Stage One, Narrative Interview

During the first stage of the proposed five-stage model, Carspecken calls for the unobtrusive and passive collection of data through observation. This outsider, or

‘etic’, perspective aligns with Spradley’s (1979) recommendation that all ethnography start with a “conscious attitude of almost complete ignorance” (p. 4). Having had no prior relationship with my participants, however, a process of passive observation was not considered appropriate. Further, I aimed to be an active participant in the observation session and not a passive observer, as promoted by stage one of Carspecken’s model. Instead I chose to begin data generation with a narrative interview (see Appendix K), prior to completing ten individual participant observation sessions, which represented the second stage of my data collection process.

Prior to beginning with any formal data collection, the letter of information and consent form was reviewed with each participant. This consent process was altered so that no demands were made upon a participant to read printed material. In order to accommodate informants’ vision loss, the information letter and consent form was printed using enlarged font (Verdana 14 point font) and was read to each informant by myself. Participants who required hand-over-hand assistance with writing were directed to where they were required to sign the consent form.

Following a review of the letter of information and consent process, I engaged participants in an audio-taped narrative style interview focusing on the

participant's experience with age-related vision loss. Although Carspecken recommends the interview stage be the third step in data collection, I began with a dialogic means of data collection. Because I had not met the participants prior to data collection, it seemed most appropriate to begin the process using a dialogical approach, such as a narrative interview, in order to create a space for the research participants voice to be heard in the research process. I applied Wengraf’s (2001) lightly structured narrative interviewing approach in order to elicit the participant’s story of their vision loss. I posed the following question during the narrative interview:

Can you tell me the story about your experience with age-related vision loss?

After asking the question, I attempted to create a space in which the participant told their story of age-related vision loss in as much or as little detail as they wished, without interrupting them. I took notes of the main events in the order in which they were told. After the participant was finished their narrative, I asked a series of follow-up questions both to clarify information presented as well as to elicit more detail regarding their story. Follow-up questions were presented in the same order as the participants' story was told. The narrative interviews ranged between 46 and 100 minutes in length with an average of 83 minutes.

Following the narrative interview, I administered the Visual Functioning

Questionnaire (VFQ-25) (see Appendix L), which is a self-reported vision-related health status survey consisting of 25 questions across 11 sub-scales (global vision rating, difficulty with near vision activities, difficulty with distance vision activities, limitations in social functioning, role limitations, dependency on others, mental health symptoms, driving difficulties, limitations with peripheral vision, colour vision, and ocular pain) (Mangione et al., 2000). Although the survey indicates it takes only 10 minutes to administer, the assessment took closer to 20

minutes to administer with the older adult participants, as many of the questions would elicit further narrative. The VFQ-25 results (see Table 3.4) were used to summarize the degree of functional performance difficulties each participant had resulting from age-related vision loss. I conducted the VFQ-25 verbally with nine of the participants. One of the participants requested to complete the assessment independently in-between the time of the narrative and semi-structured interview. This participant completed the VFQ-25 independently; however, we then

reviewed the responses together to ensure that the participant had an

opportunity to ask the researcher any questions. The participant did not make any changes to her responses.

Table 3.4: Visual Function Questionnaire (VFQ-25) Participant Results

P1 P2 P3 P4 P5 P6 P7 P8 P9 P10 Overall Mean General health 50 50 0 75 50 75 50 75 0 25 45 General vision 20 40 0 40 40 60 40 20 60 20 34 Eye pain 88 50 100 75 87.5 100 50 25 100 100 78 Near activities 25 33 17 50 17 67 33 25 83 25 38 Distance activities 0 8 8 58 8 50 37.5 16 75 8 27 Social functioning 12.5 37.5 37.5 50 0 87.5 37.5 12.5 62.5 25 36 Mental health 56 25 31 81 69 81 44 6.25 69 50 51 Role difficulties 87.5 75 25 75 37.5 100 25 62.5 75 50 61 Dependency 50 25 17 100 42 92 83 33 83 50 58 Driving N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A Colour vision 100 50 0 50 25 100 100 25 100 100 65 Peripheral vision 0 25 0 75 25 75 50 25 50 50 38 Overall Composite Score 44 37 24 65 35 81 50 25 76 48 49 *VFQ-25 scores reflect a quality of life indicator from 0 (lowest possible score) to 100 (highest possible score). The overall composite score is an average of the 11 vision-targeted subscale scores (not including general health ratings) for each participant. Overall mean scores across participants were lowest in the areas of distance activities, general vision and social functioning.

Following completion of the VFQ-25, I also collected basic demographic information through the administration of a demographic questionnaire.

Questions were asked to each participant orally and responses were recorded by the researcher. Through the initial narrative interview it became clear that many of the participants had difficulties with reading and writing. My decision to

complete the demographic questionnaire orally was intended to accommodate for that challenge.

By beginning data collection with a narrative interview I invited my participants to share the experiences of their age-related vision loss that were important to them, attempting to minimize the imposition of my own research agenda. The participant observation session and the semi-structured in-depth interview followed the narrative interview and therefore were used to expand the findings presented by the participants in this initial meeting. This dialogic approach to data collection coupled with my focus on a collaborative process of meaning- making between myself and the participants was congruent with the ontological and epistemological underpinnings of the research study.