Cuan os berbos de mobimiento se conchuguen como pronominals ye de dar que

Ethnographic analysis is an iterative and inductive process for searching for the parts of a culture, the relationships amongst the parts and their relationships to the whole (Spradley, 2016). It is important to state that ethnographic data analysis and data collection overlapped with each other, as would be expected in ethnographic study (Hammersley and Atkinson, 2007; LeCompte and Schensul, 2013; Spradley, 2016), although, for the purpose of clarity, they have been presented in a linear order, as is widely done in a research report. The task of ethnographers, according to Spradley (2016), is to describe cultural symbols and to identify their coding rules. Thus, I systematically examined and searched the field notes and interview transcripts for the discovery of cultural patterns which is a task expected of an ethnographer (LeCompte and Schensul, 2013; Spradley, 2016). However, Patton (2015) and Hammersley and Atkinson, (2007) argue that there is no formula or recipe to guarantee the success of this task. This implies that a researcher has to make decisions about the analytical strategies/framework to be used to analyse data. I considered strategies/frameworks that have been used by previous ethnographers to analyse the data. For instance, a modified grounded theory approach was used in the ethnographic study by Costello, (2001), while content analysis has been used by some ethnographers (Wilkinson and Callister 2010). In addition, thematic analysis has been used by previous ethnographers to analyse their data (Allen et al., 2015; Schober et al., 2016; Guelia et al., 2016), whilst Altkinson et al. (2001) highlighted that narrative analysis is gradually gaining relevance and recognition for analysing ethnographic data, but no article was found that had adopted this method. Notably, these methods of analysis are not peculiar to ethnographic research, but can also be used for other qualitative approaches.

I therefore considered it necessary to search for an analytical framework that is specific for analysing ethnographic data. One of the frameworks that has been widely used by

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previous ethnographers is known as Ropers and Shapira’s (2000) framework for ethnographic data analysis. These authors suggested five steps for ethnographic analysis, namely, coding for descriptive labels, sorting for patterns, identifying the outliers, generalising constructs and theories and, finally, memoing with reflective remarks. The ethnographic work of Allen et al., (2015) adopted Ropers and Shapira’s (2000) framework for ethnographic data analysis. Similarly, this framework was used in the studies by Higginbottom (2008), and Wilkinson and Callister (2010) for their ethnographic data analysis. Another framework for ethnographic data analysis was developed by Spradley in 1979 and was supported by LaCompte and Schensul (2013). Some ethnographers, for instance, Fraser et al. (2009), used Spradley’s framework for ethnographic data analysis. This framework has been recently reviewed (Spradley, 2016) and its evaluation seems to imply that it is more comprehensive than Ropers and Shapira’s (2000) framework. Spradley (2016) presented explicit steps for analysis of ethnographic field notes and interview transcripts for the discovery of cultural themes that uncover cultural meaning. As such, I adopted this framework for the analysis of data in this research. Spradley’s framework for ethnographic data analysis comprises domain, taxonomic, componential analysis and the discovery of cultural themes. These steps are briefly discussed in relation to how they have been used to analyse data in this current research to yield the cultural themes.

Domain analysis

Domain analysis is searching for cover terms, included terms and semantic relationships within the ethnographic field notes and interview transcripts. Cover term is the name for a cultural domain, while the included term is the name for all smaller categories inside the domain. The linking together of two categories is known as a semantic relationship. Table 3.2, below, shows an example of domain analysis, although the list is incomplete as it is a sample used to demonstrate how the domain analysis was conducted.

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Table 3.3: sample of domain analysis worksheet

There were enormous amounts of various clusters of included terms, cover terms and sematic relations identified from repeated reading of the field notes and interview transcripts. A computer software programme, Nvivo 10, was used to aid storage and organisation/management of the voluminous amount of data gathered from the field notes, interview transcripts, analytical memos, reflexive and reflective notes at this stage of analysis. Nvivo 10 is one of the most up-to-date computer software programmes that aids qualitative data analysis (Bazely and Jakson, 2013) and facilitates the storage and handling of large data sets (Bazely and Jakson, 2013). It facilitates easy, effective and efficient coding, searching, data retrieval and enables exploration of relationships between concepts (Zamawe, 2015). Folk terms and analytic terms were used in the construction of the included terms, cover terms and taxonomy through all the stages of analysis. Finally, several cultural categories were identified as well as gaining the overview of the cultural scene, as consistent with the goal of domain analysis (Spradley, 2016).

Taxonomic analysis

Taxonomy ‘is a set of categories organised on the basis of a single semantic relationship’ (Spradley 2016:112). Having discovered and identified several cultural domains (an important unit that exists in every culture) and the smaller units that

Included terms

God is the healer Pray it out

Devil causes sickness God cures all diseases

God does not allow people to be sick God is the holder of life

Satan causes cancer Pastors have spiritual eyes God can change all situations God is the giver of all good things

Semantic relationship

Is a form of

Cover term

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constituted these domains, the next step was a search for the relationships that existed within and among the cultural domains. Cultural meaning arises from the organisation of cultural domains and this is represented by means of taxonomy. Figure 3.1, below, shows a sample of the taxonomic analysis.

Figure 3.1 sample of taxonomic analysis

Religious beliefs

Religiosity

Religious teaching Faith

Trust in pastors

Visits to spiritual churches and prayer houses Respect for religious leaders

Game of mind-set Sacrifices to deity

Visit herbalist, priest, pastors, imam, and native doctor

God does not allow one to be sick GOD or gods is the healer

Pastors have spiritual eyes

Possession of spiritual powers for healing God cure all diseases

‘Pray it out’

Oh! All is well with you. You don’t have any problem.

The Lord says you are healed.

The Lord said that none of you shall be sick. Christians can’t have cancer! Preaching that enemies causes terminal illnesses Cancer is not your portion

You cannot die of cancer Only prayers can solve problem

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As shown in Figure 3.1, above, and as highlighted by Spradley (2016), taxonomy reveals subsets and the way they are related to the whole, and it can be constructed from folk terms, analytic terms or both. Nvivo 10 was used to aid this stage of analysis whereby the relationships between parent nodes were examined, which gave rise to a category or larger cultural domain. These relationships are the taxonomies which represent the cultural patterns under study. The five steps for taxonomic analysis (Spradley, 2016), namely, selection of a domain for taxonomic analysis, looking for similarities based on the same sematic relationship, looking for additional included terms, searching for larger, more inclusive domains that might include as a subset of the domain you are analysing, construction of tentative taxonomy, making focused observation to check out the analysis and construction of a complete taxonomy, were undertaken. At this stage, the cultural patterns people were using to organise their behaviour and make decisions that guide their practices became more explicit.

Componential analysis

Cultural meanings are not only driven by the relationship and similarities that exist within the cultural domains but are also based on the differences and contrast that are found among the cultural domains. During componential analysis, ethnographers focus

on searching, discovering, organising and representing all the

contrasts/attributes/components of meanings associated with several cultural categories identified during taxonomic analysis. Following the steps recommended for componential analysis, an illustration of how the researcher organised and represented the contrasts/units of meaning from a cultural category into what Spradley referred to as ‘paradigm worksheet’ (Spradley 2016:135) is shown below.

Domain (cultural category)

Terminally ill patients Yes Yes

Patients families Yes Yes

Healthcare providers No Yes

Table 3.4: Paradigm worksheet using cultural categories of religious beliefs

Mystical/ supernatural beings Evil others Dimensions of contrast Religiou s b elie f beli efs

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In this stage of analysis, various units of meaning were identified and will be clearly shown when presenting the ethnography in all the findings chapters. At this stage of analysis, the information was verified during further interviews and selective observations, as recommended by Spradley (2016).

Prior to the last stage of the analysis, data triangulation was done during the taxonomic analysis, whereby different sources of data were examined for similarities. At the stage of componential analysis, data triangulation focused on examining the contrasting or cultural contradictions in the participants’ opinions and perceptions in different data sources, as well as contradictions between what was observed and what was said. Fetterman (2010) stated that ethnographic analysis involves data triangulation, whereby the ethnographer compares the different sources of information with a single focus to identify areas of similarities and differences in order to understand alternative explanations of the issues under investigation. As done in this current research, previous ethnographers have reportedly undertaken data triangulation (Stajduhar and Davies, 2005; Baggs et al., 2007; Sinclair 2011; Dembinsky 2014) because it enhances the credibility of a study. On completion of this layer of analysis, the next stage, based on the Spradley framework, is to search for cultural themes which will lead to writing up the ethnography.

Discovery of cultural themes

The idea of cultural themes is based on the premise that a culture is more than units of domains and pieces of customs. It is, rather, composed of a system of meaning that is integrated into some kind of a more complex and larger pattern that conveys a sense of the whole. A cultural theme is defined as ‘any principle recurrent in a number of

domains, tacit or explicit, and serving a relationship among subsystems of cultural meaning’ (Spradley 2016:141). They connect subsystems or elements in the patterns

that make up a culture. Having done various layers of analysis, at this stage I shifted attention towards examining the relationships that existed amongst the larger set of cultural categories, grouping the categories that fitted together as subsets of single

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ideas to arrive at three cultural themes that fitted together into one cultural scene, as shown below.

cultural theme one

Perception of terminal

illness and palliation

cultural theme two

Socio-political and

economic influence on palliative care

cultural theme three Environmental

Influence on Palliative Care

These themes have subthemes, which will be discussed in the various findings chapters.

Finally, as mentioned earlier, data analysis commenced immediately when/after I got into the field. I began to make sense of the daily field notes and writing reflective notes following the first day of participant observation, before the next visit to the field, even prior to commencing domain analysis and other layers of analysis. All through the period of fieldwork, I had several supervision meetings where I discussed the progress of the data collection and sections of the field notes with my supervisors. During these meetings, I shared my impressions and discussed issues which I believed were emerging from the data. These meetings were particularly important during all phases of data analysis because the supervisors shared new ideas about the data, which left me with extensive thoughts around the emerging patterns of cultural behaviour that informed the cultural practice for the provision and use of PC. These thoughts led to a more critical reflection and identification of questions that may need further investigation for better understanding of the emerging cultural issues. I constantly reflected on how I may or may not be influencing the data collection process and analysis; this is presented in a section containing my reflexive account.