Coding

As per the principals of Charmaz’s constructivist grounded theory, the process of data analysis was rigorous and started at the same point of as the data collection process (Charmaz, 2006). Coding has helped the researcher to manage unstructured data and directed him to concentrate on further data collection. Descriptive codes for textual data were taken from the semi- structured interviews. This was performed in two main phases: 1) an initial phase involving naming each word, line, or section of data and followed by 2) a selection of significant frequent codes in order to synthesise and organise the large amount of data. During the initial coding, the researcher was flexible to all possible theoretical directions indicated by the initial reading of the data. The researcher started by making sense of what diabetes meant to people with diabetes and to Health Care Professionals. Careful attention was given to understand acts, accounts, views, scenes, and silences from participants’ view. The researchers then created the codes by defining what he saw in the data.

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Data analysis in constructionist grounded theory consists of three sets of codes: open, axial, and selective coding (Charmaz, 2006). Open coding: implicates the primary breaking of data to explore all the possible aspects or information about the phenomenon being studied. This results in the progress of descriptive codes from the initial data collected. In this study, all the transcripts were subjected to open coding by allocating meaningful theme names to each line or paragraph of the transcript, as shown in the following figure (Figure 5.4).

Figure 5.4: The process of Open Coding

This was followed by axial coding, known as theoretical coding (Strauss et al.,

1990), which examined the relationship between categories of the phenomenon in the data. Axial coding: involved the development of a coding paradigm which identified a central phenomenon, explored causal conditions, and identified the context that influenced the actions. In this level of coding, the descriptive codes were grouped at a more abstract level and linked by relationships that emerged

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from within the codes. According to Jeon (2004), the stage of open coding and axial coding is recognized as substantive coding which enabled conceptualisation of “the empirical substance of the area of research”. Axial coding enabled links to be made between categories. Furthermore, comparisons have been made between codes to enabled links that have been made between them and made the emerging analysis solider. The following figure (5.5) shows an example of the outcome of axial coding was linking a number of codes about people’s knowledge and understanding of diabetes with codes about the impact of diabetes on risk perception. These codes were linked together as a result of axial coding and the category of personal factors that affects perception of risk emerged.

Figure 5.5- The process of Axial Coding

Selective coding: involved the integration of categories from axial coding forming conceptual links that facilitates the interpretation of the data. This level

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of coding seeks to establish a core category that establishes connections between itself and other categories (Charmaz, 2006). This means that the data was viewed theoretically rather than descriptively. The following Figure (Figure 5.6) illustrates the processes of selective coding:

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5.5.20 Constant comparative analysis

Thematic analysis of the data was conducted concurrently and following the fieldwork phase, by constant comparison of the data. The researcher also compared within and between the data from people with diabetes and Health Care Professionals’ interviews to gain insight into both sets of participants’ views of risk communication and understanding. In addition, constant comparison was performed between different ethnicities, gender, and people with different grade of diabetic retinopathy. These themes helped produce the new risk tool and generate further themes that were explored in the interviews with people with diabetes and Health Care Professionals. A potential problem with thematic analysis is that the researcher subconsciously has pre-conceived ideas regarding themes (Charmaz, 2006), and potentially may failed to spot other themes which may be present in the data. This method of comparing and raising questions is rooted in the entire research process to sharpen the researcher’s thoughts and therefore help understand the content of the data. The researcher used the constant comparative method not to describe or verify comparisons, but rather to assist in the conceptualization and categorization of the data and analysis (Charmaz, 2006).

The following quotes highlight the constant comparison of data from people with diabetes and Health Care Professionals in regard to how they make sense of risk messages that are designed to instil anxiety as a means of changing certain behaviours:

“Probably strong messages would be an eye opener, wouldn’t it, to say that blindness could actually happen. I think it depends on your consultant as well at the hospital and, yes I just think you can’t have a nicely nicely approach, you have got to have that with your consultant yes but they do need to be more, you know put fear into the patient.” (Claire, 45, White British, R3)

“I normally say that the diabetes has damaged their retinae with high sugars and that this is non-reversible damage, but then we can stop further progression with good control” (Andy, Ophthalmologist, White British)

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