Photovoice: Method of Data Collection in Qualitative Research

In qualitative studies, researchers seek to discover meanings of human data by adoption of naturalistic approaches; hence, data collection methods are particularly important (1). Photovoice is an innovative data collection method which can provide deep and rich information for researchers. Photovoice is a term consisting of two words, photo and voice. It was first introduced as a data collection method for community-based participatory research (CBPR) by Wang and Burris in 1997 (2). According to these researchers, Photovoice is a process in which participants are able to record several issues in their society by cameras and they can play roles as potential facilitators to make a difference in their society. In this process, participants, who are volunteers in their society, have effective participation in sharing their experience and knowledge with researchers and policymakers. In other words, the Photovoice means expressing their life experience through photography (3). photovoice has three main goals: 1) to enable people to record and reflect their community's strengths and concerns, 2) to promote critical dialogue and knowledge about important issues through large and small group discussion of photographs, and 3) to reach policymakers (4). The main nature of Photovoice is considered as a way to empower individuals to identify individual and social health needs and make changes to improve society where people live (5). However, since people use their cameras to take photos of their daily facts and focus on issues with the highest importance in this process (6), this process is taken into account by researchers of qualitative studies as a data collection method for a deeper understanding of phenomena. Photovoice is applicable in every age group and any context and status of health and disease (2,7). This technique can be used in phenomenological studies, Grounded Theory, Ethnography, and Participatory Action Research (PAR) (2,8,9). In Photovoice method, researchers initially determine target issues or questions, and then select participants who are related to target issue, and voluntarily include them in the research. In the next step, researchers explain them the research objectives and how to use the camera and techniques of photography, observing safety issues and ethics. After taking photos by participants, each photo is discussed and analyzed through interviews or by focused groups. Therefore, researchers ask people 5 questions about reasons for selection of photos and also their feelings and emotion by SHOWeD 1. what do you see in this picture? 2. What is happening in this picture? 3. What connection does it have with our life? 4. Why is this situation created? 5. What can we do for it? After this stage, researchers analyze the content and extract semantic units and codes and themes based on the interviews. Results are then presented for policy makers or other stakeholders in participatory or community-based case studies with the aim to make changes in target issue; and photos are published in galleries, websites, magazines and papers if necessary (2,10, 11). Photovoice is a method which emphasizes on participant's direct participation as a co-researcher in the study. Participants take desired photos, and then themes are identified in a collaborative process with researchers. In other words, reflection, thoughts and feelings which describe a photo, are written for it, and then participants discuss their experience in a group and extract common themes through photos and writing reflections (8). Photovoice method has a particular conformity with philosophy and methodology of structuralism or development and construction of meaning through individual experience. In other words, photos display what participants understand, are interested in or worried about. Data of similar photos of analysis stage of qualitative data is discovered through participant's collaboration by data encoding, and then the formation and interpretation of themes appear. Ethical principles should be established in performing the Photovoice. 1) The individual property and privacy are shown in photos, and thus photos should be protected in this regard. 2) Photos may show images of an illegal relationship or other harmful items, and thus the individual safety should be provided. 3) Selection of photos should be based on participant's choice and published by their consent. 4) Photos, which are interesting for researchers and not based on the participant's real experience, may be taken. 5) Participants transfer ownership of photos by signing the consent form. 6) Participants have the right to choose (2). In the health care system, qualitative studies aim to conduct deep assessment of complex phenomena which nurses are faced. It is very important to reach perceptions, live experience and see the world from participant's perspective. In the recent two decades, Photovoice is utilized in qualitative studies on the health especially in nursing research as a way to explore individual experience of disease or other phenomena (12). Photovoice is a valuable method which helps qualitative researchers as a third eye to observe hidden parts of individual experience, desires, history, culture, problems and needs. Therefore, use of multiple sources in data collection can help to increase data richness in qualitative studies. Therefore, researchers are suggested using Photovoice method based on the research questions in addition to interview as the most common method of qualitative data collection.