Editorial

The word qualitative dredges up a few memories. It strongly reminds me of my basic research methodologies course – a level of confusion I had not encountered before (that was until I started to learn about statistics in depth). Strange and unknown words to describe research methods I had no idea ever existed. Qualitative versus quantitative was the only simple concept. Observation, systematic observation, interviews (unstructured, semi-structured, structured not forgetting oral histories), participant observation, conversation analysis, grounded theory, duoethnography, heuristic inquiry, naturalistic inquiry and orientation perspective. The list goes on.

My maiden voyage into qualitative research was in the late 1990s as part of my MSc dissertation project. The first subject (or should that be potential victim) was easy to approach as she was married to a theatre porter and had been a nurse. I explained that the overall project explored postoperative pain after cardiac surgery (using audit methodology) and that I wanted to interview a small sample of patients to learn more about their personal experience. She signed the consent form, and I went off to get the tape recorder and my semi-structured interview tool. When I returned to her bed space, I was not sure whether she was more nervous than me. I switched on the tape recorder, and after what seemed like only 2 minutes, it alarmed indicating the need to turn the tape over. Fifteen minutes had elapsed, and we had not even moved beyond my first question ‘tell me about your experience of pain after cardiac surgery’.

I learnt far more about pain after cardiac surgery from this single interview than I did from critiquing 40 publications of interventions and undertaking an audit of over 250 patients (pre- and post-assessment and proscribing interventions). What did I learn from my total of five interviews? I learnt that sternotomy isn’t inherently painful – the pain is similar to a stable fracture. Also that pain associated with pericostal and mediastinal drain removal is as severe as Kathleen Puntillo later identified in the Thunder 2^® project.^* One thing I did not expect to learn from all participants was that epicardial pacing wire removal was akin to having something tear inside you. More intense than the pulling sensation reported by the team from Edmonton some years later.^† These reports of something tearing inside prompted a brief presentation to the cardiac surgery teams and resulted in a change of insertion technique. Wires would no longer be embedded into the epicardium, but would be sutured onto the surface with a 5/0 prolene. My interest in procedural pain persists.

Felicia Cox
Editor