ANALISIS E INTERPRETACIÓN DE RESULTADOS 4.2 PRESENTACIÓN DE RESULTADOS

Focus groups continue to be popular in health research not least as ‘group processes’ are often used as an approach in the education of health professionals and service users and also match the team/group context of practice (Green & Thorogood, 2014 p.130). A focus group is a small group brought together to discuss a particular issue under the direction of a facilitator who has a specific aim and list of topics to discuss. However certain authors would suggest certain, specific criteria must pertain for the activity to legitimately be called a ‘focus group’ (Denzin & Lincoln, 2017; Kreuger & Casey, 2015; Kitzinger, 1995;).

For example, a focus group might be expected to usually include six to ten people, as larger groupscan potentially preclude all participants from having the chance to speak and a smaller group size may make group members feel as though they cannot speak freely or feel they have to speak when they consider they have nothing to offer. This reinforces the need to create an environment of support and security as a facilitator, particularly when the number of participants is relatively small.

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Similarly, traditionally focus group participants will not have met each other previously. However Green and Thorogood (2014) speak of a ‘natural group’ approach which recognises circumstances where participants already know each other in an informal group. This natural group may provide an even more ‘naturalistic’ setting than a ‘traditional’ focus group as it resembles in many ways the kind of interaction participants might have in their professional lives and allows even greater access to how people talk to each other about particular topics and issues. It also allows insight into how knowledge about health and professional identities are produced and reproduced in ‘natural’ social situations, creating a more ‘natural environment’ as participants are influencing and being influenced by others just as they are in ‘real life’.

However - despite a well-facilitated group having the feel of an everyday discussion - such groups can never be viewed as truly ‘natural’. Not least as it is not ‘natural’ to be aware that any comments or utterances that are made will be viewed as research data. The student nurses involved in the focus groups of my study, although invariably and, indeed, purposefully, peers and acquaintances, and, in fact, occasionally friends outside of the focus group, and therefore comfortable and relaxed in each other’s presence; were also inevitably within an unconventional environment. Undeniably there is still a formality inherent within such groups - whatever their title or description - as the participants are invited to attend expressly for research purposes (Gray, 2018). Therefore, despite some of the potentially problematic theoretical considerations, I shall refer to the groups of research participants as focus groups

throughout the thesis.

Focus groups, natural groups or any group interview are designed to maximise interaction between participants and between facilitator and participants. It is the interaction that provides access to shared group values, perceptions, identity and culture (Coe, Waring, Hedges & Arthur, 2017). Data are generated by interaction between group participants as they present their own views but also listen, reflect on the views and experience of others and thereby consider and reconsider their own view and standpoint further. This prompts and triggers further material as participants ask questions, seek clarification, confirm opinions, sharpen and refine responses and thereby reveal more on a deeper and more considered level (Bryman, 2015). This was evident from the discussions in the various focus groups as thoughts, ideas and opinions were being developed, crystallised and becoming more fully formed during the actual process of the focus group and the interaction between the participants. In their response to others, participants reveal their general view of the subject of study and more of their own

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frame of reference on their shifting identity. This synergistic and spontaneous group interaction is subsequently used to generate data. The insights into the social constructions, shared meanings, normative influences and collective as well as individual self-identityare the way in which experience is perceived and the world understood. Shared experience is, therefore, particularly important to encourage disclosure (Creswell & Plano Clark, 2018).

Sensitive issues may also be more readily discussed within group settings (Stewart & Shamdasani, 2015). However this may depend on the cultural group values and the nature of the group itself. In this particular research there was a risk that sensitive disclosures may have been made which were potentially impactful on participant’s lives and careers beyond the research context and therefore raise significant ethical difficulties. Ethical considerations are discussed in greater detail later in this chapter.

With focus groups, Kidd and Parshall (2000) believe that there are three criteria of reliability: these are stability, equivalence and internal consistency. Stability mainly relates to focus groups that are convened more than once, with stability becoming an important issue when group membership changes from one meeting of the group to the next - this was not the case in this particular research.

Equivalence describes the consistency of the moderators or coders of the focus groups. This research has very high equivalence as the same facilitator led the discussion across all groups, completed the majority of the transcription and undertook all of the analysis. Similarly internal consistency is high as I took sole responsibility for conducting the analysis and facilitated all the focus groups.

Validity of a focus group approach is partly used to describe a form of content validity. In other words, how convincing is it that what the participants have shared is valid information (Kidd & Parshall, 2000)? The composition of the group can help to increase the validity of data as the key feature for participant selection is their experience and membership of a specific adult nursing cohort - as opposed to participants from a variety of different cohorts and/or different years within the same focus group - validity is enhanced. Validity is similarly increased by conducting multiple focus groups, whilst ensuring participants of differing characteristics are in separate groups thereby further justifying the principle of utilising separate focus groups from each of the three years of a nursing course.

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