Data collection/semi-structured interviews

Qualitative research from within a social constructionist framework commonly employs semi structured interviews to collect data (Charmaz, 2006; Dick, 2005; Glaser, 1992). A semi-structured interview is a flexible way of asking questions that can be shaped by the interviewee’s own understanding and researcher’s interests (Bryman, 2004). Semi-structured interviews allow the researcher to investigate people’s perceptions of risk and risk communication and authentic insights can be gained into people’s experiences using open-ended questions (Dingwall and Miller, 1997). It allows participants time and space to talk freely about their personal thoughts, understandings, and experiences. Semi- structured interviews have the ability to generate in-depth detail about peoples experiences and the meanings of these experiences (Whittaker, 2002), allowing insight into their internal reality.

As the study topic is relatively under-researched, semi-structured interviews appeared the most appropriate method for a number of reasons. First, it allows the researcher to explore how patients think and talk about diabetes and diabetic retinopathy screening. It provides the researcher with the opportunity

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to create an environment in which patients feel that they are able to talk as freely as possible. Semi-structured interviews (face to face) provide the opportunity for flexibility (Dingwall and Miller, 1997) in order to cover a broad range of issues. Face to face interviews are practical and feasible within the time and cost constraints of the study:

“When we talk with someone about the world, we take into account who the other is, what that other person could be presumed to know, where that other is in relation to our self in the world we talk about” (Baker, 1982:109).

Dingwall and Miller (1997) argue that the research interview constitutes a deliberately created opportunity to talk about something that the researcher is interested in and which may or may not be of interest to the respondent. However, as (Bryman, 2004) has argued, there exist a wide range of issues that are simply not amenable to observation and creating a specific situation in which to ask people about different phenomena can be the only viable method of researching them. Semi-structured interviews employ a set of topics to inform questions in the style of conversation. However, there are a number of fundamental constraints which can affect the quality of an interview. These factors include variation between interviewee and interviewer (Cohen, 1982) such as mutual trust (especially when discussing a sensitive topic such as risk of blindness or diabetes self-care management with a minor ethnic group whose English is not their first language), social distance between interviewer and interviewee, misunderstanding about the use of language, which may be clear to one but not to the other. The interviewee may also well adopt avoidance tactics by not addressing the question or not saying anything (Cohen, 1982). This can be overcome by having follow-up questions or/and probes or by rephrasing the questions (Corbin and Strauss, 2008). Therefore, the researcher considered the broader picture and was aware of the factors that may have influenced the interviews. For example, the researcher considered the place of the interview whether it was conducted at the hospital, GP practice, or at participant’s home. The second issue considered by the researcher was whether the participant was relaxed or anxious during the interview. Another

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important factor was taken into consideration whether the interview was conducted at the same time of retinal screening or after a week or a month to explore the effect of the results on participants. Such factors were considered in order to minimize researcher’s influence on the reliability of the results (Marshall, 1996).

Other data collection methods were considered such as focus groups and structured interviews. Structured interviews mean that participants answer questions that are pre-set. It can be used if the focus of the study is narrow and the researcher wants to establish a particular fact (Silverman (2001). Focus groups usually refer to a group interview with around 10 individuals designed to discuss a specific issue or idea. The group are asked a series of questions by the researcher or moderator to which they can freely contribute and share their opinions and ideas. Kamberelis and Dimitriadis (2013) argue that focus groups provide the diversity of responses as well as have other advantages. Kamberelis and Dimitriadis (2013) also highlight some problematic issues with focus groups, such as protecting individual’s “anonymity”. Researchers are expected to respect individuals and therefore protect their integrity including their right to be anonymous. This means that focus groups may be beneficial when concentrating on public issues rather than individual’s issues, as individuals may not feel comfortable when personal issues are discussed in the presence of others. Writing (2015) argues that focus groups may not be as in- depth as individual interviews as they may not wish to expose how they feel. In addition, participants may not express honest views and feelings as they may hesitate to express their opinions, particularly when their views oppose the thoughts of rest of the group. Other important issues with focus groups (particularly with novice researchers) is that there is heavy reliance and dependence on the researcher’s skills in order to ensure that the opinions of each participant is heard (Krueger, 1988). The researcher or moderator (intentionally or unconsciously) may also influence the outcome of the focus group. McKie (1995) used discussion groups to find out about participation and views on screening. Although she states that the use of established groups ensured that women felt comfortable with each other and provided important support mechanisms, she felt that using this approach can have a reverse effect, with women being reluctant to talk about things in front of others that they

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may have otherwise disclosed. Therefore, in relation to sensitive and upsetting topics such as diabetes and blindness participants may feel intimated by the presence of others and may open up more in a one to one situation. In addition, group discussions of blindness and diabetes especially when participants are not adherent to the recommended treatment may cause unnecessary distress to patients.