Paradigms, values, assumptions and debates regarding ‘proper’ qualitative research

I was pleasantly surprised to learn about a letter to the Editor of CJRM questioning aspects of our qualitative approach in our recently published paper.1 From my experience, these dialogues are usually reserved for qualitative methodology journals and the PhD-level advanced qualitative research course that I teach every winter. While I appreciate the comments received, there are some incorrect assumptions made in this letter that warrant a response. First, research trustworthiness was called into question. As mentioned in our article, we utilised a community-based approach and we engaged a group of local partners, including people who use drugs, clinicians and other direct service providers, where results were shared and they provided feedback, which ‘enhance(d) the accuracy and trustworthiness of the results’.1 This is a key component of any community-based study and acts as a form of triangulation.2 Who better to assess the results of our study than those whom are tied to the very topic under consideration! Of course, those informed by the positivist realism paradigm would likely disagree with such an epistemological foundation that embraces the co-construction of knowledge through community engagement rather than obtaining an ‘objective reality’ through other sources (e.g., medical records). Assumptions were also made about the supposed ‘pillars’ of qualitative research with reference to various concepts such as reflexivity and data saturation. The assumption here is that these pillars cross all qualitative research, when in fact, their inclusion is dependent on which research paradigms, axiological and onto-epistemological assumptions, qualitative methodologies (e.g. grounded theory and ethnography) and analytic techniques (e.g., thematic analysis and axial coding) are informing the study at hand.3 For example, one of the founders of grounded theory, Glaser, does not support reflexivity given the ‘clean mental state’ that grounded theorists are to have before any study.4 Similarly, depending on the branch of qualitative phenomenology, reflexivity may hold strong (hermeneutic) versus no (transcendental) relevance.5 We conducted a thematic analysis in our study and did not rely on data saturation, and similarly, this concept is not a ‘pillar’ across all qualitative research. Saturation, or information redundancy, is aligned more so with positivist realism and some grounded theory approaches. For others, it has been highly criticised as a ‘logical fallacy’6 and critiqued by several prominent qualitative methodologists from the interpretivist paradigm, including Braun and Clarke for its incorrect use in thematic analysis, as saturation does not align with the values and assumptions embedded within constructivism/interpretivist approaches such as ours.7 Finally, while some readers may have benefited from a more fulsome discussion of our research approach, the word limit for most medical journals means that qualitative researchers need to be selective on what can be reported without taking away from the interview data. This was the case for this article and many others. Nevertheless, I hope this response has shed some light on our research, incorrect assumptions and current debates in qualitative research. I welcome dialogue on these important matters and perhaps this will lead to future editorial considerations in this journal on article length and reporting requirements for qualitative studies. Financial support and sponsorship: Nil. Conflicts of interest: There are no conflicts of interest.

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