DISCUSIÓN DEL DICTAMEN DE LAS COMISIONES DE SALUD, Y DE JUSTICIA, CON PROYECTO DE DECRETO QUE REFORMA Y ADICIONA DIVERSAS DISPOSICIONES DE LA LEY GENERAL DE SALUD

One of the controversial debates surrounding qualitative research has been whether it can demonstrate the scientific rigour found in quantitative research (Mays & Pope, 1995). Hence, the debate surrounding this issue has been briefly covered earlier within this chapter. Here, I outline the processes that were undertaken to establish and demonstrate rigour during the present study following the guidance of evaluative criteria techniques developed by Lincoln and Guba (1985). This framework consists of four key areas, each of which can demonstrate the trustworthiness of a qualitative study. They include; credibility (confidence in the ‘truth’ of the findings); Transferability (showing that the findings can apply to other contexts); Dependability (the findings are consistent and could be repeated) and Confirmability (showing how the findings have been arrived at via the inquiry) (Koch, 1993; Cohen & Crabtree, 2006).

4.12.1 Credibility

To demonstrate credibility, Guba and Lincoln (1985) suggest prolonged engagement in the field being researched. This is a strategy most often aligned with an ethnographic approach. I was unable to spend any time observing participants in specific settings or in their own social settings. However, I did familiarise myself with several aspects of gay culture as a way of gaining a broader understanding of the social world some men spoke about, and as a way

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of determining some of the deeper issues concerning their health. I attended a gay pride event with Prostate Cancer UK, where I was able to speak to men in the gay community about prostate cancer and their concerns more generally. I also went along to events within the gay village in Manchester, one of which I was invited to by one of the participants. Additionally I attended several events at the Lesbian and Gay Foundation in Manchester, both as a visitor and an invited speaker to discuss my research with the community and community health workers. I also attended two meetings for the first UK prostate cancer support group meetings for gay and bisexual men and was able to observe interactions within this setting for several hours.

The explication of negative cases also enhances credibility. Hence, the data was also searched for experiential accounts which were different from those frequently mentioned across the interviews as a whole. An example of this is where one participant perceives there to be some advantages to taking hormone therapy, due to the physical impact it had on his own personal sense of embodiment.

Although member-checking is also suggested as a way of demonstrating credibility, it is not a practice that is widely advocated in phenomenology (McConnell-Henry, Chapman, & Francis, 2011). There are several drawbacks to the process of member checking which may lead participants to change their experiential accounts upon reading a transcript of their interview (Sandelowski, 1993; Morse, 1991). Moreover, as phenomenological research aims to gain access to experiences that are pre-reflective, I considered it even more important to take the participant’s experiences ‘as given,’ in the time and space they were recounted. Instead, I sought ‘the phenomenological nod’ (Munhall, 1994) of the men who attended the support group for gay and bisexual men with prostate cancer, some of whom had participated in the study. During this session, I share some of the themes I had

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describing. I received a unanimous ‘nod’ of agreement from the men who described being able to identify with the findings I was able to share with them.

I also demonstrated confirmability through the process of peer debriefing. This took place within regular PhD supervision meetings with three academics. During these meetings I was challenged on a number of issues relating to every aspect of my research. These included how I related phenomenological concepts to the development of themes and being challenged on a number of assumptions or ideas I had along the way.

4.12.2 Transferability

Transferability refers to the study’s ability to be applied to wider contexts other than the setting it has been conducted in, and the extent to which a reader can derive meaning and apply that meaning to their own experiences (Guba & Lincoln, 1985; Sandelowski, 1986). Hence, the inclusion of ‘thick description’ (Guba & Lincoln, 1985) allows other researchers to gain a sense of how this could apply within settings other than that in which the research has been conducted. Hence, as opposed to including a superficial account of what the participants have experienced, the interpretations attempt to convey the meaning of experiences. In the context of this study, this meant providing additional context to situations such explanations of cultural norms. Hence, this level of thick description may enable the reader to apply the meanings to other settings.

4.12.3 Dependability

Dependability can be demonstrated within qualitative research by providing a decision trail during each stage of the research process (Guba & Lincoln, 1985). This should provide evidence of the decisions and choices that were made during the various stages during the research process and clearly explicate why they were made (Koch, 1993). The study is deemed to be ‘auditable’ when the trail of processes is sufficiently clear enough to enable

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another researcher to follow the trail and reach a similar conclusion (Ryan, Coughlan & Cronin, 2007).

As stated previously, a reflective diary was updated regularly throughout the present study as a way of documenting any decisions that were made regarding the choice of methods or any issues that arose during the course of the research. This was exemplified during the decision that was made to readdress the inclusion/exclusion criteria in relation to sexual orientation labelling, where an ethical amendment was sought. In addition, decisions relating to aspects of the study were raised and documented during monthly meetings with my supervision team. Hence, these documents contained precise accounts of what was discussed and are able to show how some decisions were formulated through informed debate.

4.12.4 Confirmability

Confirmability requires the researcher to clearly explicate how interpretations and conclusions arising from the data have been reached (Lincoln & Guba, 1984; Ryan, Coughlan & Cronin, 2007). Moreover, this is usually established when other criteria associated with rigour have been met. Confirmability has been demonstrated within the present study by the inclusion of longer quotes, as opposed to short quotes. By including longer quotes and anecdotes, it is possible for other researchers to see how the interpretations were reached. Reflexive notes and a bracketing statement formed an important part of this study. They are able to reveal how any biases or preconceptions may have impacted on the data.

4.13. Summary

This chapter has provided a comprehensive overview of the steps and processes that were undertaken in order to conduct this study. In addition to explaining why van Manen’s phenomenological approach was deemed to be most suitable for exploring the research aim and objectives, this chapter also offers a detailed outline of how the six steps

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suggested by van Manen were applied to the various stages of the research. This chapter has concluded by outlining how it has achieved rigour and trustworthiness throughout the process, in preparation for the next two chapters.

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Chapter 5: FINDINGS

5.1.

Introduction

The purpose of this chapter is to present the findings of the study through the four lifeworld existentials proposed by Merleau-Ponty (1962), as guided by van Manen (1990). The chapter opens with a breakdown of both personal and disease characteristics of the participants, which are presented in table form. A short introduction to each of the participants follows, in order to provide some context to their lives. Following a brief recapitulation of Merleau-Ponty’s existential framework, the themes derived from analysis of the data are presented visually in the form of an illustrated figure. The findings from the data are then presented in sub-chapters and are aligned to the existential categories of Spatiality, Corporeality, Temporality, and Relationality. Each of the four sub-chapters will consist of a brief description of how each respective existential lens was utilised to view the data and place the resultant themes. Each theme will then be presented, described and supported with direct quotes and anecdotes from the participants’ interviews.