Tag Archives: interviews

Being Me with IBD: The interrupted interview

This blog post focus on the challenges of conducting the Being Me with IBD interviews in busy and distracting clinical environments and how we ensure sensitivity to the young participants.

As discussed in our previous blog post we are conducting qualitative interviews with young people in a hospital clinic or a day unit about their experience of living with IBD. The participatory interview techniques we are using give the young person a high degree of control over the interview and reinforce their position as an expert in their own experience. These creative methods also enhance the young person’s ability to tell their personal stories, using their own words. Furthermore, a flexible approach aims to nurture an informal, open conversation, enhance rapport and produce richer data.

The interviews take place either on the day unit during a visit for an infusion or before or after a clinic appointment. We arrange for the interviews to be undertaken in the quietest possible place, whilst taking into account the young person’s clinical needs and what places are actually available and appropriate. All team members, particularly those with less familiarity and experience in conducting interviews in a clinical environment, have reflected on the challenges of undertaking interviews in less than ideal settings.

The interview setting

A quiet space in a hospital is often difficult to find.

We have conducted interviews in the waiting rooms of busy gastro clinics, gastro clinic consulting rooms, cubicles on day units, a matron’s office and a private specialist research room. Some of these spaces were more interrupted than others, and each brought challenges for creating a private, comfortable research space. The luxury of a private room off the main day unit may seem ideal but it brings with it repeated interruptions by nurses undertaking the young person’s regular ‘infusion’ observations and checks being done to their infusion pump. When using the ward managers office to conduct an interview, we had to pause the interview several times mid conversation due to the ward manager needing access to the office.

It’s clear that finding an ideal space to undertake an interview is tricky and this can be compounded by other issues such as background noise such as the hum and bleeping of machines. Other concerns need consideration such as the audio-recorder picking up other people’s conversations or others being able to over-hear the details the young person is sharing with the researcher.

Finding a quiet and private space is a balancing act between giving the young people the opportunity to participate without having to extend the time they are at the hospital and ensuring that they remain under the supervision of a nurse where necessary.

Managing interruptions

The reality is that conducting interviews in a clinical environment is complicated. For the team members who were new to this environment, a certain amount of familiarisation with the clinical setting was required, and this included developing a basic understanding of the clinical routines and medical terms. For example, a young person having an infusion needs half hourly observations, so it helps to time an interview to start straight after a set of observations have been taken. Researchers working within clinical settings have less situational control than in other settings and they need to be able to manage distractions and interruptions; this takes skills, focus and confidence. While an interviewer in someone’s home may have interruptions and distractions to manage, in a clinical setting they also  need to be sure that the processes related to the study (consent, interview, de-briefing etc.) do not impact on the young person’s clinical care, for example, by delaying the start of their treatment.

Each disruption, however important to either the young person’s care or the smooth running of the setting, carries the potential for a breach of a young person’s confidentiality. We have become skilled and accustomed to pausing and picking up the threads of our conversations as appropriate and ensuring that the audio-recording is paused during any clinical interactions.

The disruptions have and can affect the interview although with skill we can mediate the impact of this and, on occasion, the disruptions can give rise to new directions for the interview. Whilst clinically based interviews are not ‘text-book’ interviews they are real and authentic.

As ever we are grateful both for the young person’s understanding and the work of the clinical team for enabling our access and supporting this study.

Thanks for your interest in our study

The Being Me with IBD Study Team

Being Me with IBD: Using creative methods in a clinical setting

In this blog we focus on how the Being Me with IBD study is drawing on a range of data collection methods and techniques in line with its participatory approach and underpinned by values of person-centredness.

The quantitative approach

There are two distinct but complementary data collection phases to the Being Me with IBD study. Phase 1 is a quantitative survey using validated scales which asks the young people to numerically rate factors including friendships, loneliness, depression, anxiety, health and self-efficacy (sense of control over their lives). We understand that asking young people to complete a survey about their experiences of friendship and loneliness could be upsetting. We have aimed to be sensitive in the scales we have used and we take care to check in with the young person after they have completed the survey to make sure that they are feeling okay. When a participant hands the survey back to us we score two of the scales and if one or both of them score above a particular number, we flag this is a cause for concern about their well-being.  Any young person who triggers a flag is made aware of our concern and we talk through who they may turn to for support. We also activate a robust process with the clinical team for following this up.

The qualitative approach

The young people who complete the survey are asked if they would be interested in taking part in Phase 2, which is a qualitative interview and is arranged to take place at a subsequent appointment. The interview gives the young person an opportunity to talk about their experiences of living with IBD and about their friendships, what they value about their social connections, aspects of friendships that are difficult and how they feel having IBD has impacted on these friendships. We also discuss any future concerns they may have about their IBD (such as starting work or going to college or University) and future relationships.

Using creative approaches to support interviews

We have designed two creative approaches to assist the discussion with the process also supported by an interview guide. During the interview, the young person can draw a friendship map to highlight their friendships and connections and/or use their own (hard copy or phone-based) photographs as a basis for discussing their friendships and things that may affect or impact these. The creative approaches have been designed to give the young person as much control over the interview as possible by allowing them to choose the starting point for the conversation and help them to focus on the things that matter to them in living with IBD.

Over the first few interviews, we discovered that some young people were less interested in participating in the creative techniques while others were unable to draw a map due to being connected to an infusion pump which limited their movement.

The benefits of a flexible approach to interviewing

In this study, a significant advantage of a flexible approach has been to allow the young person to decide how they want to engage in the interview. The young people who have chosen to participate in a creative exercise have used the opportunity to lead the discussion and have been very comfortable in doing so. In these interviews, the researcher’s role has been to guide and prompt the discussion with the participant leading the direction of the conversation. Offering the chance for an interview without the additional options means that we are inclusive of those young people who prefer to steer away from the creative methods.

The use of surveys and interviews (without or without creative methods) has helped to provide richer data than using a single method and we hope it will lead to a greater insight into the young people’s lives.

Thanks for your interest in our study

The Being Me with IBD Study Team