gms | German Medical Science

Background: Abductive Thematic Network Analysis (ATNA) is a qualitative data analysis method, which was first defined by Rambaree and Faxelid (2013). It draws upon the principles of Thematic Analysis (Braun and Clarke, 2006), Thematic Network Analysis (Attride-Stirling, 2001) and Abductive Theory of Method (Haig, 2005), and seeks to use abductive reasoning to explore and explain linkages between the themes conceptualised from the analysis of empirical qualitative data.

ATNA has successfully been applied by social scientists and public health researchers; however, to-date there has been no published record of it being applied within health services research. Furthermore, the existing methodological literature solely uses the software ATLAS.ti to illustrate the process and steps in ATNA (Rambaree and Faxelid, 2013; Rambaree, 2018); therefore, there is a need for methodological papers exemplifying the process of ATNA beyond this particular software.

Solutions and suggested solutions: In the following a worked example from a qualitative study in the prehospital setting will be used to demonstrate the functionality of ATNA in health services research by describing how the 6 steps of ATNA were applied. Our research study involved semi-structured interviews and aimed to explore the perception of emergency ambulance staff regarding current provision of prehospital feedback and their views on how feedback impacts on patient care, patient safety and staff wellbeing. Step 1 (Coding Data) was conducted by uploading the interview transcripts to NVivo and familiarising ourselves with the data by repeatedly reading the transcripts. Coding was then performed using the auto-code function of NVivo and by manually coding any quotes related to feedback. Step 2 (Identifying Themes) consisted of manually categorising the lengthy and broad codes into more specific global-organising-basic themes; thereby creating a hierarchy. Step 3 (Creating & Describing Linkages) was initially conducted manually on paper, before utilising Microsoft PowerPoint to assist in creating a map of themes. The thematic map was a visual representation of the hierarchical global-organising-basic themes and newly added arrows to represent between-theme linkages. Step 4 (Developing Plausible Model) involved refining the developed thematic map into a more structured logic model that more accurately reflected the research aim of exploring the impact of feedback. In the final Step 5 (Assessing the Developed Model), we drew upon existing models from psychological theory, feedback effectiveness and feedback-seeking behaviour literature to finalise our logic model and ensure explanatory goodness.

Lessons learned: This worked example demonstrates that ATNA can be successfully applied in health services research and suggests that it may be particularly useful when researchers are aiming to explore causal mechanisms or present their findings visually for example in a logic model. Following the steps of ATNA provides a practical guide of how to move beyond iterative cycles of inductive-deductive analysis to abductive analysis in order to discover new concepts within qualitative data, which may be especially beneficial for novice qualitative health services researchers.