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.
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