In interpreting the results of my study, there were some limitations which should be taken into consideration.
The study was undertaken specifically for the completion of a Master of Philosophy in Child Health, taken as an intercalated degree as part of an undergraduate degree in Medicine. The time period for conducting the study was therefore limited and
affected the ability to continue to recruit a wide range of different participants to the study over a significant time period. Although the recruitment pool appeared as though it would be quite large at first as I had planned to recruit using Health Visitors, initiating recruitment took much longer than expected and the number of
potential participants decreased as a result. Overall the number of participants was therefore smaller than I had hoped for, although I still felt saturation was achieve. There is much debate amongst qualitative researchers as to how many participants should be included in the sample size in order to reach saturation of ideas. One review evaluates the literature available to explore the ‘ideal’ sample size in qualitative research. It found seven sources which gave specific guidelines to the numbers one should include in a sample.(129) The results ranged from at least 6 participants in phenomological research to 30-60 in ethnographic, with one report suggesting that for all qualitative research the minimum number to reach saturation is 15 participants.(129) In total 27 participants were recruited for my study with a total of 26 being included, 21 semi-structured interviews and 5 participants in the focus groups, which surpasses the 15 recommended. Despite the issues faced with
recruitment and the lower than expected number of participants, I managed to recruit a large variation of parents in terms of socio-economic backgrounds, ages, ethnicities and relationships status. This is likely to go some way to representing the views of most caregivers in Merseyside. There was however limited views from younger parents of less than 25 years old which may have altered the results. Younger mothers may seek advice from different support networks to those older parents interviewed, such as the service provided by the Family Nurse Partnership which was not discussed by any mothers interviewed.
Although the overall sample size and number of semi- structured interviews was not as large as I had hoped for, the themes emerging were re-occurring amongst
participants and it was likely that I was reaching a point of saturation of ideas. This became clear with each interview as all interviews were conducted by me. It was also agreed amongst the research team whilst discussing the progress of the project, that I was reaching the point of saturation as common themes were emerging and
subsequent interviews would not alter results.
The process of recruitment may have biased some of the results that emerged from my study. Despite having attempted to recruit parents at home through the Health Visitors by providing leaflets and information to parents, no parents contacted me in this way. I therefore recruited primarily through children’s centres. The majority of caregivers interviewed (N = 17) were recruited at children’s centres and were almost certainly using them, which may have focused results in terms of the discussions
held about children’s centres and the support that parents received. Attempts were made to reduce this bias and recruit those parents only attending for ‘weigh-in’ clinics and who weren’t using other services, but this was not always possible. As well as attempting to recruit through baby ‘weigh-in’ sessions, some recruitment also occurred during the ‘Baby Massage’ sessions as this is usually one of the first groups parents will sign up to. This was done with the hope that some parents were unlikely to have used other services or know the children’s centres well at this stage. Many parents reported this in their interviews. The technique of snowball recruitment was also used to recruit parents (N=4) and this resulted in the views of one parent who had not used children’s centres at all, although they had used other playgroups. By recruiting participants in this way it did not however stop interviewees discussing other services they had used and results show that in Merseyside parents are using more than just their local children’s centres to support their caregiving.
Time restraints meant that only one focus group discussion could be arranged and participants were selected by children’s centre managers. Despite practising the topic guide prior to the focus group discussion, English was not a first language amongst most of the participants as I had purposively sampled a mixed variety of ethnic backgrounds and socio-economic status for the group. This caused some difficulty in facilitating the discussion and encouragement of participation amongst the group. Their views however were very similar to parents interviewed and the different backgrounds of the participants added to the richness and the diversity of the parents included in my study.
Strengths of the Study
This unique study is one of the first studies to explore parents’ views across all the services and support avenues available to caregivers of children under two years old within the United Kingdom. My study has also been conducted at a critical time when the control of service provisions in Merseyside is to be given to local
authorities. It took place within a region where it is thought that many children are not reaching their developmental potential and it is therefore vital that we think
through what services parents’ value and need to enable them to be responsive, sensitive and reflective parents for their children, hopefully my study achieves this. Throughout the study Lincoln and Guba’s qualitative research terms were always at the forefront of my mind and it was important to ensure that research quality was maintained throughout.(96,97)
When evaluating the transferability of my study, the cohort of parents interviewed is representational of many modern UK cities and even despite their differing
ethnicities, socio-economic background and family dynamics the parents all reported similar views and opinions of why they use the help and support they do with their caregiving.
The number of participants although limited by time restraints, provided enough data to reach saturation and further interviews would have been unlikely to produce much new data.
The research team involved in the study come from many different professional backgrounds; paediatrics, child psychology, public health and a medical
undergraduate. Having this diversity in academic professions protected the study from any individual bias or preconceived ideas. This wealth of knowledge amongst the research team also aided in the development of the study aims and objectives to ensure the study would be of benefit and clinical relevance.
Whilst designing the study and deciding on the research methods I discussed the study with a variety of healthcare professionals in Merseyside including Health Visitors, psychologists and those involved in providing community health care in Liverpool. All aided in establishing the appropriate methods used and affirmed the importance of the study at this current time in Merseyside. I also attended a variety of qualitative research courses which gave me the opportunity to discuss the methods involved with people who had experience specifically in qualitative research
methods and no vested interest in the study. Most importantly during the planning process this project was discussed with a number of mothers and parents to ensure that the interviews and questions were appropriate; I was investigating something that was important to the people it would go onto effect. This along with embedding quotes within the results section aided the credibility and dependability of my study.
It is important at all times to reflect upon the role of the researcher during the study period and ensure confirmability of the research. Throughout the project I constantly reflected upon my experiences and with each interview improved upon my technique as well as reflecting upon and altering the topic guide to ensure that the information was relevant to the study aims throughout. Great consideration was also taken to avoid bias when it became clear I was limited to recruiting through children’s centres and snowballing techniques. Despite this recruitment technique, I took the time to establish the best way of recruiting parents who had minimal experience of children’s centres by fully immersing myself in all the centre had to offer and building up a positive relationship with the staff.