Pendekatan dan Metode

Kualitatif

DK Sunjaya

8 9: Pengantar Teori

9- 10: Praktik Wawancara

10-11: Praktik Transkripsi

11-15: Praktik Analisis: Coding,

Cathegory, Theme, Theory, Display

15-16: Praktik Penulisan Hasil

Paradigma

Trial & Error

Otoritas & Tradisi

Spekulasi & Argumentasi

Postitivisme

Modernisme

Post Positivisme

Post modernisme

Interpretivism/

Constructivism Naturalistic

Kekuatan Kata-kata

Contoh Pengalaman 1

Pengaruh kegiatan outreach dalam program harm reduction terhadap perilaku

berisiko tertular HIV AIDS pada penasun

di Kota Bandung, Cimahi dan Kabupaten

Sumedang

Tesis mahasiswa S2 IKM

2010

Latar Belakang

AIDS di Indonesia: 16 964 kasus (Maret 2009) Penasun : 42 %

STBP (2007) 4 Kota: 43 sd 56 % penasun HIV

< 30 % penasun mengikuti VCT

Hubungan sex: pasangan tetap, tidak tetap, WPS

Hubungan sex tanpa kondom

Harm reduction : pendekatan pragmatis dan humanistik mengurangi kerusakan secara individu maupun sosial

Outreach: komponen utama HR

Rumusan Masalah

Bagaimana kegiatan penjangkauan dan pendampingan (outreach) dalam pogram harm reduction berpengaruh terhadap perubahan perilaku (menyuntik dan hubungan seks) penasun

Bagaimana gambaran pencapaian tujuan dan program harm reduction dalam merubah perilaku berisiko penasun terhadap penularan HIV-AIDS (baik kepada diri sendiri, pasangan maupun orang lain)

Metode

Mixed method

Kuantitatif: cross sectional, instrumen

Kualitatif: FGD, in depth interview

Single study

Contoh Hasil

....responden menggunakan napza pada usia 18 tahun ....

.. Rata-rata informan memakai napza pada saat SLTP dengan menggunakan

ganja dan minuman beralkohol.

... Sejak SMP kelas 3.... Sebelum PT menggunakan ganja dari temen-temen.

Pakai PT sejak kelas 1 SMA.....

Heroin/putaw dan subutex/suboxon juga masih merupakan jenis napza yang paling

banyak digunakan yaitu masing-masing

oleh 84 % dan 78 % responden. Namun

dari sisi frekuensi pengunaan, dalam

setahun lebih sering menggunakan

subutex (61%) dibanding putaw (31%)

.. Disuntik itu sebenarnya lebih enak sih pak .... Cuman seringnya ritualnya....

Konsistensi penggunaan kondom

Hubungan

sex

selalu sering kadang2 Tidak pernah

Dg pasangan

tetap

32 % 3 % 37 % 23 %

Dg pasangan

tidak tetap

40 % 7 % 35 % 18 %

Dg PSK

(membeli)

50 % 15 % 18 % 18 %

Dg PSK

(menjual)

18 % 9 % 27 % 45 %

rata2 35 % 8 % 29 % 26 %

... Kadang-kadang, kadang liat dulu ceweknya, apa pernah dengan orang lain apa belum. Kalo belum ya ga pake kondom.....

.. Kalau jarum tumpul ..juga pernah kebablasan pak. Waktu itu main sama teman berdua, terus ... Yah jajan , gitu. Kebetulan engga bawa sarungnya, gitu. Karena sudah kepingin, yah kejadian engga kuat...

Peran

Keluarga

Tekanan

Kelompok

Perilaku

Risiko

Perilaku

Kelompok

Kebersamaan

Keterbukaa

n

Kesadaran

Kolektif

Pembelajaran

Positif

solidaritas

Role Model

Peran

sebaya

Penggunaa

n Napza

suntik dan

sex aman

Perubahan

Perilaku

Penasun

Peran

Gender

Peta Konsep: Pengaruh outreach terhadap perilaku berisiko penasun

dengan tema motivasi dan faktor pendukung perubahan perilaku

Types of Qualitative Inquiry

Grounded Theory

Systematic generation of theory from data that has been empirically collected & analyzed (Glasser & Strauss, 1967)

creation of theory that is based on data from fieldwork

Rich in meaning

Relatively inexpensive to use

Intent : generate new insight by discovering the social reality of those whose actions combine to

impact a given set of human phenomena

Can be used in any form of Qualitative inquiry

Embraces the perspective of multiple reality

Seeks to understand how interpretative meanings are constructed

Can be found in Case study, action research, ethnography

Methodology

Prolonged field engagement ( > 1 year)

Techniques : participant observation, informal interviewing, document

examination

Note : GT is a process and a product of of Qualitative methodology

Process: (Eagan 2002)

1. Initiation of the research

2. Data selection

3. Initiation of data collection

4. Data analysis

5. Concluding the research

Aspects of the methodology (Hansen 2005)

Constant Comparison analysis Iterative, repetitive, and replete with comparisons

New data are compared with existing data, new theoretical hunch is compared with yesterdays idea

Coding and Categorical development Coding : process of simultaneously reducing the data by dividing it into

units of analysis and identifying each conceptual units

Category : modified and organized into sets

Theoretical Sampling form of sampling is not random and is not based o statistical probability

Purposefully design to pursue data collection to support categorical development to the point of concept saturation, which occurs when the data are stable and the pattern unlikely to change

Generating knowledge using GT research :

Theory must fit the topic of study

Must be understandable to the study s informants as well as to those who

research and practice in that area

Must be general and abstract enough to be generalized to a broader theory and

applicable to a variety of setting

Should provide control of action by proposing relationship among concepts

Sunjaya (2008) :

Action research 2005 -2008

How Dinas Kesehatan Kota (public organization) respon to a new rule (driving

force)

Vision

Change

Shared

Vision

CHANGE

Driving

Forces

CHANGE

Support

Ethnography

Thick description

An insightful comment that captures both the value of descriptive methods, as well

as the multiple layers of meaning captured

by naturalistic, empathetic research

methods.

Village-centered ethnography Colonial administrator :

to present a usefull accounting of the customs and modes of live hood of indigenous peoples that had become the administrator responsibilities

Explorers report : too superficial

Missionaries narratives: too colored by their own biases

Live among the villagers, eat their food, converse with their elders in the local patois and participate in their ritual

Deep hanging out

Doing nothing

Interfere as little as possible

Organizational ethnography

Model (Sengir et al 2004)

Develop research design

Collect data

Analyze data

Validate data

Develop typology

Validate typology

Final write up

Phenomenology

Seeks understanding of the meanings and essence of experience rather than

explanation or measurement

Emphasizes the wholeness of experience rather its objects or parts

Phenomenological theory building creates new understandings of what experiences mean to individual who have had them

Since phenomenology enables comprehensive description and understanding , particularly of novel or unique experiences, it can be used for theoretical explanation

Phenomenological researcher must be completely open, receptive and naiv in hearing

research participants describe their experiences

Phenomenology relies on intuition, imagination, and openness for obtaining a picture of the

dynamics of the experience

It should not be used to create knowledge for universal structures, standardization or

generalization

Historical Research

Process of systematically examining past events to give an account of what has happened in the

past

Not a mere accumulation of facts and dates or even a description past events

A flowing, dynamic account of past events that involves an interpretation of the events in an

attempt to recapture the nuances, personalities

and ideas that influenced these events

Goal : communicate an understanding of past events

Reasons : Uncover the unknown

Answer question

Identify the relationship that the past has to present

Record and evaluate the accomplishment of individuals, agencies or institutions

Assist in understanding the culture in which we live

Methodology :

Identification of the research topic and formulation of the research problem or

question

Data collection or literature review

Evaluation of material

Data synthesis

Report preparation

Case Study

An empirical inquiry that investigates a contemporary phenomenon within its real

context, especially when the boundary

between phenomenon and context are not

clearly evident (Yin2003)

Characteristic

Bounded

Embedded

Multivariate

Multimethod

Multidiciplinary

Multisite

Design

Identifying the problem, purpose and research questions

Using literature

Selecting and bounding the case

Designing the study

Considering issues of validity and reliability in designing case study research

Collecting the data

Analyzing the data

Integrating the study findings

Action research

Label for a way of conducting social science that linked the generation of

theory to changing a social system trough

action

Method qualitative (prominent), quantitative

Critical steps :

Initiating and Organizing the project :

Defining the problem and research question

Defining the roles and relationship among those actively engaged in AR process and

entering the system

Deciding on how the problem will be studied and choosing methods that will provide the

data necessary for answering the research

question

Implementing the project

Gathering and interpreting the data trough an appropriate analysis process

Identifying appropriate and meaningful actions

Deciding on how the findings should be disseminated and used

Regulation Function Planned Change

District Health Office

Case Bandung and Yogyakarta

Deni K Sunjaya

Kota Yogya

Kota Bandung

DIY

Action research

Survey interview Observasi

interview Observasi Document review

Document review

Case study Characteristic

Bounded : organization DHO Regulation Function; organizational change

Embedded : (local) Health system

Multivariate : Man, culture, system

Multimethod : Action research, quantitative, qualitative

Multidiciplinary : Management, Policy, Law

Multisite :Bandung, Yogya

Perubahan

Terencana;

Model Action

Research

Identifikasi

Masalah

Pengumpulan

data

Umpan

balik

Diagnosis

bersama

Rencana

Aksi

bersama

Implementasi

Pengumpulan

data

Pelembagaan

Unfreezing

Movement

refreezing

Supervision

Ikes

Kandep

Merger

Kandep/

dinkes

Maximalis

Minimalis

Inertia

Transformation

Evolution

New Dinkes

Vision

Change

Shared

Vision

CHANGE

Driving

Forces

CHANGE

Support

Praktik Wawancara

Praktik Transkripsi

Buat format

Tik semua hasil wawancara

Reduksi

Pengump

ulan Data

Reduksi

Display

Kesimpulan

drawing/ver

ifikasi

Miles -Hubbermann

Praktik Analisis

Coding

Cathegorizing

Penyusunan Tema

Content Analysis

Developping Theory

Praktik Penulisan Hasil

Kontek penelitian

Penulisan Hasil

Qualitative Research

Kate Seers

EBP: a Primer for Health Care Professionals

Elsevier, 2005

The hammer and the nail

Problem Question Most

appropriate approach

Qualitative Research

Concentrates on:

Peoples experiences, attitudes and beliefs

Perceptions of a situation

Aims:

to generate an UNDERSTANDING of what is going on in an everyday setting

Q R can be used to:

generate NEW THEORY

Describe a POINT OF VIEW

Develop INSTRUMENTs

Illustrate MEANINGS

SENSITISE readers

Try to UNDERSTAND phenomena

...appropiate when we want to understand perception, motives, and actions of

individuals and organizations

...involves conceptual development and analysis of underlying patterns

.. Is not the opposite of quantitative research

.. Is not just a set of techniques for collecting descriptive data

... Has a theoretical foundation

.. knowledge generated from qualitative reasearch is to be seen as LEGITIMATE

....is concerned with the NEGOTIATION and CONSTRUCTION of MEANINGs in

social interaction

Quanti, Quali, Mixed:

Asking a clear question

Using a sensible methodology to answer question

Ensuring rigorous and systematic data collection and analysis

Explaining and interpreting the data

Ensuring conclusions follow from the data

Phenomenology: how people see their world

Grounded theory: generate theory from data

Ethnography: behavior within a culture

Hermeneutics: create a dialogue where participants and observers meanings and

interpretation interact, producing a new

understanding

Critical theory: increase peoples understanding of their situation and initiate

change. Eg. Action reasearch

E.g. Grounded theory:

Womens experiences of early motherhood Becoming mother a mother was a difficult,

multifactorial process

Cathegories: Being overwhelmed Being unready Feeling drained Feeling alone Experiencing a feeling of loss and gaining

confidence

Supporting women by health care professionals

Karakteristik Kualitatif

Creswell 2009 Natural setting Researcher as key instrument Multiple source of Data Inductive data analysis Participants meaning Emerging design Theoretical lens Interpretive Holistic account

Instrumen Penelitian

Peneliti sebagai instrumen utama

Pedoman Wawancara

Tergantung teknik pengumpulan data: wawancara terstruktur/ tidak terstruktur,

FGD, studi dokumen, observasi/ obs.

Partisipan

3 s/d 4 pertanyaan utama, 4 s/d 5 anak pertanyaan

Ingat trustworthiness