03 Mar Blog: Why use a “thick description” to describe ICC programmes?

By: Thomas Czypionka from the Institute for Advanced Studies

WP 1 of SELFIE had the ambition to work through the literature and condense what was up to now found to be best in integrated care for persons with multiple chronic conditions. One of its main achievements was the development of a conceptual framework for this type of care. While this framework is not only descriptive but also to some extent normative (What should be done? How should it be done?), things in reality might turn out differently than expected, or at least, important factors might elude us academics when we merely look at the surface.

The method of thick description stems from the qualitative paradigm of social science. Thus, its purpose is not to test some preformed hypothesis, but it is open to new and unexpected findings. It was first used by Clifford Geertz in ethnographic studies, i.e. the study of cultures in ethnic groups aimed at gaining a clearer picture of what is actually going on in a social system. This type of research is used when clear hypotheses have not yet been formulated, as is the case with care for persons with multiple chronic conditions. The method is called “thick” because the researcher does not stop by describing obvious facts, but wants to understand what lies beneath, what implicit factors cause things to work (or not to work). In the case of integrated care, many actors – including the clients, their formal and informal carers, but also the inventors and managers of the programmes – interact in manifold ways. Their relationships and their ways of communication are what keeps the programmes running, what determines success or failure.

Identifying and exploring such important implicit factors requires a twofold research strategy. First, a variety of written materials available on the programmes were subjected to a document analysis. Second, qualitative interviews with different important stakeholders involved in the programmes were conducted. Researchers of the IHS team identified the relevant stakeholder groups for the subject matter from the findings of WP1 and developed an interview guideline for each of these groups. The other partners of the SELFIE project translated the guidelines into their respective languages and discussed their choice of who to actually interview in each stakeholder group with the IHS team. As many of the partners were not familiar with the method, the IHS team developed extensive materials to guide them through the process and organized a training workshop in Vienna on how to condense the interview transcripts into a thick description.

Based on this method, the partners of the SELFIE project created thick descriptions of the 17 programmes. These contain an abundance of information that reaches beyond the explicit and descriptive nature of a document analysis, but provides insight into the inner workings of the programmes and the relationships between the stakeholders involved. These thick descriptions now serve as a basis for further analysis. Read the thick description reports here.

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