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Observation as a data collection strategy has limitations in that it does not deal with the

unobservable, such as care omissions, and participants’ feelings and thoughts. The second stage of data collection was to explore events observed with the occupational therapist using

a conversational approach to semi-structured interviews. The purpose of these interviews was

to discuss what had been observed, and explore in depth issues relating to spirituality as a

dimension of occupational therapy practice. The interview was structured; using topic guides

based on the occupational therapist’s individual observations. This gave the participants an opportunity to raise issues they had reflected on following the observation of their practice

(Angrosino, 2008). See Table 7 for an example of an interview topic guide used. Interviews

following observation are widely used to investigate further the participant’s perspectives and generate an in depth understanding of their context and the phenomenon under investigation

120

Table 7: Example of an interview topic guide

Interview topic guide for Mark (taken directly from the interview transcript) Firstly, can we explore how you began as an OT and your career path

So how did your early appreciation of the philosophy of occupational therapy impact on your values of the profession?

How did your educational experience help you to develop your values of the profession? How does your previous experience in union activity and private practice impact on your upholding of the core values and philosophy of the profession today?

Your role, in many of the cases I observed, you were the pivotal professional holding the case together. In particular, where trauma and mental health were interlinked. Can you tell me more about [case identified for further illumination] and how you addressed their hope, meaning and purpose?

Further cases discussed as raised by Mark to provide further examples of the embedding of hope, meaning and purpose in practice?

How do you articulate the values linked to spirituality, which are central to your professional practice, to your other colleagues on the ward?

You have mentioned a lot about the opportunities for addressing what you understand to be spirituality (the core values and philosophy of the profession). Can you tell me about some of the organisational issues and maybe what some of the barriers are?

What are the barriers to practicing and embedding your core principles?

An example from the observation was used to delve deeper into Mark’s response.

So often your practice looks very straight forward and not very hi tech but you were getting to the heart of your patients concern regardless of the complexity. How do you promote this to your colleagues who may not understand?

You have talked about how you view everyone as occupational beings from the perspective of occupational science and getting to the heart of what is meaningful for them. How does this work in practice for you?

Can you tell me something about the Delirium project you have pioneered on one of the wards and how this has taken you back to the core philosophies of the profession?

Lots of discussion about how this project addressed the core philosophies of the profession and how it had been an excellent example of interprofessional working in addition to applying the core philosophies of the profession to practice.

What do you feel about the environment you are working in and the opportunities to develop a therapeutic relationship?

I’m thinking about the adherence to infection prevention and having to stand not sit when speaking to a patient. Addressing the issue of power, non-threatening and engaging the patient who is in bed?

The literature around spiritualty says that an OT needs to be comfortable with and appreciate their own understanding of spirituality in order to address it with your patients. Can you tell me what this means for you?

121 Interviewing has been a well-accepted method of data collection in qualitative research design

for many years and has been employed as a key method in social research since the 1980’s. The purpose of interviews is to explore in depth an individual’s perspective and understanding of the phenomenon under investigation. The follow up individual interviews in this study gave

the opportunity to explore in more depth issues raised by the observation of the participants

practice, and to illuminate some of the complex situations where spirituality had been observed

(Kvale & Brinkman, 2009; Ritchie & Lewis, 2013). Interviewing participants individually poses

less risk of unexpected events to manage ethically, however there is the need to manage the

extent to which participants feel they want to disclose information. There should be a balance

between collecting rich data and ensuring the participants well-being is maintained (Ritchie et

al., 2014).

I did not prepare a generic interview topic guide in advance of the study; semi- structured

questions were specific to the individual practitioner and generated from the issues that

emerged during the participant observation which required further clarification or exploration.

Therefore, interview questions were individual to each participant. Participants were provided

with broad areas for discussion prior to the interview to avoid participant’s feeling unprepared for the interview and, by addressing their expectations, strengthened the transparency of the

process. Following the verbatim transcription of the interview by the researcher the transcript

of the interview was sent to each to provide the participants. This provided the participants

with the opportunity to review the transcripts for accuracy, and to request data to be removed

that they were, on reflection uncomfortable sharing (Green & Thorogood, 2014). One

participant did request some of their statements were withdrawn as they were concerned

about how they could be viewed later by their service manager. Their request was honoured

as it related to ‘verbal expressions’ used to describe situations that on reflection could out of context be deemed inappropriate, removal of the extract did not compromise the richness of

122 point in the process (see Appendix 2: Occupational Therapist participant information letter and

Appendix 7: Informed consent (Interview) Occupational Therapist).

The individual interviews could be criticised for limiting the four participants’ opportunity to debate their experiences; a focus group could have illuminated spirituality and occupational

therapy practice in more depth (Barbour, 2007; Finch & Lewis, 2013). However, adopting a

focus group approach would have limited the ability to explore the individual therapist’s observed practice. The individual interviews increased the depth of data collection as the

interview was tailored to the individual participant and their experiences. The strength of the

interviews undertaken in this study was that they were based on observation of what spirituality ‘looked like’ in the individual’s practice. They mirrored the effective use of interviews in previous studies exploring occupational therapist’s experiences of spirituality in their practice (Egan & Swedersky, 2003; Beagan & Kumas-Tan, 2005; Hoyland & Mayers, 2005).