Qualitative Analysis Using the Transcript Provided - Essay Example

QUALITATIVE ANALYSIS USING THE TRANSCRIPT PROVIDED QUALITATIVE ANALYSIS USING THE TRANSCRIPT PROVIDED Introduction Community health workers have a lot of role to play in the promotion of health in the community. But according to the Council on Credentialing in Pharmacy (2013), as much as this role may have its own professional mandates, it is also important that service providers and service users have a say in the service they provide and receive respectively. It was against backdrop that the study was carried out to find what the views of a community healthcare provider on critical issues involved in the delivery of community health service. This was done to know how well what happens in practice corresponds with what is known in theory so as to measure the level of theory-practice gap (Denscombe, 2007). In this paper, the approach to analysing findings gathered through an interview and a presentation and analysis of the findings are presented. Description and justification of the analysis approach The overall approach to analysis data was based on content analysis. This was used for its advantage of analysing the outcome of interviews in its most natural way in which it was gathered (Bowling, 2009). There were three major stages involved in the content analysis procedure, all of which have been vividly presented below. Stage 1: Segmentation Segmentation was a process that helped the researcher in coming out with categories based on which subsequent codes will be constructed. The segments were therefore broad categorisation of meanings from the content of the interview (Hennick, 2011). For form the segmentations, three major rules were set. The first rule was that an interview question was a fixed category and the question order was not relevant. Second, the meaning of analysis gained from direct answering to the question was a category. Third, a follow up question or follow up answer was considered a separate category. Based on these rules, three major categories representing three non-recurring segments were constructed. These categories also served as themes for analysis in the subsequent section where the findings are presented and discussed. Stage 2: Coding Based on the broad segmentations, it was necessary to have a coding process which highlighted key words and put them in appropriate categories based on the segmentation done earlier. In effect, whereas the segments or categories were broader themes, the codes were key words that reflected each category (Braun and Clarke, 2013). To get the most appropriate codes, rules were set in identifying key words that were most relevant to segments. Generally, the codes were named units. The first rule was that words that had same meaning with component words in the categories were considered as units. Secondly, where a single unit could fit two or more categories, it is considered a split and made to fit all possible categories. Lastly, all words considered technical for any category was tagged as a code. The decision as to whether a word was technical was based on researcher’s experience as community health worker. Stage 3: Placement After the categories and units had been marked, it was time to clearly list out or refine the categories and place the units under deserving categories. The three categories were responsibilities of a community health worker, difficulty associated with the community health work, and theory-practice dilemma. In the appendix, the leads to the segments are marked in yellow whiles the leads to codes are marked in green. The outcome of placement has been presented at the appendix. Possible alternative strategy The need to have an alternative strategy arose when it was noted that there were instances of unit boundary overlap. What this means is that some of the leads forming categories could fit anywhere under the categories. This is showed in table 1 under the appendix. The alternative approach was therefore to decrease the unit boundary overlap by using smaller units (Seale, 2007). Such smaller units were to be focused on such leads as sentences and propositions. It will be appreciated however that this alternative strategy has its own weakness such as leading to several segments which could not be coded. In effect, should this alternative strategy be used then it means that the segmentation and coding will be done simultaneously. This strategy would have been implemented by ensuring that sentences or parts of compound sentences that contained a single concept will be taken as a unit. Presentation and analysis of results As reflected in the categories produced, three major themes were produced from the interview. Below is a presentation and qualitative analysis of the findings. Responsibility of community health workers The interview sought to find the core responsibilities performed by the community health worker. From the responses, several roles and responsibilities were indicated. On the whole, the need to go from one place to another, need to offer training, need to raise awareness, need to improve people’s lives, need to help people, need to suggest healthy lifestyle, and need to make difference in the lives of people amounted to the responsibilities of the community health worker. It was for this reason the interviewee noted that “I have the responsibility of going out into to the community and doing many different things such as training, raising awareness and trying to improve people’s health”. Rightly in line with this, Fayad (2006) emphasized that the community health worker is an interface between community people and policy makers. This means that the community health worker has a responsibility of understanding the needs of the people, carrying these needs to policy makers, getting policies formulated, and bringing back policies to the community to implement them for change. Difficulty with community health work Even though the interviewee had a very spirited commitment to the role she performed, it was very clear from the interview that there were difficulties associated with the work. The coding process actually showed that the word “hard” was used in reference to the role of the community health worker several times than any other word. In effect, it can be summed that the community health work is a difficult one. According to the interview, the difficulty comes mainly as the people seem to lack knowledge of the role of the community health worker and so refuse to cooperate. This is why it was stated that “some people do not want to listen and they do not want to change their ways”. In literature, Iadecola and Gorelick (2012) stressed that one way community health workers can minimise difficulty with their work emanating from lack of cooperation is for them to present themselves as advocates rather than solution givers. This means that it is important to first educate the people to come to terms with what is involved in the work before attempting to render solutions. Theory-practice dilemma Clearly, there were times that the interviewee would not go exactly according to what is known in theory but will use personal discretion to act. It was for this reason it was stated that “I will do something different, something about what the trouble is”. This means that depending on the outcome of a prevailing situation, the interviewee acted accordingly. This was however done in the spirit of rendering quality healthcare as Rothwell (2011) agreed that even though it is important to be guided with theory, it is important to appreciate the place of theory not to be a dogmatised way of doing things. Roles of healthcare experience in the analysis The entire data collection and analysis process was facilitated and enhanced with the researcher’s experience as a community health worker. In the first place, the researcher had understanding of the major healthcare outcomes of community health practice. In the light of this, it was possible to frame interview questions that focused directly on the very issues of concern within the community. Secondly, having experience as a community health worker boasted the researcher’s understanding of the outcomes of the interview. What this means is that the researcher had understanding of the most technical issues that came out of the interview. It was based on such an understanding that themes were constructed to be discussed. What is more, the researcher’s experience helped in promoting the internal validity of the study. This is because according to Attride (2001) internal validity is achieved when the instrument prepared collects data it is meant to collect. With the researcher’s experience, the interview prepared became very focused on the goals of the study. Conclusion To conclude, it would be said that as much as community health workers try to conform to what is known in theory, there are several times that their actions and judgments are decided by prevailing situation on the ground. The justification of this conclusion is in the trend of results where the interviewee was constantly pushed to act based on what she experienced in her immediate environment. As shared in literature, theories are not there to be dogmatised approaches to practice. They are rather there to serve as a guide to practice and so the community health worker can be justified to be working as effective as it within her means. References Attride S. (2001). Thematic networks an analytic tool for qualitative research qualitative research. Maidenhead: Open University Bowling A. (2009). Research methods in health 3rd ed. Maidenhead: Open University Braun G. and Clarke A. (2013). Successful qualitative research. London: Sage Council on Credentialing in Pharmacy (2013). Scope of Contemporary Pharmacy Practice: Roles, Responsibilities, and Functions of Pharmacists and Pharmacy Technicians: J Am Pharm Assoc. 2010;50:e35-e69. Denscombe M (2007). The good research guide 3rd ed. Maidenhead: Open University Fayad P. (2006). Secondary prevention measures after a stroke—should they target stroke or heart disease? Nat Clin Pract Neurol; 2(12):646-647 Hennick H. B. (2011). Qualitative research methods. London: Sage Iadecola C. and Gorelick PB. (2012). Hypertension, angiotensin, and stroke: beyond blood pressure. Stroke; 35(2):348-350 Rothwell P.M. (2011). The interrelation between carotid, femoral and coronary artery disease [editorial]. Eur Heart J. ;22(1):11-14 Seale C. (2007). Researching society and culture. London: Sage Appendixes EXTRACT from a transcript of an INTERVIEW exploring the role of Community Health Workers in promoting health. (Interviewer questions are printed in bold). I = interviewer; P = participant I. Firstly could you tell me about your work as a Community Health Worker? P. So my role is a Community Health Worker in the district. I have the responsibility of going out into to the community and doing many different things such as training, raising awareness and trying to improve people’s health but, ah, you know, it is so very hard these days. There are so many things which people have to face and things are hard. It is difficult. I. It is difficult you say? P. Yes, um, yes it is. I. Can you explain why it is difficult? P. It is hard to say but I am being pushed here and there, from side to side. I have to do what my bosses tell me to do but sometimes I am finding that the people out there do not want to listen, they have their own ideas and it is hard. I am like a pig stuck in the middle of everything. I want to do my job well. I want to help the people in the community but I have to also listen to the people in charge of me because they are my bosses. They say one thing, the people out there, they want something else. What can I do? Sometimes my hands are tied up. But I do try to do things to make a difference to the people out there – those ones in the rural communities in the district. There are many things which they are facing which can affect their health these days. Maybe I can help them to sort some of this out by working with them. I. What kind of things do you do? P. Yes. It’s me. There’s nobody else. I deliver training on health issues such as hygiene. I try to help people to understand how they need to wash their hands before they prepare food or something like that...the children, they can get so sick with running stomachs which is bad. Or sometimes, if there is an outbreak, then I will do something different, something about what the trouble is. If there is cholera it is not about prevention it is about action and it needs to be quick and co-ordinated. But it is difficult for some people when they do not have soap or when they have to fetch water from some other place or people are sick and cannot work in the fields. Umm, but really it’s not for me to tell people what to do. I am not their mother or their father but I can try to help them to understand how they can help themselves. Sometimes they listen and sometimes they don’t. The old ones sometimes say ‘who is this young thing who is coming to tell us what it do when we have lived all this time?’ Hopefully you are just putting things into people’s heads and, you know, making them think that next time they will do something. Maybe if they are worried and they can speak to you if you are friendly. So yeah, it is only me that does…it can be a struggle…(fades off). I. OK, you mentioned earlier about raising awareness about health issues. Can you say more about your role in that? P. Me, I am the one who does this. I have to work with the people to find out what the problems are and then try to help them to help themselves and do something. Sometimes they don’t know about things, they just don’t know what is the right thing to do and what is not because they do not have the knowledge. There was one woman who was giving Coke to her little baby. She thought that Coke is good, it gives life and makes you happy but she did not know that it has too much high high sugar in it and she was shocked. Everyone knows different things and if you have not been told then how can you know? But some people do not want to listen and they do not want to change their ways. When you see improvements and some small changes here and there it is good. I. Anything else? P. Well, let me think now there was this one time, here is an example. I was travelling to very a far place to carry out a community needs assessment with some people that side. The district health people they had some ideas that the people needed to be taught about things like hygiene because there had been an outbreak there before. But when I got to those people and talked to them they were telling me that the pump handle on the well had broken and it could not be fixed so they were fetching water from the river some miles away. Sometimes people can be angry, they see you and they think that you can help them and you can give them money but you can’t. Me, I am not rich but I can help them sometimes, listen and show them what to do. Tell them about things they might not know about. If people want to take the lead and, you know, do things for themselves but I just point them in the right direction. A big issue is resources though…(tails off) I. So you support people? P. Yes, yes, I do, I try to do that. That is my job. But I have a lot to do and it is hard. I am spread around this place so there is only so much that I can do as one person. I. OK, I see, so what made you want to be a Community Health Worker? P. Well, it seems to have come from me personally … I want to do this. You know, it’s not just because I have been put on this. It is my choice. Maybe it’s different for other people, I couldn’t speak for them. Maybe they feel forced to do it. You might get one or two people that maybe feel that way. But I thought I could make a difference and help people in some way, help people to have better health but really some of the problems are so big and the government have to help more and there is a limit to what a small small person like me can do. Everything is connected to health, everything. Well I, I think, you know, from my view I would say once you’ve got the training, it’s about trying to support people to be more healthy. That would be to sum it up in a very, you know, small way and that’s… I had some very good training myself but putting it into practice can be hard. When you feel that you can make a difference it is worth it and it makes you happy but, on the other side, it can be hard work and frustrating giving and giving. The people make it worth it…they do. Segmentation and categories From the interview presented above, phrases marked in yellow formed the segmentation process and became leads for constructing the three categories. The table below gives the three categories and the leads that fall under them. Responsibility of community health workers Difficulty associated with the community health work Theory-practice dilemma Firstly could you tell me about your work as a Community Health Worker? It is difficult OK, you mentioned earlier about raising awareness about health issues. my role is a Community Health Worker in the district It is difficult you say? I have to work with the people to find out what the problems are and then try to help them to help themselves and do something What kind of things do you do? Can you explain why it is difficult? Anything else? Anything else? Anything else? But I have a lot to do So you support people? OK, I see, so what made you want to be a Community Health Worker? Coding and placement After the categories had been formed, the researcher identified codes based on the details given in the main presentation. The codes are marked in green in the transcript. After the coding, placement was done under deserving categories. Responsibility of community health workers Difficulty associated with the community health work Theory-practice dilemma Going out Hard listen to the people in charge Training Being pushed They say one thing, the people out there, they want something else Raising awareness People out there do not want to listen hands are tied up Improve people’s health Pig stuck I will do something different, something about what the trouble is deliver training Sometimes they listen and sometimes they don’t listen and show them what to do try to help people Everyone knows different things Everything is connected to health it’s not for me to tell people what to do some people do not want to listen make a difference Sometimes people can be angry Read More