Data collection

Polit and Beck (2012:725) describe data collection as “gathering of information to address a research problem”. According to Burns and Grove (2011:534), data collection is

“identification of subjects and the precise systematic gathering of information that is relevant to the research purpose or the specific objectives, questions or hypothesis of the study”.

3.3.3.1 Data collection approach and method

A self-administered structured questionnaire (Annexure C) was developed specifically for this study in order to collect the data from the respondents. As stated by Burns and Grove (2011:544) “questionnaires are printed self-report form designed to elicit information that can be obtained through written or verbal responses of the subjects”. Questionnaires can be designed to determine facts about the subject or persons known by the subject, facts about events or situations known by the subject or beliefs, attitudes, opinions, levels of knowledge or intentions of the subject.

3.3.2.2 Development and testing of the data collection instrument

The data collection instrument was prepared in consultation with the maternal child women’s health co-ordinators, specialist doctor for obstetrics and gynaecology working in a regional hospital; a statistician and from information obtained from literature review.

References to guidelines for maternity care in South Africa; a manual for clinics; CHs and district hospitals for 2007; WHO recommendations for prevention and treatment of pre-eclampsia and pre-eclampsia 2011; and guidelines used by clinics and hospital around

Questionnaire

The questionnaire was pretested on eight experienced clinicians, two obstetricians, two advanced midwives, and two experienced midwives at an obstetrics and gynaecology outpatient clinic. Two clinical assessors (nurses) who render basic antenatal care were also involved in the pretesting. The shortcomings were identified, such as the fact that drugs that are not used in primary health care settings were removed; questions were corrected to specify the exact questions required.

3.3.2.3 Characteristics of the data collection instrument

A structured and self-administered questionnaire was designed for collecting data (Annexure C) of the study. The questionnaire comprised of the following eight sections:

Section A: Demographic questions

Under this section, gender, age, qualifications, experience and position occupied by the participant as a midwife was asked.

Section B: Training on guidelines

Questions on training specifically on guidelines were asked. The respondents were given ranking structure of five options: Agree - Strongly agree – Neither agrees or disagree – Disagree and Strongly disagree.

Section C: Awareness of the guidelines

In this section, respondents were requested to respond on whether they were involved in the formation of guidelines; if guidelines were easily accessible; clear and easy to follow, and if they perceived the guidelines as effective and necessary to implement.

Section D: Referral system

Respondents were tested if they were aware and knew how and when to refer the mother who was having hypertensive disorder in pregnancy.

Section E: Equipment

The knowledge on how to use and take care of equipment was tested.

Section F: Identification of risk

The knowledge on risk factors was determined.

Section G: Medications

The knowledge of prescription of medication as per guidelines was assessed.

Section H: Health education

Knowledge about health education was assessed.

3.3.2.4 Data collection process

Polit and Beck (2012:725) describe data collection as gathering of information to address the research problem. Questionnaires were printed together with the consent forms and a letter to respondents. The researcher discussed with the operational managers and the primary health care coordinators the issues around the research study after the perinatal meeting, which was held in November 2015. The above mentioned subjects were shown permission that was granted by the KZN Health Committee and the District Manager of uMgungundlovu.

Copies of questionnaires were distributed to 17 clinics. Attached to each questionnaire were the following documents: Annexure A, a letter to respondent; Annexure B, a consent form, and Annexure C, questionnaire copy. The total number of copies that were distributed to the clinics was 150. The issue of willingness to participate was discussed and midwives were not forced to fill in questionnaires, only the consenting parties filled in

3.3.2.5 Ethical consideration related to data collection

According to Burns and Grove (2011:107), there are three ethical principles that are relevant to the conduct of the research involving human subjects; these are respect for persons, beneficence, and justice. Polit and Beck (2012:152) describe beneficence as imposing a duty on researchers to minimise harm and maximise benefits. The principles of ethical consideration were maintained through the study.

Informed consent was prepared for the participants who willingly agreed to participate.

Information was given to participants about the study. The names were not used in the questionnaire; numbers were allocated for each script.

 Rights of participants

Ethical consideration was ensured through respecting the right of each participant to self-determination; consent was requested after reading the letter that was informing the participant about the study. The respondents’ information was kept anonymous.

The study used a self-administered instrument with no risk imposed during data collection process. No harm was generated through the research process.

 Institutional rights

Ethical approval was obtained from both the Higher Degrees Committee of the Department of Health Studies at the University of South Africa (Annexure D). The UMgungundlovu District manager after requisition that was made to conduct study gave an approval letter (Annexure E). The KwaZulu-Natal Health Research Committee also gave approval for the study to be conducted (Annexure F).

Health facility administration was informed about the study and the purpose of the study was explained; permission to conduct the study including collection of data was produced as evidence from The KwaZulu-Natal Provincial Health Department.