RESEARCH METHODOLOGY
3.5 DATA COLLECTION PROCESS AND INSTRUMENTS .1 Data collection instruments
3.4.4 Qualitative data
• Snowball Sampling- 13 Nurses who had earlier left the country were identified at time of data collection.
• Purposive sampling- Nurses seeking verification of their qualifications between January and December,2006.
• Purposive sampling- participants for each of the four focus groups
• Purposive Sampling- five directors: one provincial,three district, one director at national level
3.5 DATA COLLECTION PROCESS AND INSTRUMENTS
Interview guide: for nurses seeking verifications of their qualifications from the GNC with intentions to register and work outside the country- Annex 2.
This instrument had parts on the respondents' demographic data, family responsibilities with regard to number of children and dependants to demonstrate respondent centeredness of the data collection. Bless and Higson-Smith (1995) argue that researchers should always take into account the needs, interests and problems of respondents in the design of questionnaires or interview as these are more important than the academic factors. This was even more important to nurses who were intending to leave the country and this facilitated enhancing the researcher's understanding of the respondents and their desire to migrate.
In addition, the tool had sections on professional data as well as qualitative data on nurse migration with broad questions on why the nurses wished to leave their jobs and the country, where they intended to go, why they had chosen the country of their intended destination and what would make them change their minds and stay to work in Zambia.
Interview guide for interviewing nurses who had migrated and were in Zambia during data collection - Annex 3.
The tool had parts which sought demographic data and professional qualifications of respondents. The second part was on qualitative data, with a broad topic guide that was used to collect data on nurse migration with broad questions on why nurses resigned from their employment, why they left the country and why they chose the country of their destination and how long they intended to stay in the destination countries. According to
Polit and Hungler (1997),a broad topic guide and broad questions facilitate covering all questions. Many scholars (for example Krueger, 1994; Lincoln & Guba, 1985; Mason, 1996) in qualitative research recommend that qualitative researchers should be conscious of the need to develop research questions which can generate meaningful and useful data.
The interview guide used in this study was comprehensive with open-ended questions that enabled nurses to conceptualize their perceptions and opinions in using their own words. Open-ended questions minimized the occurrence of leading or directing respondents to answer questions in a particular manner (Brenner et aI., 1985; Rubin &
Rubin, 1995).
Topic guide for focus group discussions with clinical nurses and nurse educators - Annex 4.
The topic guide was broad facilitating questions on why the nurses had stayed while others had migrated. The questions were also on how the nurses perceived nurse migration impact on the public health care system,which included their work, workload, quality of care and attitude and on the teaching and learning of students. Polit and Hungler (1997) state that a topic guide or written format set of questions guides focus group discussions. These questions were used to guide the discussions and obtain qualitative data from the focus group participants.
Two self-administeredquestionnaires completed by clinical nurses and nurse educators respectively- Annex 5.
These instruments were almost similar except that one targeted the nurses in the clinical settings and the other the nurse educators. They both had questions on demographic data, professional data, workload data and respondents' level of responsibilities. Respondents
were requested to complete the instruments themselves respectively in a paper-and-pencil format. Polit & Hungler (1997) point out that in a structured or standardized instrument, the respondents are asked to respond to exactly the same questions in exactly the same order and are given the same set of responses for their responses. These authors further assert that the purpose of using questions with such a high degree of structure is to ensure comparability of responses and to facilitate analysis. The instruments in this study consisted of closed and open-ended questions. Although, according to these authors, closed-ended questions are more difficult to construct, they are easier to analyze than open-ended questions that, on the other hand, are easier to construct. Closed ended questions are easier to complete in a questionnaire and are less time consuming on the part of the respondent although on the other hand, open-ended questions allow for a richer and fuller perspective on the topic particularly if the respondents are verbally expressive and cooperative (Polit & Hungler, 1997). Such structured closed and open- ended questions were included in this instrument which allowed the respondents to respond to the same questions in their own words in written.This enabled the researcher to compare the respondents' characteristics and professional data.
A semi-structured questionnaire for interviewing policy makers - Annex 6.
This instrument was an interview schedule. The instrument is known as the interview schedule when the questions are asked orally in face-to-face or telephone format (Polit &
Hungler, 1997). The instrument had questions on the participants' demographic data, their perceptions on the impact of nurse migration on the public health care system and policy issues on management of nurse migration. The instrument had closed and broad
open-ended questions. The broad open-ended questions allowed participants to express themselves in responding to the questions on their perceived impact of nurse migration.
3.5.2 Pilot study
According to Polit and Beck (2004),the purpose of a pilot study is to test protocols, data collection instruments and other aspects of the study in preparation for a larger study. In this study, each of the data collection tools was pre-tested before finalization. For the checklists, the first 10 GNC records of nurses with verifications sent to other countries for the year 1994 were used to test the instrument. These records were selected because they were not included in the study as the study focused on the 1995-2005 records. There were no problems observed with the instrument and no adjustments were thus made.
For the structured questionnaires,four clinical nurses from a health center and two nurse educators responded to the self-administered instruments respectively. The interview guide for both focused interviews and focus group discussions were tested with two and four nurses from a second health center respectively before finalizing the tool. For each of the tools,it was found necessary to indicate the word 'migration' in brackets wherever 'nurses leaving for greener pastures' appeared as two of the questionnaire respondents sought clarification on whether 'migration' was the same as 'nurses leaving for greener pastures'. This was done before finalizing the tool. The instrument targeting migrant nurses who were in Zambia at time of data collection was tested on the first two visiting respondents. These were not included in the study. It was found necessary from the
preliminary themes that had begun to emerge to add two questions directed at retumee nurses. These were:
• Their experiences while outside the country.
• Advice, if any,to other nurses who had not yet migrated.