FAMILIA : BIGNONIACEAE

Individual interviews were carried out with three (n=3) relatives of the post CT-ICU patients who were also recruited and interviewed in the study. The relatives at the time of recruitment might have visited the CT-ICU more than twice. The relatives were included to explore their views and opinions about their experiences of pain management in the CT-CIU when their relatives were admitted. The relatives must have visited for more than twice to have enough experience about the care to share in the interview.

2.5.2.11 Research design and method

• Research design

The exploratory, descriptive, qualitative design was used to elicit the opinions of post CT- ICU patients on pain, its assessment and treatment in the CT-ICU.

• Research method Population

All relatives who visited their family members in the CT-ICU form the population in this phase of the study. Three relatives who had visited the patient more than twice were purposively sampled and individually interviewed. All those interviewed had relatives whom had undergone cardiothoracic surgery and been transferred to the CT ward.

Sample and Sampling Method

Of the relatives, whose family members were transferred to the CT ward, three were purposively sampled within 48 hours of the transfer and interviewed for the study.

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Inclusion Criteria

• Relatives of patients who were in the ICU for more than 24 hours.

• Relatives of patients who had been transferred to the CT ward within 48 hours. • Had visited their relatives on more than two occasions.

Data Collection Procedure

Permission was obtained in writing from the management of the hospital (Appendix E & F), with the consent of the Medical and Nursing Directors of the CT-ICU. Permission was also obtained from the nurse managing the cardiothoracic ward to undertake the data collection in the unit. The patients’ relatives’ individual interviews were carried out to determine their opinions of the pain management experience when their relatives were admitted the CT-ICU and how according to them, pain management in the CT-ICU could be improved. Three (n=3) post CT-ICU patients’, who spent at least 24 hours in the CT-ICUs, relatives were purposively sampled with the help of the CT ward manager and participated in the individual interviews.

The researcher recruited the patient’s relatives within one month from the CT ward with their consent after explaining the purpose of the study to them. All three patients’ relatives interviewed could speak and read English, thus all interviews were done in English. Patients’ relatives who agreed to participate in the interview were given the information sheet (Appendix M). The interviews were carried out in the homes of the three (n=3) relatives, at their convenience. Phone appointments were made and directions to their homes were given to the researcher and one met the researcher and accompanied her home. The relatives were again informed about the aim of the study before they agreed to take part in the interview. They were asked to sign a consent form (Appendix N) after reading the information letter again. The relatives provided a quiet place in the house for the interviews to be done. One was done under a tree and the other two in the living rooms of the participants. The interviews were tape-recorded. Field notes were also taken by the researcher to provide an additional source of information.

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The patients’ families’ demographic data was collected (Appendix O) and using an interview guide (Appendix O), the patients’ relatives were first asked their opinion regarding how pain was in the CT-ICU and probed further on their experiences of the pain management.

2.5.2.12 Data Analysis

It took three weeks to interview all three relatives. It was determined that the relatives had the same issues, complaints and suggestions, and as no new information was emerging, it was realised that data saturation was achieved therefore the interviews ended after the third relative. Verbatim transcription of the tapes was carried out after each interview to understand the data, to prepare for subsequent interviews and to prepare the data for analysis (Creswell, 2014). Data collection and data analysis occurred simultaneously to enhance the researchers understanding and appreciation of the data (De Vos, et al, 2011). After transcribing each interview, the researcher checked for accuracy by listening to the tape while reading the transcripts to make necessary corrections (Kvale, 2009). The recordings were listened to repeatedly until the researcher was sure that all statements were transcribed as stated by the relatives.

Data analysis was done by following the six steps of qualitative analysis by Creswell (2014) and coding using the eight steps of Tesch (1990 in Creswell, 2014). The analysis here also followed the same methods employed in analysing the interviews with nurses and doctors (refer to point 2.5.2.3)

Three major themes and nine subthemes were identified in the study and presented in Table 4.10 in Chapter Four. The study was then presented as a narrative with all the themes and sub-themes supported by the actual relative’s quotations about pain in the CT-ICU.

Findings of the exploratory phase of the study, inclusive of systematic review, focus group discussions and individual interviews are presented in Chapters Three and Four.

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2.6 PHASE 2 – DEVELOPMENT AND VALIDATION PHASE

This phase also addressed objective one by developing and validating the clinical guideline for acute pain management in the adult CT-ICU, which was based on Phase 1 of the study. Phase 2 comprises two parts, part one addressed the development of the guideline and part two, the validation of the guideline.