Focused coding

Focused coding entailed organising and managing the developing analysis; focusing the analysis, as initial codes were explored and decisions about which to focus upon were made (Charmaz, 2014). Focused coding drew the researcher further into engaging with the participant’s transcript, as data extracts were re-read and compared with initial codes to direct and develop focused codes. When focused coding, initial codes were raised based on their prevalence, importance to the research questions, and which initial codes make the most analytic sense. Practically, this equated to raising and synthesising initial codes which were underpinned by the same or similar meaning; or where initial codes were pulled together to build a picture; or single codes which added a unique perspective or were central to the research questions. Consequently, focused codes were composed of one or many initial codes. Table 3.1. (see page 116) highlights how the initial codes shown in Figure 3.2. (see page 115) directed the analysis, and were raised and synthesised to form focused codes. For example, the initial codes Trying to help the client in a person-centred way

and Not seeing them as a “statistic like GPs” were synthesised together to form a

focused code which explicated the individuality they illuminated; this was labelled

Focused codes were usually given a new label, which detailed and illustrated the underlying meaning of the raised initial codes (as demonstrated in the previous example); again, to illustrate action and processes, gerunds were applied where possible to label focused codes, for example, Addressing shortcomings (from Table 3.1., page 116). However, In vivo focused coding was also utilised, where labels of initial codes were maintained for focused codes when either a level of abstractness was achieved, or when the researcher believed an important element of the

participant’s voice was represented in the initial code label. For example, the initial code Being able to “just pick up the phone” for support incorporated a piece of Pat’s voice and illustrated an important method of accessing support. To maintain its meaning, this initial code was raised to a focused code, with its label intact. This ensured the data and participant’s voice directed and were rooted in the progressing analysis.

Table 3.1. Examples of Focused Coding (Pat, Interview 1, Page 2). Focused Code Initial Code

Addressing shortcomings Taking steps to overcome shortcomings; Following advice and guidance from consultant

Losing support Losing support

Feeling the loss of support Affected ‘terribly’ with the loss of the health facilitation team; Appreciating support; A sadly missed form of support Treated client as an individual Trying to help the client in a person- centred way; Not seeing them as a ‘statistic like GPs’

GP not adapted Not adapted for the client

Services lacking understanding of intellectual disability

Not all services are understanding of LD let alone LD and dementia

Responsive to us Responsive to requests; Supported by a team

Focused coding was performed on each page of the transcript: ensuring thoroughness in the developing theory. Again, after completing focused coding, the researcher re- read the focused codes, checking their fit to initial codes; where necessary focused code labels were changed to ensure better representation and explanation of initial codes. For example, for Pat, the focused code, Communicating changes to staff became Supporting staff awareness. The latter better illustrated the process which underpinned the initial codes: the support offered to staff to ensure awareness of changes in the person with an intellectual disability and dementia.

Once satisfied that focused codes had focused the data whilst maintaining and being rooted in the participant’s voice, and to ensure the data for each participant was manageable, focused codes were clustered together to form overarching focused codes. Focused codes from across each participant transcript/s, were brought together based on shared meaning (see Table 3.2., page 118 for an example of this process). Focused codes were compared to one another by reading the initial codes and data extracts which underpinned them. Where there were similarities, focused codes were clustered together to form an overarching focused code; this could include focused codes at the opposite ends of the same continuum. For instance, for Pat, the overarching focused code Continuum of support encompassed focused codes which illuminated being supported as well as losing support (see Table 3.2., page 118). Both came under continuum of support but highlighted different properties of the overarching focused code.

Table 3.2. Sample of Overarching Focused Codes and the Clustering of Focused Codes from which they were Developed (Pat).

Sample of Overarching Focused Code Sample of Clustered Focused Codes

Continuum of support Being supported by external services Responsive to us

Supported by company

Being able to ‘just pick up the phone’ for support

Missing a stepping stone

Having to manage without facilitation team

Consequence of loss of support Understanding Treated the client as an individual

Services accommodating client

Lack of understanding results in lack of adaptations

Need for professionals to have understanding

Impact of dementia Burden of dementia

Negative emotions after diagnosis Added demands of dementia for carer Taking more time

Continuity Ensuring client can stay at home

Upskilling ourselves so they can stay at home

Ensuring the client is kept at home Making it work

The number of focused codes which formed overarching focused codes depended on their prevalence throughout the participant transcript/s. Constant

comparison of focused codes across the transcript/s, enabled the properties of overarching focused codes to be defined. To maintain their relationship with the data and the participant’s voice, focused and initial codes were placed in each participant’s analysis document (see Appendix K for an example of each participant’s analysis document), alongside the relevant overarching focused code. This provided physical evidence, an audit trail, of the overarching focused code’s meaning. This also allowed the researcher to compare overarching focused codes with one another: their meaning and properties. This highlighted overarching focused codes which needed to be subsumed into other overarching focused codes due to shared meaning. For example, by comparing Pat’s overarching focused codes, her focused codes, initial codes, and data extracts, the overarching focused code, Loss of support, was subsumed into

Being supported, and re-labelled Continuum of support. The researcher believed both

to be properties of experiences of support.

Bringing focused codes together, to form overarching focused codes, progressed the analysis; it increased its abstractness, and developed understanding of the processes in each participant’s experiences. Like previous stages of the analysis, overarching focused codes were checked by the researcher for their representation of focused codes and the data, and the understanding they provided for the participant’s experience. This was supported through constant comparison. As focused codes were clustered, and overarching focused codes compared, a constant checking process was applied to ensure that it made analytical sense for focused codes to be clustered under an overarching focused code.