EL METROPOLITANO – LIMA,PERÚ

Questionnaires produce large amounts of quantitative data. Their shortcoming however is found in the lack of explanation or rationale for the answer given by the participants. By contrast, interviewing allows participants to add detail and dimension to their response. Gillham (2000b) observed that interviewing as a data collection technique can have both structure and flexibility. This means that topic areas can be pre-determined, yet participants can be asked to clarify or illuminate their perspective. For the purposes of this research, semi-structured interviews were proposed to be the most useful data collection strategy. In this research, pre-determination of the topics came from analysis of the quantitative data and participants explained using their own words (Harris & Brown, 2010). Fraenkel and Wallen (2009) identified this as an

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3.15.1 Justification for the use of semi-structured Interviews

When the interview guide is used, topics are identified prior to the interview as in this study. During the interview, the order of questions is decided as the conversation unfolds. Fraenkel and Wallen (2009) urged caution with this particular type of interview because of the obvious question sequencing differences. These writers suggested that participant responses could be influenced. However, in this study, explanation of factors affecting participation in PDRP was the focus for the interview and, as many of the factors were potentially related, ‘going with the flow’ and using probes to assist participants to explain, was deemed an appropriate strategy. Given the interviewer’s role within the organisation, putting participants at their ease was most important. This was more likely to be accomplished using a conversational approach rather than rigid adherence to a structured question schedule.

3.15.2 Disadvantages of semi-structured interviews

Robson (1993) maintained that interviews can be extremely time consuming. Together with the geographically widespread study population and the unknown

location of the volunteers for interviews, time for data collection and travel was a major consideration during data collection. To ameliorate some of the issues related to time, interviews were limited to a maximum of one hour. This was stated early in the data collection phase, as nurses needed to request release from their duties in order to participate. Furthermore, issues of time and resourcing related to travel and completing data collection within the job of the researcher were also considered and negotiated within the decision to undertake interviews of any description with this population. Undertaking semi-structured interviews was supported by NZBS.

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3.15.3 Participants (Phase 2: Qualitative data collection)

In the qualitative phase, the reliance on numbers of participants to contribute to the external validity of the study was not required (Fraenkel & Wallen, 2009). Instead, the focus was on the rich description of the volunteer participants. The total number of interviews was thus dependent on achieving the ‘theoretical saturation’ described by Guest, Bunce, and Johnson (2006) and meaning that interviews were undertaken until they yielded no new data or themes. Nurses volunteered to participate in phase two of this work during completion of the questionnaire as previously described. Using survey participants as interview informants in the same sequential study sat well with

promoting the validity of mixed methods approach taken (Creswell, 2015b; Onwuegbuzi & Collins, 2007).

There were thirty-six volunteers to be interviewed. To avoid any unintentional bias when selecting individuals to follow-up, the researcher assigned each volunteer a number (1-36) on receipt of their contact details. The contact order for volunteer interviewees was made using a random number generation application. Volunteers were contacted in this order. If a volunteer changed their mind, the next volunteer was contacted and so on until 15 interviews were arranged. Appointments for interviews were made ahead of time and the researcher travelled within the context of her job role and conducted all interviews face to face.

3.15.4 Qualitative data collection procedures

Interviews were conducted by the researcher according to a semi-structured schedule derived from phase one findings of the study (see Appendix M). Information sheets and consent processes were undertaken by the researcher with each

105 digitally recorded and were transcribed by a third party transcription service

recommended by Massey University. The director of the transcription service made an electronic declaration of the transcriber confidentiality agreement on behalf of the company and its employees (See Appendix J). Interviewees were provided with a copy of their interview transcription by email and were asked to sign a transcript release form prior to analysis.

3.15.5 Data analysis

The NVIVO software program (version 11) was used to manage and support analysis in this phase of this study. The principal technique used was a general inductive approach described by Clarke and Braun (2006) and Thomas (2006). The use of this strategy for analysis was intended to provide a systematic process for data reduction to enable the findings to be displayed and interpreted. However, because the interviews were semi-structured and related to notable responses from phase one, the main adaptation of the technique was to determine nurses’ explanations in relation to each question posed. The data was validated by respondent validation of their transcripts and review of coding by the supervision team.

A systematic process was chosen because both Thomas (2006) and Braun and Clarke (2006) highlighted the tendency among researchers to overlook the need to be specific about the procedures used to analyse qualitative data. The consequences of using a robust process are found in the consequent trustworthiness of the work.

Thomas (2006) further argued that researchers also require straightforward procedures to follow without the need for the technical details required by the adoption of a particular approach like phenomenology for example. Having taken a pragmatic stance

106 to this work and being a novice researcher, it is argued that the use of a relatively straightforward procedure was an advantage in this work too.

Thomas (2006) outlined that the ‘general inductive approach’ to qualitative data analysis is concerned with the close reading and interpretation of raw data from which concepts or themes are generated. Commonly used in health and social science

research where there is a need to understand patient experiences or to evaluate service initiatives, the general inductive approach has been used in several well considered studies like that exploring end of life spiritual care by nurses in an Intensive Care Unit in the Netherlands (Noome, Kolmer, van Leeuwen, Dijkstra, & Vloet, 2016), and another examining women’s changes in eating during pregnancy (Paterson, Hay-Smith, & Treharne, 2017). The procedures followed were those outlined by Braun and Clarke (2006) and are shown below in Table 3-3. (The code book is provided in Appendix Q). Table 3-3 Phases of data analysis in the general inductive approach

Phase Objective and process

Familiarisation

Becoming familiar with the data

Achieved in this study by reading and re-reading transcripts with identification of initial topics related to each of the questions at interview. Where similar topics were raised in the same context in response to other questions, for example, when a respondent referred back to or added further description or

commentary on something already mentioned, this was noted and cross- referenced for inclusion in coding and searching.

Generation

Coding features of the data

Colour coding was used to identify topics in relation to each question within the transcripts using NVIVO. This created a systematic approach and visual reference across the transcripts. Data was then collated for each topic area for each interview question, including any outlying data generated as described above. Searching

Identification of themes within the coded data

The collated data was reviewed and initial themes were identified within the responses for each interview question.

Defining

Definition of the themes identified within the data

Themes were refined until they were a coherent map of the data and there was clear separation between the themes identified

Reporting The outcome of analysis using this process is reported in the qualitative findings chapter.

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3.15.6 Data validation

The validity of semi-structured interviews can be increased by asking

participants to review their own transcripts in processes described by Burnard, Gill, Stewart, Treasure, and Chadwick (2008). However, it was also noted by Burnard et al. (2008) that the process could add bias where participants were unable to see the relevance of their thoughts to the final outcomes and might seek to change their perspective to one that was more acceptable after reading. Creswell (2009) noted that as an alternative, an independent auditor could be helpful in reviewing not only transcripts, but the entire project to ensure that the level of data analysis from raw transcription to interpretation is cogent throughout.

For the purposes of this study, the former option was used. Participants were emailed a copy of the transcript of the interview with the researcher. They were asked to respond to the researcher within a three-week time frame if they wished to make any comments about the contents of the transcripts. The email also included a ‘release of transcript’ form which participants were asked to sign and return to the researcher (see Appendix K).

Supervisors also formed a significant part of ensuring the trustworthiness of the data analysis. Coding strategies were discussed at meetings and progress was reviewed to support the appropriateness of the themes as they were developed. The code book structure advocated by DeCuir-Gunby, Marshall, and McCulloch (2011) facilitated the documentary process. Unintentionally, the senior nurses at NZBS validated some of the emergent themes. In a planned feedback session about the research, the senior nurses indicated that the themes presented reflected some of the CPD practices they had observed among their nurses.

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