Qualitative studies are conducted to better understand the human experience and human behaviour. Accordingly, aspects of the human experience including, but not limited to, cultural practices, sociocultural phenomena, knowledge systems and beliefs, social structures, and individual and collective experiences of events can all be explored through qualitative studies. (1) Often, qualitative researchers observe and engage with patients on a more personal level to gain these insights. (1) For example, while quantitative studies are essential for measuring and comparing the efficacy of therapies, qualitative studies can help elucidate a patient's subjective experience and perception of the same treatment. Take, for example, a study by Feng et al., which investigated the perceptions of aortic dissection survivors towards exercise. (2) Through thorough analysis of interviews with survivors, the researchers were able to determine the common concerns of patients, which often centred around the impacts of the disease and exercise on daily life, as well as the patients’ intentions and confidence in being able to incorporate exercise into their lives as they recover from surgery. (2) Methods often used in qualitative research, such as purposive sampling until saturation, semi-structured interviews, and coding were employed in the study. (2) Through this review, we hope that readers who are new to qualitative research can begin to understand and appreciate qualitative research as it applies to vascular surgery, both in their conduct and in the results they generate.

The methodology and results between qualitative and quantitative studies should not be compared; qualitative and quantitative studies ask distinct questions and cannot be interchanged. Qualitative research does not aim to prove or disprove a priori hypotheses; hypotheses emerge through data analysis. (1) Criteria used to evaluate the scientific rigour of quantitative studies, such as the risk of bias in sampling, cannot be applied to qualitative studies. (3) As qualitative studies aim to identify personal experiences and perceptions of individuals, the concern of implicit bias arising from matters such as sampling is not applicable. (3) Qualitative studies are still subject to assessments of scientific rigour, and while tools have been developed for this purpose, there are no consensus criteria. (3) Common criteria used to evaluate the rigour of qualitative studies include adequate reporting of study methods (e.g., sampling, data collection and analysis), thorough consideration of researcher and participant perspectives, and whether findings were sufficiently analyzed to construct coherent theories rather than merely described in basic terms. (3)

In a 2016 review by Maragh-Bass et al., the authors found that the use of qualitative research in surgery, albeit limited, was growing. (4) More than 54% of qualitative studies published between 1983 to 2016 were published after 2011, indicating the increasing use of qualitative studies in surgical research. (4) Qualitative studies were most commonly used to understand the pre-surgery planning process and post-operative experiences. (4) Interestingly, the authors also found that vascular surgery was the second least represented surgical specialty in existing qualitative studies, with only thoracic surgery being less represented. (4) Qualitative research offers a tremendous opportunity to meaningfully improve vascular surgery care by exploring the patient and provider experience and characterizing the qualities that are most valued.

With the above in mind, this review aims to provide a brief introduction and overview of qualitative research, with emphasis on its typical study design, implementation, and analysis as it pertains to vascular surgery. This review should provide clinicians with the ability to appreciate the basics of qualitative research, the results they generate, and how its findings can be used to guide their clinical practice. This review is by no means a comprehensive guide to all qualitative study types, their design and conduct, or their applications across all fields. For readers interested in specific concepts introduced within this review, or for those who wish to conduct their own qualitative research, we strongly recommend further reading through the plethora of literature and resources available for qualitative studies.