Data Collection Strategy

Data collection was carried out using semi-structured telephone interviews. Interviews were chosen as the means of data collection for several reasons. Qualitative interviews are deeply rooted in the tradition of SI and GT (Hopf 2010). In this regard, interviews are a helpful way to gain insight into peoples’ subjective experiences and attitudes (Peräkyla & Ruusuvuori 2011). They also allow for the possibility of directly clarifying ambiguities and asking emerging questions (Hopf 2010). Another advantage for this particular

research was that participants were likely to know each other from dialysis or post-transplantation follow-up, and might not have talked as openly in focus groups as in individual interviews (Birks & Mills 2011). However, there are some issues with interview research that must be acknowledged. For example, interviews are unpredictable to a large extent (Flick 2005) and highly reliant on the researcher’s interviewing skills. In qualitative

interviewing, the researcher must be aware that each party, the interviewer and interviewee, interacts with and influences the other and the course of the interview (Breuer 2010). This also applies if tacit assumptions or power imbalances arise during the interview (Mruck & Mey 2007). Distortions of memory may occur, especially if the interviewer “inadvertently misleads and reinforces inaccurate remembering” (Porter et al. 2000, p. 510). In all cases, a high extent of reflexivity must be applied.

Due to limited past experience, I opted to use semi-structured or

“semistandardized” (Berg 2013, p. 109) interviews, or interviews allowing the researcher to be flexible during the interview within a set of guidelines. Semi- structured interview should include the following features (Berg 2013) I applied when conducting the interviews:

The decision to offer participants telephone interviews was made after weighing the advantages and disadvantages. The most obvious disadvantage of telephone interviews is the loss of the non-verbal

expressions and visual cues that contribute considerably to the appreciation of face-to-face interviews (Opdenakker 2006, Nagy et al. 2010; Berg 2013). Also, contextual or social cues may appear covered, compared to face-to- face situations (Novick 2008). Another disadvantage of telephone interviews is the interviewer’s inability to create a good interview environment, as she has no influence of the participants’ choice of location and less influence on disturbing factors (Opdenakker 2006). It might have also been the case that participants would lack access to a telephone; however, in this sample all participants did have telephone access and most provided detailed

information on how (mobile phone or landline) and when they wished to be called.

Novick (2008) argues that there is little evidence of the inferiority of telephone interviews compared with face-to-face interviews. Indeed, telephone

interviews may also have advantages: for example participants may be more relaxed and open and thus reveal more intimate information. This may have to do with the researcher being more anonymous and therefore not being perceived as potentially threatening (Sweet 2002). Also, in telephone interviews, participants are able to choose a convenient interview location which may make them feel more relaxed (Novick 2008). Lastly, for this research, telephone interviews were pragmatic and logistically convenient (Birks & Mills 2011), as the town in which sampling took place is 275 km (171 miles) from where I am based.

Interviews were carried out following the guideline outlined in Appendices 9 and 10. After a short introduction to the research aims, the interview was opened by the main question “Please tell me how it is for you to take

medication on a daily basis?” Participants were allowed as much time for this question as possible, to maximise information gain. The interview guideline also included further questions that specifically elaborated on the research aims. If participants touched on new concepts, however, the interview guideline was sidestepped in favour of this new information. If participants were reticent, follow-up questions such as “please tell me more about…” were applied. Interviews concluded with “Is there anything else you want to say?” to enable participants to add anything they considered worthwhile. The issue of non-adherence in individual participants was deliberately not addressed, as this might have prompted participants to answer in a way they perceived to be 'right' socially, rather than openly, a tendency observed in other chronically ill patient groups (Wagner & Miller 2004). Also, a question regarding adherence could have evoked feelings of distress and shame, which could not be handled easily in an interview setting. Furthermore,

individual participant adherence was not the primary interest of this research. All participants were offered the opportunity to review a copy of their

transcript, sent by post or email, and add or delete anything that did not accurately capture their point of view. If no feedback was received within two weeks, the participant’s consent was assumed and the transcript analysed. All interviews were transcribed verbatim by me, using the software f4 (audiotranskription.de, Marburg, Germany, version 2012) following the transcription procedure described by Kuckartz et al. (2008).

This “simple” procedure includes the following features8 _{(Kuckartz et al.}

2008, p. 27):

 verbatim transcription

 existing dialects are not transcribed, language and punctuation are approximated to standard German; for example: „Da musst’ich noch‘ne Tablette nehm’n”9 _{becomes „Da musste ich noch eine}

Tablette nehmen“

 all statements regarding the interviewee are anonymised  clearer and longer interruptions are marked as (…)  distinctly emphasised terms are underlined

 affirmative and statements of the interviewer (such as mhm, aha) are not transcribed as long as the interviewee’s flow of words is not interrupted

 interviewee’s expressions emphasising the content (such as laughing or sighing) are put in brackets

 each change of speaker is indicated by a blank line

In addition to the interviews, fieldnotes and memos were written at all stages of data collection and analysis. Fieldnotes are “written records of

observational data” (Montgomery & Bailey 2007, p. 67); that is, notes made in direct relation to data collection (Birks & Mills 2011). In this research, fieldnotes were made after each interview to describe the participant's non- verbal expressions, my own responses to the interview, and ideas on the most important issues covered by the participant. For this purpose, the interviews were listened to in parts or as a whole, either directly after the interview had taken place or after the first fieldnotes had been recorded.

8 _{Own translation and summary}

Memos represent the researcher’s developing ideas regarding categories and facilitate abstraction of his/her ideas (Bryant & Charmaz 2007c; Montgomery & Bailey 2007). During this research, memos were written during data collection and analysis and helped me keep track of associations and findings, develop categories, and clarify their interconnections.