Tercera etapa: Análisis y evaluación de riesgos.

Through IPA methodology, with the ideal target sample group, three emerging superordinate themes were identified that can contribute to an understanding of the concept of emergency preparedness, in relation to the research aims and objectives.

The three superordinate themes to be explored in chapters 6 – 8 are:

 Self Determination  Control

 Experience-Based Practice

Figure 7 displays the summary of IPA themes, and presents the subordinate and subcategories of each superordinate theme.

5.4 Summary

This chapter reviewed how IPA influences the presentation of this study and describes the presentation and discussion of data in chapter 6 – 10. The importance of the individual voice being visible within the data analysis process is highlighted and is a strength of IPA. Explanation of IPA terms used within this thesis occurred and the research study’s aims and

objectives presented. Three main superordinate themes; Self Determination, Control and Experience-based Practice were identified through the data analysis process. Chapters 6 – 8 explores, in detail, each of these themes (and related subordinate and subthemes), with the use of the participants’ quotes.

CHAPTER 6

Findings: Self Determination 6.0 Introduction

Within the context of this study, the superordinate theme ‘self-

determination’ emerged, particularly in relation to self-motivation and resilience. Self-determination theory provides an insight into individual characteristics that impact on self-motivation and psychological resilience (Bartholomew et al, 2011. Deci & Ryan, 1985. Ryan & Deci, 2002) and offers a “perspective on human motivation and personality that focuses on the social

environmental conditions that enhance self motivation and healthy psychological adjustment” (Bartholomew et al, 2011; p1459).

This concept will be discussed within the context of the paramedic’s experience. Firstly, detailing the importance and impact of the individual’s role perception and working culture on their motivation to work in this unpredictable environment, presented as ‘self-identity’. Secondly, the concept of personal resilience acknowledges the psychological aspect of functioning, at a personal level, within unexpected, potentially

overwhelming incidents, presented as ‘personal resilience’.

All thirteen participants contribute to this category and there are eleven participant accounts reported in this chapter.

The subordinate and subthemes are summarised in figure 8, and then further detail is included in table 5, following IPA guidelines, which

recommend this as the most appropriate way to present the data (Smith et al, 2009)(see chapter 5). Following this is a discussion of each theme, supported with extracts from participant’s quotes, ensuring that the subject discussion is rooted in the individual’s experience.

Table 5. Subordinate and subthemes for the superordinate theme ‘Self Determination’.

N.B. Each theme is presented in detail in subsequent sections

Subordinate theme Sub categories of

themes Verbatim quote from transcript

6.1 Self Identity Not just an office job

(6.1.1) “ I like the fact that you go to work not knowing what _{you’re going to get. Yeah, I don’t know, there is just some-}

thing nice about the fact that you don’t come to work 9 – 5 and sit down at a desk all day for 8 hours and then you have to sit in rush hour to get home. It’s just nice having that unpredictability, and variety and difference”. Jessica.

L28 – 34. Action hero

(6.1.2) “People who are after a new challenge, like me really, _{coming from a paramedic I wanted to do some-thing}

different, the opportunity to treat a casualty in a

dangerous, challenging environment. I think you need to be up for that challenge and physically fit as well, as it is a physically demanding job so you need to keep your fitness up”. Mary. L259 – 264.

How we speak

(6.1.3)

“Procedures, SOP in place for us to deal with any major incident as an ambulance service working with the fire service and the police”. Mary. L13 – 15.

SOP = Standard Operating Procedure 6.2 Personal Resilience We are not robots

(6.2.1) “I imagine, if the day comes and you deal with some-thing _{like that, and you are one of the crews that turns up and}

clinical person in the world, it would be likely that they would have some kind of feeling towards that, emotion towards that so it is going to be difficult. People aren’t going to be robots in doing it”. James. L415 – 421.

Coping mechanisms

(6.2.2) “some people do it better than others and my wife thinks _{I’ve got no emotion at all [laughs]… Is it a coping}

mechanism or me being in the ambulance service or is it the reason that I’m in the ambulance service [laughs]? I would suggest that it is probably a little bit of both. I’m not particularly sympathetic unless some-one warrants my sympathy”. James. L399 – 403.

Psychological preparation

(6.2.3)

“I don’t think any-thing could prepare me for that to be honest I mean, even when you simulate it, it’s hard as it is not real so you can’t, it is more the emotion of things than the actual doing. Especially with youngsters, you have a bit more of an emotional bond with them, especially if they are crying for you and things like that, it is a lot harder to walk away for any-one I would imagine, than to walk away from an adult but you can’t train properly for that, because you don’t know how you are going to feel, you just don’t and we never had to do it”. Isla. L456 –

466. Needing a back-up plan

(6.2.4) “it is going to happen you know and we have just got to _{deal with it whereas perhaps it will affect me later on, it}

wouldn’t affect me… or I feel that it wouldn’t affect me too much at that time and as I say I have not dealt with it, I don’t know what it is going to be like in the future or

any-thing like that so I would be hopeful that there would be a back up sort of plan for us, if you know what I mean, to sort us out after”. Harry. L128 – 136.