Caracterización general del Área Sorbitol

5.7.1

Semi structured interview questions

The interviews were held so that an assessment of the cross cultural utility of the PARIHS framework could be made, as well as identifying challenges and barriers to successful cultural translation and implementation. As the interviews were with the participants of the guideline development group, this allowed for an exploration of their experience of the development process and the impact on their understanding, knowledge and views of evidence based healthcare and clinical guidelines. The questions for both the pre and post

117 interviews were primarily shaped by the literature review and further informed by the focus groups held in both Malta and Jordan. The Maltese focus group was also used to; check for conceptual equivalence, particularly in regards to whether the concepts to be discussed had resonance in the population in which the semi structured interviews were to be undertaken; to check the accuracy of phraseology for the Maltese population and the familiarity of concepts such evidence based medicine.

5.7.2

Participants

The interview participants were members of the guidance development group who had been identified by the head of department; a multidisciplinary group for the treatment and management of obesity. Fourteen healthcare professionals and two patients / carers were invited to attend initially. Nine healthcare professional participants took part in the pre interviews and nine in the post interviews. The head of department provided the researcher with all contact details after he had informed them of the study.

The patient /carers did not attend the interviews or the guideline development group.

5.7.3

Organisation of interviews

The researcher introduced themselves to the participants by email. An introduction email (Appendix M) was initially sent introducing the participants to the guideline development group, outlining the task of guideline development and the dates for the development meetings. It was accompanied with an attachment detailing the research study and how the guideline development was part of this (Appendix N). This was followed by an email inviting participants to the pre guideline development interview (Appendix O), with the pre and post interview invitation attached (Appendix P).

A range of dates and times were given (between the 19th _{and 21}st _{January 2016) for} participants to choose from, with the option of choosing between 2 and 3 times. The researcher was as flexible as possible in scheduling interview appointments, to ensure the least disruption possible to the participant’s working day. Interviews were arranged to be held in the hospital, either in an office of the participant, a meeting room or a hospital meeting space. To accommodate all that wished to participate, one interview was conducted over the phone and two people were interviewed together (pre and post). Participants were informed that the interviews would last for approximately an hour. The

118 process of sending an email with a selection of dates and times was repeated for the post guideline development interviews.

Best practice suggests that healthcare professionals should be given 6 to 8 weeks’ notice to allow for adequate scheduling of a meeting. Due to time constraints experienced because of the process of moving study site, including gaining ethics approval, for the pre interview and the first guideline meeting only two weeks’ notice was given. For the post interview and the second guideline meeting, the researcher was able to give six weeks’ notice.

5.7.4

Data capture

To ensure all interviews were fully captured, they were digitally recorded. All participants were made aware of this in both the invitation letter and the consent form (Appendix Q). The consent form also gave the participants the option to stipulate if they did not wish for their contribution to be recorded. The digital recorder was checked for battery life at the beginning of each interview.

5.7.5

Interviews in action

The researcher used an interview guide and prompts to guide the pre and post interviews (Appendix R). The interviews were recorded and notes were taken as prompts on specific points. When participants spoke but requested not to be recorded, the recording was halted and restarted when requested. This happened at some points during the interview or when the schedule of questions had finished. The interviews ranged from 25 minutes to an hour which was dependant on the participant for some were more forthcoming than others. The researcher made sure that throughout the interviews eye contact was

maintained as much as possible and that participants were given time to answer questions in full. Questions were clarified when needed. The interviews were very interactive and relaxed, participants were at ease throughout and encouraged at all times to contribute using prompts to explore areas in more depth when needed.

One pre interview was conducted over the phone. The researcher was fully prepared for this as they had researched factors to be aware of and how best to conduct an interview if interviewing by phone or Skype. It has been suggested that interviewing without being face to face can lessen rapport (Sally, 2016), however this was not experienced. The interview went very smoothly and there were no problems with communication. The researcher

119 made sure that they were in a quiet place as had the participant. The interview was also recorded with a good level of clarity.

Two participants requested to be interviewed together for both the pre and post

interviews. They were happy to work in this way and understood that everything discussed was to be kept confidential between them. One participant was more forthcoming than the other thus the researcher made sure throughout the interview that questions were

directed to both and the quieter participant was encouraged to contribute. The participants were very respectful of each other and clearly ‘bounced off’ of each other.