiu-Ju Lin, PhD

CERSI In-Kind Collaborators: Kuldeep Singh Rajput; Trace Brookins; Rachel Chan; Carolyn Lam; Felis Dwiyasa, PhD; Sandi Wibowo, PhD; Chen Hao, PhD; Maulik Majmudar, MD; Sylvia Ong; Kaixiang Chong; Jackie Velarde; Rachel Chan

Non-Federal Entity Collaborators: Johnson and Johnson- Karla Childers, MSJ, Paul Coplan, ScD, MBA, Stephen Johnston, MSc

Project Start Date: October 2018

Project End Date: September 2022

Regulatory Science Challenge

Cardiovascular disease is the leading cause of death for women in the world. In recent years, approximately 1 in every 4 deaths in the United States results from heart disease, with similar rates among men and women. Patient-reported outcomes (PRO) are reports about health status that come directly from patients, usually in the form of a survey. PRO surveys can be used to gather information on health-related topics best described by patients themselves, such as quality of life. Heart failure (HF) PROs, like the Kansas City Cardiomyopathy Questionnaire (KCCQ) , which gather information about patients’ physical limitations and symptoms, have been shown to predict hospitalization and death, and are regularly used as endpoints in clinical studies and patient care. The differences in presentation and symptoms of the disease in women and men are well documented; however, because the KCCQ was developed and validated on a sample that was majority men, it is unknown whether the KCCQ captures the range of symptoms experienced by women. This is important as differences in scores between men and women may not reflect differences in HF severity. Regulatory decisions being made upon the KCCQ results may not fully reflect all patients adequately.

Project Description and Goals

The goal of this project was to explore gender differences in the KCCQ PRO measure. This work addressed improved health communication by initiating the work to make KCCQ clear and applicable to women, potentially helping to improve both patient care and regulatory decisions.

Goal 1: Using qualitative interviews, describe if and how men and women think about health-related quality of life and interpret KCCQ questions differently using qualitative interviews.

Research Outcomes/Results

Two hundred and twenty-three patients with a mean age of 65 years completed the survey. These patients preferred a higher chance of good biopsy outcomes, and a lower chance of erectile dysfunction caused by the treatment and urinary incontinence after treatment. The patients stated in the survey that they are willing to accept:

• a 15.1%-point increase in erectile dysfunction caused by the treatment to achieve a 10%-point increase in a good biopsy outcome after HIFU ablation, and
• an 8.5%-point increase in urinary incontinence for a 10%-point increase in a good biopsy.

Also, further analysis revealed that patients who thought their cancer was more aggressive were more willing to tolerate urinary incontinence. Younger men were willing to tolerate less erectile dysfunction risk than older men. Respondents with a greater than college level of education were less willing to tolerate erectile dysfunction or urinary incontinence.

Research Impacts

Incorporating patient preference information into decisions that FDA makes about regulating devices is one of the major goals of FDA’s Center for Devices and Radiological Health (CDRH). Study findings show that patients prefer specific outcomes related to prostate ablation therapies like HIFU. The study results may help inform the design and regulation of current and future prostate tissue ablation devices by providing information about outcomes that patients most desire.

Results/ Findings/ Publications

A total of 25 adults (13 women, 12 men, 22 years and older) with clinician-diagnosed HF and left ventricular ejection fraction ≤ 40% were recruited from two academic medical centers to participate in semi-structured interviews. All interviews were conducted over the phone/web and audio recorded. Interviews were transcribed and descriptive qualitative content analysis was used to summarize findings overall and by gender. The average age was 67 years (range: 25-88). Women attributed a wider variety of symptoms to HF than men. Some participants had difficulty differentiating whether their experiences were due to HF, side effects of their medications, or age. We found very little evidence that participants interpreted KCCQ items differently based on gender. Overall, our findings indicate that interpretation of the KCCQ items were similar in men and women. However, some modifications to items may improve clarity of interpretation for a wide range of patients.

An abstract was presented at the 28th Annual Conference of the International Society for Quality of Life Research (ISOQOL) (October 2021): Exploring Possible Interpretation Differences by Men and Women on the Kansas City Cardiomyopathy Questionnaire (KCCQ) via Qualitative Interviews (poster presentation).

The qualitative results were also published in a peer-reviewed journal (citation below):

Coles TM, Lucas N, McFatrich M, Henke D, Ridgeway JL, Behnken EM, Weinfurt K, Reeve BB, Corneli A, Dunlay SM, Spertus JA, Lin L, Piña IL, Bocell FD, Tarver ME, Dohse H, Saha A, Caldwell B. Investigating gender-based differential item functioning on the Kansas City Cardiomyopathy Questionnaire (KCCQ) using qualitative content analysis . Qual Life Res . 2023 Mar;32(3):841-852. doi: 10.1007/s11136-022-03276-y . Epub 2022 Nov 2. PMID: 36322269; PMCID: PMC9628332.