PROCESS OF DATA COLLECTION

3.9.1 Quantitative data collection

The quantitative data collection process was multi-staged. First, the researcher had to obtain all the in-hospital physiotherapy statistics for the period 1 January 2008 to 31 December 2009 from the Records Department. The researcher then had to go through those statistics month by month, in order to identify the stroke patients admitted to the Hospital who had been referred for physiotherapy, since only patients that had been referred for physiotherapy while hospitalised, were included in the

study. The researcher then made up month-to-month lists for the specified time period, which included the patients’ names and folder numbers. These lists were typed up and given to the research assistants, for data collection purposes. A list of the inclusion and exclusion criteria was given to each of the research assistants, in order to ensure that data would be extracted from only those folders that met the inclusion criteria.

The records had to be hand searched by both the researcher and the research assistants. The records were kept at the Central Records Department of the Hospital. The Records Department had a specific system to collect the records, which was related to the hospital folder number. It took the entire research team some time to get accustomed to the filing process, which was a time consuming and, at times, a frustrating exercise. On several occasions, each of the researchers went in with a few lists of names and folder numbers, but succeeded in locating only a few folders. On an intermittent basis, some of the clerks would go through the lists with the researcher present. They would then also only succeed in locating the folders that had already been located by the researcher herself. Some of the clerks checked the hospital computer system, which showed that while some of the patients had been readmitted, most of the folders should be in the Central Records Department.

Possible reasons for the missing folders, as offered by the clerks, were that the folders had been misplaced or that patients had taken the folders home with them.

That this had indeed occurred, was discovered by the researcher when conducting the prospective part of the study.

Of the 461stroke patients admitted to the Hospital over the specified time period, only a total of 349 folders were found after numerous attempts to locate all the relevant folders. As mentioned previously, 181 of the 349 folders were excluded due to the inclusion and exclusion criteria, 112 folders were not found, despite several attempts and 168 folders were eligible for inclusion. Data was collected over the period of March 2010 to December 2010.

The information collected from the 168 folders was then captured on a Microsoft spreadsheet. All relevant demographic data and contact details were recorded and the patients were contacted by the researcher in order to set up appointments for interviews. Of the 168 patients, only 24 patients were successfully contacted and agreed to take part in the prospective study. The problems that were encountered, included: patients were not willing to be interviewed; patients were not medically fit to be interviewed; or where patients had demised or had relocated. Other logistical problems were the lack of telephone numbers on the patients’ files, incorrect or disconnected telephone numbers. The researcher then arranged for an appointment at a time and place that was convenient for each participant. On the day of the interview, the researcher (student) discussed the aim of the study and obtained written informed consent from the patient. The Barthel Index, the Modified Rankin Scale and the FABS, were then completed. The majority (20) of the interviews were conducted at the patients’ homes, while four were conducted at a nearby Community Health Centre. The interviews conducted at the Community Health Centre were completed in a private room. The questionnaire took approximately one hour to complete.

3.9.2 Qualitative data collection

The qualitative interviews were conducted after the quantitative interviews; and these were also conducted by the main researcher (student). The aim of the interviews was to determine and explore the barriers and facilitators to participation of the participants. These interviews were, therefore, conducted a few months after the quantitative study in order to try and minimise the recollection of the questions in the questionnaires (recall bias) on the part of the participants. The participants who were part of the quantitative prospective study were contacted telephonically to ascertain their willingness to be interviewed. The qualitative interviews were conducted at times and places convenient to the participants. Many participants preferred to have the interview conducted at their homes. One patient preferred having the interview conducted telephonically. Telephonic consent was obtained to conduct the interview and to have it recorded. The qualitative interviews were recorded by means of a digital voice recorder, but where the patients did not give their consent for the recording, detailed field notes were made during and immediately after the interview.

Four of the participants gave consent to be recorded, while the remaining ones refused digital recording. As previously mentioned, face-to-face interviews were used in the current study in order to obtain in-depth descriptions of and reasons for participation restrictions post stroke. According to Domholdt (2000), the value of face-to-face interviews is that they offer researchers in-depth responses, and allow them to maintain control over who actually respond and to determine the opinions of those who cannot read or write. An interview guide (Appendix E) was used to guide the interviews. The interview guide was developed, based on the literature consulted

(Wood et al., 2010; Barker et al., 2006; Hare et al., 2006). The interviews were conducted in a language in which the participant was fluent in.

3.9.3 Trustworthiness of qualitative data

Tendencies from the transcribed interviews were kept as close as possible to the respondents’ own mode of talking (Shepard, 1997). The participants were interviewed in a language of their choice. At no point did the researcher require the services of a translator, since the participants were comfortable to converse in either English or Afrikaans. Member checking was the form of verification used. The stories that the participants shared during the interviews, were summarised and then retold to them by the researcher to ensure that the researcher understood the information given during the interview correctly.

To enhance the credibility of the qualitative data, the themes presented were illustrated with representative quotations from the transcribed texts (Graneheim &

Lundman, 2004). Peer examination was done by discussing the research process and findings with colleagues and experts at the Nelson Mandela Metropolitan University who had experience of qualitative research methods. These individuals were required to go through the field notes and transcriptions, data reduction and condensed notes, data reconstruction and thematic categories and interpretations (Lincoln & Guba, 1985) in order to ensure the confirmabiltiy of the qualitative data.