Data Collection

Demographic data such as age, gender, number of children in the family and area of residence were collected on forms (potential participant reply slip) returned by respondents indicating their willingness to participate in the study (Appendix 4).

During the initial stages o f the interview, respondents were asked a few simple questions about their experiences of post-compulsory education, current occupation and employment history. Collecting this kind of demographic data facilitated theoretical sampling by enabling individuals to be placed within their wider socio­

economic, geographical and cultural context.

3.5.1 Interviewing Respondents

Semi-structured interviews were used to collect in-depth data eliciting respondents’

own interpretations of their illness experiences of common respiratory infections.

The varied socio-economic, educational and personal background o f the sample precluded the use of a standardised interview because it was unlikely that any single structure would be suitable for all (Fielding, 2003). Semi-structured interviewing allowed the rephrasing of questions to meet individual needs. An interview guide was used to ensure key topics were included in each interview. The interview guide was revised and restructured at several points during the study (for example,

following pilot interviews, following initial data collection and as theoretical sampling continued). Version 1 of the interview guide can be seen in Appendix 5.

As the study progressed, the interviews became more focused on those topics that were most likely to support the development of the emergent categories. The interviews were, therefore, loosely conversational but focused around key

predetermined themes, with opportunities for the interviewer to prompt and probe

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when seeking clarifying details. Probes are open questions that enable further and deeper exploration of a concept or idea. They were use to rephrase questions in situations where the participant was unable to offer a response or to enable further exploration o f something the participant had mentioned during the course of the interview. Prompts provided participants with several response options following a question. They were used to enable participants to respond to questions they had been previously unable to answer. The aim being to trigger memory and to draw out ideas which participants may have been initially reluctant to share with the

interviewer. In this way the interviews became more than “ordinary conversation”

and '‘'‘examined hunches, events, views and feelings” (Charmaz, 2006, p26).

Four pilot interviews were conducted. The purpose of pilot interviews was to facilitate the development of the interview guide, test the general feasibility of the study, and to highlight any unforeseen difficulties with the fieldwork. Pilot

interviews also enabled me to practise my interviewing skills and build confidence in data collection (Fielding, 2003; Polit and Beck, 2006). The data generated from the pilot interviews was analysed along with other data as it was considered a suitable quality to justify its inclusion in the main study. However, these respondents were not recruited through community groups but through their association with members of staff within the department in which I was studying. They all, however, lived within areas targeted in subsequent recruitment.

The length o f the proposed interviews appeared crucial in respondents’ decisions to participate in the study. The initial participant information sheet stated the interview would be no longer than 90 minutes. Several respondents expressed that this would

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deter them from participating. As a consequence the information sheet was re­

worded to allow participants to negotiate the duration of the interview, with the average time being indicated as 45-60 minutes. Interviews actually lasted between 20-120 minutes.

Social interactions such as interviews are an opportunity for impression management (Goffman, 1959) in which interviewees are required “to demonstrate their

competence in the role in which the interview casts them” (Dingwall, 1997, p58).

Fielding (2003) suggests that respondents tend to rationalise their responses, may be overly polite, may be worried about being ‘shown up’, eager to impress, or attempt to anticipate the answers they imagine the interviewer wants to hear. Respondents, therefore, may either consciously or subconsciously adapt the truth in some way. In this study, illness accounts indicated several of these problems, including concerns about providing correct answers. Evidence o f altered truth is difficult to determine, however, inconsistent and contradictory accounts (the nature o f the accounts

generated is discussed in chapter 8) may perhaps indicate that respondents attempted to provide accounts that maintain a moral order (Goffman, 1959). Problems from social desirability bias, however, can occur with other methods of data collection, such as focus groups. Furthermore, face-to-face interviews allowed the interviewer to probe the truthfulness of respondents’ reported beliefs and behaviours. Whilst this may raise questions about the status of interview data, representations of the world generated in this way should be acknowledged as a valid, but not the only valid, representation possible.

R19: err this is getting relatively difficult err is a virus a type o f germ? So you got viral infections haven ’tyou, so you got viral and bacterial, is that right? (38-year- old mother, average deprivation rural ward).

R3: Um (pause) well I suppose that it means that some bacteria has got into my system and is um attacking my system and I have to try and fight it. That’s not a very good answer! (34-year-old mother, average deprivation urban ward).

Three respondents implied that they had intentions to prepare for the interview, or reflected that they wished they had because they found the questions difficult. These statements probably reflect an eagerness to impress and to provide ‘correct’ answers.

It is likely that prior preparation for an interview would alter the respondents stated beliefs and knowledge about the topic. However, no respondent admitted that they had actually prepared for the interview.

R33:1 was going to read all this up before you came (laughs hysterically) because I don’t know anything about this, I was (laughs)

NH: Have you heard o f resistant bacteria?

R33: Oh! I should have read up about this. That’s quite a difficult one (21-year-old mother, high deprivation urban ward).

Common respiratory infections include a number of non-specific symptoms and several medically defined illnesses. It was felt unlikely that lay members of the public would be familiar with the terms ‘common respiratory infection’ or

‘respiratory tract infections’ even though they would undoubtedly have had

experience of these types of infection. I recognised that my nursing background and familiarity with the currently accepted scientific determinates may influence how I conceptualised CRI. The opening question was, therefore, designed to allow the respondents to reflect upon whatever RTI was common to theme without leading them to reflect on any particular symptom or illness (See Appendix 5 for a description of the interview schedule).

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Respondents were read a list of symptoms associated with a variety o f common non­

specific minor respiratory illnesses and were asked to reflect on their feelings when they started to feel unwell from any o f the symptoms. The benefits of this approach were that respondents were given the opportunity to talk about whatever illness episodes they chose, or whichever came to mind. It also generated data on lay classification of common infections. In addition, the opening question aimed to signify to respondents that the interview was concerned with personal experience. I wanted to encourage respondents to reflect upon their personal experiences and not to think of respiratory tract infections, antibiotics or bacterial resistance purely as theoretical concepts in isolation. The benefits of asking respondents to talk about their experiences as opposed to theoretical ideas were recognised by Blaxter (1983).

I hoped that reflecting on personal experience would enable interviews to flow, respondents to talk freely and rich data to be generated.

The relationship between the interviewer and the interviewee has the potential to influence data. Cornwell (1984) has argued that when the researcher and research participant are relative strangers, such as in this study, respondents are more likely to give socially acceptable views reflecting the moral standpoint of the wider

population. Sociologists have also commented on the influence o f other variables on fieldwork relationships-typically gender, age, and ethnicity (see for example Oakley,

1981). Although a lack of shared socialisation may limit the researcher’s ability to fully comprehend the respondent’s perspective, accounts of fieldwork relationships may overstate the importance of obvious social categories. Perhaps what is of more importance, to the respondents at least, is the researcher’s personality and their overall performance during the interview (Bloor and Wood, 2006). I used several

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tactics to minimise these potentially disruptive influences. I gave careful explanation of the focus of the interview both verbally and in the participant

information sheet. If asked, I did admit to being a qualified nurse (but not practising as a nurse at the time of data collection). I attempted to put respondents at ease by informing them (before the interview commenced) that there were no wrong or right answers to the questions and by being as unselfconscious and as relaxed as I possibly could, although in the early stages this was difficult. Respondents were also

encouraged to give open and honest responses. Pill and Stott (1982) recognised that respondents found it more difficult to talk about abstract concepts than their own health experience. Therefore, whenever possible, respondents were asked to reflect on their personal experiences. For example, in the opening question I asked

respondents to tell me what they did when they started to feel unwell with a CRI, in the hope that individuals would tell me their story, to give a personal narrative account of their experiences.

Some respondents asked about my own biography and some for advice on health- related issues. Traditionally, research texts encourage the interviewer to avoid disclosures during interviews in order to maintain objectivity and to minimise response bias (Polit and Beck, 2006). Feminist researchers, however, question whether it is possible to remain completely neutral during interviews, arguing that there should be an equal and reciprocal relationship where personal information is shared by both parties (Oakley, 1981). My initial ideas about how I should approach interviewing were traditional, that is, the interviewer is there to gather data not to provide specialist information. However, I found myself repeatedly questioned by respondents and felt obliged to provide some medical information from time to time.

One respondent (R32) was adamant that the interview relationship should be

reciprocal. The interviews, therefore, became more than just a question and answer session.

R32: What do you think o f that? I think I am entitled to ask your opinion? (72-year- old man, low deprivation urban ward).

When questioned about either the study or myself, I gave open and honest answers.

Where respondents sought health advice I referred them to their local health care service, feeling that this protected all parties’ best interests. I declined to answer questions about the research topic until interviews had been completed. I continued to audio record these later conversations in case any theoretical significant data was generated.