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Interpretative Phenomenological Analysis

By Simon Moss

Introduction

Researchers have developed a range of methodologies to conduct qualitative research. This document outlines a methodology that is designed to be straightforward, even for researchers who are not experienced in research, called interpretative phenomenological analysis or IPA (Smith, Jarman & Osbourne, 1999). IPA is a technique that is often utilized to enable researchers to share the lived experience of interesting people.

An overview of IPA

To conduct interpretative phenomenological analysis, researchers tend to complete about five key activities. The following table outlines these activities.

Key activity DetailsIdentify suitable people to study

• Identify a situation in which you would like to understand the experience of people.

• The situation usually revolves around a unique setting or a significant change in the lives of these individuals, such as a physical illness or psychological disorder

Identify the sample • Decide from which participants you would like to collect information.

• Usually choose between 1 to 10 individuals who could provide key insights about this experience.

Conduct interviews or focus groups

• Conduct interviews—and sometimes focus groups or other approaches—to collect these insights.

• Develop questions that prompt the participants to discuss their experience as well as how they derive meaning from this experience.

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• Yet, deviate from these questions as well, whenever necessary

Analyse the data • Begin by affixing various codes, like “fear she will not walk again”, to these answers. Afterwards, uncover clusters of codes that revolve around a similar underlying concept, called a theme

Write a report • Write a report, in which you summarize and integrate the themes, with reference to specific quotes as well as previous literature

These steps are common to many qualitative methodologies. Nevertheless, one distinct feature of interpretative phenomenological analysis is the underlying theoretical perspective.

The theoretical perspective that underpins IPA

Interpretative phenomenological analysis combines three broad philosophical positions or perspectives: phenomenology, hermeneutics, and idiography. This combination of approaches was first proposed by Jonathon Smith in the mid 1990s.

Phenomenology

Consistent with the philosophy of phenomenology, research should attempt to characterize the lived experience of individuals—such as their sequences of thoughts, insights, perspectives, feelings, sensations, and urges.

Indeed, Jonathon Smith felt that many researchers, especially psychology researchers, tended to neglect the experiences and perspectives of individuals. These researchers delineate the behaviour and cognitive of people with reference to broad traits and numbers, neglecting the rich internal lives of people. This focus on phenomenology was intended to redress this limitation.

HermeneuticsIn general, hermeneutics reflects the motivation of researchers to interpret the meaning and significance of data rather than merely restrict their discussion to the data itself.

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When conducting interpretative phenomenological analysis, hermeneutics refers to two processes. In particular

• First, participants are encouraged to derive meaning from their own experiences. They might ask questions to themselves like “Why is this experience important to me?” or “What are the implications of this experience?”

• Second, the researcher attempts to derive meaning from the insights that participants offer. They might ask questions to themselves like “What does this person mean?” or “Why is this interpretation important for the participant”. In this sense, as Jonathon Smith highlights, researchers strive to derive meaning from the attempts of participants to derive meaning from an experience—called a double hermeneutic.

Idiography

Idiography refers to the inclination of some researchers to focus attention on each person separately—including the experience, and to some extent the context, of this individual. Researchers who adopt this perspective do not simply aggregate their results across participants or disregard the distinct perspectives and experiences of each person

When conducting interpretative phenomenological analysis, idiography sometimes manifests as case studies. That is, researchers tend to describe the distinct experience and perspective of each participant separately. In addition, researchers will often highlight the similarities and differences that emerge across participants, called convergence and divergence separately. But even during these analyses, the distinct perspectives of each person are retained.

Overall

Taken together, interpretative phenomenological analysis can be very illuminating. The insights of participants can be utilized by other people in similar circumstances or by practitioners.

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Activity 1: How to clarify your topic

To conduct interpretative phenomenological analysis, you first need to clarify your research question or topic. Overall, you should reflect upon your values, interests, passions, and skills—as well as the expertise of your supervisor—when you formulate a topic. For interpretative phenomenological analysis, the question will usually resemble something like “What is the experience of people in this interesting situation and how do they interpret this experience?” To clarify suitable topics for interpretative phenomenological analysis, you should probably skim quit a few past examples. A few illustrative topics appear in the following table.

Illustrations• How to people with chronic fatigue conceptualize their symptoms and

contemplate their situation (Arroll & Senior, 2008)?• What are the problems and possibilities that people experience when

diagnosed with Parkinson's disease( Bramley & Eatough, 2005)?• How do carers of Huntington's disease patients cope with their role

(Aubeeluck, Buchanan, & Stupple, 2012)• How do adults with visible acne reflect upon this disorder (Murray &

Rhodes, 2005)?• How does MS change the attitudes of individuals towards themselves

(Mozo-Dutton, Simpson, & Boot, 2012)?• How to people feel that visual art contributes to their experience of

cancer (Reynolds & Lim, 2007)?• What do people feel were the causes of their heart attacks (French,

Maissi, & Marteau, 2005)• What are the experiences and perspectives of individuals after they are

told they are at risk of heart disease?• What are the reactions and experiences of individuals with

hypochondria during mindfulness based training (Williams, McManus, Muse, & Williams, 2011)?

• What is the experience of patients during a live craniotomy (Fletcher, Nair, das, Macniven, Basu, & Byrne, 2012)?

• How do people reappraise their life to cope with spinal cord injuries (Kaiser & Kennedy, 2011)

• How to people with chronic fatigue conceptualize their symptoms and contemplate their situation (Arroll & Senior, 2008)?

• What are the problems and possibilities that people experience when diagnosed with Parkinson's disease( Bramley & Eatough, 2005)?

• How do carers of Huntington's disease patients cope with their role (Aubeeluck, Buchanan, & Stupple, 2012)

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• How do adults with visible acne reflect upon this disorder (Murray & Rhodes, 2005)?

• How does MS change the attitudes of individuals towards themselves (Mozo-Dutton, Simpson, & Boot, 2012)?

Then,to ensure your topic has not been studied extensively before, perhaps choose an experience that is recent. To illustrate

• you might want to consider a recent attack, event, or movement• you may decide to examine the experience of cyclists when they discovered

that Lance Armstrong cheated

Alternatively, to ensure your topic has not been studied extensively before, undertake a comprehensive literature. You may, for example, enter your topic, such as “cyclists cheat”, together with “qualitative” into Google scholar.

Activity 2: Identify your sample

After clarifying the topic, you then need to identify your participants. Typically, for one study, you might interview between 5 and 10 individuals. Note that

• rather than seek a representative population, the sample should be purposive: That is, recruit the people you feel are more likely to offer key insights into the topic of interest.

• all the participants will share some experience. They may, for example, be avid cyclists. Yet, your participants could also differ on some relevant attribute, such as whether or not they compete.

Activity 3: Collect the data

You are likely to convene interviews or focus groups—in which you, in essence, interview two or more people at once—to collect your data. You may construct about 3 to 10 questions, but then modify these questions, or probe the participants with additional remarks, each time, called a semi-structured interview. The following table illustrates some typical questions:

Typical questionsDescribe how you felt after you discovered that ... Lance Armstrong had cheatedHow did these experiences affect your behaviour?

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How did these experiences affect your thoughts about your identity or your attitudes towards yourselfWhat are some of the other effects of this experience on your life?How do you feel these experiences might affect your life in the future

Interviews should last, approximately, between 30 min and 90 minutes. For each topic, you can apply a funneling approach (Guba & Lincoln, 1981), in which you begin with a general question and then ask more specific questions. “Describe your illness?” may be followed by “What is the effect of this illness on your life” and “What advice would you offer someone with this concern?” You could also examine various issues in chronological order. Here is a suitable sequence of activities.

Before you interview someone, undertake an enjoyable task. Positive moods can enhance your intuition and social skills

Although you should be natural and trust your interpersonal skills, behave about as friendly, or slightly friendlier, than your participants. Be respectful, especially if the other person is confident. Also, if you can, demonstrate confidence, especially if the other person is shy. Research indicates that similarity in amicability, but not confidence, enhances rapport.

Use a voice recorder. Ask the person whether they are willing to be recorded—with the promise their answers will be anonymous and confidential.

Initially, highlight the aim of this study. Mention that all of their perceptions are interesting to you.

The earlier questions should be enjoyable to participants—perhaps a question that relates to their topic of expertise and is not too sensitive. More sensitive questions can be presented later.

Most of your questions should be open-ended, beginning with words like “How” or “Why” rather than “What” or “When”. Vary between “how” and “why”, however—because these two words focus attention on specific details and broad patterns respectively. Furthermore, ask general questions before more specific questions; answers to specific questions can bias answers to general questions but not vice versa (Sudman & Bradburn, 1982).

To probe for more information, you can utter simple comments like “Do you have any other examples?” or even “Mmm”. Demonstrate that you are curious and interested, facilitating rather than challenging the other person.

If someone is not answering questions extensively, you could also include a few prompts or examples to facilitate. Ensure these prompts are diverse, such as “Did you feel concerned, happy, or nothing? Why?”

Activity 4: Analyse the data

Roughly speaking, to analyse the data, researchers first tend to transcribe all the questions and answers. They read this text three or so times, coding each insight

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with a few words. Next, they organize the codes into clusters to uncover themes. They also consider the relationship between these themes, sometimes called emerging themes, to uncover broader themes, sometimes called super-ordinate themes. A typical project might generate about 20 to 30 emerging themes, often underpinned by 5 to 10 super-ordinate themes. Finally, they read this text again, reflecting upon the extent to which the themes characterize the responses of participants.

If possible, before you begin reading and coding the data, you should attempt to suspend your preconceptions or knowledge. Immerse yourself in every answer or argument rather than reflect upon your previous insights.

Read the answers of each participant several times while coding

As you read each answer, try to confine your attention to a specific remark from participants—a remark that could range from a few words to a long paragraph. Attempt to code each of these remarks with a short phase. Initially, some of these codes may merely summarize a superficial or tangible description. For example:

A participant might have said “After I discovered that Lance Armstrong was a cheat, I did not feel like riding the next day. I did not feel as proud as usual of my bike.

The research could write a few words alongside this quote, such as “Avoided riding” and “Less pride”

Also include codes that interpret the meaning or perspective of the participant

The same quote, for example, could be coded as “Negative associations with riding replaced previous pride”. Furthermore, some codes might correspond to emotions, motivations, beliefs, paradoxes, changes, as well as contradictions of previous remarks.

Consistent with the underlying theoretical perspective, this code cannot be completely derived by the behaviour of this person. The participant interpreted his or her own actions. The researcher also interpreted the meaning of this interpretation or description.

List these codes, perhaps in Word or on post-it notes. Arrange the codes into clusters

Codes that are related to each other may reflect underlying patterns, called themes. For example, the following codes may, at first glance, reflect a theme called “Shift in self-identity”.

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“Negative associations with riding replaced pride” “Reluctance to discuss riding”, and “Felt need to try another sport”

Define each theme

Write a short paragraph about the scope of this theme—as well as how this theme manifests differently in various times or people. For example, you could write “Some people shift their identity by engaging in other activities, whereas other people shift their identity by reframing their past”.

Consider how the themes may be related to each other.

For instance:

Two themes may correspond to the same category, called a super-ordinate theme

One theme may tend to precede another theme in time Two themes may conflict with each other, and so forth.

Reread the answers of each participant again.

Consider whether their answers are related to these themes. Perhaps identify answers that do not relate to these themes—indicating that perhaps the themes could be clarified or additional themes could be introduced.

Refining and reporting your themes

In practice, you need to complete the previous activities several times, gradually refining and improving your themes. To ascertain whether your themes are adequate, perhaps write a provisional results section of your report. As you write, you can more readily determine whether or not your themes need to be refined more.

In essence, the results section of a report will usually comprise a description and discussion of each theme in turn. For each theme, you would include a definition, a discussion on how the theme manifests differently across people or time, and some reference to the prevalence of this theme—all substantiated with specific quotes from the participants.

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Ensure the themes are representative

Ensure your themes are discussed by at least half your participants—and even more if the number of participants is fewer than 5. If you cannot collect enough quotes to illustrate a theme, you may need to reanalyse your data. For example, you may need to integrate two distinct themes.

Avoid themes that are superficial and merely describe tangible behaviours or events.

For example, the theme “refrain from exercising” is unlikely to be an interesting theme. Instead, construct themes that are nuanced and intangible—often integrating two conflicting tendencies or concepts. For example:

You might want to blend the codes “refraining from exercising” and “working harder” to construct a more sophisticated theme like “undertaking unrelated activities to utilize unused energy”.

Usually, the title of these themes would be shorter, however.

For each theme, highlight the commonalities and differences across participants or times.

For example:

When describing the theme “undertaking unrelated activities to utilize unused energy”, you might highlight that all participants immersed themselves in other demanding activities.

You could then present a few quotes that substantiate this claim. Then, you could highlight that some participants immersed themselves in

physical activities, whereas some participants immersed themselves in only cognitive activities. Or, you could emphasize some other variation across participants.

Again, you would present a few quotes to verify this claim.

Check with participants

Before you construct the final report, send this preliminary version of the results to your participants. In particular:

Inform participants of the pseudonym you assigned them Seek their feedback on the accuracy of your understanding of their description Permit these participants to include other remarks they may have overlooked

the first time

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Write the final report

Besides the results section, the rest of the report will resemble a typical study. Nevertheless, a few differences need to be considered. Read as many past studies as you can that adopted this approach to clarify these differences.

For the introduction and literature review:

Attempt to highlight the importance of this topic. For example, if discussing reactions to the discovery that Lance Armstrong cheated, you could include literature about how individuals identify with celebrities and so forth.

Do not include hypotheses. Outline the philosophy you adopted. That is, describe IPA,

perhaps with reference to phenomenology, hermeneutics, and idiography.

Justify the suitability of IPA. For example, you could mention that IPA is especially applicable when the meaning that individuals attach to their experience could affect the behaviour.

In the Method section:

Specify the range and the mean duration of each interview. Outline some of the questions you asked. If applicable, indicate the interviews were semi-structured

(Smith, 1995; Smith & Osborn, 2003) Describe how you derived the codes and themes as

specifically as possible. Include each phase of this process, such as the number of times you reread the data or attempted to integrate related themes.

Include references to how you optimized the extent to which the interpretations are trustworthy (Smith et al., 1999). For example, maintain a reflexive diary of all insights about the themes to maintain an audit trail of the process. If possible, two independent researchers should derive the codes and themes.

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In the Results section:

Describe each theme in turn. Most papers describe between two and six key themes.

Ensure your quotes align closely to your description of the theme

Estimate the prevalence of each theme, and justify how you arrived at this estimate.

In the Discussion section:

Reiterate the overall aim and the key themes that emerged Discuss how these themes may be integrated or related Show how these themes align to previous theories or

literature. The themes may be used to clarify or challenge past constructs. Or past theories can be utilized to clarify the causes or consequences of the theme

Discuss the limitations of this study, coupled with suggestions for future research

End with a conclusion that may refer to the implications of your work.

Descriptive versus interpretative phenomenology

To appreciate interpretative phenomenology analysis, researchers need to understand the history and distinction between interpretative phenomenology and descriptive phenomenology. To a significant extent, descriptive phenomenology emanated from the work of Husserl (1970). Husserl argued that how people experience their life—such as their perspectives and perceptions—is important to study. That is, if research characterises the experiences and perspectives of other people, scholars and practitioners can understand the motivations of behaviour more comprehensively. They can understand people better.

Yet, Husserl (1970) recognised that people seldom contemplate or reflect on their experiences critically. Therefore

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people may not be able to articulate these experiences, perceptions, or perspectives especially well

Husserl recommended that researchers need to apply systematic, scientific approaches to unearth these experiences.

One key feature of these approaches revolves around techniques to limit the degree to which the personal history, knowledge, or perspectives of researchers impedes their capacity to grasp the experiences of their participants. Somehow, researchers must identify their preconceptions and biases—and then preclude the impact of these preconceptions and biases on how they interpret the responses of participants—an objective called transcendental subjectivity. To illustrate, according to some proponents of descriptive phenomenology, researchers should even

refrain from a comprehensive literature review refrain from formulating specific research questions—but instead merely strive

to describe the lived experience of a particular subset of individuals (e.g., Streubert & Carpenter, 1999)

Besides this inclination to refrain from comprehensive literature reviews, proponents of descriptive phenomenology also apply a technique called bracketing. In essence, researchers should gradually develop the capacity to insulate, or bracket, their interpretations of responses from their preconceptions or biases. For example, they may learn how to

recognize instances in which their previous knowledge might be shaping their interpretations and then

question whether their interpretations are accurate or merely biased towards their assumptions.

Yet, although proponents of descriptive phenomenology study the experiences or perspectives of individuals, called their lived experience, they are interested in patterns that many people share. Specifically, these researchers assume that people who experience some phenomenon in common, such as racism, share features in common. The goal of researchers is to uncover these shared features, called universal essences or. eidetic structures (Natanson, 1973). These universal essences are regarded as the true nature of this phenomenon. Accordingly, descriptive phenomenology assumes that reality is objective, independent of the history or setting, rather than merely constructed by individuals.

Contrast to interpretative phenomenology

Heidegger, a student of Husserl, challenged and extended some of these assumptions. The work of Heidegger inspired the hermeneutic and interpretative research tradition. The aim of this approach is to uncover meaning or insights

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embedded and concealed in everyday life (Spielgelberg, 1976). Indeed, the term emanates from the Greek god Hermes—a god who clarified or interpreted the messages between gods (Thompson, 1990). In particular, participants are often unaware of these meanings or insights. Instead, the researcher must, according to Heidegger (1962)

glean these meanings or insights from the responses and narratives of participants

attempt to characterise the relation between the individual and the lifeworld—defined as how individuals conceptualise their circumstances.

This goal of researchers assumes the subjective experiences of individuals are greatly shaped their social, cultural, and political environment. Researchers thus explore the social, cultural, and political circumstances that shape the experiences of participants. The conclusions of these researchers are blends of the perspectives and interpretations of both participants and the researchers, sometimes called co-constitutionality.

Illustration

To illustrate, this difference between descriptive phenomenology and interpretative phenomenology, imagine a researcher who wants to investigate the experiences of house husbands—men who do not work but are married to women who work. In this instance, a descriptive phenomenologist would

ask the participants something like “Tell me what your life as a house husband is like”

ask additional questions that unearth the common features of this experience

In contrast, to characterise the experience of individuals in their world, an interpretative or hermeneutic phenomenologist would

ask participants to describe a typical day as a house husband ask participants to describe their interactions and relationships with other

people—and how these activities, interactions, and relationships change over time

Furthermore, in contrast to descriptive phenomenologists, interpretative phenomenologists do not dismiss their previous knowledge or past theories. This knowledge helps the researcher decide which topics to study, which participants to recruit, and which questions to ask. Consequently, interpretative phenomenologists seldom apply bracketing, but do believe that researchers should delineate their preconceptions.

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Other phenomenological approaches

Indeed, researchers have developed and applied many phenomenological methodologies. You should familiarise yourself with several approaches to

decide which approach you prefer understand the approach you choose better—by appreciating the alternatives

One of the most renowned methodologies is called transcendental phenomenology—an approach that Clark Moustakas delineated in 1994. This approach epitomizes descriptive phenomenology. After collecting and transcribing the data, researchers who adopt this approach tend to complete four stages in sequence: epoché, horizontalization, imaginative variation, and synthesis.

Stage 1. Epoche

During the first stage, called epoche, but also known as bracketing, researchers attempt to diminish the effects of their preconceptions and biases on the analysis. To achieve this goal, researchers complete the activities that appear in the following table. Specifically, in this table,

the first column delineates this activity the second column illustrates this activity—with reference to a study in which

the researcher wants to understand the experience of people afflicted with chronic fatigue syndrome

Activity IllustrationClarify your experiences, beliefs, values, and assumptions about the phenomenon you want to study

One of my friends claimed she was afflicted with chronic fatigue syndrome

However, her mother, a doctor, believed that she was actually depressed instead

I was not certain whether this diagnosis is genuine or not

Attempt to set these experiences, beliefs, values, or assumptions aside as you analyse the data

To achieve this goal, recognize that your goal is to characterize the experience of your participants and not to ascertain some objective truth

Therefore, acknowledge that your beliefs—such as your doubts about whether this diagnosis genuine—is irrelevant, because you merely want to understand how the participants experience and conceptualize this fatigue

As Giorgi (2006) suggested, repeat this epoche before

You can repeat this epoche three times, before horizontalization, imaginative

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every stage variation, and synthesis respectively

Stage 2: Horizontalization

During the second stage, and the first stage of analysis, called horizonalization, researchers distil every distinct statement from the transcripts—such as interviews or focus groups—and then collate these statements into a table. Next, they next arrange these statements into themes. In particular, researchers complete the activities that appear in the following table. Specifically, in this table,

the first column delineates this activity the second column illustrates this activity

Activity IllustrationDistil each significant or meaningful statement from the transcripts and record these statements in a table. These statements are usually quotes, but sometimes edited if necessary

I wondered whether my fatigue was normal I thought my fatigue would eventually vanish I believed my fatigue would disappear I tried everything, from medication to

meditation My family doubted me I could not concentrate more than 10 hours I read everything about how I could cope I sometimes assumed that everyone

experiences this fatigue, and I should just persist

…Delete statements that seem redundant. The ensuing statements are called the horizons or textual meanings

The statements

I thought my fatigue would eventually vanish I believed my fatigue would disappear

were reduced to one statement

I thought my fatigue would eventually vanishRearrange these statements into clusters—sets of statements that correspond to an overlapping theme or characteristic

Theme: Belief the fatigue is normal

I wondered whether my fatigue was normal I sometimes assumed that everyone

experiences this fatigue, and I should just persist

Theme: Frantic attempts to address the fatigue

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I tried everything, from medication to meditation

I read everything about how I could cope …

Often, researchers will first construct a table that represents the statements—the textual meanings—of each participant separately. Next, researchers will integrate the statements of all participants into a unified table, called a universal textural description. Finally, researchers will tend to convert this table into a narrative. In this narrative

each subheading will correspond to one theme researchers will write several paragraphs to describe this theme—using the

quotes to illustrate the description. Here is an example

Theme: Belief the fatigue is normal

Participants sometimes questioned whether the physiological state they were experiencing was indeed a problem. For example, Kate mused “I wondered whether my fatigue was normal”. She felt that other people may be experiencing a comparable sensation but were not complaining about this state. Because participants believed this state could be normal, they felt obliged to persist and to disregard their fatigue, as Len admitted “I sometimes assumed that everyone experiences this fatigue, and I should just persist”

Stage 3: Imaginative variation

During the third stage, called imaginative variation, researchers clarify the circumstances, conditions, or contexts in which individuals experienced the phenomenon. For example, the researcher might

realise that some participants described their experience of chronic fatigue at work, and other participants described their experience of chronic fatigue in their family life

the researcher might then describe the experience of chronic fatigue in these two contexts separately—to consider how the lived experience of this phenomenon varies across settings, conditions, and circumstances

Stage 4: Synthesis

During the final stage, the researcher attempts to reduce the textual descriptions—that is, the themes, and the structural descriptions—that is, the contexts—into a

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concise, unified description. This description is sometimes referred to as the essential, invariant structure of the lived experience. Despite this abstract terminology, this description is really a

summary of the key themes and structures usually comprising 3 to 8 sentences

Further reading and complications

You can also consider many other practices and features to enhance this research. Perhaps read about cross validation, cooperative inquiry, triangulation with quantitative data, and independent audits.

Aubeeluck, A. V., Buchanan, H., & Stupple, E. J. N. (2012). 'All the burden on all the carers': Exploring quality of life with family caregivers of Huntington's disease patients. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care & Rehabilitation, 21, 1425-1435.

Arroll, M.A., & Senior, V. (2008). Individuals’ experience of chronic fatigue syndrome/myalgic encephalomyelitis: An interpretative phenomenological analysis. Psychology & Health, 23, 443-458.

Bramley, N., & Eatough, V. (2005). The experience of living with Parkinson’s disease: An interpretative phenomenological analysis case study. Psychology & Health, 20, 223_235.

Chapman, E., Parameshwar, J., Jenkins, D., Large, S., & Tsui, S. (2007). Psychosocial issues for patients with ventricular assist devices: A qualitative pilot study. American Journal of Critical Care, 16, 72-81.

Cohen, M. Z. (1987). A historical overview of the phenomenological movement. Image: Journal of Nursing Scholarship, 19(1), 31-34.

Fletcher, K. J., Nair, R. das, Macniven, J. A. B; Basu, S., & Byrne, P. (2012). An interpretative phenomenological analysis of the patient experience of awake craniotomy: Brain tumour diagnosis to discharge. British Journal of Health Psychology, 17, 828-842.

French, D.P., Maissi, E., & Marteau, T.M. (2005). The purpose of attributing cause: Beliefs about the causes of myocardial infarction. Social Science & Medicine, 60, 1411-1421.

Geanellos, R. (2000). Exploring Ricoeur’s hermeneutic theory of interpretation as a method of analyzingresearch texts. Nursing Inquiry, 7(2), 112-119.

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Giorgi, A. (2006). Concerning variations in the application of the phenomenological method. The Humanist Psychologist, 34(5), 305–319.

Guba, E., & Lincoln, Y. (1981). Effective evaluation. San Francisco: Josey Bass.

Heidegger, M. (1962). Being and time (J. Macquarrie & E. Robinson, Trans.). New York: Harper and Row.

Heron, J. (1996). Co-operative Inquiry: Research into the human condition. London: Sage.

Husserl, E. (1970). The crisis of European sciences and transcendental phenomenology (D. Carr, Trans).Evanston IL: Northwestern University Press

Kaiser, S., & Kennedy, P. (2011). An exploration of cognitive appraisals following spinal cord injury. Psychology, Health & Medicine, 16, 708-718.

Larkin, M., Watts, S., Clifton, E. (2006). Giving voice and making sense in Interpretative Phenomenological Analysis. Qualitative Research in Psychology, 3, 102-120.

Morrow, S. L. (2005). Quality and trustworthiness in qualitative research in counseling psychology. Journal of Counseling Psychology, 52, 250-260.

Morse, J. M., Barrett, M., Mayan, M., Olson, K., & Spiers, J. (2002). Verification strategies for establishing reliability and validity in qualitative research. International Journal of Qualitative Methods, 1, 13-22.

Moustakas, C. (1994). Phenomenological research methods. Thousand Oaks, CA: Sage

Mozo-Dutton, L., Simpson, J., & Boot, J. (2012). MS and me: Exploring the impact of multiple sclerosis on perceptions of self. Disability and Rehabilitation: An International, Multidisciplinary Journal, 34, 1208-1217.

Murray, C.D., & Rhodes, K. (2005). ‘Nobody likes damaged goods’: The experience of adult visible acne. British Journal of Health Psychology, 10, 183-202.

Reid, K., Flowers, P. & Larkin, M. (2005) Exploring lived experience: An introduction to Interpretative Phenomenological Analysis. The Psychologist, 18 20-23.

Reynolds, F., & Lim, K.H. (2007). Contribution of visual art-making to the subjective wellbeing of women living with cancer: A qualitative study. Arts in Psychotherapy, 34, 1_10.

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Rolfe, G. (2006). Validity, trustworthiness and rigour: Quality and the idea of qualitative research. Journal of Advanced Nursing, 53, 304-310.

Senior, V., Smith, J.A., Michie, S., & Marteau, T.M. (2002). Making sense of risk: An interpretative phenomenological analysis of vulnerability to heart disease. Journal of Health Psychology, 7, 157-68.

Smith, J. A. (1995). Semi-structured interviewing and qualitative analysis. In J. A. Smith, R. Harre & L. Van Langenhove (Eds), Rethinking methods in psychology (pp. 9–26). London: Sage.

Smith, J. A. (2011) Evaluating the contribution of interpretative phenomenological analysis. Health Psychology Review, 5, 9-27.

Smith, J.A., Flowers, P., & Larkin, M. (2009). Interpretative Phenomenological Analysis: Theory Method and Research. London: Sage.

Smith, J. A., Jarman, M., & Osborn, M. (1999). Doing interpretative phenomenological analysis. In Murray M., & Chamberlain K. (Eds.), Qualitative health psychology: Theories and methods (pp. 219–240). London: Sage

Smith, J. A., & Osborn, M. (2003). Interpretive phenomenological analysis. In J. A. Smith (Ed.), Qualitative psychology: A practical guide to research methods (pp. 51–80). London: Sage.

Solomon, J. L. (1987). From Hegel to existentialism. New York: Oxford University Press.

Spielgelberg, H. (1976). Doing phenomenology. The Hague, the Netherlands: Martinus Nijhoff.

Sudman, S., & Bradburn, N. (1982). Asking questions: A practical guide to questionnaire design. San Francisco, California: Jossey-Bass Inc.

Williams, M. J., McManus, F., Muse, K., & Williams, J. M. G. (2011). Mindfulness-based cognitive therapy for severe health anxiety (hypochondriasis): An interpretative phenomenological analysis of patients' experiences. British Journal of Clinical Psychology, 50, 379-397.

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