Data Collection Tool

4.3.1 Rationale for choice of data collection tool

Recognised qualitative tools were considered for this study. Observations were discounted, as the researcher was not exploring behaviour (Cresswell, 2009) and pragmatically the researcher was only going to be able to see the participants on one occasion. Despite xxx a focus group being a good forum for opening up discussion amongst the PwS and their lived experience, it could restrict the participants being able to convey the details of their personal story. Documents such as personal accounts and diaries can enable the researcher to obtain the language and words of participants (Cresswell, 2009; J. A. Smith, 2008), however there are no opportunities to explore comments further with this tool. Also diaries were not available from during the REAcH trial for analysis and comparison. A structured interview design was rejected as it confines the interviewer to the questions set, and so would not allow the interviewer the scope to explore the topic (J. A. Smith, 2008).

Smith (2008) reports the most common and exemplary method to collect data for an IPA study is semi-structured interviews.

“This form of interviewing allows the researcher and participant to engage in a dialogue whereby initial questions are modified in light of the participant’ responses and the investigator is able to probe interesting and important areas which arise”. (Smith 2009 p57)

Semi-structured interviewing also allows the ordering of the questions to be adjusted, as needed, so that the respondent path may be followed in the interview, (Cresswell, 2009; J. A. Smith, 2008). Interviews also allow the capture of historical information, addressing the qualitative objectives. The disadvantages of this method can be that not all people are articulate and perceptive, and the interviewer may bias the responses (see section 4.7.3.1).

The researcher chose face-to-face interviews, rather than telephone or internet interviews, as by using this approach emotions may be captured first hand, noting non-verbal information such as body language. Also being face to face may help to maintain focus in the interview. This method would also allow the researcher to build on the rapport the researcher had established with the participant in the REAcH study

(the researcher had previously met all but one of the participants in the Salford arm of the REAcH study).

Semi-structured interviewing was chosen as the qualitative data collection method as it has the benefits of the researcher being able to probe further on interesting areas and the ordering of the questions are less important, as the researcher can follow the respondent path in the interview, (Cresswell, 2009; J. A. Smith, 2008). A structured interview design was rejected as it confines the interviewer to the questions set, and so would not allow the interviewer the scope to explore the topic (J. A. Smith, 2008).

4.3.2 Development of the data collection tool

Development of an interview topic guide forces the researcher to think explicitly with regard to what the interview might cover (J. A. Smith, 2008). By planning ahead, the researcher can give thought to any difficulties that might be encountered during the interviews, such as question wording or sensitive areas for discussion, and how these might be handled. With preparation and a good knowledge of the topic guide the interviewer can be confident in the questions and concentrate on the responses. There are different types of questions that can be asked, some general, some more specific. Questions that might be more sensitive are left till further on in the interview, as the participant is likely to be more relaxed and comfortable than at the start of the interview.

The researcher can use a variety of questions such as questions to elicit experiences, behaviour, action and activity. Background questions can also be used to understand the participants’ previous experiences, addressing one of the objectives of the study. Main questions can be used to begin topics and guide the interview. Probes can then be used to clarify and request further information on a topic. Probes need to be well timed, neutral and encouraging, not too inquisitive or demanding. Follow up questions can also be used to add depth by going back in time or going over points again (Bowling, 2009).

The content and questions of the semi-structured interview topic guide (see appendix 6) developed iteratively from the research aims (see section 2.11) and the literature review, along with the researcher’s academic and clinical knowledge and experience, (Bowling, 2009). The REAcH research team also contributed to the process, with their combined expertise in the field to assist to help revise and test the questions and ensure relevance to the study aims. The questions and prompts were also checked with academic supervisors and the interview guide was part of the documentation submitted for ethical approval.

The literature review helped shape the questions. Questions were devised to explore the experience of having an intervention (the REAcH study) in the chronic phase post stroke. As upper limb FES is still an emerging technology, investigation of the participants’ perceptions and experiences of the FES device were sought to assist in further usability, design and development of the technology (Hughes et al., 2011). The interviews also sought to capture any real or perceived changes in impairment, function or quality of life. The importance of the PwS’s personal view on recovery was discussed by Jones et al (Jones et al., 2008).

“The domination of physical measures of recovery, used in stroke research, their value to the individual, may also be misleading in terms of what constitutes a successful recovery.” (Jones et al 2008 p507).

PwS may also value recovery in terms of social, emotional and psychological changes, as well as in terms of participation and valued activities (Jones et al., 2008; J.H. Morris & Williams, 2009). This led to exploring the participants’ views of the facilitators and barriers to upper limb stroke recovery, which can be influenced by a range of individual internal and external factors (Jones et al., 2008). Barker et al (2007) noted that PwS tend to take a long term view of recovery and self-management is a factor in their recovery (Barker et al., 2007). The researcher wished to explore this area further in relation to participants’ own strategies, beliefs, attitudes and approaches. The researcher agreed with Barker et al (2007) that it was important to explore factors other than medical diagnosis and comorbidities, as the stroke recovery constitutes a complex phenomenon.

A pragmatic decision was made not to pilot the questions with actual participants as the potential participant numbers were limited by those who had taken part in the REAcH study, which had already suffered some drop outs. Therefore, the decision was taken not to recruit any of the potential participants as a pilot, so the richness of the data from any one of the participants of the REAcH study would not be lost. This decision was checked with the researcher’s academic supervisors and was clear as part of the application for ethical approval. The researcher did however reflect on each interview and used this process to refine subsequent interviews.