descriptive coding in qualitative research

Qualitative Data Coding 101

How to code qualitative data, the smart way (with examples).

By: Jenna Crosley (PhD) | Reviewed by:Dr Eunice Rautenbach | December 2020

As we’ve discussed previously , qualitative research makes use of non-numerical data – for example, words, phrases or even images and video. To analyse this kind of data, the first dragon you’ll need to slay is  qualitative data coding  (or just “coding” if you want to sound cool). But what exactly is coding and how do you do it? 

Overview: Qualitative Data Coding

In this post, we’ll explain qualitative data coding in simple terms. Specifically, we’ll dig into:

• What exactly qualitative data coding is
• What different types of coding exist
• How to code qualitative data (the process)
• Moving from coding to qualitative analysis
• Tips and tricks for quality data coding

What is qualitative data coding?

Let’s start by understanding what a code is. At the simplest level,  a code is a label that describes the content  of a piece of text. For example, in the sentence:

“Pigeons attacked me and stole my sandwich.”

You could use “pigeons” as a code. This code simply describes that the sentence involves pigeons.

So, building onto this,  qualitative data coding is the process of creating and assigning codes to categorise data extracts.   You’ll then use these codes later down the road to derive themes and patterns for your qualitative analysis (for example, thematic analysis ). Coding and analysis can take place simultaneously, but it’s important to note that coding does not necessarily involve identifying themes (depending on which textbook you’re reading, of course). Instead, it generally refers to the process of  labelling and grouping similar types of data  to make generating themes and analysing the data more manageable. 

Makes sense? Great. But why should you bother with coding at all? Why not just look for themes from the outset? Well, coding is a way of making sure your  data is valid . In other words, it helps ensure that your  analysis is undertaken systematically  and that other researchers can review it (in the world of research, we call this transparency). In other words, good coding is the foundation of high-quality analysis.

What are the different types of coding?

Now that we’ve got a plain-language definition of coding on the table, the next step is to understand what overarching types of coding exist – in other words, coding approaches . Let’s start with the two main approaches, inductive and deductive .

With deductive coding, you, as the researcher, begin with a set of  pre-established codes  and apply them to your data set (for example, a set of interview transcripts). Inductive coding on the other hand, works in reverse, as you create the set of codes based on the data itself – in other words, the codes emerge from the data. Let’s take a closer look at both.

Deductive coding 101

With deductive coding, we make use of pre-established codes, which are developed before you interact with the present data. This usually involves drawing up a set of  codes based on a research question or previous research . You could also use a code set from the codebook of a previous study.

For example, if you were studying the eating habits of college students, you might have a research question along the lines of 

“What foods do college students eat the most?”

As a result of this research question, you might develop a code set that includes codes such as “sushi”, “pizza”, and “burgers”.  

Deductive coding allows you to approach your analysis with a very tightly focused lens and quickly identify relevant data . Of course, the downside is that you could miss out on some very valuable insights as a result of this tight, predetermined focus. 

Inductive coding 101 

But what about inductive coding? As we touched on earlier, this type of coding involves jumping right into the data and then developing the codes  based on what you find  within the data. 

For example, if you were to analyse a set of open-ended interviews , you wouldn’t necessarily know which direction the conversation would flow. If a conversation begins with a discussion of cats, it may go on to include other animals too, and so you’d add these codes as you progress with your analysis. Simply put, with inductive coding, you “go with the flow” of the data.

Inductive coding is great when you’re researching something that isn’t yet well understood because the coding derived from the data helps you explore the subject. Therefore, this type of coding is usually used when researchers want to investigate new ideas or concepts , or when they want to create new theories. 

A little bit of both… hybrid coding approaches

If you’ve got a set of codes you’ve derived from a research topic, literature review or a previous study (i.e. a deductive approach), but you still don’t have a rich enough set to capture the depth of your qualitative data, you can  combine deductive and inductive  methods – this is called a  hybrid  coding approach. 

To adopt a hybrid approach, you’ll begin your analysis with a set of a priori codes (deductive) and then add new codes (inductive) as you work your way through the data. Essentially, the hybrid coding approach provides the best of both worlds, which is why it’s pretty common to see this in research.

Need a helping hand?

How to code qualitative data

Now that we’ve looked at the main approaches to coding, the next question you’re probably asking is “how do I actually do it?”. Let’s take a look at the  coding process , step by step.

Both inductive and deductive methods of coding typically occur in two stages:  initial coding  and  line by line coding . 

In the initial coding stage, the objective is to get a general overview of the data by reading through and understanding it. If you’re using an inductive approach, this is also where you’ll develop an initial set of codes. Then, in the second stage (line by line coding), you’ll delve deeper into the data and (re)organise it according to (potentially new) codes. 

Step 1 – Initial coding

The first step of the coding process is to identify  the essence  of the text and code it accordingly. While there are various qualitative analysis software packages available, you can just as easily code textual data using Microsoft Word’s “comments” feature. 

Let’s take a look at a practical example of coding. Assume you had the following interview data from two interviewees:

What pets do you have?

I have an alpaca and three dogs.

Only one alpaca? They can die of loneliness if they don’t have a friend.

I didn’t know that! I’ll just have to get five more. 

I have twenty-three bunnies. I initially only had two, I’m not sure what happened. 

In the initial stage of coding, you could assign the code of “pets” or “animals”. These are just initial,  fairly broad codes  that you can (and will) develop and refine later. In the initial stage, broad, rough codes are fine – they’re just a starting point which you will build onto in the second stage. 

How to decide which codes to use

But how exactly do you decide what codes to use when there are many ways to read and interpret any given sentence? Well, there are a few different approaches you can adopt. The  main approaches  to initial coding include:

• In vivo coding 

Process coding

• Open coding

Descriptive coding

Structural coding.

• Value coding

Let’s take a look at each of these:

In vivo coding

When you use in vivo coding , you make use of a  participants’ own words , rather than your interpretation of the data. In other words, you use direct quotes from participants as your codes. By doing this, you’ll avoid trying to infer meaning, rather staying as close to the original phrases and words as possible. 

In vivo coding is particularly useful when your data are derived from participants who speak different languages or come from different cultures. In these cases, it’s often difficult to accurately infer meaning due to linguistic or cultural differences. 

For example, English speakers typically view the future as in front of them and the past as behind them. However, this isn’t the same in all cultures. Speakers of Aymara view the past as in front of them and the future as behind them. Why? Because the future is unknown, so it must be out of sight (or behind us). They know what happened in the past, so their perspective is that it’s positioned in front of them, where they can “see” it. 

In a scenario like this one, it’s not possible to derive the reason for viewing the past as in front and the future as behind without knowing the Aymara culture’s perception of time. Therefore, in vivo coding is particularly useful, as it avoids interpretation errors.

Next up, there’s process coding , which makes use of  action-based codes . Action-based codes are codes that indicate a movement or procedure. These actions are often indicated by gerunds (words ending in “-ing”) – for example, running, jumping or singing.

Process coding is useful as it allows you to code parts of data that aren’t necessarily spoken, but that are still imperative to understanding the meaning of the texts. 

An example here would be if a participant were to say something like, “I have no idea where she is”. A sentence like this can be interpreted in many different ways depending on the context and movements of the participant. The participant could shrug their shoulders, which would indicate that they genuinely don’t know where the girl is; however, they could also wink, showing that they do actually know where the girl is. 

Simply put, process coding is useful as it allows you to, in a concise manner, identify the main occurrences in a set of data and provide a dynamic account of events. For example, you may have action codes such as, “describing a panda”, “singing a song about bananas”, or “arguing with a relative”.

Descriptive coding aims to summarise extracts by using a  single word or noun  that encapsulates the general idea of the data. These words will typically describe the data in a highly condensed manner, which allows the researcher to quickly refer to the content. 

Descriptive coding is very useful when dealing with data that appear in forms other than traditional text – i.e. video clips, sound recordings or images. For example, a descriptive code could be “food” when coding a video clip that involves a group of people discussing what they ate throughout the day, or “cooking” when coding an image showing the steps of a recipe. 

Structural coding involves labelling and describing  specific structural attributes  of the data. Generally, it includes coding according to answers to the questions of “ who ”, “ what ”, “ where ”, and “ how ”, rather than the actual topics expressed in the data. This type of coding is useful when you want to access segments of data quickly, and it can help tremendously when you’re dealing with large data sets. 

For example, if you were coding a collection of theses or dissertations (which would be quite a large data set), structural coding could be useful as you could code according to different sections within each of these documents – i.e. according to the standard  dissertation structure . What-centric labels such as “hypothesis”, “literature review”, and “methodology” would help you to efficiently refer to sections and navigate without having to work through sections of data all over again. 

Structural coding is also useful for data from open-ended surveys. This data may initially be difficult to code as they lack the set structure of other forms of data (such as an interview with a strict set of questions to be answered). In this case, it would useful to code sections of data that answer certain questions such as “who?”, “what?”, “where?” and “how?”.

Let’s take a look at a practical example. If we were to send out a survey asking people about their dogs, we may end up with a (highly condensed) response such as the following: 

Bella is my best friend. When I’m at home I like to sit on the floor with her and roll her ball across the carpet for her to fetch and bring back to me. I love my dog.

In this set, we could code  Bella  as “who”,  dog  as “what”,  home  and  floor  as “where”, and  roll her ball  as “how”. 

Values coding

Finally, values coding involves coding that relates to the  participant’s worldviews . Typically, this type of coding focuses on excerpts that reflect the values, attitudes, and beliefs of the participants. Values coding is therefore very useful for research exploring cultural values and intrapersonal and experiences and actions.   

To recap, the aim of initial coding is to understand and  familiarise yourself with your data , to  develop an initial code set  (if you’re taking an inductive approach) and to take the first shot at  coding your data . The coding approaches above allow you to arrange your data so that it’s easier to navigate during the next stage, line by line coding (we’ll get to this soon). 

While these approaches can all be used individually, it’s important to remember that it’s possible, and potentially beneficial, to  combine them . For example, when conducting initial coding with interviews, you could begin by using structural coding to indicate who speaks when. Then, as a next step, you could apply descriptive coding so that you can navigate to, and between, conversation topics easily. 

Step 2 – Line by line coding

Once you’ve got an overall idea of our data, are comfortable navigating it and have applied some initial codes, you can move on to line by line coding. Line by line coding is pretty much exactly what it sounds like – reviewing your data, line by line,  digging deeper  and assigning additional codes to each line. 

With line-by-line coding, the objective is to pay close attention to your data to  add detail  to your codes. For example, if you have a discussion of beverages and you previously just coded this as “beverages”, you could now go deeper and code more specifically, such as “coffee”, “tea”, and “orange juice”. The aim here is to scratch below the surface. This is the time to get detailed and specific so as to capture as much richness from the data as possible. 

In the line-by-line coding process, it’s useful to  code everything  in your data, even if you don’t think you’re going to use it (you may just end up needing it!). As you go through this process, your coding will become more thorough and detailed, and you’ll have a much better understanding of your data as a result of this, which will be incredibly valuable in the analysis phase.

Moving from coding to analysis

Once you’ve completed your initial coding and line by line coding, the next step is to  start your analysis . Of course, the coding process itself will get you in “analysis mode” and you’ll probably already have some insights and ideas as a result of it, so you should always keep notes of your thoughts as you work through the coding.  

When it comes to qualitative data analysis, there are  many different types of analyses  (we discuss some of the  most popular ones here ) and the type of analysis you adopt will depend heavily on your research aims, objectives and questions . Therefore, we’re not going to go down that rabbit hole here, but we’ll cover the important first steps that build the bridge from qualitative data coding to qualitative analysis.

When starting to think about your analysis, it’s useful to  ask yourself  the following questions to get the wheels turning:

• What actions are shown in the data? 
• What are the aims of these interactions and excerpts? What are the participants potentially trying to achieve?
• How do participants interpret what is happening, and how do they speak about it? What does their language reveal?
• What are the assumptions made by the participants? 
• What are the participants doing? What is going on? 
• Why do I want to learn about this? What am I trying to find out? 
• Why did I include this particular excerpt? What does it represent and how?

Code categorisation

Categorisation is simply the process of reviewing everything you’ve coded and then  creating code categories  that can be used to guide your future analysis. In other words, it’s about creating categories for your code set. Let’s take a look at a practical example.

If you were discussing different types of animals, your initial codes may be “dogs”, “llamas”, and “lions”. In the process of categorisation, you could label (categorise) these three animals as “mammals”, whereas you could categorise “flies”, “crickets”, and “beetles” as “insects”. By creating these code categories, you will be making your data more organised, as well as enriching it so that you can see new connections between different groups of codes. 

Theme identification

From the coding and categorisation processes, you’ll naturally start noticing themes. Therefore, the logical next step is to  identify and clearly articulate the themes  in your data set. When you determine themes, you’ll take what you’ve learned from the coding and categorisation and group it all together to develop themes. This is the part of the coding process where you’ll try to draw meaning from your data, and start to  produce a narrative . The nature of this narrative depends on your research aims and objectives, as well as your research questions (sounds familiar?) and the  qualitative data analysis method  you’ve chosen, so keep these factors front of mind as you scan for themes. 

Tips & tricks for quality coding

Before we wrap up, let’s quickly look at some general advice, tips and suggestions to ensure your qualitative data coding is top-notch.

• Before you begin coding,  plan out the steps  you will take and the coding approach and technique(s) you will follow to avoid inconsistencies. 
• When adopting deductive coding, it’s useful to  use a codebook  from the start of the coding process. This will keep your work organised and will ensure that you don’t forget any of your codes. 
• Whether you’re adopting an inductive or deductive approach,  keep track of the meanings  of your codes and remember to revisit these as you go along.
• Avoid using synonyms  for codes that are similar, if not the same. This will allow you to have a more uniform and accurate coded dataset and will also help you to not get overwhelmed by your data.
• While coding, make sure that you  remind yourself of your aims  and coding method. This will help you to  avoid  directional drift , which happens when coding is not kept consistent. 
• If you are working in a team, make sure that everyone has  been trained and understands  how codes need to be assigned. 

Psst... there’s more!

This post was based on one of our popular Research Bootcamps . If you're working on a research project, you'll definitely want to check this out ...

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31 Comments

I appreciated the valuable information provided to accomplish the various stages of the inductive and inductive coding process. However, I would have been extremely satisfied to be appraised of the SPECIFIC STEPS to follow for: 1. Deductive coding related to the phenomenon and its features to generate the codes, categories, and themes. 2. Inductive coding related to using (a) Initial (b) Axial, and (c) Thematic procedures using transcribe data from the research questions

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deductive data analysis of my Focus group discussion results very helpful

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University Library, University of Illinois at Urbana-Champaign

Qualitative Data Analysis: Coding

• Atlas.ti web
• R for text analysis
• Microsoft Excel & spreadsheets
• Other options
• Planning Qual Data Analysis
• Free Tools for QDA
• QDA with NVivo
• QDA with Atlas.ti
• QDA with MAXQDA
• PKM for QDA
• QDA with Quirkos
• Working Collaboratively
• Qualitative Methods Texts
• Transcription
• Data organization
• Example Publications

Coding Qualitative Data

Planning your coding strategy.

Coding is a qualitative data analysis strategy in which some aspect of the data is assigned a descriptive label that allows the researcher to identify related content across the data. How you decide to code - or whether to code- your data should be driven by your methodology. But there are rarely step-by-step descriptions, and you'll have to make many decisions about how to code for your own project.

Some questions to consider as you decide how to code your data:

What will you code? 

What aspects of your data will you code? If you are not coding all of your available data, how will you decide which elements need to be coded? If you have recordings interviews or focus groups, or other types of multimedia data, will you create transcripts to analyze and code? Or will you code the media itself (see Farley, Duppong & Aitken, 2020 on direct coding of audio recordings rather than transcripts). 

Where will your codes come from? 

Depending on your methodology, your coding scheme may come from previous research and be applied to your data (deductive). Or you my try to develop codes entirely from the data, ignoring as much as possible, previous knowledge of the topic under study, to develop a scheme grounded in your data (inductive). In practice, however, many practices will fall between these two approaches. 

How will you apply your codes to your data? 

You may decide to use software to code your qualitative data, to re-purpose other software tools (e.g. Word or spreadsheet software) or work primarily with physical versions of your data. Qualitative software is not strictly necessary, though it does offer some advantages, like: 

• Codes can be easily re-labeled, merged, or split. You can also choose to apply multiple coding schemes to the same data, which means you can explore multiple ways of understanding the same data. Your analysis, then, is not limited by how often you are able to work with physical data, such as paper transcripts. 
• Most software programs for QDA include the ability to export and import coding schemes. This means you can create a re-use a coding scheme from a previous study, or that was developed in outside of the software, without having to manually create each code. 
• Some software for QDA includes the ability to directly code image, video, and audio files. This may mean saving time over creating transcripts. Or, your coding may be enhanced by access to the richness of mediated content, compared to transcripts.
• Using QDA software may also allow you the ability to use auto-coding functions. You may be able to automatically code all of the statements by speaker in a focus group transcript, for example, or identify and code all of the paragraphs that include a specific phrase. 

What will be coded? 

Will you deploy a line-by-line coding approach, with smaller codes eventually condensed into larger categories or concepts? Or will you start with codes applied to larger segments of the text, perhaps later reviewing the examples to explore and re-code for differences between the segments? 

How will you explain the coding process? 

• Regardless of how you approach coding, the process should be clearly communicated when you report your research, though this is not always the case (Deterding & Waters, 2021).
• Carefully consider the use of phrases like "themes emerged." This phrasing implies that the themes lay passively in the data, waiting for the researcher to pluck them out. This description leaves little room for describing how the researcher "saw" the themes and decided which were relevant to the study. Ryan and Bernard (2003) offer a terrific guide to ways that you might identify themes in the data, using both your own observations as well as manipulations of the data. 

How will you report the results of your coding process? 

How you report your coding process should align with the methodology you've chosen. Your methodology may call for careful and consistent application of a coding scheme, with reports of inter-rater reliability and counts of how often a code appears within the data. Or you may use the codes to help develop a rich description of an experience, without needing to indicate precisely how often the code was applied. 

How will you code collaboratively?

If you are working with another researcher or a team, your coding process requires careful planning and implementation. You will likely need to have regular conversations about your process, particularly if your goal is to develop and consistently apply a coding scheme across your data. 

Coding Features in QDA Software Programs

• Atlas.ti (Mac)
• Atlas.ti (Windows)
• NVivo (Windows)
• NVivo (Mac)
• Coding data See how to create and manage codes and apply codes to segments of the data (known as quotations in Atlas.ti).

• Search and Code Using the search and code feature lets you locate and automatically code data through text search, regular expressions, Named Entity Recognition, and Sentiment Analysis.
• Focus Group Coding Properly prepared focus group documents can be automatically coded by speaker.
• Inter-Coder Agreement Coded text, audio, and video documents can be tested for inter-coder agreement. ICA is not available for images or PDF documents.
• Quotation Reader Once you've coded data, you can view just the data that has been assigned that code.

• Find Redundant Codings (Mac) This tool identifies "overlapping or embedded" quotations that have the same code, that are the result of manual coding or errors when merging project files.
• Coding Data in Atlas.ti (Windows) Demonstrates how to create new codes, manage codes and applying codes to segments of the data (known as quotations in Atlas.ti)
• Search and Code in Atlas.ti (Windows) You can use a text search, regular expressions, Named Entity Recognition, and Sentiment Analysis to identify and automatically code data in Atlas.ti.
• Focus Group Coding in Atlas.ti (Windows) Properly prepared focus group transcripts can be automatically coded by speaker.
• Inter-coder Agreement in Atlas.ti (Windows) Coded text, audio, and video documents can be tested for inter-coder agreement. ICA is not available for images or PDF documents.
• Quotation Reader in Atlas.ti (Windows) Once you've coded data, you can view and export the quotations that have been assigned that code.
• Find Redundant Codings in Atlas.ti (Windows) This tool identifies "overlapping or embedded" quotations that have the same code, that are the result of manual coding or errors when merging project files.
• Coding in NVivo (Windows) This page includes an overview of the coding features in NVivo.
• Automatic Coding in Documents in NVivo (Windows) You can use paragraph formatting styles or speaker names to automatically format documents.
• Coding Comparison Query in NVivo (Windows) You can use the coding comparison feature to compare how different users have coded data in NVivo.
• Review the References in a Node in NVivo (Windows) References are the term that NVivo uses for coded segments of the data. This shows you how to view references related to a code (or any node)
• Text Search Queries in NVivo (Windows) Text queries let you search for specific text in your data. The results of your query can be saved as a node (a form of auto coding).
• Coding Query in NVivo (Windows) Use a coding query to display references from your data for a single code or multiples of codes.
• Code Files and Manage Codes in NVivo (Mac) This page offers an overview of coding features in NVivo. Note that NVivo uses the concept of a node to refer to any structure around which you organize your data. Codes are a type of node, but you may see these terms used interchangeably.
• Automatic Coding in Datasets in NVivo (Mac) A dataset in NVivo is data that is in rows and columns, as in a spreadsheet. If a column is set to be codable, you can also automatically code the data. This approach could be used for coding open-ended survey data.
• Text Search Query in NVivo (Mac) Use the text search query to identify relevant text in your data and automatically code references by saving as a node.
• Review the References in a Node in NVivo (Mac) NVivo uses the term references to refer to data that has been assigned to a code or any node. You can use the reference view to see the data linked to a specific node or combination of nodes.
• Coding Comparison Query in NVivo (Mac) Use the coding comparison query to calculate a measure of inter-rater reliability when you've worked with multiple coders.

The MAXQDA interface is the same across Mac and Windows devices. 

• The "Code System" in MAXQDA This section of the manual shows how to create and manage codes in MAXQDA's code system.
• How to Code with MAXQDA

• Display Coded Segments in the Document Browser Once you've coded a document within MAXQDA, you can choose which of those codings will appear on the document, as well as choose whether or not the text is highlighted in the color linked to the code.
• Creative Coding in MAXQDA Use the creative coding feature to explore the relationships between codes in your system. If you develop a new structure to you codes that you like, you can apply the changes to your overall code scheme.
• Text Search in MAXQDA Use a Text Search to identify data that matches your search terms and automatically code the results. You can choose whether to code only the matching results, the sentence the results are in, or the paragraph the results appear in.
• Segment Retrieval in MAXQDA Data that has been coded is considered a segment. Segment retrieval is how you display the segments that match a code or combination of codes. You can use the activation feature to show only the segments from a document group, or that match a document variable.
• Intercorder Agreement in MAXQDA MAXQDA includes the ability to compare coding between two coders on a single project.
• Create Tags in Taguette Taguette uses the term tag to refer to codes. You can create single tags as well as a tag hierarchy using punctuation marks.
• Highlighting in Taguette Select text with a document (a highlight) and apply tags to code data in Taguette.

Useful Resources on Coding

Deterding, N. M., & Waters, M. C. (2021). Flexible coding of in-depth interviews: A twenty-first-century approach. Sociological Methods & Research , 50 (2), 708–739. https://doi.org/10.1177/0049124118799377

Farley, J., Duppong Hurley, K., & Aitken, A. A. (2020). Monitoring implementation in program evaluation with direct audio coding. Evaluation and Program Planning , 83 , 101854. https://doi.org/10.1016/j.evalprogplan.2020.101854

Ryan, G. W., & Bernard, H. R. (2003). Techniques to identify themes. Field Methods , 15 (1), 85–109. https://doi.org/10.1177/1525822X02239569. 

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• Last Updated: Apr 5, 2024 2:23 PM
• URL: https://guides.library.illinois.edu/qualitative

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28 Coding and Analysis Strategies

Johnny Saldaña, School of Theatre and Film, Arizona State University

• Published: 04 August 2014
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This chapter provides an overview of selected qualitative data analytic strategies with a particular focus on codes and coding. Preparatory strategies for a qualitative research study and data management are first outlined. Six coding methods are then profiled using comparable interview data: process coding, in vivo coding, descriptive coding, values coding, dramaturgical coding, and versus coding. Strategies for constructing themes and assertions from the data follow. Analytic memo writing is woven throughout the preceding as a method for generating additional analytic insight. Next, display and arts-based strategies are provided, followed by recommended qualitative data analytic software programs and a discussion on verifying the researcher’s analytic findings.

Coding and Analysis Strategies

Anthropologist Clifford Geertz (1983) charmingly mused, “Life is just a bowl of strategies” (p. 25). Strategy , as I use it here, refers to a carefully considered plan or method to achieve a particular goal. The goal in this case is to develop a write-up of your analytic work with the qualitative data you have been given and collected as part of a study. The plans and methods you might employ to achieve that goal are what this article profiles.

Some may perceive strategy as an inappropriate if not colonizing word, suggesting formulaic or regimented approaches to inquiry. I assure you that that is not my intent. My use of strategy is actually dramaturgical in nature: strategies are actions that characters in plays take to overcome obstacles to achieve their objectives. Actors portraying these characters rely on action verbs to generate belief within themselves and to motivate them as they interpret the lines and move appropriately on stage. So what I offer is a qualitative researcher’s array of actions from which to draw to overcome the obstacles to thinking to achieve an analysis of your data. But unlike the pre-scripted text of a play in which the obstacles, strategies, and outcomes have been predetermined by the playwright, your work must be improvisational—acting, reacting, and interacting with data on a moment-by-moment basis to determine what obstacles stand in your way, and thus what strategies you should take to reach your goals.

Another intriguing quote to keep in mind comes from research methodologist Robert E. Stake (1995) who posits, “Good research is not about good methods as much as it is about good thinking” (p. 19). In other words, strategies can take you only so far. You can have a box full of tools, but if you do not know how to use them well or use them creatively, the collection seems rather purposeless. One of the best ways we learn is by doing . So pick up one or more of these strategies (in the form of verbs) and take analytic action with your data. Also keep in mind that these are discussed in the order in which they may typically occur, although humans think cyclically, iteratively, and reverberatively, and each particular research project has its own unique contexts and needs. So be prepared for your mind to jump purposefully and/or idiosyncratically from one strategy to another throughout the study.

QDA (Qualitative Data Analysis) Strategy: To Foresee

To foresee in QDA is to reflect beforehand on what forms of data you will most likely need and collect, which thus informs what types of data analytic strategies you anticipate using.

Analysis, in a way, begins even before you collect data. As you design your research study in your mind and on a word processor page, one strategy is to consider what types of data you may need to help inform and answer your central and related research questions. Interview transcripts, participant observation field notes, documents, artifacts, photographs, video recordings, and so on are not only forms of data but foundations for how you may plan to analyze them. A participant interview, for example, suggests that you will transcribe all or relevant portions of the recording, and use both the transcription and the recording itself as sources for data analysis. Any analytic memos (discussed later) or journal entries you make about your impressions of the interview also become data to analyze. Even the computing software you plan to employ will be relevant to data analysis as it may help or hinder your efforts.

As your research design formulates, compose one to two paragraphs that outline how your QDA may proceed. This will necessitate that you have some background knowledge of the vast array of methods available to you. Thus surveying the literature is vital preparatory work.

QDA Strategy: To Survey

To survey in QDA is to look for and consider the applicability of the QDA literature in your field that may provide useful guidance for your forthcoming data analytic work.

General sources in QDA will provide a good starting point for acquainting you with the data analytic strategies available for the variety of genres in qualitative inquiry (e.g., ethnography, phenomenology, case study, arts-based research, mixed methods). One of the most accessible is Graham R. Gibbs’ (2007)   Analysing Qualitative Data , and one of the most richly detailed is Frederick J. Wertz et al.'s (2011)   Five Ways of Doing Qualitative Analysis . The author’s core texts for this article came from The Coding Manual for Qualitative Researchers ( Saldaña, 2009 , 2013 ) and Fundamentals of Qualitative Research ( Saldaña, 2011 ).

If your study’s methodology or approach is grounded theory, for example, then a survey of methods works by such authors as Barney G. Glaser, Anselm L. Strauss, Juliet Corbin and, in particular, the prolific Kathy Charmaz (2006) may be expected. But there has been a recent outpouring of additional book publications in grounded theory by Birks & Mills (2011) , Bryant & Charmaz (2007) , Stern & Porr (2011) , plus the legacy of thousands of articles and chapters across many disciplines that have addressed grounded theory in their studies.

Particular fields such as education, psychology, social work, health care, and others also have their own QDA methods literature in the form of texts and journals, plus international conferences and workshops for members of the profession. Most important is to have had some university coursework and/or mentorship in qualitative research to suitably prepare you for the intricacies of QDA. Also acknowledge that the emergent nature of qualitative inquiry may require you to adopt different analytic strategies from what you originally planned.

QDA Strategy: To Collect

To collect in QDA is to receive the data given to you by participants and those data you actively gather to inform your study.

QDA is concurrent with data collection and management. As interviews are transcribed, field notes are fleshed out, and documents are filed, the researcher uses the opportunity to carefully read the corpus and make preliminary notations directly on the data documents by highlighting, bolding, italicizing, or noting in some way any particularly interesting or salient portions. As these data are initially reviewed, the researcher also composes supplemental analytic memos that include first impressions, reminders for follow-up, preliminary connections, and other thinking matters about the phenomena at work.

Some of the most common fieldwork tools you might use to collect data are notepads, pens and pencils, file folders for documents, a laptop or desktop with word processing software (Microsoft Word and Excel are most useful) and internet access, a digital camera, and a voice recorder. Some fieldworkers may even employ a digital video camera to record social action, as long as participant permissions have been secured. But everything originates from the researcher himself or herself. Your senses are immersed in the cultural milieu you study, taking in and holding on to relevant details or “significant trivia,” as I call them. You become a human camera, zooming out to capture the broad landscape of your field site one day, then zooming in on a particularly interesting individual or phenomenon the next. Your analysis is only as good as the data you collect.

Fieldwork can be an overwhelming experience because so many details of social life are happening in front of you. Take a holistic approach to your entree, but as you become more familiar with the setting and participants, actively focus on things that relate to your research topic and questions. Of course, keep yourself open to the intriguing, surprising, and disturbing ( Sunstein & Chiseri-Strater, 2012 , p. 115), for these facets enrich your study by making you aware of the unexpected.

QDA Strategy: To Feel

To feel in QDA is to gain deep emotional insight into the social worlds you study and what it means to be human.

Virtually everything we do has an accompanying emotion(s), and feelings are both reactions and stimuli for action. Others’ emotions clue you to their motives, attitudes, values, beliefs, worldviews, identities, and other subjective perceptions and interpretations. Acknowledge that emotional detachment is not possible in field research. Attunement to the emotional experiences of your participants plus sympathetic and empathetic responses to the actions around you are necessary in qualitative endeavors. Your own emotional responses during fieldwork are also data because they document the tacit and visceral. It is important during such analytic reflection to assess why your emotional reactions were as they were. But it is equally important not to let emotions alone steer the course of your study. A proper balance must be found between feelings and facts.

QDA Strategy: To Organize

To organize in QDA is to maintain an orderly repository of data for easy access and analysis.

Even in the smallest of qualitative studies, a large amount of data will be collected across time. Prepare both a hard drive and hard copy folders for digital data and paperwork, and back up all materials for security from loss. I recommend that each data “chunk” (e.g., one interview transcript, one document, one day’s worth of field notes) get its own file, with subfolders specifying the data forms and research study logistics (e.g., interviews, field notes, documents, Institutional Review Board correspondence, calendar).

For small-scale qualitative studies, I have found it quite useful to maintain one large master file with all participant and field site data copied and combined with the literature review and accompanying researcher analytic memos. This master file is used to cut and paste related passages together, deleting what seems unnecessary as the study proceeds, and eventually transforming the document into the final report itself. Cosmetic devices such as font style, font size, rich text (italicizing, bolding, underlining, etc.), and color can help you distinguish between different data forms and highlight significant passages. For example, descriptive, narrative passages of field notes are logged in regular font. “Quotations, things spoken by participants, are logged in bold font.”   Observer’s comments, such as the researcher’s subjective impressions or analytic jottings, are set in italics.

QDA Strategy: To Jot

To jot in QDA is to write occasional, brief notes about your thinking or reminders for follow up.

A jot is a phrase or brief sentence that will literally fit on a standard size “sticky note.” As data are brought and documented together, take some initial time to review their contents and to jot some notes about preliminary patterns, participant quotes that seem quite vivid, anomalies in the data, and so forth.

As you work on a project, keep something to write with or to voice record with you at all times to capture your fleeting thoughts. You will most likely find yourself thinking about your research when you're not working exclusively on the project, and a “mental jot” may occur to you as you ruminate on logistical or analytic matters. Get the thought documented in some way for later retrieval and elaboration as an analytic memo.

QDA Strategy: To Prioritize

To prioritize in QDA is to determine which data are most significant in your corpus and which tasks are most necessary.

During fieldwork, massive amounts of data in various forms may be collected, and your mind can get easily overwhelmed from the magnitude of the quantity, its richness, and its management. Decisions will need to be made about the most pertinent of them because they help answer your research questions or emerge as salient pieces of evidence. As a sweeping generalization, approximately one half to two thirds of what you collect may become unnecessary as you proceed toward the more formal stages of QDA.

To prioritize in QDA is to also determine what matters most in your assembly of codes, categories, themes, assertions, and concepts. Return back to your research purpose and questions to keep you framed for what the focus should be.

QDA Strategy: To Analyze

To analyze in QDA is to observe and discern patterns within data and to construct meanings that seem to capture their essences and essentials.

Just as there are a variety of genres, elements, and styles of qualitative research, so too are there a variety of methods available for QDA. Analytic choices are most often based on what methods will harmonize with your genre selection and conceptual framework, what will generate the most sufficient answers to your research questions, and what will best represent and present the project’s findings.

Analysis can range from the factual to the conceptual to the interpretive. Analysis can also range from a straightforward descriptive account to an emergently constructed grounded theory to an evocatively composed short story. A qualitative research project’s outcomes may range from rigorously achieved, insightful answers to open-ended, evocative questions; from rich descriptive detail to a bullet-pointed list of themes; and from third-person, objective reportage to first-person, emotion-laden poetry. Just as there are multiple destinations in qualitative research, there are multiple pathways and journeys along the way.

Analysis is accelerated as you take cognitive ownership of your data. By reading and rereading the corpus, you gain intimate familiarity with its contents and begin to notice significant details as well as make new insights about their meanings. Patterns, categories, and their interrelationships become more evident the more you know the subtleties of the database.

Since qualitative research’s design, fieldwork, and data collection are most often provisional, emergent, and evolutionary processes, you reflect on and analyze the data as you gather them and proceed through the project. If preplanned methods are not working, you change them to secure the data you need. There is generally a post-fieldwork period when continued reflection and more systematic data analysis occur, concurrent with or followed by additional data collection, if needed, and the more formal write-up of the study, which is in itself an analytic act. Through field note writing, interview transcribing, analytic memo writing, and other documentation processes, you gain cognitive ownership of your data; and the intuitive, tacit, synthesizing capabilities of your brain begin sensing patterns, making connections, and seeing the bigger picture. The purpose and outcome of data analysis is to reveal to others through fresh insights what we have observed and discovered about the human condition. And fortunately, there are heuristics for reorganizing and reflecting on your qualitative data to help you achieve that goal.

QDA Strategy: To Pattern

To pattern in QDA is to detect similarities within and regularities among the data you have collected.

The natural world is filled with patterns because we, as humans, have constructed them as such. Stars in the night sky are not just a random assembly; our ancestors pieced them together to form constellations like the Big Dipper. A collection of flowers growing wild in a field has a pattern, as does an individual flower’s patterns of leaves and petals. Look at the physical objects humans have created and notice how pattern oriented we are in our construction, organization, and decoration. Look around you in your environment and notice how many patterns are evident on your clothing, in a room, and on most objects themselves. Even our sometimes mundane daily and long-term human actions are reproduced patterns in the form of roles, relationships, rules, routines, and rituals.

This human propensity for pattern making follows us into QDA. From the vast array of interview transcripts, field notes, documents, and other forms of data, there is this instinctive, hardwired need to bring order to the collection—not just to reorganize it but to look for and construct patterns out of it. The discernment of patterns is one of the first steps in the data analytic process, and the methods described next are recommended ways to construct them.

QDA Strategy: To Code

To code in QDA is to assign a truncated, symbolic meaning to each datum for purposes of qualitative analysis.

Coding is a heuristic—a method of discovery—to the meanings of individual sections of data. These codes function as a way of patterning, classifying, and later reorganizing them into emergent categories for further analysis. Different types of codes exist for different types of research genres and qualitative data analytic approaches, but this article will focus on only a few selected methods. First, a definition of a code:

A code in qualitative data analysis is most often a word or short phrase that symbolically assigns a summative, salient, essence-capturing, and/or evocative attribute for a portion of language-based or visual data. The data can consist of interview transcripts, participant observation fieldnotes, journals, documents, literature, artifacts, photographs, video, websites, e-mail correspondence, and so on. The portion of data to be coded can... range in magnitude from a single word to a full sentence to an entire page of text to a stream of moving images.... Just as a title represents and captures a book or film or poem’s primary content and essence, so does a code represent and capture a datum’s primary content and essence. [ Saldaña, 2009 , p. 3]

One helpful pre-coding task is to divide long selections of field note or interview transcript data into shorter stanzas . Stanza division “chunks” the corpus into more manageable paragraph-like units for coding assignments and analysis. The transcript sample that follows illustrates one possible way of inserting line breaks in-between self-standing passages of interview text for easier readability.

Process Coding

As a first coding example, the following interview excerpt about an employed, single, lower-middle-class adult male’s spending habits during the difficult economic times in the U.S. during 2008–2012 is coded in the right-hand margin in capital letters. The superscript numbers match the datum unit with its corresponding code. This particular method is called process coding, which uses gerunds (“-ing” words) exclusively to represent action suggested by the data. Processes can consist of observable human actions (e.g., BUYING BARGAINS), mental processes (e.g., THINKING TWICE), and more conceptual ideas (e.g., APPRECIATING WHAT YOU’VE GOT). Notice that the interviewer’s (I) portions are not coded, just the participant’s (P). A code is applied each time the subtopic of the interview shifts—even within a stanza—and the same codes can (and should) be used more than once if the subtopics are similar. The central research question driving this qualitative study is, “In what ways are middle-class Americans influenced and affected by the current [2008–2012] economic recession?”

Different researchers analyzing this same piece of data may develop completely different codes, depending on their lenses and filters. The previous codes are only one person’s interpretation of what is happening in the data, not the definitive list. The process codes have transformed the raw data units into new representations for analysis. A listing of them applied to this interview transcript, in the order they appear, reads:

BUYING BARGAINS

QUESTIONING A PURCHASE

THINKING TWICE

STOCKING UP

REFUSING SACRIFICE

PRIORITIZING

FINDING ALTERNATIVES

LIVING CHEAPLY

NOTICING CHANGES

STAYING INFORMED

MAINTAINING HEALTH

PICKING UP THE TAB

APPRECIATING WHAT YOU’VE GOT

Coding the data is the first step in this particular approach to QDA, and categorization is just one of the next possible steps.

QDA Strategy: To Categorize

To categorize in QDA is to cluster similar or comparable codes into groups for pattern construction and further analysis.

Humans categorize things in innumerable ways. Think of an average apartment or house’s layout. The rooms of a dwelling have been constructed or categorized by their builders and occupants according to function. A kitchen is designated as an area to store and prepare food and the cooking and dining materials such as pots, pans, and utensils. A bedroom is designated for sleeping, a closet for clothing storage, a bathroom for bodily functions and hygiene, and so on. Each room is like a category in which related and relevant patterns of human action occur. Of course, there are exceptions now and then, such as eating breakfast in bed rather than in a dining area or living in a small studio apartment in which most possessions are contained within one large room (but nonetheless are most often organized and clustered into subcategories according to function and optimal use of space).

The point here is that the patterns of social action we designate into particular categories during QDA are not perfectly bounded. Category construction is our best attempt to cluster the most seemingly alike things into the most seemingly appropriate groups. Categorizing is reorganizing and reordering the vast array of data from a study because it is from these smaller, larger, and meaning-rich units that we can better grasp the particular features of each one and the categories’ possible interrelationships with one another.

One analytic strategy with a list of codes is to classify them into similar clusters. Obviously, the same codes share the same category, but it is also possible that a single code can merit its own group if you feel it is unique enough. After the codes have been classified, a category label is applied to each grouping. Sometimes a code can also double as a category name if you feel it best summarizes the totality of the cluster. Like coding, categorizing is an interpretive act, for there can be different ways of separating and collecting codes that seem to belong together. The cut-and-paste functions of a word processor are most useful for exploring which codes share something in common.

Below is my categorization of the fifteen codes generated from the interview transcript presented earlier. Like the gerunds for process codes, the categories have also been labeled as “-ing” words to connote action. And there was no particular reason why fifteen codes resulted in three categories—there could have been less or even more, but this is how the array came together after my reflections on which codes seemed to belong together. The category labels are ways of answering “why” they belong together. For at-a-glance differentiation, I place codes in CAPITAL LETTERS and categories in upper and lower case Bold Font :

Category 1: Thinking Strategically

Category 2: Spending Strategically

Category 3: Living Strategically

APPRECIATING WHAT YOU'VE GOT

Notice that the three category labels share a common word: “strategically.” Where did this word come from? It came from analytic reflection on the original data, the codes, and the process of categorizing the codes and generating their category labels. It was the analyst’s choice based on the interpretation of what primary action was happening. Your categories generated from your coded data do not need to share a common word or phrase, but I find that this technique, when appropriate, helps build a sense of unity to the initial analytic scheme.

The three categories— Thinking Strategically , Spending Strategically , and Living Strategically —are then reflected upon for how they might interact and interplay. This is where the next major facet of data analysis, analytic memos, enters the scheme. But a necessary section on the basic principles of interrelationship and analytic reasoning must precede that discussion.

QDA Strategy: To Interrelate

To interrelate in QDA is to propose connections within, between, and among the constituent elements of analyzed data.

One task of QDA is to explore the ways our patterns and categories interact and interplay. I use these terms to suggest the qualitative equivalent of statistical correlation, but interaction and interplay are much more than a simple relationship. They imply interrelationship . Interaction refers to reverberative connections—for example, how one or more categories might influence and affect the others, how categories operate concurrently, or whether there is some kind of “domino” effect to them. Interplay refers to the structural and processual nature of categories—for example, whether some type of sequential order, hierarchy, or taxonomy exists; whether any overlaps occur; whether there is superordinate and subordinate arrangement; and what types of organizational frameworks or networks might exist among them. The positivist construct of “cause and effect” becomes influences and affects in QDA.

There can even be patterns of patterns and categories of categories if your mind thinks conceptually and abstractly enough. Our minds can intricately connect multiple phenomena but only if the data and their analyses support the constructions. We can speculate about interaction and interplay all we want, but it is only through a more systematic investigation of the data—in other words, good thinking—that we can plausibly establish any possible interrelationships.

QDA Strategy: To Reason

To reason in QDA is to think in ways that lead to causal probabilities, summative findings, and evaluative conclusions.

Unlike quantitative research, with its statistical formulas and established hypothesis-testing protocols, qualitative research has no standardized methods of data analysis. Rest assured, there are recommended guidelines from the field’s scholars and a legacy of analytic strategies from which to draw. But the primary heuristics (or methods of discovery) you apply during a study are deductive , inductive , abductive , and retroductive reasoning. Deduction is what we generally draw and conclude from established facts and evidence. Induction is what we experientially explore and infer to be transferable from the particular to the general, based on an examination of the evidence and an accumulation of knowledge. Abduction is surmising from the evidence that which is most likely, those explanatory hunches based on clues. “Whereas deductive inferences are certain (so long as their premises are true) and inductive inferences are probable, abductive inferences are merely plausible” ( Shank, 2008 , p. 1). Retroduction is historic reconstruction, working backwards to figure out how the current conditions came to exist.

It is not always necessary to know the names of these four ways of reasoning as you proceed through analysis. In fact, you will more than likely reverberate quickly from one to another depending on the task at hand. But what is important to remember about reasoning is:

to base your conclusions primarily on the participants’ experiences, not just your own

not to take the obvious for granted, as sometimes the expected won't always happen. Your hunches can be quite right and, at other times, quite wrong

to examine the evidence carefully and make reasonable inferences

to logically yet imaginatively think about what is going on and how it all comes together.

Futurists and inventors propose three questions when they think about creating new visions for the world: What is possible (induction)? What is plausible (abduction)? What is preferable (deduction)? These same three questions might be posed as you proceed through QDA and particularly through analytic memo writing, which is retroductive reflection on your analytic work thus far.

QDA Strategy: To Memo

To memo in QDA is to reflect in writing on the nuances, inferences, meanings, and transfer of coded and categorized data plus your analytic processes.

Like field note writing, perspectives vary among practitioners as to the methods for documenting the researcher’s analytic insights and subjective experiences. Some advise that such reflections should be included in field notes as relevant to the data. Others advise that a separate researcher’s journal should be maintained for recording these impressions. And still others advise that these thoughts be documented as separate analytic memos. I prescribe the latter as a method because it is generated by and directly connected to the data themselves.

An analytic memo is a “think piece” of reflexive free writing, a narrative that sets in words your interpretations of the data. Coding and categorizing are heuristics to detect some of the possible patterns and interrelationships at work within the corpus, and an analytic memo further articulates your deductive, inductive, abductive, and retroductive thinking processes on what things may mean. Though the metaphor is a bit flawed and limiting, think of codes and their consequent categories as separate jigsaw puzzle pieces, and their integration into an analytic memo as the trial assembly of the complete picture.

What follows is an example of an analytic memo based on the earlier process coded and categorized interview transcript. It is not intended as the final write-up for a publication but as an open-ended reflection on the phenomena and processes suggested by the data and their analysis thus far. As the study proceeds, however, initial and substantive analytic memos can be revisited and revised for eventual integration into the final report. Note how the memo is dated and given a title for future and further categorization, how participant quotes are occasionally included for evidentiary support, and how the category names are bolded and the codes kept in capital letters to show how they integrate or weave into the thinking:

March 18, 2012 EMERGENT CATEGORIES: A STRATEGIC AMALGAM There’s a popular saying now: “Smart is the new rich.” This participant is Thinking Strategically about his spending through such tactics as THINKING TWICE and QUESTIONING A PURCHASE before he decides to invest in a product. There’s a heightened awareness of both immediate trends and forthcoming economic bad news that positively affects his Spending Strategically . However, he seems unaware that there are even more ways of LIVING CHEAPLY by FINDING ALTERNATIVES. He dines at all-you-can-eat restaurants as a way of STOCKING UP on meals, but doesn’t state that he could bring lunch from home to work, possibly saving even more money. One of his “bad habits” is cigarettes, which he refuses to give up; but he doesn’t seem to realize that by quitting smoking he could save even more money, not to mention possible health care costs. He balks at the idea of paying $1.50 for a soft drink, but doesn’t mind paying $6.00–$7.00 for a pack of cigarettes. Penny-wise and pound-foolish. Addictions skew priorities. Living Strategically , for this participant during “scary times,” appears to be a combination of PRIORITIZING those things which cannot be helped, such as pet care and personal dental care; REFUSING SACRIFICE for maintaining personal creature-comforts; and FINDING ALTERNATIVES to high costs and excessive spending. Living Strategically is an amalgam of thinking and action-oriented strategies.

There are several recommended topics for analytic memo writing throughout the qualitative study. Memos are opportunities to reflect on and write about:

how you personally relate to the participants and/or the phenomenon

your study’s research questions

your code choices and their operational definitions

the emergent patterns, categories, themes, assertions, and concepts

the possible networks (links, connections, overlaps, flows) among the codes, patterns, categories, themes, assertions, and concepts

an emergent or related existent theory

any problems with the study

any personal or ethical dilemmas with the study

future directions for the study

the analytic memos generated thus far [labeled “metamemos”]

the final report for the study [adapted from Saldaña, 2013 , p. 49]

Since writing is analysis, analytic memos expand on the inferential meanings of the truncated codes and categories as a transitional stage into a more coherent narrative with hopefully rich social insight.

QDA Strategy: To Code—A Different Way

The first example of coding illustrated process coding, a way of exploring general social action among humans. But sometimes a researcher works with an individual case study whose language is unique, or with someone the researcher wishes to honor by maintaining the authenticity of his or her speech in the analysis. These reasons suggest that a more participant-centered form of coding may be more appropriate.

In Vivo Coding

A second frequently applied method of coding is called in vivo coding. The root meaning of “in vivo” is “in that which is alive” and refers to a code based on the actual language used by the participant ( Strauss, 1987 ). What words or phrases in the data record you select as codes are those that seem to stand out as significant or summative of what is being said.

Using the same transcript of the male participant living in difficult economic times, in vivo codes are listed in the right-hand column. I recommend that in vivo codes be placed in quotation marks as a way of designating that the code is extracted directly from the data record. Note that instead of fifteen codes generated from process coding, the total number of in vivo codes is thirty. This is not to suggest that there should be specific numbers or ranges of codes used for particular methods. In vivo codes, though, tend to be applied more frequently to data. Again, the interviewer’s questions and prompts are not coded, just the participant's responses:

The thirty in vivo codes are then extracted from the transcript and listed in the order they appear to prepare them for analytic action and reflection:

“SKYROCKETED”

“TWO-FOR-ONE”

“THE LITTLE THINGS”

“THINK TWICE”

“ALL-YOU-CAN-EAT”

“CHEAP AND FILLING”

“BAD HABITS”

“DON'T REALLY NEED”

“LIVED KIND OF CHEAP”

“NOT A BIG SPENDER”

“HAVEN'T CHANGED MY HABITS”

“NOT PUTTING AS MUCH INTO SAVINGS”

“SPENDING MORE”

“ANOTHER DING IN MY WALLET”

“HIGH MAINTENANCE”

“COUPLE OF THOUSAND”

“INSURANCE IS JUST WORTHLESS”

“PICK UP THE TAB”

“IT ALL ADDS UP”

“NOT AS BAD OFF”

“SCARY TIMES”

Even though no systematic reorganization or categorization has been conducted with the codes thus far, an analytic memo of first impressions can still be composed:

March 19, 2012 CODE CHOICES: THE EVERYDAY LANGUAGE OF ECONOMICS After eyeballing the in vivo codes list, I noticed that variants of “CHEAP” appear most often. I recall a running joke between me and a friend of mine when we were shopping for sales. We’d say, “We're not ‘cheap,’ we're frugal .” There’s no formal economic or business language is this transcript—no terms such as “recession” or “downsizing”—just the everyday language of one person trying to cope during “SCARY TIMES” with “ANOTHER DING IN MY WALLET.” The participant notes that he’s always “LIVED KIND OF CHEAP” and is “NOT A BIG SPENDER” and, due to his employment, “NOT AS BAD OFF” as others in the country. Yet even with his middle class status, he’s still feeling the monetary pinch, dining at inexpensive “ALL-YOU-CAN-EAT” restaurants and worried about the rising price of peanut butter, observing that he’s “NOT PUTTING AS MUCH INTO SAVINGS” as he used to. Of all the codes, “ANOTHER DING IN MY WALLET” stands out to me, particularly because on the audio recording he sounded bitter and frustrated. It seems that he’s so concerned about “THE LITTLE THINGS” because of high veterinary and dental charges. The only way to cope with a “COUPLE OF THOUSAND” dollars worth of medical expenses is to find ways of trimming the excess in everyday facets of living: “IT ALL ADDS UP.”

Like process coding, in vivo codes could be clustered into similar categories, but another simple data analytic strategy is also possible.

QDA Strategy: To Outline

To outline in QDA is to hierarchically, processually, and/or temporally assemble such things as codes, categories, themes, assertions, and concepts into a coherent, text-based display.

Traditional outlining formats and content provide not only templates for writing a report but templates for analytic organization. This principle can be found in several CAQDAS (Computer Assisted Qualitative Data Analysis Software) programs through their use of such functions as “hierarchies,” “trees,” and “nodes,” for example. Basic outlining is simply a way of arranging primary, secondary, and sub-secondary items into a patterned display. For example, an organized listing of things in a home might consist of:

Large appliances

Refrigerator

Stove-top oven

Microwave oven

Small appliances

Coffee maker

Dining room

In QDA, outlining may include descriptive nouns or topics but, depending on the study, it may also involve processes or phenomena in extended passages, such as in vivo codes or themes.

The complexity of what we learn in the field can be overwhelming, and outlining is a way of organizing and ordering that complexity so that it does not become complicated. The cut-and-paste and tab functions of a word processor page enable you to arrange and rearrange the salient items from your preliminary coded analytic work into a more streamlined flow. By no means do I suggest that the intricate messiness of life can always be organized into neatly formatted arrangements, but outlining is an analytic act that stimulates deep reflection on both the interconnectedness and interrelationships of what we study. As an example, here are the thirty in vivo codes generated from the initial transcript analysis, arranged in such a way as to construct five major categories:

“DON’T REALLY NEED”

“HAVEN’T CHANGED MY HABITS”

Now that the codes have been rearranged into an outline format, an analytic memo is composed to expand on the rationale and constructed meanings in progress:

March 19, 2012 NETWORKS: EMERGENT CATEGORIES The five major categories I constructed from the in vivo codes are: “SCARY TIMES,” “PRIORTY,” “ANOTHER DING IN MY WALLET,” “THE LITTLE THINGS,” and “LIVED KIND OF CHEAP.” One of the things that hit me today was that the reason he may be pinching pennies on smaller purchases is that he cannot control the larger ones he has to deal with. Perhaps the only way we can cope with or seem to have some sense of agency over major expenses is to cut back on the smaller ones that we can control. $1,000 for a dental bill? Skip lunch for a few days a week. Insulin medication to buy for a pet? Don’t buy a soft drink from a vending machine. Using this reasoning, let me try to interrelate and weave the categories together as they relate to this particular participant: During these scary economic times, he prioritizes his spending because there seems to be just one ding after another to his wallet. A general lifestyle of living cheaply and keeping an eye out for how to save money on the little things compensates for those major expenses beyond his control.

QDA Strategy: To Code—In Even More Ways

The process and in vivo coding examples thus far have demonstrated only two specific methods of thirty-two documented approaches ( Saldaña, 2013 ). Which one(s) you choose for your analysis depends on such factors as your conceptual framework, the genre of qualitative research for your project, the types of data you collect, and so on. The following sections present a few other approaches available for coding qualitative data that you may find useful as starting points.

Descriptive Coding

Descriptive codes are primarily nouns that simply summarize the topic of a datum. This coding approach is particularly useful when you have different types of data gathered for one study, such as interview transcripts, field notes, documents, and visual materials such as photographs. Descriptive codes not only help categorize but also index the data corpus’ basic contents for further analytic work. An example of an interview portion coded descriptively, taken from the participant living in tough economic times, follows to illustrate how the same data can be coded in multiple ways:

For initial analysis, descriptive codes are clustered into similar categories to detect such patterns as frequency (i.e., categories with the largest number of codes), interrelationship (i.e., categories that seem to connect in some way), and initial work for grounded theory development.

Values Coding

Values coding identifies the values, attitudes, and beliefs of a participant, as shared by the individual and/or interpreted by the analyst. This coding method infers the “heart and mind” of an individual or group’s worldview as to what is important, perceived as true, maintained as opinion, and felt strongly. The three constructs are coded separately but are part of a complex interconnected system.

Briefly, a value (V) is what we attribute as important, be it a person, thing, or idea. An attitude (A) is the evaluative way we think and feel about ourselves, others, things, or ideas. A belief (B) is what we think and feel as true or necessary, formed from our “personal knowledge, experiences, opinions, prejudices, morals, and other interpretive perceptions of the social world” ( Saldaña, 2009 , pp. 89–90). Values coding explores intrapersonal, interpersonal, and cultural constructs or ethos . It is an admittedly slippery task to code this way, for it is sometimes difficult to discern what is a value, attitude, or belief because they are intricately interrelated. But the depth you can potentially obtain is rich. An example of values coding follows:

For analysis, categorize the codes for each of the three different constructs together (i.e., all values in one group, attitudes in a second group, and beliefs in a third group). Analytic memo writing about the patterns and possible interrelationships may reveal a more detailed and intricate worldview of the participant.

Dramaturgical Coding

Dramaturgical coding perceives life as performance and its participants as characters in a social drama. Codes are assigned to the data (i.e., a “play script”) that analyze the characters in action, reaction, and interaction. Dramaturgical coding of participants examines their objectives (OBJ) or wants, needs, and motives; the conflicts (CON) or obstacles they face as they try to achieve their objectives; the tactics (TAC) or strategies they employ to reach their objectives; their attitudes (ATT) toward others and their given circumstances; the particular emotions (EMO) they experience throughout; and their subtexts (SUB) or underlying and unspoken thoughts. The following is an example of dramaturgically coded data:

Not included in this particular interview excerpt are the emotions the participant may have experienced or talked about. His later line, “that’s another ding in my wallet,” would have been coded EMO: BITTER. A reader may not have inferred that specific emotion from seeing the line in print. But the interviewer, present during the event and listening carefully to the audio recording during transcription, noted that feeling in his tone of voice.

For analysis, group similar codes together (e.g., all objectives in one group, all conflicts in another group, all tactics in a third group), or string together chains of how participants deal with their circumstances to overcome their obstacles through tactics (e.g., OBJ: SAVING MEAL MONEY > TAC: SKIPPING MEALS). Explore how the individuals or groups manage problem solving in their daily lives. Dramaturgical coding is particularly useful as preliminary work for narrative inquiry story development or arts-based research representations such as performance ethnography.

Versus Coding

Versus coding identifies the conflicts, struggles, and power issues observed in social action, reaction, and interaction as an X VS. Y code, such as: MEN VS. WOMEN, CONSERVATIVES VS. LIBERALS, FAITH VS. LOGIC, and so on. Conflicts are rarely this dichotomous. They are typically nuanced and much more complex. But humans tend to perceive these struggles with an US VS. THEM mindset. The codes can range from the observable to the conceptual and can be applied to data that show humans in tension with others, themselves, or ideologies.

What follows are examples of versus codes applied to the case study participant’s descriptions of his major medical expenses:

As an initial analytic tactic, group the versus codes into one of three categories: the Stakeholders , their Perceptions and/or Actions , and the Issues at stake. Examine how the three interrelate and identify the central ideological conflict at work as an X vs. Y category. Analytic memos and the final write-up can detail the nuances of the issues.

Remember that what has been profiled in this section is a broad brushstroke description of just a few basic coding processes, several of which can be compatibly “mixed and matched” within a single analysis (see Saldaña’s [2013]   The Coding Manual for Qualitative Researchers for a complete discussion). Certainly with additional data, more in-depth analysis can occur, but coding is only one approach to extracting and constructing preliminary meanings from the data corpus. What now follows are additional methods for qualitative analysis.

QDA Strategy: To Theme

To theme in QDA is to construct summative, phenomenological meanings from data through extended passages of text.

Unlike codes, which are most often single words or short phrases that symbolically represent a datum, themes are extended phrases or sentences that summarize the manifest (apparent) and latent (underlying) meanings of data ( Auerbach & Silverstein, 2003 ; Boyatzis, 1998 ). Themes, intended to represent the essences and essentials of humans’ lived experiences, can also be categorized or listed in superordinate and subordinate outline formats as an analytic tactic.

Below is the interview transcript example used in the coding sections above. (Hopefully you are not too fatigued at this point with the transcript, but it’s important to know how inquiry with the same data set can be approached in several different ways.) During the investigation of the ways middle-class Americans are influenced and affected by the current (2008–2012) economic recession, the researcher noticed that participants’ stories exhibited facets of what he labeled “economic intelligence” or EI (based on the formerly developed theories of Howard Gardner’s multiple intelligences and Daniel Goleman’s emotional intelligence). Notice how themeing interprets what is happening through the use of two distinct phrases—ECONOMIC INTELLIGENCE IS (i.e., manifest or apparent meanings) and ECONOMIC INTELLIGENCE MEANS (i.e., latent or underlying meanings):

Unlike the fifteen process codes and thirty in vivo codes in the previous examples, there are now fourteen themes to work with. In the order they appear, they are:

EI IS TAKING ADVANTAGE OF UNEXPECTED OPPORTUNITY

EI MEANS THINKING BEFORE YOU ACT

EI IS BUYING CHEAP

EI MEANS SACRIFICE

EI IS SAVING A FEW DOLLARS NOW AND THEN

EI MEANS KNOWING YOUR FLAWS

EI IS SETTING PRIORITIES

EI IS FINDING CHEAPER FORMS OF ENTERTAINMENT

EI MEANS LIVING AN INEXPENSIVE LIFESTYLE

EI IS NOTICING PERSONAL AND NATIONAL ECONOMIC TRENDS

EI MEANS YOU CANNOT CONTROL EVERYTHING

EI IS TAKING CARE OF ONE’S OWN HEALTH

EI MEANS KNOWING YOUR LUCK

There are several ways to categorize the themes as preparation for analytic memo writing. The first is to arrange them in outline format with superordinate and subordinate levels, based on how the themes seem to take organizational shape and structure. Simply cutting and pasting the themes in multiple arrangements on a word processor page eventually develops a sense of order to them. For example:

A second approach is to categorize the themes into similar clusters and to develop different category labels or theoretical constructs . A theoretical construct is an abstraction that transforms the central phenomenon’s themes into broader applications but can still use “is” and “means” as prompts to capture the bigger picture at work:

Theoretical Construct 1: EI Means Knowing the Unfortunate Present

Supporting Themes:

Theoretical Construct 2: EI is Cultivating a Small Fortune

Theoretical Construct 3: EI Means a Fortunate Future

What follows is an analytic memo generated from the cut-and-paste arrangement of themes into an outline and into theoretical constructs:

March 19, 2012 EMERGENT THEMES: FORTUNE/FORTUNATELY/UNFORTUNATELY I first reorganized the themes by listing them in two groups: “is” and “means.” The “is” statements seemed to contain positive actions and constructive strategies for economic intelligence. The “means” statements held primarily a sense of caution and restriction with a touch of negativity thrown in. The first outline with two major themes, LIVING AN INEXPENSIVE LIFESTYLE and YOU CANNOT CONTROL EVERYTHING also had this same tone. This reminded me of the old children’s picture book, Fortunately/Unfortunately , and the themes of “fortune” as a motif for the three theoretical constructs came to mind. Knowing the Unfortunate Present means knowing what’s (most) important and what’s (mostly) uncontrollable in one’s personal economic life. Cultivating a Small Fortune consists of those small money-saving actions that, over time, become part of one's lifestyle. A Fortunate Future consists of heightened awareness of trends and opportunities at micro and macro levels, with the understanding that health matters can idiosyncratically affect one’s fortune. These three constructs comprise this particular individual’s EI—economic intelligence.

Again, keep in mind that the examples above for coding and themeing were from one small interview transcript excerpt. The number of codes and their categorization would obviously increase, given a longer interview and/or multiple interviews to analyze. But the same basic principles apply: codes and themes relegated into patterned and categorized forms are heuristics—stimuli for good thinking through the analytic memo-writing process on how everything plausibly interrelates. Methodologists vary in the number of recommended final categories that result from analysis, ranging anywhere from three to seven, with traditional grounded theorists prescribing one central or core category from coded work.

QDA Strategy: To Assert

To assert in QDA is to put forward statements that summarize particular fieldwork and analytic observations that the researcher believes credibly represent and transcend the experiences.

Educational anthropologist Frederick Erickson (1986) wrote a significant and influential chapter on qualitative methods that outlined heuristics for assertion development . Assertions are declarative statements of summative synthesis, supported by confirming evidence from the data, and revised when disconfirming evidence or discrepant cases require modification of the assertions. These summative statements are generated from an interpretive review of the data corpus and then supported and illustrated through narrative vignettes—reconstructed stories from field notes, interview transcripts, or other data sources that provide a vivid profile as part of the evidentiary warrant.

Coding or themeing data can certainly precede assertion development as a way of gaining intimate familiarity with the data, but Erickson’s methods are a more admittedly intuitive yet systematic heuristic for analysis. Erickson promotes analytic induction and exploration of and inferences about the data, based on an examination of the evidence and an accumulation of knowledge. The goal is not to look for “proof” to support the assertions but plausibility of inference-laden observations about the local and particular social world under investigation.

Assertion development is the writing of general statements, plus subordinate yet related ones called subassertions , and a major statement called a key assertion that represents the totality of the data. One also looks for key linkages between them, meaning that the key assertion links to its related assertions, which then link to their respective subassertions. Subassertions can include particulars about any discrepant related cases or specify components of their parent assertions.

Excerpts from the interview transcript of our case study will be used to illustrate assertion development at work. By now, you should be quite familiar with the contents, so I will proceed directly to the analytic example. First, there is a series of thematically related statements the participant makes:

“Buy one package of chicken, get the second one free. Now that was a bargain. And I got some.”

“With Sweet Tomatoes I get those coupons for a few bucks off for lunch, so that really helps.”

“I don’t go to movies anymore. I rent DVDs from Netflix or Redbox or watch movies online—so much cheaper than paying over ten or twelve bucks for a movie ticket.”

Assertions can be categorized into low-level and high-level inferences . Low-level inferences address and summarize “what is happening” within the particulars of the case or field site—the “micro.” High-level inferences extend beyond the particulars to speculate on “what it means” in the more general social scheme of things—the “meso” or “macro.” A reasonable low-level assertion about the three statements above collectively might read: The participant finds several small ways to save money during a difficult economic period . A high-level inference that transcends the case to the macro level might read: Selected businesses provide alternatives and opportunities to buy products and services at reduced rates during a recession to maintain consumer spending.

Assertions are instantiated (i.e., supported) by concrete instances of action or participant testimony, whose patterns lead to more general description outside the specific field site. The author’s interpretive commentary can be interspersed throughout the report, but the assertions should be supported with the evidentiary warrant . A few assertions and subassertions based on the case interview transcript might read (and notice how high-level assertions serve as the paragraphs’ topic sentences):

Selected businesses provide alternatives and opportunities to buy products and services at reduced rates during a recession to maintain consumer spending. Restaurants, for example, need to find ways during difficult economic periods when potential customers may be opting to eat inexpensively at home rather than spending more money by dining out. Special offers can motivate cash-strapped clientele to patronize restaurants more frequently. An adult male dealing with such major expenses as underinsured dental care offers: “With Sweet Tomatoes I get those coupons for a few bucks off for lunch, so that really helps.” The film and video industries also seem to be suffering from a double-whammy during the current recession: less consumer spending on higher-priced entertainment, resulting in a reduced rate of movie theatre attendance (currently 39 percent of the American population, according to CNN); coupled with a media technology and business revolution that provides consumers less costly alternatives through video rentals and internet viewing: “I don’t go to movies anymore. I rent DVDs from Netflix or Redbox or watch movies online—so much cheaper than paying over ten or twelve bucks for a movie ticket.”

“Particularizability”—the search for specific and unique dimensions of action at a site and/or the specific and unique perspectives of an individual participant—is not intended to filter out trivial excess but to magnify the salient characteristics of local meaning. Although generalizable knowledge serves little purpose in qualitative inquiry since each naturalistic setting will contain its own unique set of social and cultural conditions, there will be some aspects of social action that are plausibly universal or “generic” across settings and perhaps even across time. To work toward this, Erickson advocates that the interpretive researcher look for “concrete universals” by studying actions at a particular site in detail, then comparing those to other sites that have also been studied in detail. The exhibit or display of these generalizable features is to provide a synoptic representation, or a view of the whole. What the researcher attempts to uncover is what is both particular and general at the site of interest, preferably from the perspective of the participants. It is from the detailed analysis of actions at a specific site that these universals can be concretely discerned, rather than abstractly constructed as in grounded theory.

In sum, assertion development is a qualitative data analytic strategy that relies on the researcher’s intense review of interview transcripts, field notes, documents, and other data to inductively formulate composite statements that credibly summarize and interpret participant actions and meanings, and their possible representation of and transfer into broader social contexts and issues.

QDA Strategy: To Display

To display in QDA is to visually present the processes and dynamics of human or conceptual action represented in the data.

Qualitative researchers use not only language but illustrations to both analyze and display the phenomena and processes at work in the data. Tables, charts, matrices, flow diagrams, and other models help both you and your readers cognitively and conceptually grasp the essence and essentials of your findings. As you have seen thus far, even simple outlining of codes, categories, and themes is one visual tactic for organizing the scope of the data. Rich text, font, and format features such as italicizing, bolding, capitalizing, indenting, and bullet pointing provide simple emphasis to selected words and phrases within the longer narrative.

“Think display” was a phrase coined by methodologists Miles and Huberman (1994) to encourage the researcher to think visually as data were collected and analyzed. The magnitude of text can be essentialized into graphics for “at-a-glance” review. Bins in various shapes and lines of various thicknesses, along with arrows suggesting pathways and direction, render the study as a portrait of action. Bins can include the names of codes, categories, concepts, processes, key participants, and/or groups.

As a simple example, Figure 28.1 illustrates the three categories’ interrelationship derived from process coding. It displays what could be the apex of this interaction, LIVING STRATEGICALLY, and its connections to THINKING STRATEGICALLY, which influences and affects SPENDING STRATEGICALLY.

Figure 28.2 represents a slightly more complex (if not playful) model, based on the five major in vivo codes/categories generated from analysis. The graphic is used as a way of initially exploring the interrelationship and flow from one category to another. The use of different font styles, font sizes, and line and arrow thicknesses are intended to suggest the visual qualities of the participant’s language and his dilemmas—a way of heightening in vivo coding even further.

Accompanying graphics are not always necessary for a qualitative report. They can be very helpful for the researcher during the analytic stage as a heuristic for exploring how major ideas interrelate, but illustrations are generally included in published work when they will help supplement and clarify complex processes for readers. Photographs of the field setting or the participants (and only with their written permission) also provide evidentiary reality to the write-up and help your readers get a sense of being there.

QDA Strategy: To Narrate

To narrate in QDA is to create an evocative literary representation and presentation of the data in the form of creative nonfiction.

All research reports are stories of one kind or another. But there is yet another approach to QDA that intentionally documents the research experience as story, in its traditional literary sense. Narrative inquiry plots and story lines the participant’s experiences into what might be initially perceived as a fictional short story or novel. But the story is carefully crafted and creatively written to provide readers with an almost omniscient perspective about the participants’ worldview. The transformation of the corpus from database to creative nonfiction ranges from systematic transcript analysis to open ended literary composition. The narrative, though, should be solidly grounded in and emerge from the data as a plausible rendering of social life.

A simple illustration of category interrelationship.

An illustration with rich text and artistic features.

The following is a narrative vignette based on interview transcript selections from the participant living through tough economic times:

Jack stood in front of the soft drink vending machine at work and looked almost worriedly at the selections. With both hands in his pants pockets, his fingers jingled the few coins he had inside them as he contemplated whether he could afford the purchase. One dollar and fifty cents for a twenty-ounce bottle of Diet Coke. One dollar and fifty cents. “I can practically get a two-liter bottle for that same price at the grocery store,” he thought. Then Jack remembered the upcoming dental surgery he needed—that would cost one thousand dollars—and the bottle of insulin and syringes he needed to buy for his diabetic, “high maintenance” cat—about one hundred and twenty dollars. He sighed, took his hands out of his pockets, and walked away from the vending machine. He was skipping lunch that day anyway so he could stock up on dinner later at the cheap-but-filling-all-you-can-eat Chinese buffet. He could get his Diet Coke there.

Narrative inquiry representations, like literature, vary in tone, style, and point of view. The common goal, however, is to create an evocative portrait of participants through the aesthetic power of literary form. A story does not always have to have a moral explicitly stated by its author. The reader reflects on personal meanings derived from the piece and how the specific tale relates to one’s self and the social world.

QDA Strategy: To Poeticize

To poeticize in QDA is to create an evocative literary representation and presentation of the data in the form of poetry.

One form for analyzing or documenting analytic findings is to strategically truncate interview transcripts, field notes, and other pertinent data into poetic structures. Like coding, poetic constructions capture the essence and essentials of data in a creative, evocative way. The elegance of the format attests to the power of carefully chosen language to represent and convey complex human experience.

In vivo codes (codes based on the actual words used by participants themselves) can provide imagery, symbols, and metaphors for rich category, theme, concept, and assertion development, plus evocative content for arts-based interpretations of the data. Poetic inquiry takes note of what words and phrases seem to stand out from the data corpus as rich material for reinterpretation. Using some of the participant’s own language from the interview transcript illustrated above, a poetic reconstruction or “found poetry” might read:

Scary Times Scary times... spending more (another ding in my wallet) a couple of thousand (another ding in my wallet) insurance is just worthless (another ding in my wallet) pick up the tab (another ding in my wallet) not putting as much into savings (another ding in my wallet) It all adds up. Think twice: don't really need skip Think twice, think cheap: coupons bargains two-for-one free Think twice, think cheaper: stock up all-you-can-eat (cheap—and filling) It all adds up.

Anna Deavere Smith, a verbatim theatre performer, attests that people speak in forms of “organic poetry” in everyday life. Thus in vivo codes can provide core material for poetic representation and presentation of lived experiences, potentially transforming the routine and mundane into the epic. Some researchers also find the genre of poetry to be the most effective way to compose original work that reflects their own fieldwork experiences and autoethnographic stories.

QDA Strategy: To Compute

To compute in QDA is to employ specialized software programs for qualitative data management and analysis.

CAQDAS is an acronym for Computer Assisted Qualitative Data Analysis Software. There are diverse opinions among practitioners in the field about the utility of such specialized programs for qualitative data management and analysis. The software, unlike statistical computation, does not actually analyze data for you at higher conceptual levels. CAQDAS software packages serve primarily as a repository for your data (both textual and visual) that enable you to code them, and they can perform such functions as calculate the number of times a particular word or phrase appears in the data corpus (a particularly useful function for content analysis) and can display selected facets after coding, such as possible interrelationships. Certainly, basic word-processing software such as Microsoft Word, Excel, and Access provide utilities that can store and, with some pre-formatting and strategic entry, organize qualitative data to enable the researcher’s analytic review. The following internet addresses are listed to help in exploriong these CAQDAS packages and obtaining demonstration/trial software and tutorials:

AnSWR: www.cdc.gov/hiv/topics/surveillance/resources/software/answr

ATLAS.ti: www.atlasti.com

Coding Analysis Toolkit (CAT): cat.ucsur.pitt.edu/

Dedoose: www.dedoose.com

HyperRESEARCH: www.researchware.com

MAXQDA: www.maxqda.com

NVivo: www.qsrinternational.com

QDA Miner: www.provalisresearch.com

Qualrus: www.qualrus.com

Transana (for audio and video data materials): www.transana.org

Weft QDA: www.pressure.to/qda/

Some qualitative researchers attest that the software is indispensable for qualitative data management, especially for large-scale studies. Others feel that the learning curve of CAQDAS is too lengthy to be of pragmatic value, especially for small-scale studies. From my own experience, if you have an aptitude for picking up quickly on the scripts of software programs, explore one or more of the packages listed. If you are a novice to qualitative research, though, I recommend working manually or “by hand” for your first project so you can focus exclusively on the data and not on the software.

QDA Strategy: To Verify

To verify in QDA is to administer an audit of “quality control” to your analysis.

After your data analysis and the development of key findings, you may be thinking to yourself, “Did I get it right?” “Did I learn anything new?” Reliability and validity are terms and constructs of the positivist quantitative paradigm that refer to the replicability and accuracy of measures. But in the qualitative paradigm, other constructs are more appropriate.

Credibility and trustworthiness ( Lincoln & Guba, 1985 ) are two factors to consider when collecting and analyzing the data and presenting your findings. In our qualitative research projects, we need to present a convincing story to our audiences that we “got it right” methodologically. In other words, the amount of time we spent in the field, the number of participants we interviewed, the analytic methods we used, the thinking processes evident to reach our conclusions, and so on should be “just right” to persuade the reader that we have conducted our jobs soundly. But remember that we can never conclusively “prove” something; we can only, at best, convincingly suggest. Research is an act of persuasion.

Credibility in a qualitative research report can be established through several ways. First, citing the key writers of related works in your literature review is a must. Seasoned researchers will sometimes assess whether a novice has “done her homework” by reviewing the bibliography or references. You need not list everything that seminal writers have published about a topic, but their names should appear at least once as evidence that you know the field’s key figures and their work.

Credibility can also be established by specifying the particular data analytic methods you employed (e.g., “Interview transcripts were taken through two cycles of process coding, resulting in five primary categories”), through corroboration of data analysis with the participants themselves (e.g., “I asked my participants to read and respond to a draft of this report for their confirmation of accuracy and recommendations for revision”) or through your description of how data and findings were substantiated (e.g., “Data sources included interview transcripts, participant observation field notes, and participant response journals to gather multiple perspectives about the phenomenon”).

Creativity scholar Sir Ken Robinson is attributed with offering this cautionary advice about making a convincing argument: “Without data, you’re just another person with an opinion.” Thus researchers can also support their findings with relevant, specific evidence by quoting participants directly and/or including field note excerpts from the data corpus. These serve both as illustrative examples for readers and to present more credible testimony of what happened in the field.

Trustworthiness , or providing credibility to the writing, is when we inform the reader of our research processes. Some make the case by stating the duration of fieldwork (e.g., “Seventy-five clock hours were spent in the field”; “The study extended over a twenty-month period”). Others put forth the amounts of data they gathered (e.g., “Twenty-seven individuals were interviewed”; “My field notes totaled approximately 250 pages”). Sometimes trustworthiness is established when we are up front or confessional with the analytic or ethical dilemmas we encountered (e.g., “It was difficult to watch the participant’s teaching effectiveness erode during fieldwork”; “Analysis was stalled until I recoded the entire data corpus with a new perspective.”).

The bottom line is that credibility and trustworthiness are matters of researcher honesty and integrity . Anyone can write that he worked ethically, rigorously, and reflexively, but only the writer will ever know the truth. There is no shame if something goes wrong with your research. In fact, it is more than likely the rule, not the exception. Work and write transparently to achieve credibility and trustworthiness with your readers.

The length of this article does not enable me to expand on other qualitative data analytic strategies, such as to conceptualize, abstract, theorize, and write. Yet there are even more subtle thinking strategies to employ throughout the research enterprise, such as to synthesize, problematize, persevere, imagine, and create. Each researcher has his or her own ways of working, and deep reflection (another strategy) on your own methodology and methods as a qualitative inquirer throughout fieldwork and writing provides you with metacognitive awareness of data analytic processes and possibilities.

Data analysis is one of the most elusive processes in qualitative research, perhaps because it is a backstage, behind-the-scenes, in-your-head enterprise. It is not that there are no models to follow. It is just that each project is contextual and case specific. The unique data you collect from your unique research design must be approached with your unique analytic signature. It truly is a learning-by-doing process, so accept that and leave yourself open to discovery and insight as you carefully scrutinize the data corpus for patterns, categories, themes, concepts, assertions, and possibly new theories through strategic analysis.

Auerbach, C. F. , & Silverstein, L. B. ( 2003 ). Qualitative data: An introduction to coding and analysis . New York: New York University Press.

Google Scholar

Google Preview

Birks, M. , & Mills, J. ( 2011 ). Grounded theory: A practical guide . London: Sage.

Boyatzis, R. E. ( 1998 ). Transforming qualitative information: Thematic analysis and code development . Thousand Oaks, CA: Sage.

Bryant, A. , & Charmaz, K. (Eds.). ( 2007 ). The Sage handbook of grounded theory . London: Sage.

Charmaz, K. ( 2006 ). Constructing grounded theory: A practical guide through qualitative analysis . Thousand Oaks, CA: Sage.

Erickson, F. ( 1986 ). Qualitative methods in research on teaching. In M. C. Wittrock (Ed.), Handbook of research on teaching (3rd ed.) (pp. 119–161). New York: Macmillan.

Geertz, C. ( 1983 ). Local knowledge: Further essays in interpretive anthropology . New York: Basic Books.

Gibbs, G. R. ( 2007 ). Analysing qualitative data . London: Sage.

Lincoln, Y. S. , & Guba, E. G. ( 1985 ). Naturalistic inquiry . Newbury Park, CA: Sage.

Miles, M. B. , & Huberman, A. M. ( 1994 ). Qualitative data analysis (2nd ed.). Thousand Oaks, CA: Sage.

Saldaña, J. ( 2009 ). The coding manual for qualitative researchers . London: Sage.

Saldaña, J. ( 2011 ). Fundamentals of qualitative research . New York: Oxford University Press.

Saldaña, J. ( 2013 ). The coding manual for qualitative researchers (2nd ed.). London: Sage.

Shank, G. ( 2008 ). Abduction. In L. M. Given (Ed.), The Sage encyclopedia of qualitative research methods (pp. 1–2). Thousand Oaks, CA: Sage.

Stake, R. E. ( 1995 ). The art of case study research . Thousand Oaks, CA: Sage.

Stern, P. N. , & Porr, C. J. ( 2011 ). Essentials of accessible grounded theory . Walnut Creek, CA: Left Coast Press.

Strauss, A. L. ( 1987 ). Qualitative analysis for social scientists . Cambridge: Cambridge University Press.

Sunstein, B. S. , & Chiseri-Strater, E. ( 2012 ). FieldWorking: Reading and writing research (4th ed.). Boston: Bedford/St. Martin’s.

Wertz, F. J. , Charmaz, K. , McMullen, L. M. , Josselson, R. , Anderson, R. , & McSpadden, E. ( 2011 ). Fives ways of doing qualitative analysis: Phenomenological psychology, grounded theory, discourse analysis, narrative research, and intuitive inquiry . New York: Guilford.

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The Coding Manual for Qualitative Researchers

Student resources.

Welcome to the companion website for The Coding Manual for Qualitative Research , third edition, by Johnny Saldaña.  This website offers a wealth of additional resources to support students and lecturers including:

CAQDAS links giving guidance and links to a variety of qualitative data analysis software.

Code lists including data extracted from the author’s study, “Lifelong Learning Impact: Adult Perceptions of Their High School Speech and/or Theatre Participation” (McCammon, Saldaña, Hines, & Omasta, 2012), which you can download and make your own practice manipulations to the data.

Coding examples from SAGE journals providing actual examples of coding at work, giving you insight into coding procedures.

Three sample interview transcripts that allow you to test your coding skills.

Group exercises for small and large groups encourage you to get to grips with basic principles of coding, partner development, categorization and qualitative data analysis

Flashcard glossary of terms enables you to test your knowledge of the terminology commonly used in qualitative research and coding.

About the book

Johnny Saldaña’s unique and invaluable manual demystifies the qualitative coding process with a comprehensive assessment of different coding types, examples and exercises. The ideal reference for students, teachers, and practitioners of qualitative inquiry, it is essential reading across the social sciences and neatly guides you through the multiple approaches available for coding qualitative data.

Its wide array of strategies, from the more straightforward to the more complex, is skilfully explained and carefully exemplified, providing a complete toolkit of codes and skills that can be applied to any research project. For each code Saldaña provides information about the method's origin, gives a detailed description of the method, demonstrates its practical applications, and sets out a clearly illustrated example with analytic follow up. 

This international bestseller is an extremely usable, robust manual and is a must-have resource for qualitative researchers at all levels.

This website may contain links to both internal and external websites. All links included were active at the time the website was launched. SAGE does not operate these external websites and does not necessarily endorse the views expressed within them. SAGE cannot take responsibility for the changing content or nature of linked sites, as these sites are outside of our control and subject to change without our knowledge. If you do find an inactive link to an external website, please try to locate that website by using a search engine. SAGE will endeavour to update inactive or broken links when possible. 

Coding Qualitative Data

• First Online: 02 January 2023

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With the advent and proliferation of analysis software (e.g., Nvivo, Atlas.ti), coding data has become much easier in terms of application. Where autocoding algorithms do much to assist and enlighten a researcher in analysis, coding qualitative data remains an act that must largely be undertaken by a human in order to fully address the research question(s) (Kaufmann, A. A., Barcomb, A., & Riehle, D. (2020). Supporting interview analysis with autocoding. HICSS. https://www.semanticscholar.org/paper/Supporting-Interview-Analysis-with-Autocoding-Kaufmann-Barcomb/b6e045859b5ce94e1eb144a9545b26c5e9fa6f32 ). Even seasoned qualitative researchers can find the process of coding their datum corpus to be arduous at times. For novice researchers, the task can quickly become baffling and overwhelming.

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Anonymous Author. (2019, July 2). Resolve: Finding a resolution for infertility: Infertility support group and discussion community [online discussion post]. https://www.inspire.com/

Basit, T. N. (2003). Manual or electronic? The role of coding in qualitative data analysis. Educational Research, 45 (2), 143–154.

Article   Google Scholar  

Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3 (2), 77–101.

Caulfield, J. (2019, September 6). How to do thematic analysis . www.scribbr.com/methodology/thematicanalysis

Creswell, J. (2015). 30 Essential skills for the qualitative researcher . SAGE.

Google Scholar  

Elliot, V. (2018). Thinking about the coding process in qualitative data analysis. The Qualitative Report, 23 (11), 2850–2861. https://nsuworks.nova.edu/tqr/vol23/iss11/14

Kaufmann, A. A., Barcomb, A., & Riehle, D. (2020). Supporting interview analysis with autocoding. HICSS. https://www.semanticscholar.org/paper/Supporting-Interview-Analysis-with-Autocoding-Kaufmann-Barcomb/b6e045859b5ce94e1eb144a9545b26c5e9fa6f32

Saldana, J. (2009). The coding manual for qualitative researchers. SAGE.

Further Readings

Analyzing Qualitative Data: Nvivo 12 Pro for Windows (2 hours). https://www.youtube.com/watch?v=CKPS4LF9G8A

How to Analyze Interview Transcripts. (2 minutes). https://www.rev.com/blog/analyze-interview-transcripts-in-qualitative-research

How to Know You Are Coding Correctly (4 minutes). https://www.youtube.com/watch?v=iL7Ww5kpnIM

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Rogers, M. (2023). Coding Qualitative Data. In: Okoko, J.M., Tunison, S., Walker, K.D. (eds) Varieties of Qualitative Research Methods. Springer Texts in Education. Springer, Cham. https://doi.org/10.1007/978-3-031-04394-9_12

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Qualitative Coding: Start

Qualitative Coding

Coding Qualitative Data Using NVivo

Qualitative Coding is a core strategy for qualitative data analysis in which some aspects of a data is assigned a descriptive label that allows the researcher to identify related content across the data.

SImply put, Qualitative coding involves creating and assigning codes to categorize data extracts and derive themes.

What methodologies does NVivo support?

Researchers usually adopt a qualitative methodology to suit their research question. For example, a social scientist wanting to develop new concepts or hypotheses may take a ‘grounded theory’ approach. A health researcher looking for ways to improve policy or program design might use ‘evaluation methods’. NVivo does not favor a particular methodology no matter what method you use. It is  designed to facilitate common qualitative techniques for organizing, analyzing and sharing data.

BEFORE YOU BEGIN

• Prepare your interview/focus group transcriptions

• Prepare a coding table based on your first impression from your transcriptions.

FOUR IMPERATIVE STEPS TO FOLLOW IN CODING QUALITATIVE DATA USING NVIVO

• Step I. Import Data: Import the document/transcriptions you intend to use and this will become you coding source(s) as you get along with coding

• Step 2. Set up a Coding Table: You will have to have prepared a coding table based on your first impression from your transcriptions (first cycle coding) before applying it on NVivo.To view and export your code book: Go to “Share”, Go to “Export”, Click on “Export “Codebook”

• Step 3. Coding: Highlight what you intend to code, right click and select code. This will bring out a backdrop of the available categories and you care able to choose which categories you want to code into. You are able to double code or triple code and have daughter codes as relevant to each category. 

• Step 4. Analyze the Data: You can simply highlight/cope and post what you have coded in a word document on your computer. You can also export and download them.

Here is what a coded document looks like for a particular node or category.

Performing an inter-rater reliability check

• Open the NVivo project that contains both users' or user groups' coding
• In the menu bar, click on the Query tab or click on the ‘Explore’ icon on the top in the Nvivo Click Coding Comparison 
• For User Group A and User Group B, select the users whose coding you want to compare
• Select the files in which you want to compare the coding (e.g., Select Files and Externals to compare all data files and externals but not memos; Select Selected Items to compare selected data files, externals, and/or memos, etc.)
• Select the codes in which you want to compare coding (e.g., Select All Nodes to compare all codes in the selected files; Select Selected Codes to compare selected codes in the selected files)
• Under Calculations Based On, select your unit of observation (i.e., character, sentence, paragraph)
• Click Run Query

Coding Qualitative Data (A summary and simple four step-by-step Guide to Coding Interview and Focus Groups Data)

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Chapter 19. Advanced Codes and Coding

Introduction: forest and trees.

Chapter 17 introduced you to content analysis, a particular way of analyzing historical artifacts, media, and other such “content” for its communicative aspects. Chapter 18 introduced you to the more general process of data analysis for qualitative research, how you would go about beginning to organize, simplify, and code interview transcripts and fieldnotes. This chapter takes you a bit deeper into the specifics of codes and how to use them, particularly the later stages of coding, in which our codes are refined, simplified, combined, and organized for the purpose of identifying what it all means , theoretically. These later rounds of coding are essential to getting the most out of the data we’ve collected. By the end of the chapter, you should understand how “findings” are actually found.

I am going to use a particular analogy throughout this chapter, that of the relationship between the forest and trees. You know the saying “You can’t see the forest for the trees”? Think about what this actually means. One is so focused on individual trees that one neglects to notice the overall system of which the trees are a part. This is something beginning researchers do all the time, and the laborious process of coding can make this tendency worse. You focus on the details of your codes but forget that they are merely the first step in the analysis process, that after you have tagged your trees, you need to step back and look at the big picture that is the entire forest. Keep this metaphor in mind. We will come back to it a few times.

Let’s imagine you have interviewed fifty college students about their experiences during the pandemic, both as students and as workers. Each of these interviews has been transcribed and runs to about 35 pages, double-spaced. That is 1,750 pages of data you will need to code before you can properly begin to make sense of it all. Taking a sample of the interviews for a first round of coding (see chapter 17), you are likely to first note things that are common to the interviews. A general feeling of fear, anxiety, or frustration may jump out at you. There is something about the human brain that is primed to look for “the one common story” at the outset. Often, we are wrong about this. The process of coding and recoding and memoing will often show us that our initial takes on “what the data say” are seriously misleading for a couple of reasons: first, because voices or stories that counter the predominant theme are often ignored in the first round, and, second, because what startles us or surprises us can drive away the more mundane findings that actually are at the heart of what the data are saying. If we have experienced the pandemic with little anxiety, seeing anxiety in the interviews will surprise us and make us overstate its importance in general. If we expect to find something and we see something very different, we tend to overnotice that difference. This is basic psychology, I am sure.

This is where coding comes in to help you verify, amplify, complicate, or delimit your initial first impressions. Coding is a rigorous process because it helps us move away from preconceptions and other judgment errors and pin down what is actually present in the data. It helps you identify the trees, which is actually important before we can properly see the forest. We start with “It’s a forest” (not really that helpful), then move to “These are specific trees, with particular roots and branches,” and finally move back to a better understanding of the forest (“It’s a boreal forest that works like this…”). Coding is the rigorous connecting process between the first (often wrong or incomplete) impression and the final interpretation, the “results” of the study (figure 19.1). If you remember that this is the point of coding, you will be less likely to get lost in the woods. Coding is not about tagging every possible root and branch of every tree to create some kind of master compendium of forest particulars. Coding is about learning how to identify what is important about that forest overall. [1] When you are new to the forest, you won’t know which root or branch is of importance, but as you walk through it again and again, you will learn to appreciate its rhythms and know what to pick up as important and what to discard as irrelevant.

There is no single correct way to go about coding your data. When I first began teaching qualitative research methods, I resolutely refused to “teach” coding, as I thought it was a little like trying to teach people to write fiction. It’s very personal and best developed through practice. But I have come to see the value of providing some guidelines—maps through the forest, if you will. I have drawn heavily here from Johnny Saldaña’s extensive and beautiful “coding manual,” but the particular suggestions here are what have worked best for me. We are going to walk through the forest many times, first in an open exploratory way and then in a more focused way once we have found our stride. Finally, we will sit down with all of our maps and materials and see what it is we can discover about the world by looking at our data.

First Walks in the Woods: Open Coding

Saldaña ( 2014 ) provides dozens of types of codes and coding processes, but we are going to confine our discussion two five. These are the five kinds of codes that I think work best for beginning researchers in your first walks through the woods. Used together, they have the potential to get at the heart of what is important in social science research. They are descriptive , i n vivo , process , values , and emotions . Select a sample of your data in the first round of coding. If you tried to tag everything in these initial rounds, you will never get out of the woods. Your sample should be broad enough to capture essential aspects of your data corpus but small enough to allow you free rein to pick up as many branches as you think interesting. Set aside a significant amount of time for this. And then double or triple that time allotment. You’ll need it.

Descriptive codes are codes used to tag specific activities, places, and things that seem to be important in particular passages. They are identifying tags (“This is a branch from an elm tree”; “This is an acorn”). Be careful here because you can really end up trying to identify everything—every word, every line, every passage. Don’t do that! It’s helpful to remind yourself what your research is about—what is your research question or focus? Some twigs can stay on the forest floor. Saldaña’s ( 2014 ) use of the term is narrower. Descriptive codes are meant to summarize the basic topic of a passage in a single word or short phrase, what is also called “topic coding” or “index coding.” These descriptive codes will allow you to easily search for and return to passages about a particular topic or feature of the forest; this will allow you to make better comparisons in later rounds of analysis. The actual word or phrase you come up with will be rather personal to you and dependent on the focus of your research. Here is an exemplary passage from a fictitious interview with a working-class college student: “I had no idea what scholarships were available! No one in my family had ever gone to college before, so there was no one I could ask. And my high school counselor was always too busy. What a joke! Plus, I was a little embarrassed, to be honest. So, yeah, I owe a lot of money. It’s really not that fair.”

What descriptive codes can be developed here? How would you define the topic or topics of this passage? On the one hand, the subject appears to be scholarships or how this student paid for college. “How Pay” might be a good descriptive code for the entire passage. But there are a lot of other interesting things going on here too. If your focus is on how peer groups work or social networks, you might focus on those aspects of the passage. Perhaps “No Assistance” could work as a descriptive code in this first round of coding. Descriptive codes are pretty straightforward, so they are easy for beginning researchers to use, but “they may not enable more complex and theoretical analyses as the study progresses, particularly with interview transcript data” ( 137 ).

In vivo codes are codes that use the actual words people have used to tag an important point or message. In the above passage, “no one I could ask” might be such a code. These indigenous terms or phrases are particularly useful when seeking to “honor or prioritize” the voice of the participants ( Saldaña 2014:138 ). They don’t require you to impose your own sense on a passage. They are also rather enjoyable to generate, as they encourage you to step into the shoes of those you have interviewed or observed. The terms or phrases should jump out at you as something salient to your research question or focus (or simply jump out at you in surprising ways that you hadn’t expected, given your research question).

Process codes are codes that label conceptual actions. This is another way to describe the data, but rather than focus on the topic, we organize it around key actions and activities. For example, we could tag the passage above with “asking for help.” By convention, process codes are gerunds , those strange verb forms that end in -ing and operate a bit like nouns. Process codes are particularly helpful for studies that focus on change and development over time, as the use of tagged gerunds can really highlight stages, if such exist. Grounded theorists often employ process codes for this reason. I find it useful, as it reminds me to focus not only on what participants say and how they say it but on the activities that they are engaged in.

Values codes are codes that reflect the attitudes, beliefs, or values held by a participant. Values codes capture things such as principles, moral codes and situational norms (“values”), the way we think about ourselves and others (“attitudes”), and all of our personal knowledge, experience, opinions, assumptions, biases, prejudices, morals, and other interpretive perceptions of the world (“beliefs”). They are extremely powerful tags and absolutely essential for phenomenological researchers. We might attach the values code “unfair” to the passage above or even note the “What a joke!” passage as disbelief or disgust.

Values codes are a particular subset of affective coding , where codes are developed to “investigate subjective qualities of human experience (e.g., emotions, values, conflicts, judgments) by directly acknowledging and naming those experiences” ( Saldaña 2014:159 ). The fifth suggested code is also another form of affective coding, emotions codes , labels of feelings shared by the participants. “Embarrassment” is an obvious emotion code in the above passage. In the kinds of research I mostly do, phenomenological and interview based, often about sensitive subjects around discrimination, power, and marginalization, coding emotions is incredibly helpful and productive: “Emotion coding is appropriate for virtually all qualitative studies, but particularly for those that explore intrapersonal or interpersonal participant experiences and actions, especially in matters of identity, social relationships, reasoning, decision-making, judgment, and risk-taking” ( 160 ).

A Final Purposeful Hike through the Forest: Closed Coding

After initial rounds of coding (several walks through the woods), you should begin to see important themes emerge from your data and have a general idea of what is important enough to look at more closely. Between first-cycle coding and your last hike through the forest, you will have created a list of codes or even a codebook that records these emergent categories and themes (see chapter 18). It is quite possible your research question(s) or focus has shifted based on what you have seen in the first rounds of coding. [2] If you need more data collection based on these shifts, collect more data. Once you feel comfortable that you have reached saturation and know what it is you are looking at and for, you are ready for one final purposeful hike through your forest to tag (code) all your data using a pared-down set of codes.

Building Meaning, Identifying Patterns, Comparing Trees, and Seeing Forests

The final cycle of coding is also the time to generate analyses of your data. As with so much qualitative research, this is not a linear process (finish stage A and move to stage B followed by stage C). To some extent, analysis is happening all the time, even when you are in the field. Journaling, reflecting, and writing analytical memos are important in all stages of coding. But it is in the final stages of coding that you truly start to put everything together—that’s when you start understanding the nature of the forest you have been walking through. That, after all, is the point. What do all these codes of various people’s actions (fieldnotes) or people’s words (interviews) tell you about the larger phenomenon of interest? This will require mapping your codes across your data set, comparing and contrasting themes and patterns often relative to demographic factors, and overall trying to “see” the forest instead of the trees.

Different researchers employ various tools and methods to do this. Some draw pictures or concept maps, seeking to understand the connections between the themes that have emerged. Others spend time counting code frequencies or drawing elaborate outlines of codes and reworking these in search of general patterns and structure. Some even use in vivo codes to generate found poems that might provide insight into the deeper meanings and connections of the data. Mapping word clouds is a similar process. As a sociologist who is interested in issues of identity, my go-to method is to look for interactions between the codes, noting demographic elements of comparison. For example, in the very first study I conducted ( Hurst 2010a ), I used emotion codes. Specifically, I found numerous examples of sadness, anger, shame, embarrassment, pride, resentment, and fear. With the exception of pride, these are not very positive emotions. I could have stopped there, with the finding of overwhelming instances of negative emotions in the stories told by working-class college students. But I played around with these categories, clustering them by incidence and frequency and then comparing these across demographic categories (age, race, gender). I found no race or gender differences and only a hint of a difference between traditional-age college students and older students. What I did find, however, was that the emotions sorted themselves out in clusters relative to other codes. Embarrassment, shame, resentment, and fear were often found together in the same interview, along with a pattern of using “they” to refer to working-class people like the interviewees’ families. Conversely, anger, sadness, and pride were often found together, along with a pattern of using “we” to refer to working-class people. This led me to develop a theory about how working-class students manage their class identities in college, with some desirous of becoming middle class (“Renegades”) and others wanting very strongly to remain identified as working class (“Loyalists”; Hurst 2010a ).

Saldaña ( 2014 ) summarizes many of these techniques. He draws a distinction between "code mapping" and “ code landscaping .” Code mapping is a systematic and rigorous reordering of all codes into an increasingly simplified hierarchical organization. One can move from fifty or so specific stand-alone codes of various types (e.g., sadness, “I was so alone,” socializing, financial aid) and attempt to impose some meaningful order on them by clustering like phenomena with like phenomena. Perhaps sadness (an emotion code), “I was so alone” (an in vivo code), and socializing (an action code) are understood as belonging together, perhaps under a category of SOCIAL CONNECTIONS or, depending on what has emerged from your data, EXCLUSION. Code mapping is an iterative process, meaning that you can do a second or a third take of simplification and reordering. In the end, you might be left with one or two big conceptual themes or patterns.

Code landscaping “integrates textual and visual methods to see both the forest and trees” ( Saldaña 2014:285 ). Using computer-assisted word cloud mapping (WordItOut.com, wordclouds.com, wordle.net) is one way of doing this, or at least a way to jump-start the process. Word clouds quickly allow you to see what stands out in the interview or fieldnotes and can suggest relationships of importance between codes. Manually, one can also diagram the codes in terms of relationship, stressing the processual elements (what leads to what: “I felt so alone” >> sadness).

Another helpful suggestion is to chart the incidence of codes across your data set. This is particularly helpful with interview data. What (simplified) codes emerge in each interview transcript? Is there a pattern here? The two categories of Loyalist and Renegade would not have emerged had I not made these kinds of code comparisons by person interviewed. You might create a master document or spreadsheet that places each interview subject on its own row, with a brief description of that person’s story (what emerges as the focus of the interview or who they are in terms of social location, character, etc.) in a separate column and then a third column listing the key codes found in the interview. This is a good way to “see” the forest in a snapshot.

Whatever method or technique is employed, the general direction is to move from simple tags (codes) to categories to themes/concepts (figure 19.2). Eventually, those identified themes/concepts will help you build a new theory or at a minimum produce relevant theoretically informed findings, as in the second example at the end of this chapter.

Grounded Theory has its own vocabulary when it comes to coding and data analysis, so if you are trying to do a “proper” Grounded Theory study, you might want to read up on this in more detail ( Charmaz 2014 ; Strauss 1987 ; Strauss and Corbin 2015 ). A quick summary of the approach follows. First-cycle coding employs the following kinds of codes: in vivo , process, and initial. Second-cycle coding employs focused , axial , and theoretical codes. The names of these second-cycle codes are meant to evoke the Grounded Theory approach itself: in the second cycle, the grounded theorists focus the study on axes of importance to generate theories. Focused coding pulls out the most frequent or significant codes from the first round. Axial coding reassembles data around a category, or axis. These categories or axes are meant to be concept generating: “Categories should not be so abstract as to lose their sensitizing aspect, but yet must be abstract enough to make [the emerging] theory a general guide” ( Glaser and Strauss 1967:242 ). Theoretical codes “function like umbrellas that cover and account for all other codes and categories” ( Saldaña 2014:314 ). Key words or key phrases (e.g., “Exclusion” or “Always Crying”) capture the emergent theory in the theoretical code.

Describing and Explaining the Forest: Findings and Theories

It is only now, after the laborious process of coding is complete, that you can actually move on to generate and present findings about your data. Many beginning researchers attempt to skip the middle work and get straight to writing, only to find that what they say about the data is pretty thin. The quality of qualitative research comes from the entire analytical process: open and closed coding, writing analytical memos, identifying patterns, making comparisons, and searching for order in the voluminous transcripts and fieldnotes.

But let’s say that you have followed all the steps so far. You have done multiple rounds of coding—refining, simplifying, and ordering your codes. You’ve looked for patterns. You think you have seen some master concepts emerge, and you have a good idea of what the important themes and stories are in your data. How do you begin to explain and describe those themes and stories and theories to an audience? Chapter 20 will go into further detail on how to present your work (e.g., formats, length, audience, etc.), but before we get to that, we need to talk about the stage after coding but before writing. You will want to be clear in your mind that you have the story right, that you have not missed anything of importance, and that you have searched for disconfirming evidence and not found it (if you have, you have to go back to the data and start again on a new track).

Begin with your research question(s), either as originally asked or as reformulated. What is your answer to these questions? How have your underlying goals (see chapter 4) been addressed or achieved by these answers? In other words, what is the outcome of your study? Is it about describing a culture, raising awareness of a problem, finding solutions, or delineating strategies employed by participants? Perhaps you have taken a critical approach, and your outcome is all about “giving voice” to those whose voices are often unheard. In that case, your findings will be participant driven, and your challenge will be to present passages (direct quotes) that exemplify the most salient themes found in your data. On the other hand, if you have engaged in an ethnographic study, your findings may be thick, theoretically informed descriptions of the culture under study. Your challenge there will be writing evocatively. Or to take a final example, perhaps you undertook a mixed methods study to find the best way to improve a program or policy. Your findings should be such that suggest particular recommendations. Note that in none of these cases are you presenting your codes as your findings! The coding process merely helps you find what is important to say about the case based on your research questions and underlying aims and goals.

The gold star of qualitative research presentation is the formulation of theory. Even for those not following the Grounded Theory tradition, finding something to say that goes beyond the particulars of your case is an important part of doing social science research. Remember, social science is generally not idiographic. A “theory” need not be earth shattering, as in the case of Freud’s theory of Ego, Id, and Superego. A theory is simply an explanation of something general. [3] It is a story we tell about how the world works. Theories are provisional. They can never be proven (although they can be disproven). My description of Loyalists and Renegades is a theory about how college students from the working class manage the problem of class identity when their class backgrounds no longer match their class destinations. While qualitative research is not statistically generalizable , it is and should be theoretically generalizable in this way. Loyalists and Renegades are strategies that I believe occur generally among those who are experiencing upward social mobility; they are not confined solely to the twenty-one students I interviewed in 2005 in a college in the Pacific Northwest.

What is the story your research results are telling about the world? That is the ultimate question to ask yourself as you conclude your data analysis and begin to think about writing up your results.

Further Readings

Note: Please see chapter 18 for further reading on coding generally.

Charmaz, Kathy 2014. Constructing Grounded Theory . 2nd ed. Thousand Oaks, CA: SAGE. Although this is a general textbook on conducting all stages of Grounded Theory research, a significant portion is directed at the coding process.

Strauss, Anselm. 1987. Qualitative Analysis for Social Scientists . Cambridge: Cambridge University Press. An essential reading on coding Grounded Theory for advanced students, written by one of the originators of the Grounded Theory approach. Not an easy read.

Strauss, Anselm, and Juliet Corbin. 2015. Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory . 4th ed. Thousand Oaks, CA: SAGE. A good basic textbook for those exploring Grounded Theory. Accessible to undergraduates and graduate students

• A small aside here on social science in general and sociology in particular: It is often believed that sociologists are concerned about “people” and what people do and believe. Actually, people are our trees. We are really interested in the forest, or society. We try to understand society by listening to and observing the people who compose it. Behavioral science, in contrast, does take the individual as the object of study. ↵
• It might be helpful to read the first example of writings about qualitative data analysis in the "Further Readings" section. ↵
• Saldaña ( 2014 ) lists five essential characteristics of a social science theory: “(1) expresses a patterned relationship between two or more concepts; (2) predicts and controls action through if-then logic; (3) accounts for parameters of or variation in the empirical observations; (4) explains how and/or why something happens by stating its cause(s); and (5) provides insights and guidance for improving social life” ( 349 ). ↵

A form of first-cycle coding in which codes are developed to “investigate subjective qualities of human experience (e.g., emotions, values, conflicts, judgments) by directly acknowledging and naming those experiences” (Saldaña 2021:159).  See also emotions coding and values coding .

A technique of second-cycle coding in which codes developed in the first rounds of coding are restructured into an increasingly simplified hierarchical organization, thereby allowing the general patterns and underlying structure of the field data to emerge more clearly.

A technique of second-cycle coding that “integrates textual and visual methods to see both the forest and trees" (Saldaña 2021:285).

A first-cycle coding process in which terms or phrases used by the participants become the code applied to a particular passage.  It is also known as “verbatim coding,” “indigenous coding,” “natural coding,” “emic coding,” and “inductive coding,” depending on the tradition of inquiry of the researcher.  It is common in Grounded Theory approaches and has even given its name to one of the primary CAQDAS programs (“NVivo”).

A later stage coding process used in Grounded Theory that pulls out the most frequent or significant codes from initial coding .

A later stage coding process used in Grounded Theory in which data is reassembled around a category, or axis.

A later stage-coding process used in Grounded Theory in which key words or key phrases capture the emergent theory.

Introduction to Qualitative Research Methods Copyright © 2023 by Allison Hurst is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License , except where otherwise noted.

A guide to coding qualitative research data

Last updated

12 February 2023

Reviewed by

Each time you ask open-ended and free-text questions, you'll end up with numerous free-text responses. When your qualitative data piles up, how do you sift through it to determine what customers value? And how do you turn all the gathered texts into quantifiable and actionable information related to your user's expectations and needs?

Qualitative data can offer significant insights into respondents’ attitudes and behavior. But to distill large volumes of text / conversational data into clear and insightful results can be daunting. One way to resolve this is through qualitative research coding.

Streamline data coding

Use global data tagging systems in Dovetail so everyone analyzing research is speaking the same language

• What is coding in qualitative research?

This is the system of classifying and arranging qualitative data . Coding in qualitative research involves separating a phrase or word and tagging it with a code. The code describes a data group and separates the information into defined categories or themes. Using this system, researchers can find and sort related content.

They can also combine categorized data with other coded data sets for analysis, or analyze it separately. The primary goal of coding qualitative data is to change data into a consistent format in support of research and reporting.

A code can be a phrase or a word that depicts an idea or recurring theme in the data. The code’s label must be intuitive and encapsulate the essence of the researcher's observations or participants' responses. You can generate these codes using two approaches to coding qualitative data: manual coding and automated coding.

• Why is it important to code qualitative data?

By coding qualitative data, it's easier to identify consistency and scale within a set of individual responses. Assigning codes to phrases and words within feedback helps capture what the feedback entails. That way, you can better analyze and   understand the outcome of the entire survey.

Researchers use coding and other qualitative data analysis procedures to make data-driven decisions according to customer responses. Coding in customer feedback will help you assess natural themes in the customers’ language. With this, it's easy to interpret and analyze customer satisfaction .

• How do inductive and deductive approaches to qualitative coding work?

Before you start qualitative research coding, you must decide whether you're starting with some predefined code frames, within which the data will be sorted (deductive approach). Or, you may plan to develop and evolve the codes while reviewing the qualitative data generated by the research (inductive approach). A combination of both approaches is also possible.

In most instances, a combined approach will be best. For example, researchers will have some predefined codes/themes they expect to find in the data, but will allow for a degree of discovery in the data where new themes and codes come to light.

Inductive coding

This is an exploratory method in which new data codes and themes are generated by the review of qualitative data. It initiates and generates code according to the source of the data itself. It's ideal for investigative research, in which you devise a new idea, theory, or concept. 

Inductive coding is otherwise called open coding. There's no predefined code-frame within inductive coding, as all codes are generated by reviewing the raw qualitative data.

If you're adding a new code, changing a code descriptor, or dividing an existing code in half, ensure you review the wider code frame to determine whether this alteration will impact other feedback codes.  Failure to do this may lead to similar responses at various points in the qualitative data,  generating different codes while containing similar themes or insights.

Inductive coding is more thorough and takes longer than deductive coding, but offers a more unbiased and comprehensive overview of the themes within your data.

Deductive coding

This is a hierarchical approach to coding. In this method, you develop a codebook using your initial code frames. These frames may depend on an ongoing research theory or questions. Go over the data once again and filter data to different codes. 

After generating your qualitative data, your codes must be a match for the code frame you began with. Program evaluation research could use this coding approach.

Inductive and deductive approaches

Research studies usually blend both inductive and deductive coding approaches. For instance, you may use a deductive approach for your initial set of code sets, and later use an inductive approach to generate fresh codes and recalibrate them while you review and analyze your data.

• What are the practical steps for coding qualitative data?

You can code qualitative data in the following ways:

1. Conduct your first-round pass at coding qualitative data

You need to review your data and assign codes to different pieces in this step. You don't have to generate the right codes since you will iterate and evolve them ahead of the second-round coding review.

Let's look at examples of the coding methods you may use in this step.

Open coding : This involves the distilling down of qualitative data into separate, distinct coded elements.

Descriptive coding : In this method, you create a description that encapsulates the data section’s content. Your code name must be a noun or a term that describes what the qualitative data relates to.

Values coding : This technique categorizes qualitative data that relates to the participant's attitudes, beliefs, and values.

Simultaneous coding : You can apply several codes to a single piece of qualitative data using this approach.

Structural coding : In this method, you can classify different parts of your qualitative data based on a predetermined design to perform additional analysis within the design.

In Vivo coding : Use this as the initial code to represent specific phrases or single words generated via a qualitative interview (i.e., specifically what the respondent said).

Process coding : A process of coding which captures action within data.  Usually, this will be in the form of gerunds ending in “ing” (e.g., running, searching, reviewing).

2. Arrange your qualitative codes into groups and subcodes

You can start organizing codes into groups once you've completed your initial round of qualitative data coding. There are several ways to arrange these groups. 

You can put together codes related to one another or address the same subjects or broad concepts, under each category. Continue working with these groups and rearranging the codes until you develop a framework that aligns with your analysis.

3. Conduct more rounds of qualitative coding

Conduct more iterations of qualitative data coding to review the codes and groups you've already established. You can change the names and codes, combine codes, and re-group the work you've already done during this phase. 

In contrast, the initial attempt at data coding may have been hasty and haphazard. But these coding rounds focus on re-analyzing, identifying patterns, and drawing closer to creating concepts and ideas.

Below are a few techniques for qualitative data coding that are often applied in second-round coding.

Pattern coding : To describe a pattern, you join snippets of data, similarly classified under a single umbrella code.

Thematic analysis coding : When examining qualitative data, this method helps to identify patterns or themes.

Selective coding/focused coding : You can generate finished code sets and groups using your first pass of coding.

Theoretical coding : By classifying and arranging codes, theoretical coding allows you to create a theoretical framework's hypothesis. You develop a theory using the codes and groups that have been generated from the qualitative data.

Content analysis coding : This starts with an existing theory or framework and uses qualitative data to either support or expand upon it.

Axial coding : Axial coding allows you to link different codes or groups together. You're looking for connections and linkages between the information you discovered in earlier coding iterations.

Longitudinal coding : In this method, by organizing and systematizing your existing qualitative codes and categories, it is possible to monitor and measure them over time.

Elaborative coding : This involves applying a hypothesis from past research and examining how your present codes and groups relate to it.

4. Integrate codes and groups into your concluding narrative

When you finish going through several rounds of qualitative data coding and applying different forms of coding, use the generated codes and groups to build your final conclusions. The final result of your study could be a collection of findings, theory, or a description, depending on the goal of your study.

Start outlining your hypothesis , observations , and story while citing the codes and groups that served as its foundation. Create your final study results by structuring this data.

• What are the two methods of coding qualitative data?

You can carry out data coding in two ways: automatic and manual. Manual coding involves reading over each comment and manually assigning labels. You'll need to decide if you're using inductive or deductive coding.

Automatic qualitative data analysis uses a branch of computer science known as Natural Language Processing to transform text-based data into a format that computers can comprehend and assess. It's a cutting-edge area of artificial intelligence and machine learning that has the potential to alter how research and insight is designed and delivered.

Although automatic coding is faster than human coding, manual coding still has an edge due to human oversight and limitations in terms of computer power and analysis.

• What are the advantages of qualitative research coding?

Here are the benefits of qualitative research coding:

Boosts validity : gives your data structure and organization to be more certain the conclusions you are drawing from it are valid

Reduces bias : minimizes interpretation biases by forcing the researcher to undertake a systematic review and analysis of the data 

Represents participants well : ensures your analysis reflects the views and beliefs of your participant pool and prevents you from overrepresenting the views of any individual or group

Fosters transparency : allows for a logical and systematic assessment of your study by other academics

• What are the challenges of qualitative research coding?

It would be best to consider theoretical and practical limitations while analyzing and interpreting data. Here are the challenges of qualitative research coding:

Labor-intensive: While you can use software for large-scale text management and recording, data analysis is often verified or completed manually.

Lack of reliability: Qualitative research is often criticized due to a lack of transparency and standardization in the coding and analysis process, being subject to a collection of researcher bias. 

Limited generalizability : Detailed information on specific contexts is often gathered using small samples. Drawing generalizable findings is challenging even with well-constructed analysis processes as data may need to be more widely gathered to be genuinely representative of attitudes and beliefs within larger populations.

Subjectivity : It is challenging to reproduce qualitative research due to researcher bias in data analysis and interpretation. When analyzing data, the researchers make personal value judgments about what is relevant and what is not. Thus, different people may interpret the same data differently.

• What are the tips for coding qualitative data?

Here are some suggestions for optimizing the value of your qualitative research now that you are familiar with the fundamentals of coding qualitative data.

Keep track of your codes using a codebook or code frame

It can be challenging to recall all your codes offhand as you code more and more data. Keeping track of your codes in a codebook or code frame will keep you organized as you analyze the data. An Excel spreadsheet or word processing document might be your codebook's basic format.

Ensure you track:

The label applied to each code and the time it was first coded or modified

An explanation of the idea or subject matter that the code relates to

Who the original coder is

Any notes on the relationship between the code and other codes in your analysis

Add new codes to your codebook as you code new data, and rearrange categories and themes as necessary.

• How do you create high-quality codes?

Here are four useful tips to help you create high-quality codes.

1. Cover as many survey responses as possible

The code should be generic enough to aid your analysis while remaining general enough to apply to various comments. For instance, "product" is a general code that can apply to many replies but is also ambiguous. 

Also, the specific statement, "product stops working after using it for 3 hours" is unlikely to apply to many answers. A good compromise might be "poor product quality" or "short product lifespan."

2. Avoid similarities

Having similar codes is acceptable only if they serve different objectives. While "product" and "customer service" differ from each other, "customer support" and "customer service" can be unified into a single code.

3. Take note of the positive and the negative

Establish contrasting codes to track an issue's negative and positive aspects separately. For instance, two codes to identify distinct themes would be "excellent customer service" and "poor customer service."

4. Minimize data—to a point

Try to balance having too many and too few codes in your analysis to make it as useful as possible.

What is the best way to code qualitative data?

Depending on the goal of your research, the procedure of coding qualitative data can vary. But generally, it entails: 

Reading through your data

Assigning codes to selected passages

Carrying out several rounds of coding

Grouping codes into themes

Developing interpretations that result in your final research conclusions 

You can begin by first coding snippets of text or data to summarize or characterize them and then add your interpretative perspective in the second round of coding.

A few techniques are more or less acceptable depending on your study’s goal; there is no right or incorrect way to code a data set.

What is an example of a code in qualitative research?

A code is, at its most basic level, a label specifying how you should read a text. The phrase, "Pigeons assaulted me and took my meal," is an illustration. You can use pigeons as a code word.

Is there coding in qualitative research?

An essential component of qualitative data analysis is coding. Coding aims to give structure to free-form data so one can systematically study it.

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Qualitative Descriptive Methods in Health Science Research

Karen jiggins colorafi.

1 College of Nursing & Health Innovation, Arizona State University, Phoenix, AZ, USA

Bronwynne Evans

The purpose of this methodology paper is to describe an approach to qualitative design known as qualitative descriptive that is well suited to junior health sciences researchers because it can be used with a variety of theoretical approaches, sampling techniques, and data collection strategies.

Background:

It is often difficult for junior qualitative researchers to pull together the tools and resources they need to embark on a high-quality qualitative research study and to manage the volumes of data they collect during qualitative studies. This paper seeks to pull together much needed resources and provide an overview of methods.

A step-by-step guide to planning a qualitative descriptive study and analyzing the data is provided, utilizing exemplars from the authors’ research.

This paper presents steps to conducting a qualitative descriptive study under the following headings: describing the qualitative descriptive approach, designing a qualitative descriptive study, steps to data analysis, and ensuring rigor of findings.

Conclusions:

The qualitative descriptive approach results in a summary in everyday, factual language that facilitates understanding of a selected phenomenon across disciplines of health science researchers.

There is an explosion in qualitative methodologies among health science researchers because social problems lend themselves toward thoughtful exploration, such as when issues of interest are complex, have variables or concepts that are not easily measured, or involve listening to populations who have traditionally been silenced ( Creswell, 2013 ). Creswell (2013 , p. 48) suggests qualitative research is preferred when health science researchers seek to (a) share individual stories, (b) write in a literary, flexible style, (c) understand the context or setting of issues, (d) explain mechanisms or linkages in causal theories, (e) develop theories, and (f) when traditional quantitative statistical analyses do not fit the problem at hand. Typically, qualitative textbooks present learners with five approaches for qualitative inquiry: narrative, phenomenological, grounded theory, case study, and ethnography. Yet eminent researcher Margarete Sandelowski argues that in “the now vast qualitative methods literature, there is no comprehensive description of qualitative description as a distinctive method of equal standing with other qualitative methods, although it is one of the most frequently employed methodological approaches in the practice disciplines” ( Sandelowski, 2000 ). Qualitative description is especially amenable to health environments research because it provides factual responses to questions about how people feel about a particular space, what reasons they have for using features of the space, who is using particular services or functions of a space, and the factors that facilitate or hinder use.

The purpose of this methodology article is to define and outline qualitative description for health science researchers, providing a starter guide containing important primary sources for those who wish to become better acquainted with this methodological approach.

Describing the Qualitative Descriptive Approach

In two seminal articles, Sandelowski promotes the mainstream use of qualitative description ( Sandelowski, 2000 , 2010 ) as a well-developed but unacknowledged method which provides a “comprehensive summary of an event in the every day terms of those events” ( Sandelowski, 2000 , p. 336). Such studies are characterized by lower levels of interpretation than are high-inference qualitative approaches such as phenomenology or grounded theory and require a less “conceptual or otherwise highly abstract rendering of data” ( Sandelowski, 2000 , p. 335). Researchers using qualitative description “stay closer to their data and to the surface of words and events” ( Sandelowski, 2000 , p. 336) than many other methodological approaches. Qualitative descriptive studies focus on low-inference description, which increases the likelihood of agreement among multiple researchers. The difference between high and low inference approaches is not one of rigor but refers to the amount of logical reasoning required to move from a data-based premise to a conclusion. Researchers who use qualitative description may choose to use the lens of an associated interpretive theory or conceptual framework to guide their studies, but they are prepared to alter that framework as necessary during the course of the study ( Sandelowski, 2010 ). These theories and frameworks serve as conceptual hooks upon which hang study procedures, analysis, and re-presentation. Findings are presented in straightforward language that clearly describes the phenomena of interest.

Other cardinal features of the qualitative descriptive approach include (a) a broad range of choices for theoretical or philosophical orientations, (b) the use of virtually any purposive sampling technique (e.g., maximum variation, homogenous, typical case, criterion), (c) the use of observations, document review, or minimally to moderately structured interview or focus group questions, (d) content analysis and descriptive statistical analysis as data analysis techniques, and (e) the provision of a descriptive summary of the informational contents of the data organized in a way that best fits the data ( Neergaard, Olesen, Andersen, & Sondergaard, 2009 ; Sandelowski, 2000 , 2001 , 2010 ).

Designing a Qualitative Descriptive Study

Methodology.

Unlike traditional qualitative methodologies such as grounded theory, which are built upon a particular, prescribed constellation of procedures and techniques, qualitative description is grounded in the general principles of naturalistic inquiry. Lincoln and Guba suggest that naturalistic inquiry deals with the concept of truth, whereby truth is “a systematic set of beliefs, together with their accompanying methods” ( Lincoln & Guba, 1985 , p. 16). Using an often eclectic compilation of sampling, data collection, and data analysis techniques, the researcher studies something in its natural state and does not attempt to manipulate or interfere with the ordinary unfolding of events. Taken together, these practices lead to “true understanding” or “ultimate truth.” Table 1 describes design elements in two exemplar qualitative descriptive studies and serves as guide to the following discussion.

Example of Study Design Elements for Two Studies.

Theoretical Framework

Theoretical frameworks serve as organizing structures for research design: sampling, data collection, analysis, and interpretation, including coding schemes, and formatting hypothesis for further testing ( Evans, Coon, & Ume, 2011 ; Miles, Huberman, & Saldana, 2014 ; Sandelowski, 2010 ). Such frameworks affect the way in which data are ultimately viewed; qualitative description supports and allows for the use of virtually any theory ( Sandelowski, 2010 ). Creswell’s chapter on “Philosophical Assumptions and Interpretative Frameworks” (2013) is a useful place to gain understanding about how to embed a theory into a study.

Sampling choices place a boundary around the conclusions you can draw from your qualitative study and influence the confidence you and others place in them ( Miles et al., 2014 ). A hallmark of the qualitative descriptive approach is the acceptability of virtually any sampling technique (e.g., maximum variation where you aim to collect as many different cases as possible or homogenous whereby participants are mostly the same). See Miles, Huberman, and Saldana’s (2014 , p. 30) “Bounding the Collection of Data” discussion to select an appropriate and congruent purposive sampling strategy for your qualitative study.

Data Collection

In qualitative descriptive studies, data collection attempts to discover “the who, what and where of events” or experiences ( Sandelowski, 2000 , p.339). This includes, but is not limited to focus groups, individual interviews, observation, and the examination of documents or artifacts.

Data Analysis

Content analysis refers to a technique commonly used in qualitative research to analyze words or phrases in text documents. Hsieh and Shannon (2005) present three types of content analysis, any of which could be used in a qualitative descriptive study. Conventional content analysis is used in studies that aim to describe a phenomenon where exiting research and theory are limited. Data are collected from open-ended questions, read word for word, and then coded. Notes are made and codes are categorized. Directed content analysis is used in studies where existing theory or research exists: it can be used to further describe phenomena that are incomplete or would benefit from further description. Initial codes are created from theory or research and applied to data and unlabeled portions of text are given new codes. Summative content analysis is used to quantify and interpret words in context, exploring their usage. Data sources are typically seminal texts or electronic word searches.

Quantitative data can be included in qualitative descriptive studies if they aim to more adequately or fully describe the participants or phenomenon of interest. Counting is conceptualized as a “means to and end, not the end itself” by Sandelowski (2000 , p. 338) who emphasizes that careful descriptive statistical analysis is an effort to understand the content of data, not simply the means and frequencies, and results in a highly nuanced description of the patterns or regularities of the phenomenon of interest ( Sandelowski, 2000 , 2010 ). The use of validated measures can assist with generating dependable and meaningful findings, especially when the instrument (e.g., survey, questionnaire, or list of questions) used in your study has been used in others, helping to build theory, improve predictions, or make recommendations ( Miles et al., 2014 ).

Data Re-Presentation

In clear and simple terms, the “expected outcome of qualitative descriptive studies is a straight forward descriptive summary of the informational contents of data organized in a way that best fits the data” ( Sandelowski, 2000 , p. 339). Data re-presentation techniques allow for tremendous creativity and variation among researchers and studies. Several good resources are provided to spur imagination ( Miles et al., 2014 ; Munhall & Chenail, 2008 ; Wolcott, 2009 ).

Steps to Data Analysis

It is often difficult for junior health science researchers to know what to do with the volumes of data collected during a qualitative study and formal course work in traditional qualitative methods courses are typically sparse regarding the specifics of data management. It is for those reasons that this section of our article will provide a detailed description of the data analysis techniques used in qualitative descriptive methodology. The following steps are case examples of a study undertaken by one author (K.J.C.) after completing a data management course offered by another author (B.E.). Examples are offered from the two studies noted in Table 1 . It is offered in list format for general readability, but the qualitative researcher should recognize that qualitative analyses are iterative and recursive by nature.

Example of a Coding Manual.

Note . SES = socioeconomic status.

Reading from the left in Table 2 , codes were given a number and letter for use in marking sections of text. Next, the code name indicating a theme was entered in boldface type with a definition in the code immediately under it. The second column provided an exemplar of each code, along with a notation indicating where it was found in the data, so that coders could recognize instances of that particular code when they saw them.

The coding manual was tested against data gathered in a preliminary study and was revised as codes found to overlap or be missing entirely. We continued to revise it iteratively during the study as data collection and analysis proceeded and then used it to recode previously coded data. Using this procedure, it was used to revisit the data several times.

• Each transcribed document was formatted with wide right margins that allowed the investigator to apply codes and generate marginal remarks by hand. Marginal remarks are handwritten comments entered by the investigator. They represent an attempt to stay “alert” about analysis, forming ideas and recording reactions to the meaning of what is seen in the data. Marginal remarks often suggest new interpretations, leads, and connections or distinctions with other parts of the data ( Miles et al., 2014 ). Such remarks are preanalytic and add meaning and clarity to transcripts.

Level 1 Coding With Meaning Units.

• Conceptually similar codes were organized into categories (coding groups of coded themes that were increasingly abstract) through revisiting the theory framing the study (asking, “does this system of coding make sense according to the chosen theory?”). Miles et al. (2014) provide many examples for creating, categorizing, and revising codes, including highlighting a technique used by Corbin and Strauss ( Corbin & Strauss, 2015 ) that includes growing a list of codes and then applying a slightly more abstract label to the code, creating new categories of codes with each revision. This is often referred to as second-level or pattern coding, a way of grouping data into a smaller number of sets, themes, or constructs. During the analysis of data, patterns were generated and the researcher spent significant amounts of time with different categorizations, asking questions, checking relationships, and generally resisting the urge to be “locked too quickly into naming a pattern” ( Miles et al., 2014 , p. 69).
• During this phase of analysis, pattern codes were revised and redefined in the coding manual and exemplars were used to clarify the understanding of each code. Miles et al. (2014) suggest that software can be helpful during this categorization (counting) step, so lists of observed engagement behaviors were also recorded in Dedoose software ( Dedoose, 2015 ) by code so that frequencies could be captured and analyzed. Despite the assistance of Dedoose, the researcher found that hand sorting codes into themes and categories was best done on paper.

Example of an analytic memo used in qualitative description analysis.

Data Matrix.

Note . The CLOX is an executive clock drawing task that tests cognition and was used in this study with the caregiver (CG) and the care recipient (CR). The CG Strain and the CG Gain scores were derived by the researcher through a qualitative content analysis ( Evans, Coon, & Belyea, 2006 ).

• Finally, the data are re-presented in a creative but rigorous way that are judged to best fit the findings ( Miles et al., 2014 ; Sandelowski & Leeman, 2012 ; Stake, 2010 ; Wolcott, 2009 ).

Strategies for Ensuring Rigor of Findings

Many qualitative researchers do not provide enough information in their reports about the analytic strategies used to ensure verisimilitude or the “ring of truth” for the conclusions. Miles, Huberman, and Saldana (2014) outline 13 tactics for generating meaning from data and another 13 for testing or confirming findings. They also provide five standards for assessing the quality of conclusions. The techniques relied upon most heavily during a qualitative descriptive study ought to be addressed within the research report. It is important to establish “trustworthiness” and “authenticity” in qualitative research that are similar to the terms validity and reliability in quantitative research. The five standards (objectivity, dependability, credibility, transferability, and application) typically used in qualitative descriptive studies to assess quality and legitimacy (trustworthiness and authenticity) of the conclusions are discussed in the next sections ( Lincoln & Guba, 1985 ; Miles et al., 2014 ).

Objectivity

First, objectivity (confirmability) is conceptualized as relative neutrality and reasonable freedom from researcher bias and can be addressed by (a) describing the study’s methods and procedures in explicit detail, (b) sharing the sequence of data collection, analysis, and presentation methods to create an audit trail, (c) being aware of and reporting personal assumptions and potential bias, (d) retaining study data and making it available to collaborators for evaluation.

Dependability

Second, dependability (reliability or auditability) can be fostered by consistency in procedures across participants over time through various methods, including the use of semistructured interview questions and an observation data collection worksheet. Quality control ( Miles et al., 2014 ) can be fostered by:

• deriving study procedures from clearly outlined research questions and conceptual theory, so that data analysis could be linked back to theoretical constructs;
• clearly describing the investigator’s role and status at the research site;
• demonstrating parallelism in findings across sources (i.e., interview vs. observation, etc.);
• triangulation through the use of observations, interviews, and standardized measures to more adequately describe various characteristics of the sample population ( Denzin & Lincoln, 1994 );
• demonstrating consistency in data collection for all participants (i.e., using the same investigator and preprinted worksheets, asking the same questions in the same order);
• developing interview questions and observation techniques based on theory, revised, and tested during preliminary work;
• developing a coding manual a priori to guide data analysis, containing a “start list” of codes derived from the theoretical framework and relevant literature ( Fonteyn et al., 2008 ; Hsieh & Shannon, 2005 ; Miles et al., 2014 ); and
• developing a monitoring plan (fidelity) to ensure that junior researchers, especially do not go “beyond the data” ( Sandelowski, 2000 ) in interpretation. In keeping with the qualitative tradition, data analysis and collection should occur simultaneously, giving the investigator the opportunity to correct errors or make revisions.

Credibility

Third, credibility or verisimilitude (internal validity) is defined as the truth value of data: Do the findings of the study make sense ( Miles et al., 2014 , p. 312). Credibility in qualitative work promotes descriptive and evaluative understanding, which can be addressed by (a) providing context-rich “thick descriptions,” that is, the work of interpretation based on data ( Sandelowski, 2004 ), (b) checking with other practitioners or researchers that the findings “ring true,” (c) providing a comprehensive account, (d) using triangulation strategies, (e) searching for negative evidence, and (f) linking findings to a theoretical framework.

Transferability

Fourth, transferability (external validity or “fittingness”) speaks to whether the findings of your study have larger import and application to other settings or studies. This includes a discussion of generalizability. Sample to population generalizability is important to quantitative researchers and less helpful to qualitative researchers who seek more of an analytic or case-to-case transfer ( Miles et al., 2014 ). Nonetheless, transferability can be aided by (a) describing the characteristics of the participants fully so that comparisons with other groups may be made, (b) adequately describing potential threats to generalizability through sample and setting sections, (c) using theoretical sampling, (d) presenting findings that are congruent with theory, and (e) suggesting ways that findings from your study could be tested further by other researchers.

Application

Finally, Miles et al. (2014) speak to the utilization, application, or action orientation of the data. “Even if we know that a study’s findings are valid and transferable,” they write, “we still need to know what the study does for its participants and its consumers” ( Miles et al., 2014 , p. 314). To address application, findings of qualitative descriptive studies are typically made accessible to potential consumers of information through the publication of manuscripts, poster presentations, and summary reports written for consumers. In addition, qualitative descriptive study findings may stimulate further research, promote policy discussions, or suggest actual changes to a product or environment.

Implications for Practice

The qualitative description clarified and advocated by Sandelowski (2000 , 2010 ) is an excellent methodological choice for the healthcare environments designer, practitioner, or health sciences researcher because it provides rich descriptive content from the subjects’ perspective. Qualitative description allows the investigator to select from any number of theoretical frameworks, sampling strategies, and data collection techniques. The various content analysis strategies described in this paper serve to introduce the investigator to methods for data analysis that promote staying “close” to the data, thereby avoiding high-inference techniques likely challenging to the novice investigator. Finally, the devotion to thick description (interpretation based on data) and flexibility in the re-presentation of study findings is likely to produce meaningful information to designers and healthcare leaders. The practical, step-by-step nature of this article should serve as a starting guide to researchers interested in this technique as a way to answer their own burning questions.

Acknowledgments

The author would like to recognize the other members of her dissertation committee for their contributions to the study: Gerri Lamb, Karen Dorman Marek, and Robert Greenes.

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Research assistance for data analysis and manuscript development was supported by training funds from the National Institutes of Health/National Institute on Nursing Research (NIH/NINR), award T32 1T32NR012718-01 Transdisciplinary Training in Health Disparities Science (C. Keller, P.I.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or the NINR. This research was supported through the Hartford Center of Gerontological Nursing Excellence at Arizona State University College of Nursing & Health Innovation.

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.

• Corbin J, & Strauss A (2015). Basics of qualitative research: Techniques and procedures for developing grounded theory (4th ed.). Thousand Oaks, CA: Sage. [ Google Scholar ]
• Creswell J (2013). Qualitative inquiry and research design: Choosing among five approaches (3rd ed.). Los Angeles, CA: Sage. [ Google Scholar ]
• Creswell J, & Plano-Clark V (2007). Designing and conducting mixed methods research . Thousand Oaks, CA: Sage. [ Google Scholar ]
• Dedoose. (2015). Version 6.1.18, web application for managing, analyzing, and presenting qualitative and mixed method research data Los Angeles, CA: SocioCultural Research Consultants, LLC; Retrieved from www.dedoose.com [ Google Scholar ]
• Denzin N, & Lincoln Y (1994). The handbook of qualitative research . New York, NY: Sage. [ Google Scholar ]
• Denzin N, Lincoln Y, & Giardina M (2006). Disciplining qualitative research . International Journal of Qualitative Studies in Education , 19 , 769–782. [ Google Scholar ]
• Evans BC, Belyea MJ, Coon DW, & Ume E (2012). Activities of daily living in Mexican American caregivers: The key to continuing informal care . Journal of Family Nursing , 18 , 439–466. doi:410.1177/1074840712450210. Epub 1074840 712452012 Jun 1074840712450226 [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Evans BC, Belyea MJ, & Ume E (2011). Mexican-American males providing personal care for their mothers . Hispanic Journal of Behavioral Sciences , 33 , 234–260. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Evans B, Coon D, & Belyea M (2006). Worry among Mexican American caregivers of community-dwelling elders . Public Health Nursing , 23 ( 3 ), 284–291. doi: 10.1111/j.1525-1446.2006.230312.x [ CrossRef ] [ Google Scholar ]
• Evans BC, Coon DW, & Ume E (2011). Use of theoretical frameworks as a pragmatic guide for mixed methods studies: A methodological necessity? Journal of Mixed Methods Research , 5 , 276–292. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Fonteyn ME, Vettese M, Lancaster DR, & Bauer-Wu S (2008). Developing a codebook to guide content analysis of expressive writing transcripts . Applied Nursing Research , 21 , 165–168. doi: 10.1016/j.apnr.2006.08.005 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Hsieh H, & Shannon S (2005). Three approaches to qualitative content analysis . Qualitative Health Research , 15 , 1277–1288. [ PubMed ] [ Google Scholar ]
• Jiggins Colorafi K (2015). Patient centered health information technology: Engagement with the plan of care among older adults with multi-morbidities . Retrieved from ProQuest. [ Google Scholar ]
• Lincoln Y, & Guba E (1985). Naturalistic inquiry . New York, NY: Sage. [ Google Scholar ]
• Miles M, Huberman M, & Saldana J (2014). Qualitative data analysis: A methods sourcebook (3rd ed.). Thousand Oaks, CA: Sage. [ Google Scholar ]
• Munhall P, & Chenail R (2008). Qualitative research proposals and reports: A guide (3rd ed.). Boston, MA: Jones and Bartlett. [ Google Scholar ]
• Neergaard MA, Olesen F, Andersen RS, & Sondergaard J (2009). Qualitative description - the poor cousin of health research? BMC Medical Research Methodology , 9 , 52. doi: 10.1186/1471-2288-9-52 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Sandelowski M (2000). Whatever happened to qualitative description? Research in Nursing & Health , 23 , 334–340. [ PubMed ] [ Google Scholar ]
• Sandelowski M (2001). Focus on research methods. Real qualitative researchers do not count: The use of numbers in qualitative research . Research in Nursing & Health , 24 , 230–240. [ PubMed ] [ Google Scholar ]
• Sandelowski M (2004). Counting cats in Zanzibar . Research in Nursing & Health , 27 , 215–216. [ PubMed ] [ Google Scholar ]
• Sandelowski M (2010). What’s in a name? Qualitative description revisited . Research in Nursing & Health , 33 , 77–84. doi: 10.1002/nur.20362 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Sandelowski M, & Leeman J (2012). Writing usable qualitative health research findings . Qualitative Health Research , 22 , 1404–1413. [ PubMed ] [ Google Scholar ]
• Spradley J (1980). Patricipant observation . Belmont, CA: Wadsworth Cengage Learning. [ Google Scholar ]
• Stake R (2010). Qualitative research: Studying how things work . New York, NY: The Guilford Press. [ Google Scholar ]
• Wolcott H (2009). Writing up qualitative research (3rd ed.). Los Angeles, CA: Sage. [ Google Scholar ]

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Coding: An Overview and Guide to Qualitative Data Analysis for Integral Researchers

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Coding Qualitative Data: How to Code Qualitative Research

How many hours have you spent sitting in front of Excel spreadsheets trying to find new insights from customer feedback?

You know that asking open-ended survey questions gives you more actionable insights than asking your customers for just a numerical Net Promoter Score (NPS) . But when you ask open-ended, free-text questions, you end up with hundreds (or even thousands) of free-text responses.

How can you turn all of that text into quantifiable, applicable information about your customers’ needs and expectations? By coding qualitative data.

Keep reading to learn:

• What coding qualitative data means (and why it’s important)
• Different methods of coding qualitative data
• How to manually code qualitative data to find significant themes in your data

What is coding in qualitative research?

Coding is the process of labeling and organizing your qualitative data to identify different themes and the relationships between them.

When coding customer feedback , you assign labels to words or phrases that represent important (and recurring) themes in each response. These labels can be words, phrases, or numbers; we recommend using words or short phrases, since they’re easier to remember, skim, and organize.

Coding qualitative research to find common themes and concepts is part of thematic analysis . Thematic analysis extracts themes from text by analyzing the word and sentence structure.

Within the context of customer feedback, it's important to understand the many different types of qualitative feedback a business can collect, such as open-ended surveys, social media comments, reviews & more.

What is qualitative data analysis?

Qualitative data analysis is the process of examining and interpreting qualitative data to understand what it represents.

Qualitative data is defined as any non-numerical and unstructured data; when looking at customer feedback, qualitative data usually refers to any verbatim or text-based feedback such as reviews, open-ended responses in surveys , complaints, chat messages, customer interviews, case notes or social media posts

For example, NPS metric can be strictly quantitative, but when you ask customers why they gave you a rating a score, you will need qualitative data analysis methods in place to understand the comments that customers leave alongside numerical responses.

Methods of qualitative data analysis

Thematic analysis.

This refers to the uncovering of themes, by analyzing the patterns and relationships in a set of qualitative data. A theme emerges or is built when related findings appear to be meaningful and there are multiple occurences. Thematic analysis can be used by anyone to transform and organize open-ended responses, online reviews and other qualitative data into significant themes.

Content analysis:

This refers to the categorization, tagging and thematic analysis of qualitative data. Essentially content analysis is a quantification of themes, by counting the occurrence of concepts, topics or themes. Content analysis can involve combining the categories in qualitative data with quantitative data, such as behavioral data or demographic data, for deeper insights.

Narrative analysis:

Some qualitative data, such as interviews or field notes may contain a story on how someone experienced something. For example, the process of choosing a product, using it, evaluating its quality and decision to buy or not buy this product next time. The goal of narrative analysis is to turn the individual narratives into data that can be coded. This is then analyzed to understand how events or experiences had an impact on the people involved.

Discourse analysis:

This refers to analysis of what people say in social and cultural context. The goal of discourse analysis is to understand user or customer behavior by uncovering their beliefs, interests and agendas. These are reflected in the way they express their opinions, preferences and experiences. It’s particularly useful when your focus is on building or strengthening a brand , by examining how they use metaphors and rhetorical devices.

Framework analysis:

When performing qualitative data analysis, it is useful to have a framework to organize the buckets of meaning. A taxonomy or code frame (a hierarchical set of themes used in coding qualitative data) is an example of the result. Don't fall into the trap of starting with a framework to make it faster to organize your data.  You should look at how themes relate to each other by analyzing the data and consistently check that you can validate that themes are related to each other .

Grounded theory:

This method of analysis starts by formulating a theory around a single data case. Therefore the theory is “grounded’ in actual data. Then additional cases can be examined to see if they are relevant and can add to the original theory.

Why is it important to code qualitative data?

Coding qualitative data makes it easier to interpret customer feedback. Assigning codes to words and phrases in each response helps capture what the response is about which, in turn, helps you better analyze and summarize the results of the entire survey.

Researchers use coding and other qualitative data analysis processes to help them make data-driven decisions based on customer feedback. When you use coding to analyze your customer feedback, you can quantify the common themes in customer language. This makes it easier to accurately interpret and analyze customer satisfaction.

What is thematic coding?

Thematic coding, also called thematic analysis, is a type of qualitative data analysis that finds themes in text by analyzing the meaning of words and sentence structure.

When you use thematic coding to analyze customer feedback for example, you can learn which themes are most frequent in feedback. This helps you understand what drives customer satisfaction in an accurate, actionable way.

To learn more about how Thematic analysis software helps you automate the data coding process, check out this article .

Automated vs. Manual coding of qualitative data

Methods of coding qualitative data fall into three categories: automated coding and manual coding, and a blend of the two.

You can automate the coding of your qualitative data with thematic analysis software . Thematic analysis and qualitative data analysis software use machine learning, artificial intelligence (AI) , and natural language processing (NLP) to code your qualitative data and break text up into themes.

Thematic analysis software is autonomous , which means…

• You don’t need to set up themes or categories in advance.
• You don’t need to train the algorithm — it learns on its own.
• You can easily capture the “unknown unknowns” to identify themes you may not have spotted on your own.

…all of which will save you time (and lots of unnecessary headaches) when analyzing your customer feedback.

Businesses are also seeing the benefit of using thematic analysis software. The capacity to aggregate data sources into a single source of analysis helps to break down data silos, unifying the analysis and insights across departments . This is now being referred to as Omni channel analysis or Unified Data Analytics .

Use Thematic Analysis Software

Try Thematic today to discover why leading companies rely on the platform to automate the coding of qualitative customer feedback at scale. Whether you have tons of customer reviews, support chat or open-ended survey responses, Thematic brings every valuable insight to the surface, while saving you thousands of hours.

Advances in natural language processing & machine learning have made it possible to automate the analysis of qualitative data, in particular content and framework analysis.  The most commonly used software for automated coding of qualitative data is text analytics software such as Thematic .

While manual human analysis is still popular due to its perceived high accuracy, automating most of the analysis is quickly becoming the preferred choice. Unlike manual analysis, which is prone to bias and doesn’t scale to the amount of qualitative data that is generated today, automating analysis is not only more consistent and therefore can be more accurate, but can also save a ton of time, and therefore money.

Our Theme Editor tool ensures you take a reflexive approach, an important step in thematic analysis. The drag-and-drop tool makes it easy to refine, validate, and rename themes as you get more data. By guiding the AI, you can ensure your results are always precise, easy to understand and perfectly aligned with your objectives.

Thematic is the best software to automate code qualitative feedback at scale.

Don't just take it from us. Here's what some of our customers have to say:

I'm a fan of Thematic's ability to save time and create heroes. It does an excellent job using a single view to break down the verbatims into themes displayed by volume, sentiment and impact on our beacon metric, often but not exclusively NPS.

It does a superlative job using GenAI in summarizing a theme or sub-theme down to a single paragraph making it clear what folks are trying to say. Peter K, Snr Research Manager.

Thematic is a very intuitive tool to use. It boasts a robust level of granularity, allowing the user to see the general breadth of verbatim themes, dig into the sub-themes, and further into the sentiment of the open text itself. Artem C, Sr Manager of Research. LinkedIn.

AI-powered software to transform qualitative data at scale through a thematic and content analysis.

How to manually code qualitative data

For the rest of this post, we’ll focus on manual coding. Different researchers have different processes, but manual coding usually looks something like this:

• Choose whether you’ll use deductive or inductive coding.
• Read through your data to get a sense of what it looks like. Assign your first set of codes.
• Go through your data line-by-line to code as much as possible. Your codes should become more detailed at this step.
• Categorize your codes and figure out how they fit into your coding frame.
• Identify which themes come up the most — and act on them.

Let’s break it down a little further…

Deductive coding vs. inductive coding

Before you start qualitative data coding, you need to decide which codes you’ll use.

What is Deductive Coding?

Deductive coding means you start with a predefined set of codes, then assign those codes to the new qualitative data. These codes might come from previous research, or you might already know what themes you’re interested in analyzing. Deductive coding is also called concept-driven coding.

For example, let’s say you’re conducting a survey on customer experience . You want to understand the problems that arise from long call wait times, so you choose to make “wait time” one of your codes before you start looking at the data.

The deductive approach can save time and help guarantee that your areas of interest are coded. But you also need to be careful of bias; when you start with predefined codes, you have a bias as to what the answers will be. Make sure you don’t miss other important themes by focusing too hard on proving your own hypothesis.  

What is Inductive Coding?

Inductive coding , also called open coding, starts from scratch and creates codes based on the qualitative data itself. You don’t have a set codebook; all codes arise directly from the survey responses.

Here’s how inductive coding works:

• Break your qualitative dataset into smaller samples.
• Read a sample of the data.
• Create codes that will cover the sample.
• Reread the sample and apply the codes.
• Read a new sample of data, applying the codes you created for the first sample.
• Note where codes don’t match or where you need additional codes.
• Create new codes based on the second sample.
• Go back and recode all responses again.
• Repeat from step 5 until you’ve coded all of your data.

If you add a new code, split an existing code into two, or change the description of a code, make sure to review how this change will affect the coding of all responses. Otherwise, the same responses at different points in the survey could end up with different codes.

Sounds like a lot of work, right? Inductive coding is an iterative process, which means it takes longer and is more thorough than deductive coding. A major advantage is that it gives you a more complete, unbiased look at the themes throughout your data.

Combining inductive and deductive coding

In practice, most researchers use a blend of inductive and deductive approaches to coding.

For example, with Thematic, the AI inductively comes up with themes, while also framing the analysis so that it reflects how business decisions are made . At the end of the analysis, researchers use the Theme Editor to iterate or refine themes. Then, in the next wave of analysis, as new data comes in, the AI starts deductively with the theme taxonomy.

Categorize your codes with coding frames

Once you create your codes, you need to put them into a coding frame. A coding frame represents the organizational structure of the themes in your research. There are two types of coding frames: flat and hierarchical.

Flat Coding Frame

A flat coding frame assigns the same level of specificity and importance to each code. While this might feel like an easier and faster method for manual coding, it can be difficult to organize and navigate the themes and concepts as you create more and more codes. It also makes it hard to figure out which themes are most important, which can slow down decision making.

Hierarchical Coding Frame

Hierarchical frames help you organize codes based on how they relate to one another. For example, you can organize the codes based on your customers’ feelings on a certain topic:

In this example:

• The top-level code describes the topic (customer service)
• The mid-level code specifies whether the sentiment is positive or negative
• The third level details the attribute or specific theme associated with the topic

Hierarchical framing supports a larger code frame and lets you organize codes based on organizational structure. It also allows for different levels of granularity in your coding.

Whether your code frames are hierarchical or flat, your code frames should be flexible. Manually analyzing survey data takes a lot of time and effort; make sure you can use your results in different contexts.

For example, if your survey asks customers about customer service, you might only use codes that capture answers about customer service. Then you realize that the same survey responses have a lot of comments about your company’s products. To learn more about what people say about your products, you may have to code all of the responses from scratch! A flexible coding frame covers different topics and insights, which lets you reuse the results later on.

Tips for manually coding qualitative data

Now that you know the basics of coding your qualitative data, here are some tips on making the most of your qualitative research.

Use a codebook to keep track of your codes

As you code more and more data, it can be hard to remember all of your codes off the top of your head. Tracking your codes in a codebook helps keep you organized throughout the data analysis process. Your codebook can be as simple as an Excel spreadsheet or word processor document. As you code new data, add new codes to your codebook and reorganize categories and themes as needed.

Make sure to track:

• The label used for each code
• A description of the concept or theme the code refers to
• Who originally coded it
• The date that it was originally coded or updated
• Any notes on how the code relates to other codes in your analysis

How to create high-quality codes - 4 tips

1. cover as many survey responses as possible..

The code should be generic enough to apply to multiple comments, but specific enough to be useful in your analysis. For example, “Product” is a broad code that will cover a variety of responses — but it’s also pretty vague. What about the product? On the other hand, “Product stops working after using it for 3 hours” is very specific and probably won’t apply to many responses. “Poor product quality” or “short product lifespan” might be a happy medium.

2. Avoid commonalities.

Having similar codes is okay as long as they serve different purposes. “Customer service” and “Product” are different enough from one another, while “Customer service” and “Customer support” may have subtle differences but should likely be combined into one code.

3. Capture the positive and the negative.

Try to create codes that contrast with each other to track both the positive and negative elements of a topic separately. For example, “Useful product features” and “Unnecessary product features” would be two different codes to capture two different themes.

4. Reduce data — to a point.

Let’s look at the two extremes: There are as many codes as there are responses, or each code applies to every single response. In both cases, the coding exercise is pointless; you don’t learn anything new about your data or your customers. To make your analysis as useful as possible, try to find a balance between having too many and too few codes.

Group responses based on themes, not words

Make sure to group responses with the same themes under the same code, even if they don’t use the same exact wording. For example, a code such as “cleanliness” could cover responses including words and phrases like:

• Looked like a dump
• Could eat off the floor

Having only a few codes and hierarchical framing makes it easier to group different words and phrases under one code. If you have too many codes, especially in a flat frame, your results can become ambiguous and themes can overlap. Manual coding also requires the coder to remember or be able to find all of the relevant codes; the more codes you have, the harder it is to find the ones you need, no matter how organized your codebook is.

Make accuracy a priority

Manually coding qualitative data means that the coder’s cognitive biases can influence the coding process. For each study, make sure you have coding guidelines and training in place to keep coding reliable, consistent, and accurate .

One thing to watch out for is definitional drift, which occurs when the data at the beginning of the data set is coded differently than the material coded later. Check for definitional drift across the entire dataset and keep notes with descriptions of how the codes vary across the results.

If you have multiple coders working on one team, have them check one another’s coding to help eliminate cognitive biases.

Conclusion: 6 main takeaways for coding qualitative data

Here are 6 final takeaways for manually coding your qualitative data:

• Coding is the process of labeling and organizing your qualitative data to identify themes. After you code your qualitative data, you can analyze it just like numerical data.
• Inductive coding (without a predefined code frame) is more difficult, but less prone to bias, than deductive coding.
• Code frames can be flat (easier and faster to use) or hierarchical (more powerful and organized).
• Your code frames need to be flexible enough that you can make the most of your results and use them in different contexts.
• When creating codes, make sure they cover several responses, contrast one another, and strike a balance between too much and too little information.
• Consistent coding = accuracy. Establish coding procedures and guidelines and keep an eye out for definitional drift in your qualitative data analysis.

Some more detail in our downloadable guide

If you’ve made it this far, you’ll likely be interested in our free guide: Best practices for analyzing open-ended questions.

The guide includes some of the topics covered in this article, and goes into some more niche details.

If your company is looking to automate your qualitative coding process, try Thematic !

If you're looking to trial multiple solutions, check out our free buyer's guide . It covers what to look for when trialing different feedback analytics solutions to ensure you get the depth of insights you need.

Happy coding!

Authored by Alyona Medelyan, PhD – Natural Language Processing & Machine Learning

CEO and Co-Founder

Alyona has a PhD in NLP and Machine Learning. Her peer-reviewed articles have been cited by over 2600 academics. Her love of writing comes from years of PhD research.

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A Guide to Coding Qualitative Data

Published September 18, 2014 by Salma Patel

Coding qualitative data can be a daunting task, especially for the first timer. Below are my notes, which is  a useful summary on coding qualitative data (please note, most of the text has been taken directly from The Coding Manual for Qualitative Researchers  by Johnny Saldana ).

Background to Coding

A coding pattern can be characterised by:

• similarity (things happen the same way)
• difference (they happen in predictably different ways)
• frequency (they happen often or seldom)
• sequence (they happen in a certain order)
• correspondence (they happen in relation to other activities or events)
• causation (one appears to cause another)

A theme is an outcome of coding

Questions to consider when you are coding:

• what are people doing? What are they trying to accomplish?
• How, exactly, do they do this? What specific means and/or strategies do they use?
• How do members talk about, characterise, and understand what is going on?
• what assumptions are they making?
• what do I see going on here?
• what did I learn from these notes?
• why did I include them?
• what surprised me? (To track your assumptions)
• what intrigued me? (To track your positionality)
• what disturbed me? (To track the tensions within your value, attitude, and belief systems)

Writing Analytic Memos

Gordon-Finlayson (2010) emphasises that “coding is simply a structure on which reflection (via memo writing) happens. It is memo-writing that is the engine go grounded theory, not coding”. Glazer and Holton (2004) further clarify that “Memos present hypotheses about connections between categories and/or their properties and begin to integrate these connections with clusters of other categories to generate the theory”.

The coding cycles

Depending on the qualitative coding method(s) you employ, the choice may have numerical conversion and transformation possibilities for basic descriptive statistics for mixed method studies.

First Cycle Coding

 1. Grammatical Methods include

• attribute coding (essential information about the data and demographic characteristics of the participants for future management and reference)
• magnitude coding (applies alphanumeric or symbolic codes to data, to describe their variable characteristics such as intensity or frequency, example, Strongly (STR) Moderately (MOD) No opinions (NO). They can be qualitative, quantitative and/or nominal indicators to enhance description, and it’s a way of quantitizing and qualitizing data
• sub coding and simultaneous coding.

2. Elemental methods are primary approaches to data analysis. They include:

• structural coding is a question-based code that acts as a labelling and index device, allowing researchers to quickly access data likely to be relevant to a particular analysis from a larger data set. It’s used as a categorisation technique for further qualitative data analysis.
• descriptive coding summarises in a word or noun the basic topic of a passage of qualitative data.
• In Vivo Coding refers to coding with a word or short phrase from the actual language found in the qualitative data record.
• Process coding uses gerunds (“-ing” words) exclusively to connote action in the data.
• Initial Coding is breaking down qualitative data into discrete parts, closely examining them, and comparing them for similarities and differences.

3. Affective methods investigate subjective qualities of human experience (eg emotions, values, conflicts, judgements) by directly acknowledging and naming those experiences. They include:

• Emotion coding labels the emotion recalled or experienced
• Values coding assess a participant’s integrated value, attitude, and belief systems. (side note: Questionnaires and surveys such as Likert scales and semantic differentials, are designed to collect and measure a participant’s values, attitudes, and beliefs about selected subjects).
• Versus Coding acknowledges that humans are frequently in conflict, and the codes identify which individuals, groups, or systems are struggling for power.
• Evaluation Coding focuses on how we can analyse data that judge the merit and worth of programs and policies.

4. Literary and Language Methods are a contemporary approach to the analysis of Oral communication. They include Dramaturgical Coding, Motif Coding, Narrative coding and Verbal Exchange Coding, and all explore underlying sociological, psychological and cultural constructs.

5. Exploratory Methods are preliminary assignment of codes to the data, after which the researcher might proceed to more specific First Cycle or Second Cycle coding methods.

• Holistic Coding applies a single code to each large unit of data in the corpus to capture a sense of the overall contents and the possible categories that may develop.
• Provisional Coding begins with a “start list” of researcher- generated codes based on what preparatory investigation suggest might appear in the data before they are analysed.
• Hypothesis Coding applies researcher-developed “hunches” of what might occur in the data before or after they have been initially analysed.

6. Procedural Methods consist of pre- established systems or very specific ways of analysing qualitative data. They include:

• Protocol Coding is coding data according to a pre-established, recommended, standardised or prescribed system.
• OCM (Outline of Cultural Materials) Coding is a systematic coding system for ethnographic studies.
• Domain and Taxonomic Coding is an ethnographic method for discovering the cultural knowledge people use to organise their behaviours and interpret their experiences.
• Causation coding is to locate, extract, and/or infer causal beliefs from qualitative data.

Code Mapping and Landscaping

Code Mapping is categorising and organising the codes, and code landscaping is presenting these codes in a visual manner, for example by using a Wordle graphic.

Operational Model Diagramming can be used to map or diagram the emergent sequences or networks of your codes and categories related to your study in a sophisticated way.

Second Cycle Coding

Second cycle coding is reorganising and condensing the vast array of initial analytic details into a “main dish”. They include:

1. Pattern coding is a way of grouping summaries into a smaller number of sets, themes, or constructs.

2. Focused coding searches for the most frequent or significant codes. It categorises coded data based on thematic or conceptual similarity

3. Axial coding describes a category’s properties and dimensions and explores how the categories and subcategories relate to each other.

4. Theoretical coding progresses towards discovering the central or core category that identifies the primary theme of the research

5. Elaborative coding builds on a previous study’s codes, categories, and themes while a current and related study is underway. This method employs additional qualitative data to support or modify the researcher’s observations developed in an earlier project.

6. Longitudinal coding is the attribution of selected change processes to qualitative data collected and compared across time.

After Second Cycle Coding

Code weaving  is the actual integration of key code words and phrases into narrative form to see how the puzzle pieces for together. Codeweave the primary codes, categories, themes, and/or concepts of your analysis into as few sentences as possible. Try writing several variations to investigate how the items might interrelate, suggest causation, indicate a process, or work holistically to create a broader theme. Search for evidence in the data that supports your summary statements, and/or disconfirming evidence that suggests revision of your statements.

From Coding to Theorising

A social science theory has three main characteristics: it predicts and controls action through an if-then logic; explains how and/or why something happens by stating it’s cause(s); and provides insights and guidance for improving social life.

The stage at which I seem to find a theory emerging in my mind is when I create categories of categories.

Use categories and analytic memos as sources of theory.

If I cannot develop a theory, then I will be satisfied with my construction of a key assertion, a summative and data supported statement about the particulars of a research study, rather than generalisable and transferable meanings of my findings to other settings and contexts.

Findings at a glance can be presented as follows:

The coding journey should be noted in the analytical memos and discussed in your dissertation.

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Published in Headline Qualitative Research Research Methods

• coding data
• coding qualitative data
• qualitative research
• research design

10 Comments

Very helpful article. Can you please list the references you mentioned in the article? which book are you refering to explain the coding types?

Thanks. Which specific reference would you like? I can look it up in the book.

Same question. You show a number of books in the various images, none of which look familiar. Could you list/cite those resources? That would be most helpful

The reference is mentioned at the top of the article. It links to the book these images are all from. See here: https://www.amazon.co.uk/gp/product/1446247376 (Sadana, 2012)

Best wishes, Salma

I also got a a question regarding the second cycle coding. Is it possible to use multiple coding forms? For example, can I code my interviews by using pattern coding, focused coding and axial coding? Or would I have to decide on one?

Yes Lara, you can use multiple coding forms. Just keep a note of it for your write up.

Thank you so much, Salma Patel, for taking the time to lay this critical and complex process out with all the illustrations. It’s so helpful to me. May your work and life continue to flourish.

thank you so much Ms. Patel

great article. thanks a lot

Great article. Very helpful! Can you point us to any examples of how researchers have coded data using some of these techniques? It would be helpful to see this in action, especially in helping understand how these different aspects of coding sit side by side in the analytical process. Thanks again!

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• Open access
• Published: 13 May 2024

Patient medication management, understanding and adherence during the transition from hospital to outpatient care - a qualitative longitudinal study in polymorbid patients with type 2 diabetes

• Léa Solh Dost   ORCID: orcid.org/0000-0001-5767-1305 1 , 2 ,
• Giacomo Gastaldi   ORCID: orcid.org/0000-0001-6327-7451 3 &
• Marie P. Schneider   ORCID: orcid.org/0000-0002-7557-9278 1 , 2  

BMC Health Services Research volume  24 , Article number:  620 ( 2024 ) Cite this article

32 Accesses

Metrics details

Continuity of care is under great pressure during the transition from hospital to outpatient care. Medication changes during hospitalization may be poorly communicated and understood, compromising patient safety during the transition from hospital to home. The main aims of this study were to investigate the perspectives of patients with type 2 diabetes and multimorbidities on their medications from hospital discharge to outpatient care, and their healthcare journey through the outpatient healthcare system. In this article, we present the results focusing on patients’ perspectives of their medications from hospital to two months after discharge.

Patients with type 2 diabetes, with at least two comorbidities and who returned home after discharge, were recruited during their hospitalization. A descriptive qualitative longitudinal research approach was adopted, with four in-depth semi-structured interviews per participant over a period of two months after discharge. Interviews were based on semi-structured guides, transcribed verbatim, and a thematic analysis was conducted.

Twenty-one participants were included from October 2020 to July 2021. Seventy-five interviews were conducted. Three main themes were identified: (A) Medication management, (B) Medication understanding, and (C) Medication adherence, during three periods: (1) Hospitalization, (2) Care transition, and (3) Outpatient care. Participants had varying levels of need for medication information and involvement in medication management during hospitalization and in outpatient care. The transition from hospital to autonomous medication management was difficult for most participants, who quickly returned to their routines with some participants experiencing difficulties in medication adherence.

Conclusions

The transition from hospital to outpatient care is a challenging process during which discharged patients are vulnerable and are willing to take steps to better manage, understand, and adhere to their medications. The resulting tension between patients’ difficulties with their medications and lack of standardized healthcare support calls for interprofessional guidelines to better address patients’ needs, increase their safety, and standardize physicians’, pharmacists’, and nurses’ roles and responsibilities.

Peer Review reports

Introduction

Continuity of patient care is characterized as the collaborative engagement between the patient and their physician-led care team in the ongoing management of healthcare, with the mutual objective of delivering high-quality and cost-effective medical care [ 1 ]. Continuity of care is under great pressure during the transition of care from hospital to outpatient care, with a risk of compromising patients’ safety [ 2 , 3 ]. The early post-discharge period is a high-risk and fragile transition: once discharged, one in five patients experience at least one adverse event during the first three weeks following discharge, and more than half of these adverse events are drug-related [ 4 , 5 ]. A retrospective study examining all discharged patients showed that adverse drug events (ADEs) account for up to 20% of 30-day hospital emergency readmissions [ 6 ]. During hospitalization, patients’ medications are generally modified, with an average of nearly four medication changes per patient [ 7 ]. Information regarding medications such as medication changes, the expected effect, side effects, and instructions for use are frequently poorly communicated to patients during hospitalization and at discharge [ 8 , 9 , 10 , 11 ]. Between 20 and 60% of discharged patients lack knowledge of their medications [ 12 , 13 ]. Consideration of patients’ needs and their active engagement in decision-making during hospitalization regarding their medications are often lacking [ 11 , 14 , 15 ]. This can lead to unsafe discharge and contribute to medication adherence difficulties, such as non-implementation of newly prescribed medications [ 16 , 17 ].

Patients with multiple comorbidities and polypharmacy are at higher risk of ADE [ 18 ]. Type 2 diabetes is one of the chronic health conditions most frequently associated with comorbidities and patients with type 2 diabetes often lack care continuum [ 19 , 20 , 21 ]. The prevalence of patients hospitalized with type 2 diabetes can exceed 40% [ 22 ] and these patients are at higher risk for readmission due to their comorbidities and their medications, such as insulin and oral hypoglycemic agents [ 23 , 24 , 25 ].

Interventions and strategies to improve patient care and safety at transition have shown mixed results worldwide in reducing cost, rehospitalization, ADE, and non-adherence [ 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ]. However, interventions that are patient-centered, with a patient follow-up and led by interprofessional healthcare teams showed promising results [ 34 , 35 , 36 ]. Most of these interventions have not been implemented routinely due to the extensive time to translate research into practice and the lack of hybrid implementation studies [ 37 , 38 , 39 , 40 , 41 ]. In addition, patient-reported outcomes and perspectives have rarely been considered, yet patients’ involvement is essential for seamless and integrated care [ 42 , 43 ]. Interprofessional collaboration in which patients are full members of the interprofessional team, is still in its infancy in outpatient care [ 44 ]. Barriers and facilitators regarding medications at the transition of care have been explored in multiple qualitative studies at one given time in a given setting (e.g., at discharge, one-month post-discharge) [ 8 , 45 , 46 , 47 , 48 ]. However, few studies have adopted a holistic methodology from the hospital to the outpatient setting to explore changes in patients’ perspectives over time [ 49 , 50 , 51 ]. Finally, little is known about whether, how, and when patients return to their daily routine following hospitalization and the impact of hospitalization weeks after discharge.

In Switzerland, continuity of care after hospital discharge is still poorly documented, both in terms of contextual analysis and interventional studies, and is mainly conducted in the hospital setting [ 31 , 35 , 52 , 53 , 54 , 55 , 56 ]. The first step of an implementation science approach is to perform a contextual analysis to set up effective interventions adapted to patients’ needs and aligned to healthcare professionals’ activities in a specific context [ 41 , 57 ]. Therefore, the main aims of this study were to investigate the perspectives of patients with type 2 diabetes and multimorbidities on their medications from hospital discharge to outpatient care, and on their healthcare journey through the outpatient healthcare system. In this article, we present the results focusing on patients’ perspectives of their medications from hospital to two months after discharge.

Study design

This qualitative longitudinal study, conducted from October 2020 to July 2021, used a qualitative descriptive methodology through four consecutive in-depth semi-structured interviews per participant at three, 10-, 30- and 60-days post-discharge, as illustrated in Fig.  1 . Longitudinal qualitative research is characterized by qualitative data collection at different points in time and focuses on temporality, such as time and change [ 58 , 59 ]. Qualitative descriptive studies aim to explore and describe the depth and complexity of human experiences or phenomena [ 60 , 61 , 62 ]. We focused our qualitative study on the 60 first days after discharge as this period is considered highly vulnerable and because studies often use 30- or 60-days readmission as an outcome measure [ 5 , 63 ].

This qualitative study follows the Consolidated Criteria for Reporting Qualitative Research (COREQ). Ethics committee approval was sought and granted by the Cantonal Research Ethics Commission, Geneva (CCER) (2020 − 01779).

Recruitment took place during participants’ hospitalization in the general internal medicine divisions at the Geneva University Hospitals in the canton of Geneva (500 000 inhabitants), Switzerland. Interviews took place at participants’ homes, in a private office at the University of Geneva, by telephone or by secure video call, according to participants’ preference. Informal caregivers could also participate alongside the participants.

Study flowchart

Researcher characteristics

All the researchers were trained in qualitative studies. The diabetologist and researcher (GG) who enrolled the patients in the study was involved directly or indirectly (advice asked to the Geneva University Hospital diabetes team of which he was a part) for most participants’ care during hospitalization. LS (Ph.D. student and community pharmacist) was unknown to participants and presented herself during hospitalization as a “researcher” and not as a healthcare professional to avoid any risk of influencing participants’ answers. This study was not interventional, and the interviewer (LS) invited participants to contact a healthcare professional for any questions related to their medication or medical issues.

Population and sampling strategy

Patients with type 2 diabetes were chosen as an example population to describe polypharmacy patients as these patients usually have several health issues and polypharmacy [ 20 , 22 , 25 ]. Inclusions criteria for the study were: adult patients with type 2 diabetes, with at least two other comorbidities, hospitalized for at least three days in a general internal medicine ward, with a minimum of one medication change during hospital stay, and who self-managed their medications once discharged home. Exclusion criteria were patients not reachable by telephone following discharge, unable to give consent (patients with schizophrenia, dementia, brain damage, or drug/alcohol misuse), and who could not communicate in French. A purposive sampling methodology was applied aiming to include participants with different ages, genders, types, and numbers of health conditions by listing participants’ characteristics in a double-entry table, available in Supplementary Material 1 , until thematic saturation was reached. Thematic saturation was considered achieved when no new code or theme emerged and new data repeated previously coded information [ 64 ]. The participants were identified if they were hospitalized in the ward dedicated to diabetes care or when the diabetes team was contacted for advice. The senior ward physician (GG) screened eligible patients and the interviewer (LS) obtained written consent before hospital discharge.

Data collection and instruments

Sociodemographic (age, gender, educational level, living arrangement) and clinical characteristics (reason for hospitalization, date of admission, health conditions, diabetes diagnosis, medications before and during hospitalization) were collected by interviewing participants before their discharge and by extracting participants’ data from electronic hospital files by GG and LS. Participants’ pharmacies were contacted with the participant’s consent to obtain medication records from the last three months if information regarding medications before hospitalization was missing in the hospital files.

Semi-structured interview guides for each interview (at three, 10-, 30- and 60-days post-discharge) were developed based on different theories and components of health behavior and medication adherence: the World Health Organization’s (WHO) five dimensions for adherence, the Information-Motivation-Behavioral skills model and the Social Cognitive Theory [ 65 , 66 , 67 ]. Each interview explored participants’ itinerary in the healthcare system and their perspectives on their medications. Regarding medications, the following themes were mentioned at each interview: changes in medications, patients’ understanding and implication; information on their medications, self-management of their medications, and patients’ medication adherence. Other aspects were mentioned in specific interviews: patients’ hospitalization and experience on their return home (interview 1), motivation (interviews 2 and 4), and patient’s feedback on the past two months (interview 4). Interview guides translated from French are available in Supplementary Material 2 . The participants completed self-reported and self-administrated questionnaires at different interviews to obtain descriptive information on different factors that may affect medication management and adherence: self-report questionnaires on quality of life (EQ-5D-5 L) [ 68 ], literacy (Schooling-Opinion-Support questionnaire) [ 69 ], medication adherence (Adherence Visual Analogue Scale, A-VAS) [ 70 ] and Belief in Medication Questionnaire (BMQ) [ 71 ] were administered to each participant at the end of selected interviews to address the different factors that may affect medication management and adherence as well as to determine a trend of determinants over time. The BMQ contains two subscores: Specific-Necessity and Specific-Concerns, addressing respectively their perceived needs for their medications, and their concerns about adverse consequences associated with taking their medication [ 72 ].

Data management

Informed consent forms, including consent to obtain health data, were securely stored in a private office at the University of Geneva. The participants’ identification key was protected by a password known only by MS and LS. Confidentiality was guaranteed by pseudonymization of participants’ information and audio-recordings were destroyed once analyzed. Sociodemographic and clinical characteristics, medication changes, and answers to questionnaires were securely collected by electronic case report forms (eCRFs) on RedCap®. Interviews were double audio-recorded and field notes were taken during interviews. Recorded interviews were manually transcribed verbatim in MAXQDA® (2018.2) by research assistants and LS and transcripts were validated for accuracy by LS. A random sample of 20% of questionnaires was checked for accuracy for the transcription from the paper questionnaires to the eCRFs. Recorded sequences with no link to the discussed topics were not transcribed and this was noted in the transcripts.

Data analysis

A descriptive statistical analysis of sociodemographic, clinical characteristics and self-reported questionnaire data was carried out. A thematic analysis of transcripts was performed, as described by Braun and Clarke [ 73 ], by following six steps: raw data was read, text segments related to the study objectives were identified, text segments to create new categories were identified, similar or redundant categories were reduced and a model that integrated all significant categories was created. The analysis was conducted in parallel with patient enrolment to ensure data saturation. To ensure the validity of the coding method, transcripts were double coded independently and discussed by the research team until similar themes were obtained. The research group developed and validated an analysis grid, with which LS coded systematically the transcriptions and met regularly with the research team to discuss questions on data analysis and to ensure the quality of coding. The analysis was carried out in French, and the verbatims of interest cited in the manuscript were translated and validated by a native English-speaking researcher to preserve the meaning.

In this analysis, we used the term “healthcare professionals” when more than one profession could be involved in participants’ medication management. Otherwise, when a specific healthcare professional was involved, we used the designated profession (e.g. physicians, pharmacists).

Patient and public involvement

During the development phase of the study, interview guides and questionnaires were reviewed for clarity and validity and adapted by two patient partners, with multiple health conditions and who experienced previously a hospital discharge. They are part of the HUG Patients Partners + 3P platform for research and patient and public involvement.

Interviews and participants’ descriptions

A total of 75 interviews were conducted with 21 participants. In total, 31 patients were contacted, seven refused to participate (four at the project presentation and three at consent), two did not enter the selection criteria at discharge and one was unreachable after discharge. Among the 21 participants, 15 participated in all interviews, four in three interviews, one in two interviews, and one in one interview, due to scheduling constraints. Details regarding interviews and participants characteristics are presented in Tables  1 and 2 .

The median length of time between hospital discharge and interviews 1,2,3 and 4 was 5 (IQR: 4–7), 14 (13-20), 35 (22-38), and 63 days (61-68), respectively. On average, by comparing medications at hospital admission and discharge, a median of 7 medication changes (IQR: 6–9, range:2;17) occurred per participant during hospitalization and a median of 7 changes (5–12) during the two months following discharge. Details regarding participants’ medications are described in Table  3 .

Patient self-reported adherence over the past week for their three most challenging medications are available in Supplementary Material 3 .

Qualitative analysis

We defined care transition as the period from discharge until the first medical appointment post-discharge, and outpatient care as the period starting after the first medical appointment. Data was organized into three key themes (A. Medication management, B. Medication understanding, and C. Medication adherence) divided into subthemes at three time points (1. Hospitalization, 2. Care transition and 3. Outpatient care). Figure  2 summarizes and illustrates the themes and subthemes with their influencing factors as bullet points.

Participants’ medication management, understanding and adherence during hospitalization, care transition and outpatient care

A. Medication management

A.1 medication management during hospitalization: medication management by hospital staff.

Medications during hospitalization were mainly managed by hospital healthcare professionals (i.e. nurses and physicians) with varying degrees of patient involvement: “At the hospital, they prepared the medications for me. […] I didn’t even know what the packages looked like.” Participant 22; interview 1 (P22.1) Some participants reported having therapeutic education sessions with specialized nurses and physicians, such as the explanation and demonstration of insulin injection and glucose monitoring. A patient reported that he was given the choice of several treatments and was involved in shared decision-making. Other participants had an active role in managing and optimizing dosages, such as rapid insulin, due to prior knowledge and use of medications before hospitalization.

A.2 Medication management at transition: obtaining the medication and initiating self-management

Once discharged, some participants had difficulties obtaining their medications at the pharmacy because some medications were not stored and had to be ordered, delaying medication initiation. To counter this problem upstream, a few participants were provided a 24-to-48-hour supply of medications at discharge. It was sometimes requested by the patient or suggested by the healthcare professionals but was not systematic. The transition from medication management by hospital staff to self-management was exhausting for most participants who were faced with a large amount of new information and changes in their medications: “ When I was in the hospital, I didn’t even realize all the changes. When I came back home, I took away the old medication packages and got out the new ones. And then I thought : « my God, all this…I didn’t know I had all these changes » ” P2.1 Written documentation, such as the discharge prescription or dosage labels on medication packages, was helpful in managing their medication at home. Most participants used weekly pill organizers to manage their medications, which were either already used before hospitalization or were introduced post-discharge. The help of a family caregiver in managing and obtaining medications was reported as a facilitator.

A.3 Medication management in outpatient care: daily self-management and medication burden

A couple of days or weeks after discharge, most participants had acquired a routine so that medication management was less demanding, but the medication burden varied depending on the participants. For some, medication management became a simple action well implemented in their routine (“It has become automatic” , P23.4), while for others, the number of medications and the fact that the medications reminded them of the disease was a heavy burden to bear on a daily basis (“ During the first few days after getting out of the hospital, I thought I was going to do everything right. In the end, well [laughs] it’s complicated. I ended up not always taking the medication, not monitoring the blood sugar” P12.2) To support medication self-management, some participants had written documentation such as treatment plans, medication lists, and pictures of their medication packages on their phones. Some participants had difficulties obtaining medications weeks after discharge as discharge prescriptions were not renewable and participants did not see their physician in time. Others had to visit multiple physicians to have their prescriptions updated. A few participants were faced with prescription or dispensing errors, such as prescribing or dispensing the wrong dosage, which affected medication management and decreased trust in healthcare professionals. In most cases, according to participants, the pharmacy staff worked in an interprofessional collaboration with physicians to provide new and updated prescriptions.

B. Medication understanding

B.1 medication understanding during hospitalization: new information and instructions.

The amount of information received during hospitalization varied considerably among participants with some reporting having received too much, while others saying they received too little information regarding medication changes, the reason for changes, or for introducing new medications: “They told me I had to take this medication all my life, but they didn’t tell me what the effects were or why I was taking it.” P5.3

Hospitalization was seen by some participants as a vulnerable and tiring period during which they were less receptive to information. Information and explanations were generally given verbally, making it complicated for most participants to recall it. Some participants reported that hospital staff was attentive to their needs for information and used communication techniques such as teach-back (a way of checking understanding by asking participants to say in their own words what they need to know or do about their health or medications). Some participants were willing to be proactive in the understanding of their medications while others were more passive, had no specific needs for information, and did not see how they could be engaged more.

B.2 Medication understanding at transition: facing medication changes

At hospital discharge, the most challenging difficulty for participants was to understand the changes made regarding their medications. For newly diagnosed participants, the addition of new medications was more difficult to understand, whereas, for experienced participants, changes in known medications such as dosage modification, changes within a therapeutic class, and generic substitutions were the most difficult to understand. Not having been informed about changes caused confusion and misunderstanding. Therefore, medication reconciliation done by the patient was time-consuming, especially for participants with multiple medications: “ They didn’t tell me at all that they had changed my treatment completely. They just told me : « We’ve changed a few things. But it was the whole treatment ». ” P2.3 Written information, such as the discharge prescription, the discharge report (brief letter summarizing information about the hospitalization, given to the patient at discharge), or the label on the medication box (written by the pharmacist with instructions on dosage) helped them find or recall information about their medications and diagnoses. However, technical terms were used in hospital documentations and were not always understandable. For example, this participant said: “ On the prescription of valsartan, they wrote: ‘resume in the morning once profile…’[once hypertension profile allows]… I don’t know what that means.” P8.1 In addition, some documents were incomplete, as mentioned by a patient who did not have the insulin dosage mentioned on the hospital prescription. Some participants sought help from healthcare professionals, such as pharmacists, hospital physicians, or general practitioners a few days after discharge to review medications, answer questions, or obtain additional information.

B.3 Medication understanding in the outpatient care: concerns and knowledge

Weeks after discharge, most participants had concerns about the long-term use of their medications, their usefulness, and the possible risk of interactions or side effects. Some participants also reported having some lack of knowledge regarding indications, names, or how the medication worked: “I don’t even know what Brilique® [ticagrelor, antiplatelet agent] is for. It’s for blood pressure, isn’t it?. I don’t know.” P11.4 According to participants, the main reasons for the lack of understanding were the lack of information at the time of prescribing and the large number of medications, making it difficult to search for information and remember it. Participants sought information from different healthcare professionals or by themselves, on package inserts, through the internet, or from family and friends. Others reported having had all the information needed or were not interested in having more information. In addition, participants with low medication literacy, such as non-native speakers or elderly people, struggled more with medication understanding and sought help from family caregivers or healthcare professionals, even weeks after discharge: “ I don’t understand French very well […] [The doctor] explained it very quickly…[…] I didn’t understand everything he was saying” P16.2

C. Medication adherence

C.2 medication adherence at transition: adopting new behaviors.

Medication adherence was not mentioned as a concern during hospitalization and a few participants reported difficulties in medication initiation once back home: “I have an injection of Lantus® [insulin] in the morning, but obviously, the first day [after discharge], I forgot to do it because I was not used to it.” P23.1 Participants had to quickly adopt new behaviors in the first few days after discharge, especially for participants with few medications pre-hospitalization. The use of weekly pill organizers, alarms and specific storage space were reported as facilitators to support adherence. One patient did not initiate one of his medications because he did not understand the medication indication, and another patient took her old medications because she was used to them. Moreover, most participants experienced their hospitalization as a turning point, a time when they focused on their health, thought about the importance of their medications, and discussed any new lifestyle or dietary measures that might be implemented.

C.3 Medication adherence in outpatient care: ongoing medication adherence

More medication adherence difficulties appeared a few weeks after hospital discharge when most participants reported nonadherence behaviors, such as difficulties implementing the dosage regimen, or intentionally discontinuing the medication and modifying the medication regimen on their initiative. Determinants positively influencing medication adherence were the establishment of a routine; organizing medications in weekly pill-organizers; organizing pocket doses (medications for a short period that participants take with them when away from home); seeking support from family caregivers; using alarm clocks; and using specific storage places. Reasons for nonadherence were changes in daily routine; intake times that were not convenient for the patient; the large number of medications; and poor knowledge of the medication or side effects. Healthcare professionals’ assistance for medication management, such as the help of home nurses or pharmacists for the preparation of weekly pill-organizers, was requested by participants or offered by healthcare professionals to support medication adherence: “ I needed [a home nurse] to put my pills in the pillbox. […] I felt really weak […] and I was making mistakes. So, I’m very happy [the doctor] offered me [home care]. […] I have so many medications.” P22.3 Some participants who experienced prehospitalization non-adherence were more aware of their non-adherence and implemented strategies, such as modifying the timing of intake: “I said to my doctor : « I forget one time out of two […], can I take them in the morning? » We looked it up and yes, I can take it in the morning.” P11.2 In contrast, some participants were still struggling with adherence difficulties that they had before hospitalization. Motivations for taking medications two months after discharge were to improve health, avoid complications, reduce symptoms, reduce the number of medications in the future or out of obligation: “ I force myself to take them because I want to get to the end of my diabetes, I want to reduce the number of pills as much as possible.” P14.2 After a few weeks post-hospitalization, for some participants, health and illness were no longer the priority because of other life imperatives (e.g., family or financial situation).

This longitudinal study provided a multi-faceted representation of how patients manage, understand, and adhere to their medications from hospital discharge to two months after discharge. Our findings highlighted the varying degree of participants’ involvement in managing their medications during their hospitalization, the individualized needs for information during and after hospitalization, the complicated transition from hospital to autonomous medication management, the adaptation of daily routines around medication once back home, and the adherence difficulties that surfaced in the outpatient care, with nonadherence prior to hospitalization being an indicator of the behavior after discharge. Finally, our results confirmed the lack of continuity in care and showed the lack of patient care standardization experienced by the participants during the transition from hospital to outpatient care.

This in-depth analysis of patients’ experiences reinforces common challenges identified in the existing literature such as the lack of personalized information [ 9 , 10 , 11 ], loss of autonomy during hospitalization [ 14 , 74 , 75 ], difficulties in obtaining medication at discharge [ 11 , 45 , 76 ] and challenges in understanding treatment modifications and generics substitution [ 11 , 32 , 77 , 78 ]. Some of these studies were conducted during patients’ hospitalization [ 10 , 75 , 79 ] or up to 12 months after discharge [ 80 , 81 ], but most studies focused on the few days following hospital discharge [ 9 , 11 , 14 , 82 ]. Qualitative studies on medications at transition often focused on a specific topic, such as medication information, or a specific moment in time, and often included healthcare professionals, which muted patients’ voices [ 9 , 10 , 11 , 47 , 49 ]. Our qualitative longitudinal methodology was interested in capturing the temporal dynamics, in-depth narratives, and contextual nuances of patients’ medication experiences during transitions of care [ 59 , 83 ]. This approach provided a comprehensive understanding of how patients’ perspectives and behaviors evolved over time, offering insights into the complex interactions of medication management, understanding and adherence, and turning points within their medication journeys. A qualitative longitudinal design was used by Fylan et al. to underline patients’ resilience in medication management during and after discharge, by Brandberg et al. to show the dynamic process of self-management during the 4 weeks post-discharge and by Lawton et al. to examine how patients with type 2 diabetes perceived their care after discharge over a period of four years [ 49 , 50 , 51 ]. Our study focused on the first two months following hospitalization and future studies should focus on following discharged and at-risk patients over a longer period, as “transitions of care do not comprise linear trajectories of patients’ movements, with a starting and finishing point. Instead, they are endless loops of movements” [ 47 ].

Our results provide a particularly thorough description of how participants move from a state of total dependency during hospitalization regarding their medication management to a sudden and complete autonomy after hospital discharge impacting medication management, understanding, and adherence in the first days after discharge for some participants. Several qualitative studies have described the lack of shared decision-making and the loss of patient autonomy during hospitalization, which had an impact on self-management and created conflicts with healthcare professionals [ 75 , 81 , 84 ]. Our study also highlights nuanced patient experiences, including varying levels of patient needs, involvement, and proactivity during hospitalization and outpatient care, and our results contribute to capturing different perspectives that contrast with some literature that often portrays patients as more passive recipients of care [ 14 , 15 , 74 , 75 ]. Shared decision-making and proactive medication are key elements as they contribute to a smoother transition and better outcomes for patients post-discharge [ 85 , 86 , 87 ].

Consistent with the literature, the study identifies some challenges in medication initiation post-discharge [ 16 , 17 , 88 ] but our results also describe how daily routine rapidly takes over, either solidifying adherence behavior or generating barriers to medication adherence. Participants’ nonadherence prior to hospitalization was a factor influencing participants’ adherence post-hospitalization and this association should be further investigated, as literature showed that hospitalized patients have high scores of non-adherence [ 89 ]. Mortel et al. showed that more than 20% of discharged patients stopped their medications earlier than agreed with the physician and 25% adapted their medication intake [ 90 ]. Furthermore, patients who self-managed their medications had a lower perception of the necessity of their medication than patients who received help, which could negatively impact medication adherence [ 91 ]. Although participants in our study had high BMQ scores for necessity and lower scores for concerns, some participants expressed doubts about the need for their medications and a lack of motivation a few weeks after discharge. Targeted pharmacy interventions for newly prescribed medications have been shown to improve medication adherence, and hospital discharge is an opportune moment to implement this service [ 92 , 93 ].

Many medication changes were made during the transition of care (a median number of 7 changes during hospitalization and 7 changes during the two months after discharge), especially medication additions during hospitalization and interruptions after hospitalization. While medication changes during hospitalization are well described, the many changes following discharge are less discussed [ 7 , 94 ]. A Danish study showed that approximately 65% of changes made during hospitalization were accepted by primary healthcare professionals but only 43% of new medications initiated during hospitalization were continued after discharge [ 95 ]. The numerous changes after discharge may be caused by unnecessary intensification of medications during hospitalization, delayed discharge letters, lack of standardized procedures, miscommunication, patient self-management difficulties, or in response to an acute situation [ 96 , 97 , 98 ]. During the transition of care, in our study, both new and experienced participants were faced with difficulties in managing and understanding medication changes, either for newly prescribed medication or changes in previous medications. Such difficulties corroborate the findings of the literature [ 9 , 10 , 47 ] and our results showed that the lack of understanding during hospitalization led to participants having questions about their medications, even weeks after discharge. Particular attention should be given to patients’ understanding of medication changes jointly by physicians, nurses and pharmacists during the transition of care and in the months that follow as medications are likely to undergo as many changes as during hospitalization.

Implication for practice and future research

The patients’ perspectives in this study showed, at a system level, that there was a lack of standardization in healthcare professional practices regarding medication dispensing and follow-up. For now, in Switzerland, there are no official guidelines on medication prescription and dispensation during the transition of care although some international guidelines have been developed for outpatient healthcare professionals [ 3 , 99 , 100 , 101 , 102 ]. Here are some suggestions for improvement arising from our results. Patients should be included as partners and healthcare professionals should systematically assess (i) previous medication adherence, (ii) patients’ desired level of involvement and (iii) their needs for information during hospitalization. Hospital discharge processes should be routinely implemented to standardize hospital discharge preparation, medication prescribing, and dispensing. Discharge from the hospital should be planned with community pharmacies to ensure that all medications are available and, if necessary, doses of medications should be supplied by the hospital to bridge the gap. A partnership with outpatient healthcare professionals, such as general practitioners, community pharmacists, and homecare nurses, should be set up for effective asynchronous interprofessional collaboration to consolidate patients’ medication management, knowledge, and adherence, as well as to monitor signs of deterioration or adverse drug events.

Future research should consolidate our first attempt to develop a framework to better characterize medication at the transition of care, using Fig. 2   as a starting point. Contextualized interventions, co-designed by health professionals, patients and stakeholders, should be tested in a hybrid implementation study to test the implementation and effectiveness of the intervention for the health system [ 103 ].

Limitations

This study has some limitations. First, the transcripts were validated for accuracy by the interviewer but not by a third party, which could have increased the robustness of the transcription. Nevertheless, the interviewer followed all methodological recommendations for transcription. Second, patient inclusion took place during the COVID-19 pandemic, which may have had an impact on patient care and the availability of healthcare professionals. Third, we cannot guarantee the accuracy of some participants’ medication history before hospitalization, even though we contacted the participants’ main pharmacy, as participants could have gone to different pharmacies to obtain their medications. Fourth, our findings may not be generalizable to other populations and other healthcare systems because some issues may be specific to multimorbid patients with type 2 diabetes or to the Swiss healthcare setting. Nevertheless, issues encountered by our participants regarding their medications correlate with findings in the literature. Fifth, only 15 out of 21 participants took part in all the interviews, but most participants took part in at least three interviews and data saturation was reached. Lastly, by its qualitative and longitudinal design, it is possible that the discussion during interviews and participants’ reflections between interviews influenced participants’ management, knowledge, and adherence, even though this study was observational, and no advice or recommendations were given by the interviewer during interviews.

Discharged patients are willing to take steps to better manage, understand, and adhere to their medications, yet they are also faced with difficulties in the hospital and outpatient care. Furthermore, extensive changes in medications not only occur during hospitalization but also during the two months following hospital discharge, for which healthcare professionals should give particular attention. The different degrees of patients’ involvement, needs and resources should be carefully considered to enable them to better manage, understand and adhere to their medications. At a system level, patients’ experiences revealed a lack of standardization of medication practices during the transition of care. The healthcare system should provide the ecosystem needed for healthcare professionals responsible for or involved in the management of patients’ medications during the hospital stay, discharge, and outpatient care to standardize their practices while considering the patient as an active partner.

Data availability

The anonymized quantitative survey datasets and the qualitative codes are available in French from the corresponding author on reasonable request.

Abbreviations

adverse drug events

Adherence Visual Analogue Scale

Belief in Medication Questionnaire

Consolidated Criteria for Reporting Qualitative Research

case report form

standard deviation

World Health Organization

American Academy of Family Physician. Continuity of Care, Definition of 2020. Accessed 10 July 2022 https://www.aafp.org/about/policies/all/continuity-of-care-definition.html

Kripalani S, LeFevre F, Phillips CO, Williams MV, Basaviah P, Baker DW. Deficits in communication and information transfer between hospital-based and primary care physicians: implications for patient safety and continuity of care. JAMA. 2007;297(8):831–41.

Article   CAS   PubMed   Google Scholar  

World Health Organization (WHO). Medication Safety in Transitions of Care. 2019.

Forster AJ, Murff HJ, Peterson JF, Gandhi TK, Bates DW. The incidence and severity of adverse events affecting patients after discharge from the hospital. Ann Intern Med. 2003;138(3):161–7.

Article   PubMed   Google Scholar  

Krumholz HM. Post-hospital syndrome–an acquired, transient condition of generalized risk. N Engl J Med. 2013;368(2):100–2.

Article   CAS   PubMed   PubMed Central   Google Scholar  

Banholzer S, Dunkelmann L, Haschke M, Derungs A, Exadaktylos A, Krähenbühl S, et al. Retrospective analysis of adverse drug reactions leading to short-term emergency hospital readmission. Swiss Med Wkly. 2021;151:w20400.

Blozik E, Signorell A, Reich O. How does hospitalization affect continuity of drug therapy: an exploratory study. Ther Clin Risk Manag. 2016;12:1277–83.

Article   PubMed   PubMed Central   Google Scholar  

Allen J, Hutchinson AM, Brown R, Livingston PM. User experience and care for older people transitioning from hospital to home: patients’ and carers’ perspectives. Health Expect. 2018;21(2):518–27.

Daliri S, Bekker CL, Buurman BM, Scholte Op Reimer WJM, van den Bemt BJF, Karapinar-Çarkit F. Barriers and facilitators with medication use during the transition from hospital to home: a qualitative study among patients. BMC Health Serv Res. 2019;19(1):204.

Bekker CL, Mohsenian Naghani S, Natsch S, Wartenberg NS, van den Bemt BJF. Information needs and patient perceptions of the quality of medication information available in hospitals: a mixed method study. Int J Clin Pharm. 2020;42(6):1396–404.

Foulon V, Wuyts J, Desplenter F, Spinewine A, Lacour V, Paulus D, et al. Problems in continuity of medication management upon transition between primary and secondary care: patients’ and professionals’ experiences. Acta Clin Belgica: Int J Clin Lab Med. 2019;74(4):263–71.

Article   Google Scholar  

Micheli P, Kossovsky MP, Gerstel E, Louis-Simonet M, Sigaud P, Perneger TV, et al. Patients’ knowledge of drug treatments after hospitalisation: the key role of information. Swiss Med Wkly. 2007;137(43–44):614–20.

PubMed   Google Scholar  

Ziaeian B, Araujo KL, Van Ness PH, Horwitz LI. Medication reconciliation accuracy and patient understanding of intended medication changes on hospital discharge. J Gen Intern Med. 2012;27(11):1513–20.

Allen J, Hutchinson AM, Brown R, Livingston PM. User experience and care integration in Transitional Care for older people from hospital to home: a Meta-synthesis. Qual Health Res. 2016;27(1):24–36.

Mackridge AJ, Rodgers R, Lee D, Morecroft CW, Krska J. Cross-sectional survey of patients’ need for information and support with medicines after discharge from hospital. Int J Pharm Pract. 2018;26(5):433–41.

Mulhem E, Lick D, Varughese J, Barton E, Ripley T, Haveman J. Adherence to medications after hospital discharge in the elderly. Int J Family Med. 2013;2013:901845.

Fallis BA, Dhalla IA, Klemensberg J, Bell CM. Primary medication non-adherence after discharge from a general internal medicine service. PLoS ONE. 2013;8(5):e61735.

Zhou L, Rupa AP. Categorization and association analysis of risk factors for adverse drug events. Eur J Clin Pharmacol. 2018;74(4):389–404.

Moreau-Gruet F. La multimorbidité chez les personnes de 50 ans et plus. Résultats basés sur l’enqête SHARE (Survey of Health, Ageing and Retirement in Europe. Obsan Bulletin 4/2013. 2013(Neuchâtel: OBservatoire suisse de la santé).

Iglay K, Hannachi H, Joseph Howie P, Xu J, Li X, Engel SS, et al. Prevalence and co-prevalence of comorbidities among patients with type 2 diabetes mellitus. Curr Med Res Opin. 2016;32(7):1243–52.

Sibounheuang P, Olson PS, Kittiboonyakun P. Patients’ and healthcare providers’ perspectives on diabetes management: a systematic review of qualitative studies. Res Social Adm Pharm. 2020;16(7):854–74.

Müller-Wieland D, Merkel M, Hamann A, Siegel E, Ottillinger B, Woker R, et al. Survey to estimate the prevalence of type 2 diabetes mellitus in hospital patients in Germany by systematic HbA1c measurement upon admission. Int J Clin Pract. 2018;72(12):e13273.

Blanc AL, Fumeaux T, Stirnemann J, Dupuis Lozeron E, Ourhamoune A, Desmeules J, et al. Development of a predictive score for potentially avoidable hospital readmissions for general internal medicine patients. PLoS ONE. 2019;14(7):e0219348.

Hansen LO, Greenwald JL, Budnitz T, Howell E, Halasyamani L, Maynard G, et al. Project BOOST: effectiveness of a multihospital effort to reduce rehospitalization. J Hosp Med. 2013;8(8):421–7.

Khalid JM, Raluy-Callado M, Curtis BH, Boye KS, Maguire A, Reaney M. Rates and risk of hospitalisation among patients with type 2 diabetes: retrospective cohort study using the UK General Practice Research Database linked to English Hospital Episode statistics. Int J Clin Pract. 2014;68(1):40–8.

Lussier ME, Evans HJ, Wright EA, Gionfriddo MR. The impact of community pharmacist involvement on transitions of care: a systematic review and meta-analysis. J Am Pharm Assoc. 2020;60(1):153–.

van der Heijden A, de Bruijne MC, Nijpels G, Hugtenburg JG. Cost-effectiveness of a clinical medication review in vulnerable older patients at hospital discharge, a randomized controlled trial. Int J Clin Pharm. 2019;41(4):963–71.

Bingham J, Campbell P, Schussel K, Taylor AM, Boesen K, Harrington A, et al. The Discharge Companion Program: an interprofessional collaboration in Transitional Care Model Delivery. Pharm (Basel). 2019;7(2):68.

Google Scholar  

Farris KB, Carter BL, Xu Y, Dawson JD, Shelsky C, Weetman DB, et al. Effect of a care transition intervention by pharmacists: an RCT. BMC Health Serv Res. 2014;14:406.

Meslot C, Gauchet A, Hagger MS, Chatzisarantis N, Lehmann A, Allenet B. A Randomised Controlled Trial to test the effectiveness of planning strategies to improve Medication Adherence in patients with Cardiovascular Disease. Appl Psychol Health Well Being. 2017;9(1):106–29.

Garnier A, Rouiller N, Gachoud D, Nachar C, Voirol P, Griesser AC, et al. Effectiveness of a transition plan at discharge of patients hospitalized with heart failure: a before-and-after study. ESC Heart Fail. 2018;5(4):657–67.

Daliri S, Bekker CL, Buurman BM, Scholte Op Reimer WJM, van den Bemt BJF, Karapinar-Çarkit F. Medication management during transitions from hospital to home: a focus group study with hospital and primary healthcare providers in the Netherlands. Int J Clin Pharm. 2020.

Hansen LO, Young RS, Hinami K, Leung A, Williams MV. Interventions to reduce 30-day rehospitalization: a systematic review. Ann Intern Med. 2011;155(8):520–8.

Leppin AL, Gionfriddo MR, Kessler M, Brito JP, Mair FS, Gallacher K, et al. Preventing 30-day hospital readmissions: a systematic review and meta-analysis of randomized trials. JAMA Intern Med. 2014;174(7):1095–107.

Donzé J, John G, Genné D, Mancinetti M, Gouveia A, Méan M et al. Effects of a Multimodal Transitional Care Intervention in patients at high risk of readmission: the TARGET-READ Randomized Clinical Trial. JAMA Intern Med. 2023.

Rodrigues CR, Harrington AR, Murdock N, Holmes JT, Borzadek EZ, Calabro K, et al. Effect of pharmacy-supported transition-of-care interventions on 30-Day readmissions: a systematic review and Meta-analysis. Ann Pharmacother. 2017;51(10):866–89.

Lam MYY, Dodds LJ, Corlett SA. Engaging patients to access the community pharmacy medicine review service after discharge from hospital: a cross-sectional study in England. Int J Clin Pharm. 2019;41(4):1110–7.

Hossain LN, Fernandez-Llimos F, Luckett T, Moullin JC, Durks D, Franco-Trigo L, et al. Qualitative meta-synthesis of barriers and facilitators that influence the implementation of community pharmacy services: perspectives of patients, nurses and general medical practitioners. BMJ Open. 2017;7(9):e015471.

En-Nasery-de Heer S, Uitvlugt EB, Bet PM, van den Bemt BJF, Alai A, van den Bemt P et al. Implementation of a pharmacist-led transitional pharmaceutical care programme: process evaluation of medication actions to reduce hospital admissions through a collaboration between Community and Hospital pharmacists (MARCH). J Clin Pharm Ther. 2022.

Morris ZS, Wooding S, Grant J. The answer is 17 years, what is the question: understanding time lags in translational research. J R Soc Med. 2011;104(12):510–20.

De Geest S, Zúñiga F, Brunkert T, Deschodt M, Zullig LL, Wyss K, et al. Powering Swiss health care for the future: implementation science to bridge the valley of death. Swiss Med Wkly. 2020;150:w20323.

Noonan VK, Lyddiatt A, Ware P, Jaglal SB, Riopelle RJ, Bingham CO 3, et al. Montreal Accord on patient-reported outcomes (PROs) use series - paper 3: patient-reported outcomes can facilitate shared decision-making and guide self-management. J Clin Epidemiol. 2017;89:125–35.

Hesselink G, Schoonhoven L, Barach P, Spijker A, Gademan P, Kalkman C, et al. Improving patient handovers from hospital to primary care: a systematic review. Ann Intern Med. 2012;157(6):417–28.

(OFSP) Interprofessionnalité dans le domaine de la santé Soins ambulatoire. Accessed 4 January 2024. https://www.bag.admin.ch/bag/fr/home/strategie-und-politik/nationale-gesundheitspolitik/foerderprogramme-der-fachkraefteinitiative-plus/foerderprogramme-interprofessionalitaet.html

Mitchell SE, Laurens V, Weigel GM, Hirschman KB, Scott AM, Nguyen HQ, et al. Care transitions from patient and caregiver perspectives. Ann Fam Med. 2018;16(3):225–31.

Davoody N, Koch S, Krakau I, Hägglund M. Post-discharge stroke patients’ information needs as input to proposing patient-centred eHealth services. BMC Med Inf Decis Mak. 2016;16:66.

Ozavci G, Bucknall T, Woodward-Kron R, Hughes C, Jorm C, Joseph K, et al. A systematic review of older patients’ experiences and perceptions of communication about managing medication across transitions of care. Res Social Adm Pharm. 2021;17(2):273–91.

Fylan B, Armitage G, Naylor D, Blenkinsopp A. A qualitative study of patient involvement in medicines management after hospital discharge: an under-recognised source of systems resilience. BMJ Qual Saf. 2018;27(7):539–46.

Fylan B, Marques I, Ismail H, Breen L, Gardner P, Armitage G, et al. Gaps, traps, bridges and props: a mixed-methods study of resilience in the medicines management system for patients with heart failure at hospital discharge. BMJ Open. 2019;9(2):e023440.

Brandberg C, Ekstedt M, Flink M. Self-management challenges following hospital discharge for patients with multimorbidity: a longitudinal qualitative study of a motivational interviewing intervention. BMJ Open. 2021;11(7):e046896.

Lawton J, Rankin D, Peel E, Douglas M. Patients’ perceptions and experiences of transitions in diabetes care: a longitudinal qualitative study. Health Expect. 2009;12(2):138–48.

Mabire C, Bachnick S, Ausserhofer D, Simon M. Patient readiness for hospital discharge and its relationship to discharge preparation and structural factors: a cross-sectional study. Int J Nurs Stud. 2019;90:13–20.

Meyers DC, Durlak JA, Wandersman A. The quality implementation framework: a synthesis of critical steps in the implementation process. Am J Community Psychol. 2012;50(3–4):462–80.

Meyer-Massetti C, Hofstetter V, Hedinger-Grogg B, Meier CR, Guglielmo BJ. Medication-related problems during transfer from hospital to home care: baseline data from Switzerland. Int J Clin Pharm. 2018;40(6):1614–20.

Neeman M, Dobrinas M, Maurer S, Tagan D, Sautebin A, Blanc AL, et al. Transition of care: a set of pharmaceutical interventions improves hospital discharge prescriptions from an internal medicine ward. Eur J Intern Med. 2017;38:30–7.

Geese F, Schmitt KU. Interprofessional Collaboration in Complex Patient Care Transition: a qualitative multi-perspective analysis. Healthc (Basel). 2023;11(3).

Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M. Developing and evaluating complex interventions: the new Medical Research Council guidance. Int J Nurs Stud. 2013;50(5):587–92.

Thomson R, Plumridge L, Holland J, Editorial. Int J Soc Res Methodol. 2003;6(3):185–7.

Audulv Å, Hall EOC, Kneck Å, Westergren T, Fegran L, Pedersen MK, et al. Qualitative longitudinal research in health research: a method study. BMC Med Res Methodol. 2022;22(1):255.

Kim H, Sefcik JS, Bradway C. Characteristics of qualitative descriptive studies: a systematic review. Res Nurs Health. 2017;40(1):23–42.

Sandelowski M. Whatever happened to qualitative description? Res Nurs Health. 2000;23(4):334–40.

Bradshaw C, Atkinson S, Doody O. Employing a qualitative description Approach in Health Care Research. Glob Qual Nurs Res. 2017;4:2333393617742282.

PubMed   PubMed Central   Google Scholar  

Bellone JM, Barner JC, Lopez DA. Postdischarge interventions by pharmacists and impact on hospital readmission rates. J Am Pharm Assoc (2003). 2012;52(3):358–62.

Hennink MM, Kaiser BN, Marconi VC. Code saturation versus meaning saturation: how many interviews are Enough? Qual Health Res. 2016;27(4):591–608.

World Health Organization. Adherence to long-term therapies: evidence for action. 2003.

Fisher JD, Fisher WA, Amico KR, Harman JJ. An information-motivation-behavioral skills model of adherence to antiretroviral therapy. Health Psychol. 2006;25(4):462–73.

Bandura A. Health promotion from the perspective of social cognitive theory. Psychol Health. 1998;13(4):623–49.

ShiftEUROQOL Research FOndation EQ 5D Instruments. Accessed 30 July 2022 https://euroqol.org/eq-5d-instruments/sample-demo/

Jeppesen KM, Coyle JD, Miser WF. Screening questions to predict limited health literacy: a cross-sectional study of patients with diabetes mellitus. Ann Fam Med. 2009;7(1):24–31.

Giordano TP, Guzman D, Clark R, Charlebois ED, Bangsberg DR. Measuring adherence to antiretroviral therapy in a diverse population using a visual analogue scale. HIV Clin Trials. 2004;5(2):74–9.

Horne R, Weinman J, Hankins M. The beliefs about medicines questionnaire: the development and evaluation of a new method for assessing the cognitive representation of medication. Psychol Health. 1999;14(1):1–24.

Horne R, Chapman SC, Parham R, Freemantle N, Forbes A, Cooper V. Understanding patients’ adherence-related beliefs about medicines prescribed for long-term conditions: a meta-analytic review of the necessity-concerns Framework. PLoS ONE. 2013;8(12):e80633.

Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Res Psychol. 2006;3(2):77–101.

Waibel S, Henao D, Aller M-B, Vargas I, Vázquez M-L. What do we know about patients’ perceptions of continuity of care? A meta-synthesis of qualitative studies. Int J Qual Health Care. 2011;24(1):39–48.

Rognan SE, Jørgensen MJ, Mathiesen L, Druedahl LC, Lie HB, Bengtsson K, et al. The way you talk, do I have a choice?’ Patient narratives of medication decision-making during hospitalization. Int J Qualitative Stud Health Well-being. 2023;18(1):2250084.

Michel B, Hemery M, Rybarczyk-Vigouret MC, Wehrle P, Beck M. Drug-dispensing problems community pharmacists face when patients are discharged from hospitals: a study about 537 prescriptions in Alsace. Int J Qual Health Care. 2016;28(6):779–84.

Bruhwiler LD, Hersberger KE, Lutters M. Hospital discharge: what are the problems, information needs and objectives of community pharmacists? A mixed method approach. Pharm Pract (Granada). 2017;15(3):1046.

Knight DA, Thompson D, Mathie E, Dickinson A. Seamless care? Just a list would have helped!’ Older people and their carer’s experiences of support with medication on discharge home from hospital. Health Expect. 2013;16(3):277–91.

Gualandi R, Masella C, Viglione D, Tartaglini D. Exploring the hospital patient journey: what does the patient experience? PLoS ONE. 2019;14(12):e0224899.

Norberg H, Håkansson Lindqvist M, Gustafsson M. Older individuals’ experiences of Medication Management and Care after Discharge from Hospital: an interview study. Patient Prefer Adherence. 2023;17:781–92.

Jones KC, Austad K, Silver S, Cordova-Ramos EG, Fantasia KL, Perez DC, et al. Patient perspectives of the hospital discharge process: a qualitative study. J Patient Exp. 2023;10:23743735231171564.

Hesselink G, Flink M, Olsson M, Barach P, Dudzik-Urbaniak E, Orrego C, et al. Are patients discharged with care? A qualitative study of perceptions and experiences of patients, family members and care providers. BMJ Qual Saf. 2012;21(Suppl 1):i39–49.

Murray SA, Kendall M, Carduff E, Worth A, Harris FM, Lloyd A, et al. Use of serial qualitative interviews to understand patients’ evolving experiences and needs. BMJ. 2009;339:b3702.

Berger ZD, Boss EF, Beach MC. Communication behaviors and patient autonomy in hospital care: a qualitative study. Patient Educ Couns. 2017;100(8):1473–81.

Davis RE, Jacklin R, Sevdalis N, Vincent CA. Patient involvement in patient safety: what factors influence patient participation and engagement? Health Expect. 2007;10(3):259–67.

Greene J, Hibbard JH. Why does patient activation matter? An examination of the relationships between patient activation and health-related outcomes. J Gen Intern Med. 2012;27(5):520–6.

Mitchell SE, Gardiner PM, Sadikova E, Martin JM, Jack BW, Hibbard JH, et al. Patient activation and 30-day post-discharge hospital utilization. J Gen Intern Med. 2014;29(2):349–55.

Weir DL, Motulsky A, Abrahamowicz M, Lee TC, Morgan S, Buckeridge DL, et al. Failure to follow medication changes made at hospital discharge is associated with adverse events in 30 days. Health Serv Res. 2020;55(4):512–23.

Kripalani S, Goggins K, Nwosu S, Schildcrout J, Mixon AS, McNaughton C, et al. Medication nonadherence before hospitalization for Acute Cardiac events. J Health Commun. 2015;20(Suppl 2):34–42.

Mortelmans L, De Baetselier E, Goossens E, Dilles T. What happens after Hospital Discharge? Deficiencies in Medication Management encountered by geriatric patients with polypharmacy. Int J Environ Res Public Health. 2021;18(13).

Mortelmans L, Goossens E, Dilles T. Beliefs about medication after hospital discharge in geriatric patients with polypharmacy. Geriatr Nurs. 2022;43:280–7.

Bandiera C, Ribaut J, Dima AL, Allemann SS, Molesworth K, Kalumiya K et al. Swiss Priority setting on implementing Medication Adherence interventions as Part of the European ENABLE COST action. Int J Public Health. 2022;67.

Elliott R, Boyd M, Nde S. at e. Supporting adherence for people starting a new medication for a long-term condition through community pharmacies: a pragmaticrandomised controlled trial of the New Medicine Service. 2015.

Grimmsmann T, Schwabe U, Himmel W. The influence of hospitalisation on drug prescription in primary care–a large-scale follow-up study. Eur J Clin Pharmacol. 2007;63(8):783–90.

Larsen MD, Rosholm JU, Hallas J. The influence of comprehensive geriatric assessment on drug therapy in elderly patients. Eur J Clin Pharmacol. 2014;70(2):233–9.

Viktil KK, Blix HS, Eek AK, Davies MN, Moger TA, Reikvam A. How are drug regimen changes during hospitalisation handled after discharge: a cohort study. BMJ Open. 2012;2(6):e001461.

Strehlau AG, Larsen MD, Søndergaard J, Almarsdóttir AB, Rosholm J-U. General practitioners’ continuation and acceptance of medication changes at sectorial transitions of geriatric patients - a qualitative interview study. BMC Fam Pract. 2018;19(1):168.

Anderson TS, Lee S, Jing B, Fung K, Ngo S, Silvestrini M, et al. Prevalence of diabetes medication intensifications in older adults discharged from US Veterans Health Administration Hospitals. JAMA Netw Open. 2020;3(3):e201511.

Royal Pharmaceutical Society. Keeping patients safewhen they transfer between care providers– getting the medicines right June 2012. Accessed 27 October 2023 https://www.rpharms.com/Portals/0/RPS%20document%20library/Open%20access/Publications/Keeping%20patients%20safe%20transfer%20of%20care%20report.pdf

International Pharmaceutical Federation (FIP). Medicines reconciliation: A toolkit for pharmacists. Accessed 23 September 2023 https://www.fip.org/file/4949

Californian Pharmacist Assiociation Transitions of Care Resource Guide. https://cdn.ymaws.com/www.cshp.org/resource/resmgr/Files/Practice-Policy/For_Pharmacists/transitions_of_care_final_10.pdf

Royal Collegue of Physicians. Medication safety at hospital discharge: Improvement guide and resource. Accessed 18 September 2023 https://www.rcplondon.ac.uk/file/33421/download

Douglas N, Campbell W, Hinckley J. Implementation science: buzzword or game changer. J Speech Lang Hear Res. 2015;58.

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Acknowledgements

The authors would like to thank all the patients who took part in this study. We would also like to thank the Geneva University Hospitals Patients Partners + 3P platform as well as Mrs. Tourane Corbière and Mr. Joël Mermoud, patient partners, who reviewed interview guides for clarity and significance. We would like to thank Samuel Fabbi, Vitcoryavarman Koh, and Pierre Repiton for the transcriptions of the audio recordings.

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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LS, GG, and MS conceptualized and designed the study. LS and GG screened and recruited participants. LS conducted the interviews. LS, GG, and MS performed data analysis and interpretation. LS drafted the manuscript and LS and MS worked on the different versions. MS and GG approved the final manuscript.

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Solh Dost, L., Gastaldi, G. & Schneider, M. Patient medication management, understanding and adherence during the transition from hospital to outpatient care - a qualitative longitudinal study in polymorbid patients with type 2 diabetes. BMC Health Serv Res 24 , 620 (2024). https://doi.org/10.1186/s12913-024-10784-9

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Received : 28 June 2023

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Published : 13 May 2024

DOI : https://doi.org/10.1186/s12913-024-10784-9

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