Investigaciones realizadas en México sobre la conducta suicida

In order to analyse the qualitative data obtained, thematic analysis was deemed to be the most appropriate methodology to answer the overall research question. Thematic analysis is defined as ‘a method for identifying, analysing and reporting patterns (themes) within data’ (341). It is a process that encodes qualitative information, often generating lists of related themes, making the information more accessible and understandable to others (342). Themes are usually formed by patterns found in the data that, at a minimum, describes and organises information and at a maximum, interprets aspects of a phenomenon.

Although the methodology is widely used within psychology and health related qualitative research, thematic analysis in many instances is not acknowledged, possibly because it does not appear to exist as a named analysis unlike discourse analysis or grounded theory, for example. There is also less of a clear agreement about how it should be conducted which can be perceived as a weakness but also one of its strengths. Since it does not have any pre-existing theoretical framework this makes thematic analysis flexible in that it can be applied to a variety of data sets as well as not being restricted to the part of the data it may report. Analysis using this technique may report experience, meaning and the potential reality of

participants. For the inexperienced qualitative researcher, it is more accessible as it does not require the detailed theoretical and technological knowledge as required by

165 grounded theory and discourse analysis. Researchers find thematic analysis to be of most use in the early stages of research enquiry (342).

The flexibility, its use in initial exploratory studies and the methods applicability to all types of data sets is a major strength given the fact that this study is one of just a handful of studies aiming to qualitatively explore the experiences of mental health professionals working within the psychosis field (185). By providing a clear framework and account of how the analysis was completed, any disagreement in how thematic analysis should be conducted is potentially overcome. This rule of providing a transparent account of the methods adopted applies for all ‘good’ qualitative research studies (334).

Data analysis initially took place on a case by case basis. The first step was to immerse oneself with the first interview and transcript through a period of re- reading and reflection. Once comfortable with the transcript a free textual analysis or coding process was undertaken, highlighting and describing the perceived key elements of what the participant had discussed during the interview. The codes generated identify items of interest to the analyst and refer to the most basic elements of the transcript and the phenomenon under investigation (341). Once completed the next stage involved searching for emergent themes from the key highlighted text. In this instance the emergent themes were generated inductively from the raw data as opposed to being based on prior theory or research (342). This took the form of creating a summary statement describing what was important or the meaning behind a particular aspect of the highlighted text. Emerging themes as opposed to codes are often broader and are the beginning of organising the data into meaningful groups. It is important to code for as many potential themes as possible at this stage as it is not clear what might become interesting later. An example of the free textual analysis/coding, highlighting process and the identification of emergent themes can be seen in Appendix 13. Once the transcript was coded for as many potential themes as deemed possible, themes were ordered chronologically and typed into a list with the location of key supporting text also attached (See Appendix 14 for an example of a list of emergent themes). At this stage the aforementioned process was repeated for all the remaining transcripts.

166 Lists of emergent themes were then printed with each theme from each transcript on a separate piece of paper. Themes were then rearranged to form clusters of related themes where possible. Other themes that did not seem to belong anywhere were placed in a miscellaneous theme, temporarily, as they may become useful and demonstrate relationships during the on-going review process (See Appendix 15). The process of organising themes is continuous and involves an on-going review of inter-relationships, combining themes, refining them or even discarding themes where there are few data to support them. Themes that were related and clustered together became super-ordinate themes and were given their own distinct names. Names were chosen which seemed to accurately conceptualise and represent the cluster of themes they represented. After settling on the number and names of these super-ordinate themes these were further broken down into several subordinate themes (See Appendix 16 for the final list of themes).

Although the process of coding and the generation of emergent themes can be aided using computer software, a more traditional paper and pen method was favoured. The method of paper and pen is clearly more flexible in allowing choice and creativity in how to conduct and organise each stage of the data analysis and interpretation process.

Reflexivity (the process of reflecting upon one’s background, motivation and prior assumptions and how this may influence data collection and analysis) is important to consider in qualitative research (334). Although all qualitative data analysis is interpretative the author contemplated how their position as a mental health professional for the Early Intervention in Psychosis Service may have influenced participant’s accounts during the interview and any subsequent interpretation of the responses given.

Thus, in order to explore their involvement with the study, a reflexive log was kept throughout the research process. This involved reflecting on a regular basis (usually after conducting interviews or after the generation of potential themes) upon the ways in which the author’s own values, experiences, interests and beliefs may have

167 shaped the subsequent data and interpretations. Important reflections were discussed with the study supervisor and addressed where possible.

Quantitative data collected via the survey was initially coded and entered into the statistical package SPSS version 19 for statistical analysis (314). Each survey was initially entered and then re-checked to ensure accurate data entry. A variety of parametric and non-parametric tests were employed where appropriate.

6.3

Results

6.3.1 The common experiences of EIP clinicians currently working with