Design Considerations: Data Collection

The type of data collection method favoured for the IPA approach is usually semi- structured interviews (Barbour, 2008), because they allow the researcher to explore personal to general issues on the topic under investigation in a flexible way with the guidance of an interview schedule (Smith et al., 2009). Unstructured interviews are also advocated by Smith et al. (2009) for IPA data collection, to gain clarity and understanding from the perspectives of the participants, and not from the

researcher’s own perspective which a highly structured interview would potentially reveal (Steen & Roberts, 2011).

Other data collection methods such as focus groups and diaries have been used for this approach, but one-to-one interviews whereby questions are asked of the participant and further questions are modified in light of the participant’s responses are preferred to facilitate the researcher and participant engaging in a dialogue (Smith, 2007). The researcher chose to use one-to-one interviews in both parts 1 and 2 of this study because this meets the concepts of IPA data collection (Smith et

al., 2009), as there is a clear emphasis on the importance of the participants’

individual accounts when following this approach (Roberts, 2013). Focus groups were also considered as they are now being advocated as a method to collect data utilising this approach (Palmer, Larkin, de Visser, & Fadden, 2010; Hawtin & Sullivan, 2011; Aubleeluck, Buchanan, & Stupple, 2012). A criticism of using focus groups is that the researcher has to ensure that consideration is given to the individual voice, so that it does not become eclipsed by the group, which has

previously happened when using focus groups for IPA studies (Tomkins & Eatough, 2010). After due consideration focus groups were not chosen, due to the potential difficulties of collecting data using this method and because one-to-one interviews were thought to meet the integrated principles of IPA in this data collection approach (Palmer et al., 2010), whereby ‘the participant talks and the researcher listens’ (Smith et al., 2009, p.57).

Conducting an interview can be an intense and time consuming process, as the interviewer has to become immersed into understanding the situation from the participants’ perspective (Gillham, 2005), which again fits the remit of the IPA approach to collecting data. Still, the distinct advantage to using interviews is that they draw from the interviewee a vivid picture of the experience which leads to understanding of shared meanings (Sorrell & Redmond, 1995). This fulfils the aim of IPA, which is to interpret peoples’ experiences of phenomena and how they

understand it. This can only be achieved if the participants are not influenced by the researcher.

Prior to all interviews being digitally recorded in this study, a social conversation aimed at creating a relaxed and trusting atmosphere was strived for to put the participants at ease (Mapp, 2008). Next the researcher suggested to all interviewees that they take a few moments to focus on the experience fully, prior to the start of the interviews as suggested by Moustakas (1994).

4.5.1 Data collection: Part 1

It is suggested that an interview schedule is required to guide researchers, but they must be wary of planning to ask too many questions and using too structured a format because participants may be less forthcoming in their responses; a flexible approach is therefore advocated (Pringle et al., 2011). Because of this, and to collect data from the participants’ perspectives with no undue influence from the researcher, unstructured one-to-one in-depth interviews were chosen as the data collection method in part 1 of the study. One question was asked of all the

participants in part 1: ‘Please tell me what it means to you to care for women

either antenatally, intrapartum or postnatally with BMIs ≥30kg/m2_{?’ This meets} the principle of conducting an unstructured IPA interview, whereby one question is asked and ‘how the interview unfolds will then depend on how the participant answers this first question’ (Smith et al., 2009, p.69). Reflexivity was strived for in that no assumptions were made by the researcher (Kingdon, 2005) about the participants’ potential responses, as discussed in chapter 3. The researcher did not guide responses during the interview and the participants identified the areas of the topic they wished to express. This was a very important and crucial aspect of the research design for the study, namely that the participants in the first phase of data collection had a voice, shaped the study’s findings and gave meaning to what it is to care for women with raised BMIs during the childbirth continuum. Essentially, this data collection process aimed to attempt to ‘implement IPA’s inductive epistemology

to the fullest extent’ (Smith et al., 2009, p.70), a participant-centred approach to realising new information.

All interviews were digitally recorded with consent (Rees, 2011). Participants were offered a choice of locations for the interviews to take place (Mapp, 2008). Out of the sixteen midwives who participated, two were interviewed in their own homes, eight were interviewed in a hospital setting (in a private room), and the remaining six were interviewed at three different campus settings (in private rooms). The length of the interview was guided by saturation, e.g. when no new information was

forthcoming (Cohen, 2002). The interview lengths ranged from 30 minutes to 70 minutes. The shorter interview lengths were from the eight midwives, who were interviewed in their own hospital setting; and though the interviews were shorter, the midwives appeared to have considered what they were going to say and spoke at speed. The longest interview was in the participant’s home, suggesting participants feel under pressure in a hospital setting and the optimum location would be their homes, which Smith et al. (2009) concur with by stating that participants are most comfortable in familiar surroundings. Data collection commenced on 7th January 2012 and was completed by 30th March 2012.

Though the plan to collect data from this group was to use unstructured interviews, probes were prepared to give confidence to the researcher conducting the interview. Gillham (2005, p.32) recommends the use of probes as a ‘form of responsive encouragement; to help participants expand or clarify or develop their account’. One example is ‘I’m not sure I’ve quite got that’ (Gillham, 2005, p.33), so the interviewee clarifies or explains or expands on what they are describing from their perspective. Using phrases such as ‘take your time’ can reassure participants and aid the flow of the interview (Jones, 2004, p.43). Gillham’s (2005) probes were not required in this sense, but repetition of the question was utilised by the

researcher if the respondents appeared to be faltering in their focus.

4.5.2 Data collection: Part 2

Part 2 involved collecting data from 3rd _{year student midwives on the point of}

qualification using semi-structured interviews to allow flexibility (Smith et al., 2009) if a topic was not raised which was discovered in part 1 of the study. The students were all asked the same question: ‘Please tell me what it means to you to care

for women either antenatally, intrapartum or postnatally with BMIs ≥30kg/m2_?’ If a student appeared to be ‘drying up’, another question was asked but with the same intended meaning: ‘What does it mean to you to care for women with

semi-structured interviews was not to lead the participant in their answers, but to discover if there was a difference in what it meant to the students to care for this client group.

Table 4.3 gives an outline of the interview schedule which was produced in order to prompt the researcher to ensure that all the areas for investigation had been explored. Only one prompt of, ‘How does it make you feel to arrive on a labour

ward shift and to be allocated to care for a client with a raised BMI?’ was used

by the researcher, as none of the students mentioned the ‘sinking feeling’ or ‘hard work’, issues which the midwives had emphasised in their interviews. This question was posed to the students in a scenario format so as not to influence their answers.

One question that was asked of the students which differed to the unstructured interview format of the midwife interviews was, ‘Do you feel prepared by your

training to care for this client group?’ This question was added for four reasons,

principally that the findings realised in part 1 of the study identified the difficulties that midwives had encountered in caring for this client group, that in the midst of an obesity epidemic there is a rapidly changing landscape of the maternity population in the delivery of midwifery care, and that the shortest time that participants had been qualified in part 1 was three years. From the researcher’s perspective it also provided an opportunity to seek confirmation that present training methods are adequate.

Table 4.3: Interview schedule for part 2: 3rd _{year student midwives} Question 1

Prompt

Please tell me what it means to you to care for women either antenatally, intrapartum or postnatally with BMIs ≥30kg/m2_?

What does it mean to you to care for women with raised BMIs (≥30kg/m2_{) during} the childbirth continuum?

Super-ordinate theme prompts

 Catch 22 How have you found communication with

this client group?

 Size matters Does size matter in caring for this client

group?

 Negative impact How does it make you feel to arrive on a

labour ward shift and to be allocated to care for a client with a raised BMI?

 That sinking feeling How does it make you feel to arrive on a

labour ward shift and to be allocated to care for a client with a raised BMI?

 Caring against all odds Do you think that you can promote

normality with this client group?

Question 2 Do you feel prepared by your training to

The students were offered a choice of locations for the interview setting, but all chose the campus site of their training for convenience and the interviews were conducted in a private office. All the interviews were digitally recorded with consent; audio-recording interviews is considered to be the optimum choice for gathering information during an interview (Steen & Roberts, 2011), and to provide a rich source of data which can be analysed after the interview. Nuances of description may be missed if the interviewer is handwriting the notes of the interview whilst it is occurring (Mapp, 2008). In addition, Robinson (2006) suggests that the researcher should have the facility to make notes once the recording has finished, because at this time it is not unusual for participants to provide further data. For all interviews in both parts 1 and 2 of the study, the researcher had available a book and pen with which these comments were recorded. Initial impressions about what the

participants were trying to express and convey were also noted post-interview when the participant had left the room. The length of the interviews ranged from 25

minutes to 60 minutes. The students did not appear to be as relaxed as the

midwives about being recorded, and did express comments once the recordings had stopped. Data collection commenced on 16th _{August 2013 and was completed by}

20th _{September 2013.}