Pearls, Pith, and Provocation Qualitative Health Research

Volume 19 Number 6
June 2009 859-867
© 2009 The Author(s)

Interviewing Family Caregivers: 10.1177/1049732309334105

http://qhr.sagepub.com

Implications of the Caregiving

Context for the Research Interview
Laura M. Funk
Kelli I. Stajduhar
University of Victoria, Victoria, British Columbia, Canada

Family caregiving tends to involve strong and often competing emotional experiences. Most of our knowledge of
caregiving stems from interview research, much of it cross-sectional in nature. In this article we explore the implica-
tions of interviews as a research method for understanding caregiving. Specifically, we address difficulties in inter-
preting participants’ talk about caregiving when this talk is simultaneously an articulation of experience and an
attempt to cope with that experience. Either uncritically accepting accounts as reflective of experience, without con-
sidering the role of coping, or making assumptions about the success of caregiver coping in this context, might be
erroneous. Our own experiences of interviewing family caregivers in different research projects will be drawn upon
as examples. We conclude by questioning the ability to draw conclusions about caregiving and/or caregiver coping
based solely on interview research, and call for greater integration of observational and longitudinal methods in fam-
ily caregiving research.

Keywords: caregiving, informal; coping and adaptation; families, caregiving; interviews

T here is a wealth of existing academic knowledge

about family caregiving and caregiver coping,
yet the vast majority is based on interview research,
that critical reflection on our ability to draw conclu-
sions about caregiving, including caregiver coping,
based solely on interview research, is needed. Our
much of it cross-sectional in nature. It has even been own experiences of interviewing family caregivers in
said that qualitative research now seems equated with different research projects will be drawn upon as
interviewing (Atkinson, Coffey, & Delamont, 2003), examples.
as opposed to, for instance, observational research or
the analysis of texts. Qualitative interviews tend to be
particularly relied upon for the study of family care- Background
giving experiences as well as coping; also, qualitative
interviews are often the basis for developing quantita- Family Caregiving as a Research Context
tive measures of the ways in which caregivers cope or Family caregiving has been the subject of much
the strategies that they use to cope. research, particularly as it applies to care for seniors
In this article we consider family caregiving as a and the terminally ill. Family caregivers represent a
research context, and examine the implications of group that might be vulnerable to stress and burden.
interviews as a particular research method for under- For instance, Gottlieb and Wolfe (2002) describe
standing family caregiving. In particular, we argue family caregiving for persons with dementia as “usu-
ally a chronically stressful experience that poses sig-
Authors’ Note: Dr. Laura Funk’s dissertation research was nificant adaptive challenges” (p. 325). Another group
funded by an award from the Social Sciences and Humanities of grounded theory researchers (Proot et al., 2003)
Research Council of Canada. The guidance and support of her
identified “vulnerability” as a core category in their
supervisor, Dr. Neena Chappell, is also acknowledged. Dr. Kelli
Stajduhar is supported by a New Investigator Award from the family caregiving research, concluding that “caring
Canadian Institutes for Health Research and a Scholar Award for a terminally ill person at home requires continu-
from the Michael Smith Foundation for Health Research. ous balancing between care burden and capacity to
859

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860   Qualitative Health Research

cope” (p. 119). Other research indicates that provid- to the macro-context of the availability and affordabil-
ing care to family members can have negative impli- ity of formal services, and structural constraints on
cations, such as mental and physical burden (Proot women to care. In the context of family caregiving,
et al., 2003), health problems (Kneebone & Martin, coping involves the deployment of “a complex and
2003), and depression (Gottlieb & Wolfe, 2002), dynamic set of cognitive, affective, and behavioural
although some individuals and groups are at greater responses” to “regulate their emotions, solve or
risk than others. improve the practical problems they face, and maintain
What is it about family caregiving that contributes the psychological resistance and fortitude needed to
to heightened risk of negative health outcomes? Both stay productively engaged in caregiving” (Gottlieb &
primary and secondary stressors, such as difficulties Wolfe, 2002, p. 325).
both within and outside of the caregiving role, are
implicated (Pearlin, Mullan, Semple, & Skaff, 1990).
How Interviews Can Influence Coping
One qualitative study (Proot et al., 2003) in particular
explored caregiver burnout and fatigue as related to a There is particular concern within the context of
variety of factors that contributed to feelings of vul- family caregiving research that interviewing itself
nerability (a core category in their research), such as might trouble caregivers further and otherwise disrupt
care burden, restrictions of normal activity, fear, inse- their coping processes. For instance, Sinding and
curity, loneliness, facing death, and lack of support. Aronson (2003) note ethical concerns around difficul-
Further, family caregiving tends to involve strong, ties that emerged in their research, when participants’
and often competing, emotional experiences. Not only experiences of the realities of caregiving for dying
are family relationships—particularly parent–child— relatives did not fit with dominant ideals of “a good
subject to feelings of ambivalence (Pillemer & Luscher, death” (p. 97), exposing a sense of failure and threat
2004) and power struggles, but the provision of ongo- to identity for some participants within the interview
ing and increasingly technical care and advocacy for context. As a result, particular caution is advised for
chronically ill and dying family members often entails researchers; they should attempt to help participants
difficult emotional experiences and tensions. For “control the degree of exposure or disruption they
instance, caregivers can often experience guilt (exacer- will tolerate, and to maintain valued narratives about
bated by the moral imperative to care), burden, and at themselves” (p. 110). Ultimately, this reflects aware-
times loss of the quality of the relationship (Stajduhar, ness that what happens in interviews could potentially
2003). It is also speculated that factors more difficult influence the coping processes of family caregivers.
to measure, such as the reawakening of unresolved Other research more broadly speaks to the potentially
emotional issues from childhood; the conflict between harmful impacts of participating in qualitative inter-
norms of reciprocity and solidarity (George, 1986); views (Clarke, 2006; Hewitt, 2007; Robson, 2001).
emotion work and perceived deviance from feeling However, as Corbin and Morse (2003) suggest, despite
rules, particularly for women (Aronson, 1992; Macrae, “evidence that qualitative interviews may cause some
1998); the mismatch or cognitive dissonance involved emotional distress, there is no indication that this dis-
between caregiving expectations, ideals, and reality tress is any greater than in everyday life or that it
(Aronson, 1992; Brody, 1990; Groger & Mayberry, requires follow-up counselling” (p. 335).
2001; Hong & Liu, 2000); and the confusion of the In fact, there is growing support for the idea that
caring about and caring for (Hooyman & Gonyea, interviewing, performed ethically and with sensitiv-
1995) also contribute to guilt and stress. For those with ity, can positively impact coping; qualitative inter-
reduced resources, whether in terms of social support views are often described as having therapeutic effects
or socioeconomic resources, there can be additional (Corbin & Morse, 2003; Hutchinson, Wilson, & Skodol
hardship. For others, conflicts exist between work and Wilson, 1994; Kvale, 1996; Lowes & Gill, 2006), and
caregiving, and stressors are involved in dealing with indeed, some participants volunteer to participate for
the health care system and/or other family members this reason (Hiller & DiLuzio, 2004), and report bene-
(Stajduhar & Davies, 2005; Stajduhar, Martin, Barwich, fits of talking about their experiences (Lowes & Gill,
& Fyles, 2007). Although there are negative aspects in 2006). Interviews are believed to provide opportunity
some caregiving and care receiving situations, it is for and facilitate validation, introspection and growth,
important to remember that these are not only private, self-acknowledgement and self-discovery, a sense of
individual problems of coping; they need to be linked purpose, empowerment, healing, unburdening and

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 Funk, Stajduhar / Interviewing Family Caregivers   861  

catharsis, a sense of helping others, and a means to constructionist approaches, a critical approach would
make sense of experiences through speaking about also reject the idea of interviews as windows into the
them and refining thoughts through the interview reality of a participant’s experience; instead, the
(Corbin & Morse, 2003; Hiller & DiLuzio, 2004; analysis focuses on viewing talk as manifestations of
Hutchinson et al., 1994; Lowes & Gill, 2006). For dominant norms and ideologies within a society (or in
instance, “expressing the stress” or “unburdening” is some cases, as resistance to these ideologies).
described as an emotion-focused coping strategy To some extent, there might be, within interviews,
(Lowes & Gill, 2006). evidence of all three types of information (the realities
of experience; the meanings attributed to experience;
and the ideologies at work in everyday lives). What
A Different Perspective:
these three approaches might miss, however, is atten-
Interviews as Coping
tion to the role of psychological processes of coping
In this article we adopt a slightly different angle on within interviews. Indeed, we contend that much of
the debate: Rather than focusing on whether or not what we hear in interviews with caregivers might also
qualitative research interviews influence coping and represent participants’ active attempts to manage and
well-being of family caregivers, we conceptualize cope with difficulties and/or make meaning of their
what occurs during interviews as representing cop- caregiving situation. We maintain that participants’
ing. In this section, we present this perspective. talk about their caregiving experience is simultane-
Approaches to the conceptualization and interpreta- ously an articulation of experience that draws on
tion of interview data can be grouped rather broadly broader ideologies, as well as an attempt to cope with
(albeit simplistically) into three dominant paradigmatic perceived experience. Ultimately, they might even be
approaches. These paradigms point to different inter- indistinguishable. For instance, Sinding and Aronson
pretations of participant talk within interviews, and (2003) note how participants in their interviews
will be described here in broad groupings (with the attempted to cope with the particular disjuncture
exception of postmodern approaches) for the purposes between experience and ideals through accommoda-
of framing our discussion. First, a positivist approach tions such as “consoling refrains” in the interview
tends to view interviews as a recording of actual events (e.g., she didn’t suffer/everything possible was done).
or behaviors that represent an objective reality; the aim These consoling refrains functioned, for instance, to
is to collect information about an individual’s subjec- “narrow the distance between ‘the good death’ and
tive experiences, and the influence of “social desirabil- the death research participants witnessed” (p. 103).
ity” is hoped to be minimized. The focus of analysis is Furthermore, Gottlieb and Wolfe (2002) note that
on the substantive information the interview provides “meaning making” (Affleck & Tennen, 1996) and social
about the realities of a participant’s life. comparison (Tennen & Affleck, 1997) are themselves
In contrast, interpretive or constructivist perspec- particular ways of coping; these processes are evident
tives tend to view experience as social action and in many interviews. For instance, interpretive
interviews as illustrative of the participants’ attempts approaches to interviewing, although not discussing
to understand, interpret, and otherwise construct their coping per se, do maintain that interviewees are not
social worlds and the meanings of their experiences only trying to articulate their experience but also trying
through the use of cultural resources. Analysis focuses to show how their action makes sense; they are
on what we can learn from the process of how mean- accounting for their feelings and actions and justifying
ing is constructed through talk—in particular, what them (Atkinson et al., 2003). Holstein and Gubrium
we can learn about both the social or shared meanings (1997) speak of how respondents “simultaneously and
that are enacted in talk, and about how the context of continuously monitor who they are in relation to the
talk informs meaning. Interview data, from this per- person questioning them” (p. 122); Sinding and
spective, are viewed as illustrative of the participants’ Aronson (2003) speak of how participants try to create
attempts to understand, interpret, and otherwise con- “stories about loss that can be ‘lived with’” (p. 115);
struct the meanings of their experiences, drawing on and Nunkoosing (2005) notes how in some cases par-
and re-creating shared meaning. ticipant digressions might serve to protect their egos.
Finally, a critical approach to interviewing tends If talk in interviews represents coping, we might
to view interview accounts as windows into taken- wonder whether we could make assumptions about
for-granted dominant ideologies. Like interpretive or the success of coping through analyzing interview

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862   Qualitative Health Research

talk. In what follows, we present two illustrative case or busy with their own family responsibilities. Olive
examples from our research that demonstrate how our and Frank’s involvement in the study included one
interpretations of interview data might lead to errone- formal tape-recorded interview and field notes from
ous assumptions about caregiver coping, followed by participant observation that occurred in their home
a discussion of the implications of our perspectives over a 3-month period as Frank’s health deteriorated
for the understanding of caregiver coping, the inter- and he died at home. The second author (in this sec-
pretation of interview data on family caregiving, and tion referred to as “the researcher”) also conducted a
consideration of alternative methods for research on number of follow-up visits to Olive after Frank’s
family caregiving. death.
In the time that the researcher spent immersed in
their family life, her impressions and that of the many
Case Examples
health providers involved in their care was that of an
incredibly supportive family who respected Frank’s
The Case of Frank and Olive
wishes and desires to die at home. With the exception
The first illustrative example comes from a study of one emotionally charged discussion that was wit-
examining the social context of home-based palliative nessed between Frank and Olive, in which Frank was
caregiving (Stajduhar, 2003; Stajduhar & Davies, insisting that Olive assist him to die (through giving
2005). The primary sample consisted of 12 dying a lethal amount of pain medication), they seemed to
patients, 13 family members who were providing be very happy together, and Olive was most attentive
care for them, and 47 bereaved family caregivers who to Frank, who constantly needed assistance. The
were purposefully sampled. After obtaining approval grandchildren visited frequently, and Louie, the fam-
from the local university ethics board, data collection ily golden retriever, was a source of joy for everyone.
commenced and included 130 hours of participant By all accounts, this was a “happy family,” with fam-
observation in the homes of 13 palliative caregivers. ily members who were supportive of each other dur-
Field notes were written to document observations and ing a trying time. Olive told the researcher in their
were validated with caregivers. In-depth interviews interview and in informal discussions that she consid-
were also conducted with all family caregivers. ered caring for Frank as a “final gift” to him, and her
Frank and Olive1 volunteered to participate in the way of showing him and their children that “love is
study after seeing an advertisement in the local news- everlasting.” Frank died at home on a warm spring
paper. Frank was an 82-year-old man who had been day, listening to jazz and looking out over the bloom-
diagnosed with multiple sclerosis 20 years prior. His ing tulips and daffodils that had sprouted from their
disease had advanced to the point where recurrent leg garden. The researcher attended Frank’s funeral, at
and bladder spasms left him unable to walk and with which Frank’s son Brent gave the eulogy and Olive
severe pain that was unresponsive to treatment. Frank spoke a few words about what a caring and wonderful
required extensive assistance with activities of daily man Frank had been.
living, including bathing and toileting. He was able to Over the coming weeks, the researcher visited
feed himself and was cognitively intact. He loved Olive and helped her sort through some of Frank’s
jazz music, having played in a band while in the belongings and pack up things that Olive thought
army, and spent countless hours listening to music should be sent to a charitable organization. As the two
and watching comedies on TV in his rented hospital were sitting down in her kitchen to eat a lunch of
bed, which was located in the middle of the living tomato soup and stone wheat crackers (this had
room in the home he shared with his wife, Olive. become Frank’s favorite meal as he was growing
Olive had been a psychiatric nurse for over 40 years weaker and weaker), Olive said, “I need to talk to you
and had just celebrated her 75th birthday. She had about something.” The researcher replied, “Okay.”
previously enjoyed traveling and volunteering, but Olive asked, “Is this conversation still part of the
caring for Frank was now a full-time job and she was research?” The researcher responded, “Only if you
unable to leave the home unless someone was avail- want it to be.” Olive said, “I do,” and proceeded to
able and could handle caring for Frank. Frank and relate how she felt that she had deceived the researcher
Olive had two adopted sons and five grandchildren. and the research over the course of the past many
Both sons were supportive and helped Olive with months. Olive revealed that not only was she not
Frank’s care during the times they were not working happy with Frank but that, in fact, Frank had been

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 Funk, Stajduhar / Interviewing Family Caregivers   863  

quite emotionally abusive throughout their marriage relationship with his reclusive and depressed father,
and had engaged in several extramarital affairs that Harold, who was in his 90s and having particular dif-
had left her with little self-esteem and a lack of con- ficulties with losing his sense of independence and
fidence. Olive proceeded to describe how during her privacy as his care needs increased. For a number of
entire caregiving experience, she wore a “mask” as a years Tom and his father had not been on speaking
way to cope with the situation, explaining that she terms, but Tom described their relationship as having
had to put on a “brave face” for the sake of her chil- since improved. Harold and Sue lived in their own
dren and grandchildren. She said that much of what home in the community, and despite declining health,
she had told the researcher about Frank and her care- resisted bringing in paid help, although they needed
giving was less about how she “truly” felt and more and could afford it.
about her attempts to cope and to hide her true feel- During the first interview, which took place in a
ings. Olive said she shared this because “you need to university office, Tom expressed that he did not feel
know that in caregiving, what you see and hear from obligation or guilt in his relationship with this par-
us isn’t necessarily what really is.” She indicated that ents, and that he did not very often feel “irritated.”
she was glad that the researcher continued to visit her Tom had set limits on his filial responsibility, to pro-
because it wasn’t until this point that she felt comfort- tect himself: “It means that I don’t feel guilty on a
able, safe, and even able to articulate how she was Saturday that I HAVE to go over and accomplish
feeling. chores.” In fact, what the researcher found particu-
Within the research relationship, disclosures such larly interesting was that Tom defined setting limits
as this are highly sensitive. Olive had ongoing coun- as part of being responsible; for instance, doing so
seling support throughout her caregiving experience, involved not setting up false expectations, protecting
and it was through this support that she decided to his parents’ independence, and respecting their own
disclose her abuse. Even with this support in place, responsibility for their decisions.
researchers need to be mindful of the ethical implica- Tom strove for his contact with his parents to
tions of such disclosures and be vigilant about prevent- involve “real bonding,” and described a sense of sat-
ing further vulnerabilities in caregiving participants. isfaction from helping his parents: “It’s just nice to
have a good relationship with my parents, basically.
One of the side effects of going over and helping them
The Case of Tom
out with things is that we can just sit and talk as adults
Tom first heard about the first author’s dissertation and enjoy each other’s company.” Although he enjoyed
research on responsibility for aging parents (Funk, certain aspects of providing support, he clearly empha-
2008) late in 2004, through an e-mail forwarded to sized, “I don’t feel that it is my job to keep either of
him by a colleague. The focus of that research was my parents alive; that is their job.” Tom, who himself
the interpretation of the meaning of filial responsibil- came from a counseling background, appeared confi-
ity in participant talk. A nonrandom sample of 28 men dent in setting practical and emotional boundaries
and women with one or both elderly parents living in around the provision of support to his parents.
or near Victoria, British Columbia, Canada, were In the second interview, Tom’s father’s health had
included in the study, which had approval from the deteriorated and Tom was providing more support.
Human Ethics Review Board at the University of He had, however, successfully convinced his parents
Victoria. Written informed consent was obtained from to hire outside help (such as a housekeeper). Although
participants prior to commencing the research. he was no longer able to maintain a quite limited
Tom contacted the first author (in this section level of involvement, Tom expressed that he felt a
referred to as the “researcher”) and they met for two sense of control:
in-person interviews about 7 months apart. The inter-
views were qualitative in nature and loosely struc- If I chose not to do it I would just simply choose not
tured; the researcher had a set of broad issues she to do it . . . but I choose to do it and that is probably
wanted to discuss about a sense of responsibility for why I can do it positively I guess. Because I feel like
parents. Tom was in his mid-50s, divorced, with no it is all in my control. It hasn’t been forced on me.
children of his own. He enjoyed intellectual conver-
sations, music, and was trained in counseling. In the Tom had taken on the role of accompanying his
first interview, Tom described a somewhat difficult father to the doctor, and expressed that in fact, this

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864   Qualitative Health Research

was an “easier” role because “there is a little better social desirability effects in the initial data collection.
understanding of what I am doing, and why I am Interpretive and critical approaches might examine
doing it.” Furthermore, Tom still placed limits on his the interview accounts as reflective of broader social
responsibility, not only in terms of how often he norms and ideologies such as familialism (“love is
checked in on his parents, but with regard to his emo- everlasting”) or individualism (“I choose to do it”) in
tional boundaries: “I never feel guilty about things participant accounts. However, the interpretation of
that are going on for them.” He also still defined the these data might be enhanced if we adopt a perspec-
provision of support as positive, particularly as his tive that views interview talk as simultaneously rep-
previous estrangement from his father had meant that resenting an articulation of experience and an attempt
“this is time that I didn’t really expect to have with to interpret and cope with that experience (while
my parents.” drawing on social norms and dominant ideologies).
Based on these data, Tom appeared to be coping Therefore, we suggest a need to be wary of interpre-
well with increasing caregiving responsibilities for tations that view interview data solely as unmediated
his ailing father. However, several months after the representations of actual experiences (Atkinson et al.,
interviews were complete, events transpired that sug- 2003; Nunkoosing, 2005).
gested that Tom had experienced considerable diffi- Uncritically accepting accounts as reflective of
culty in coping; he experienced a traumatic health experience, without considering the role of coping—
event linked in part to his caregiving. This was a and therefore, for instance, making assumptions
shock to the researcher, given the absence of identifi- about the nature and success of caregiver coping in
able indicators in his interview accounts. this context—might be erroneous. However, just as
Tom’s emphasis on a sense of choice and control, uncritically analyzing interviews as reflective of expe-
his desire to respect his parents’ independence, and rience might be misleading, so might be uncritically
his rejection of the idea of feeling responsible had analyzing accounts as reflective of normative ideals
echoes in the majority of 28 adult children in the or dominant ideologies, without considering or
study. For instance, some participants spoke specifi- acknowledging that interview talk is simultaneous
cally to the need to have “a frame of mind” that with coping. For instance, when participants empha-
viewed responsibility as a choice, that it was “the size internal motivations and free choice in filial
healthiest way to do it,” and involved approaching responsibility, there is likely an important psycho-
responsibility from a “more positive place” (Funk, logical function at work; in the sense that perceived
2008). By employing ideas such as this, therefore, choice provides a sense of control, it might help pro-
participants were aligning themselves with a domi- tect their well-being, and thus participants might be
nant cultural discourse of independence, but they motivated to define their responsibility in terms of a
might have done so to facilitate coping with parent framework of choice. Distinguishing between psy-
care. Similarly, as reported elsewhere (Funk, in press), chological coping mechanisms and the deployment
prioritizing parental independence and constructing of normative and ideological discourses poses par-
filial support as done without obligation might also ticular difficulties in interview research, because they
represent attempts to set boundaries and approach are to a large extent indistinguishable.
parent care with a positive attitude; that is, they can
represent coping strategies. Implications for Understanding
Caregiver Coping
Discussion
The above examples suggest strong caution is
needed about generalizing about coping based on
Implications for the Interpretation
what we hear in interviews, because we have very
of Interview Data on Family Caregiving
little means of knowing whether the “truth” a person
The interview data collected in the above research is constructing in an interview account is “working”
examples would, from a positivist approach, be for them in terms of their mental health and coping.
viewed rather uncritically as evidence of positive Furthermore, coping within interviews is intertwined
experiences with family caregiving, and perhaps as and perhaps indistinguishable from meaning-making,
evidence of coping well. The subsequent, additional processes of social desirability, and responding to
information obtained might lead to concerns about feeling rules. Finally, even if we ask specifically about

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 Funk, Stajduhar / Interviewing Family Caregivers   865  

coping, these accounts are themselves part of the period of time, has greater potential to teach us more
interpretive process, and might also be influenced by about the caregiving experience than interviewing
social desirability (Gottlieb & Wolfe, 2002). In addi- alone.
tion, there are likely “more subtle, cognitive coping Indeed, one rationale for mixed-methods studies
responses that are outside the caregivers’ awareness (including mixing different qualitative methods) is
and other responses that they do not define as coping” methods triangulation (Denzin, 1978), which is
(Gottlieb & Wolfe, 2002, p. 334). argued to enhance research credibility through “com-
Essentially, the issue might be one of whether we paring and cross-checking the consistency of infor-
can locate a “truth” of coping in interviews. How do mation derived at different times and by different
we tell if family caregivers are coping or not? Is it means” (Patton, 1999). However, mixing data collec-
our responsibility to know? Not only is there diffi- tion methods alone (e.g., interviews and observation)
culty in distinguishing coping from interpretation and might be insufficient; we need to consider integrating
social desirability, but coping success varies over analytic strategies for data collected through differ-
time, depending on the nature of the stressor (Gottlieb ent methods (Creswell, 2003; Tashakkori & Teddlie,
& Wolfe, 2002). Thus, conclusions about coping 2003). In addition, although convergent results
should be made with careful consideration of these regarding caregiver coping might be welcomed, they
processes and their variation, a clear understanding can never fully prove the validity of results, as both
of the perceived source of caregiving stress for the methods might be biased in the same direction.
individual, and clear definitions of what constitutes Furthermore, a dilemma arises when findings are
“coping success.” divergent: How should apparent differences in care-
giver coping be interpreted and explained? There is
Considering Other and Mixed Methods as yet little guidance for qualitative researchers in
this area. Finally, Sandelowski (2003) posits that the
for Research on Family Caregiving
idea that mixed-methods findings will reconverge on
Nunkoosing (2005) believes that because stories one “true” understanding negates one of the key
and accounts are not necessarily “true,” the interview rationale for triangulation, which is that it provides a
should only occur at the beginning of a research pro- “fuller” or “more thorough” understanding. Indeed,
cess, and that researchers should seek confirmation perhaps the greatest benefit to mixing observations
through other methods. Similarly, Atkinson and col- and interviews, and to enhanced immersion in
leagues (2003) argue that we need to reaffirm the the field over time, is that it might yield further
equal importance of participant observation in terms insight into the complexity of caregiver coping (as
of understanding the naturally occurring settings of opposed to making dichotomous assumptions about
social action. Observational research, with significant whether or not a caregiver is coping well). As such,
immersion in the field, combined with interviewing, research on caregiver coping needs to be accompa-
might well be able to tell us more about how caregiv- nied by ongoing conceptual attention to the defini-
ers are coping than interviews alone. Observational tion of “coping.”
research also tends to facilitate ongoing longitudinal
collection of data, which might shed light on how
caregivers perceive their experiences over time and Conclusion
might reduce issues of social desirability and reactiv-
ity as the researcher spends more time in the field and Although the family caregiving context makes
begins to develop trusting relationships with partici- coping within interview accounts perhaps more
pants (Bernard, 1994). It is true, of course, that obser- salient and easy to identify, our perspective is that
vations are filtered through our own interpretations; coping occurs within all qualitative interview accounts,
furthermore, tapping into caregiving coping might be because interpretation and coping are to a large extent
difficult even with observation, because of the com- synonymous. This perspective goes beyond the debate
plexity of emotional, social, and cultural factors impli- about the impact of research interviews on participant
cated in the process. However, our research experiences coping and well-being, to direct our attention to the
suggest that combining at least interview and obser- ways in which individuals use talk and interpretation
vational methods in the study of caregiving, and to cope. In addition, this idea has implications for
particularly working with participants over a longer clinical work in fields other than research; for instance,

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866   Qualitative Health Research

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Proot, I. M., Abu-Saad, H. H., Crebolder, H. F. J. M, Goldsteen, Laura M. Funk, PhD, is a research associate at the Centre on
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Sandelowski, M. (2003). Tables or tableaux? The challenges of the Michael Smith Foundation for Health Research.
writing and reading mixed methods studies. In A. Tashakkori
& C. Teddlie (Eds.), Handbook of mixed methods in social
and behavioral research (pp. 321-350). Thousand Oaks, CA: For reprints and permission queries, please visit SAGE’s Web site
Sage. at http://www.sagepub.com/journalsPermissions.nav.

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