CHAPTER 4
4.3.2 Piloting the Survey
The survey was piloted amongst a group of nurses (n=10). The pilot study aimed:
1. to ensure that the questions were comprehensible and user friendly;
2. to ensure the aims of the survey were being met; and
3. to establish the length of time required to complete the survey.
The overall feedback from the pilot was positive and, as a result, only minor amendments were made to the wording of questions. Prior to dissemination, the fi nal draft of the survey was reviewed by the project team to ensure it refl ected its purpose.
4.3.3 Recruitment of the survey to maximise response rate
A variety of approaches were employed to maximise the number of people that were informed of the study; thus, providing increased opportunities for participation amongst the eligible population.
In an attempt to reach as many people as possible, the survey was developed for on-line or hard copy completion. In order to facilitate on-line completion, a number of organisations (Appendix III) helped promote the survey by including project information and a hyperlink to the survey on their websites. All steering group members were encouraged to disseminate project information packs which consisted of a Microsoft Word copy of the survey, a fl yer to advertise the survey for notice boards (Appendix IV) and invitation letters to complete the survey from the ONMSD and Offi ce of the Assistant National Director of Mental Health (Appendix V). The survey, invitation letter to complete the survey, fl yers and project information were disseminated widely by the steering group and the information packs were also disseminated at the NCNM Conference. To enable people who may not have internet access to participate, all advertising material included telephone details inviting people to request a postal version of the survey.
4.3.4 Data collection for survey
The survey data was collected during a three and a half month period from to 10/11/10 to 25/2/11.
In total, 1017 completed questionnaires were returned. Thirty seven surveys were excluded from the sample as they were incomplete.
4.4 Focus groups and written submissions
4.4.1 Recruitment and designing the format for the focus groups and written submissions
The focus groups and submissions aimed to:
Identify the knowledge, skills and competencies that require development by nurses working with people with mental health diffi culties to respond to A Vision for Change (2006).
4.4.2 Advertising for the focus groups and inviting written submissions
Focus groups were mainly organised though the NMPDUs nationally who were provided with information on the project and asked to nominate a ‘link person’. This link person agreed the time and date for focus group with the project offi cer and organised a venue in the various regions. The link person then liaised with the organisations and mental health services in their region to advertise the focus group. Interested and eligible individuals were asked to come forward to participate.
A number of additional key groups/organisations were also invited to participate. Each focus group participant was provided with an information letter (Appendix VI) explaining the rationale, procedures and the criteria for participation in the group and a consent form (Appendix VII). The focus group schedule is included in Appendix VIII. Each focus group took approximately two hours and questions (Appendix IX) to provide structure had been agreed upon by the project team. Minor adjustments to the schedule were made on occasions. Focus group interviews were recorded using fl ip charts and project offi cer’s notes. Due to the time it would have taken to transcribe, the focus groups were not audio recorded. Probes to clarify answers and to request further information from participants were used. The project offi cer attempted to be refl exive throughout this process.
Following each focus group, the data on the fl ip charts was collated with the project offi cer’s notes.
The project offi cer then sent the narrative to the facilitator or a nominated focus group attendee to ensure it was an accurate refl ection of the group that took place. On receiving confi rmation that the narrative was accurate, it was included in the analysis. All interested parties, organisations and individuals were invited to complete written submissions and those making a written submission were invited to do so using an agreed format (Appendix X). In total, 22 focus groups (Appendix XI) were conducted nationally and 28 written submissions were received (Appendix XII) from November 2010 to June 2011.
4.5 Data analysis 4.5.1 Quantitative data
The online survey software application ‘surveymethods’ was employed to assist with launching the survey, data collection and analysis. Hard copies of the survey that were returned were inputted into
‘surveymethods’. Each survey variable was analysed to generate descriptive or frequency statistics.
All percentages displayed in the fi ndings were rounded to the nearest whole number for ease of interpretation and analysis.
4.5.2 Qualitative data
Burnard’s (1991) method of data analysis was employed to analyse the qualitative data. This has been described as a method of ‘thematic content analysis’ (Burnard, 1991:461). This step-by-step approach was chosen as it was clear and concise. All focus group data and submissions were collated. Stage two entailed reading and re-reading the transcripts and the submissions thoroughly and making notes, so that the project offi cer was immersed in the data. Initially, the data were ‘open coded’. These open codes were then sorted into higher order headings. Finally, the higher order headings were organised into fi nal themes that incorporated all the data collected in the interviews and submissions. The project offi cer approached the project lead to verify whether the themes that were generated were authentic. The transcripts and submissions were re-read alongside the fi nal themes to ensure that all major areas of the transcripts and the submissions were identifi ed.
4.6 Ethical considerations
Nurse researchers have a professional responsibility to design research that upholds sound ethical principles and protects human rights (ABA, 2007). Informed consent, autonomy, benefi cence and confi dentiality were the main ethical considerations in the present study. Informed consent is a prerequisite for all research involving identifi able participants. To obtain consent, researchers must give as much information as possible to participants to enable them to make up their minds (Parahoo, 2006). Participants were given information about the purpose and scope of the study and how their anonymity and confi dentiality was to be protected. The principle of benefi cence, doing good and preventing harm, applies to providing confi dentiality and anonymity for participants.
Data were stored in a locked cabinet in a locked room and any data on electronic instruments had password restrictions in keeping with the Data Protection Act 2003. After fi ve years, the data will be destroyed in accordance with the Department of Health Data Protection Act (2003). In the absence of an ethics committee, the project team sought and received ethical opinions from three experts in the area of ethics and mental health in relation to the survey instrument. This process was endorsed by the HSE Strategic Mental Health Management team (Appendix XIII)
4.7 Limitations
A fi rst limitation of the study is that participants self-selected to complete the survey so it is diffi cult to answer how those who did not choose to participate would have responded. Secondly, due to time constraints, the written submissions and the data generated from focus groups were not analysed separately; thus, what is presented is an overview of the major themes and issues raised in both as not all of the individual messages or minor themes could be elaborated on fully.
4.8 Summary
This chapter provided an overview of the methodology used for the project. The design adopted for the project was an exploratory design using both qualitative and quantitative approaches to facilitate data collection. A combination of an anonymous survey that could be completed in a variety of ways, focus groups and written submissions were utilised. A variety of approaches towards recruitment were employed to maximise the number of people informed about the study.
This approach included adding hyperlinks on websites, distributing information at conferences and promoting the project in their areas and organisations through the steering group. The following chapters will present the fi ndings, both quantitative and qualitative, that emerged during the data analysis stage.