Given that the researcher intended to provide the participants with an opportunity to share their personal experiences with regard to the phenomenon of nursing workplace violence, it was decided that data would be collected by means of a focus group session and two
semi-structured interviews conducted with each participant by the researcher. The focus group session and all interviews were conducted face to face.
A thematically semi-structured interview format was used. In phenomenological research any questions posed to the participants must be open-ended and non-directive, because these are intended to facilitate the participant's sharing of their experiences (Willig, 2001). Notwithstanding the above, Kvale (1996) additionally notes that the semi- structured interview format accommodates any specific questions and issues that the researcher may need to address and simultaneously allows the researcher a degree of flexibility in terms of 'the order' in which aspects of a phenomenon may be considered.
A semi-structured interview format was further selected because interpretative phenomenology specifically works with transcripts of thematically semi-structured interviews (Willig, 2001).
In addition to the above, the semi-structured format permits the interviewees to speak more widely on issues that will be raised either by the researcher or themselves
(Denscombe, 1998). Denscombe (1998) argues that the semi-structured interview format
"permits... interviewees to use their own words and develop their own thoughts"
(p. 113). Thus the researcher posits that the interview format used in this study is suited to the investigation of personal accounts of experiences and feelings, and that it
complements the IPA utilized in this study.
The focus group session and first interview were based on open-ended questions that were designed to elicit the participants' direct and indirect experiences of theatre nursing workplace violence and the meanings attached to them (see Focus Group and Interview Schedule, Appendix One). Interview questions (and prompts) were carefully formulated firstly to directly address the five research questions of the study (see p. 4); and secondly, to avoid explicit mention of the concept of "violence", which might have different
emotional/ physical connotations for participants. The interview was thus built around the following five questions as thematic clusters:
1. How would you describe your current interpersonal relationships in the operating theatre?
2. Are there specific items or incidents that come to mind in respect of workplace incidents that have affected you personally, e.g. a situation in which you felt less than pleased with the events or outcome?
3. What effect did the witnessing of the incident have on you?
4. When X [a disclosed incident or experience of workplace violence] happens to you / has happened how do you react to the situation?
5. How should negative workplace incidents be handled?
The second interview was a verifying and follow up interview in which the researcher presented the summarized material from the first interview to each participant, in order to obtain confirmation and clarification of the material. Participants were afforded the opportunity to add new material to the interview at their follow up interviews.
Written consent pertaining to each individual's participation in the study was obtained from each participant prior to the focus group session and the interviews. Furthermore, written consent for the tape recording of interviews was obtained from each participant (see Appendix Seven).
3.5.1 Setting and interview process
Eleven interviews including the focus group interview were conducted with eight female participants. The focus group and individual interviews were conducted at times that were convenient for both the participants and the hospital. The venues for the interviews were mutually agreed upon by the researcher and the participants. The majority of the initial interviews took place within the hospital setting - usually in an unoccupied tea lounge, conference room or area elsewhere within the hospital. Two interviews (RN F and RN M) were conducted away from the hospital. These were conducted in private venues as per each participant's choice.
The privacy of each interaction was ensured and a concerted effort was made to ensure that interruptions were kept to a minimum. Where possible the researcher placed a notice on the door to the venue advising that a 'meeting' was in progress. Despite these efforts, a number of interruptions presented with certain interviews - usually doctors or nursing staff looking for something. Where interruptions occurred, the interview was halted and the tape recorder was turned off until the situation had been resolved. Prior to each interview commencing the voluntary nature of participating in the study, and matters pertaining to confidentiality were emphasized.
At each individual interview a pseudonym (a letter of the alphabet) was chosen by each participant in order to ensure that her identity in the study remained anonymous and that her participation in the study remained confidential. Any incidents of workplace violence that were potentially recognizable were appropriately modified to protect the participants' confidentiality and anonymity (see more on ethical considerations below).
3.5.2 Field notes
Field notes were compiled during and immediately after the interview. The field notes provided the researcher with information regarding the verbal and non-verbal
communication patterns of the participant, and on the quality of the rapport established with the participant. The field notes additionally included basic demographic information regarding the age and gender of the participants, and information such as the time, place and duration of the interview.
A synthesis of the field notes with regard to the verbal and non-verbal communications of the participants evidenced that the majority of the participants were uncomfortable
discussing matters pertaining to certain collegial relationships in the workplace. This discomfort was conveyed through a noticeable reduction and/ or avoidance of eye
contact, by means of a change in body posture (arms folded across the chest), and also by fidgeting. With certain participants, discomfort was also conveyed by means of giggling, inappropriate laughter /jokes and silences when awkward situations were discussed.
While a number of participants were emotive in their responses, a large degree of discomfort was expressed by one participant who became flushed and tearful when discussing certain incidents of workplace violence that she had experienced (physical assault and sexual harassment). Where participant discomfort was evident, the researcher asked the participant if she would like to halt the interview, withdraw or reschedule the interview. None of the participants opted to withdraw or to reschedule their interview.
Despite the discomfort and tension conveyed by the non-verbal communications of certain participants with regard to specific matters, the majority of the participants were enthusiastic about taking part in the study and wanted to have their opinions and voices heard. The researcher attempted to create a good rapport with the participants by utilizing a basic listening sequence (attending and listening behaviours) that included maintaining appropriate eye contact, summarizing, paraphrasing, and the mirroring of verbal and non verbal patterns.
3.5.3 Difficulties experienced in conducting the research
Despite obtaining ethical clearance from the University Ethics Committee in September 2006 and having submitted the proposal in September 2006 to the Department of Health (see Appendix Three), permission to conduct this study from the Department of Health was only received on the 8th of January 2007. The private hospital was approached on the 10th of January and it took an additional seven weeks for the institution to process the request and to grant the researcher access to their facility. This permission was received on the 28th of February 2007.
It was decided by the researcher and several of the participants that it would be easier to interview them at their place of work. This meant that participants were interviewed while they were either 'on duty' or immediately after the end of their shift. For those participants who were on duty this was problematic because they were not able to relax fully and were constantly watching the time to ensure that they were not late in getting back to their theatres. Two participants agreed to be interviewed on their 'day off at a venue of their choice. This was found to be more conducive to the interview process. A further problem encountered by the researcher was that many of the participants -
although eager to participate, initially regarded the study and the researcher with a degree of apprehension - as if the study was part of a 'spying operation'. The researcher found that she had to spend time allaying participants' fears, and had to repeatedly emphasize the fact that she was not aligned to any of the institutions or their management structures, that participation was voluntary and that all material was confidential. Once this had been established the participants were more at ease with being interviewed and with discussing their interpersonal relationships in the workplace, incidents of workplace violence (either those personally experienced or witnessed) and other relevant matters.