Thesis: Semi-Structured Interviewing Method Developed by Brown, Karley

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¶ … semi-structured interviewing method developed by Brown, Karley, Boudville, Builas, Garg and Muirhead (2008) for use in their study of living kidney donors. In the Brown et al. study, the researchers conducted a series of semi-structured interviews which will be administered to both paid and non-paid living kidney donors who agree in advance to participate in the study. The initial questions in the semi-structured interview format used by Brown et al. included the following:

What factors influenced your decision to donate?

In what way has your relationship changed with the recipient?

What advice would you give to a person considering donation?

The semi-structured interviews will be conducted either telephonically or in person depending on the geographic proximity of the interviewees and their preference for the interview format, which is the same approach used by researchers in the Brown et al. study; in their approach, Brown et al. conducted the interviews using the questions above with the use of an interview guide that provided various follow-up questions to identify new themes and expand on the issues involved.

The data collected through the semi-structured interviewing process will be an iterative process that allows for the addition and/or deletion of interview questions as they and conducted and analyzed for key words, common metaphors and emerging themes, the same approach used by the Brown et al. researchers. According to these authors, following the completion of every two semi-structured interviews, an analysis of the transcripts was conducted in order to develop a standard template that provided corresponding coding and aggregation of the themed information (Brown et al., 2008). As noted above, this approach will be iterative in nature and will include steps that refine the questioning as well as opportunities for clarification and confirmation following the methods used by Brown and his colleagues. This approach also contributed to the Brown et al. study's findings: "Throughout the analysis process, phrases or quotes that most accurately supported the key themes were identified. This supported the credibility and trustworthiness of the findings. The trustworthiness of the data was further enhanced by field notes" (p. 93). An initial reading and content analysis of the interview transcript will be used to highlight recurring words and general themes, and this process will be used following the completion of each subsequent interview with newly identified key words and themes added to the coding template, a process that is congruent with that used by the Brown et al. (2008) study. According to the Brown et al. study's data collection methodology, "All the transcripts were coded according to the same template; however, as new themes emerged in subsequent interviews, they were added to the template. Hence, initial categories were very broad, but as the analysis progressed the various categories and final themes were synthesized by using the analysis techniques of immersion and crystallization" p. 94).

The specific interviews in which these steps will be applied in the proposed study will depend on the total number of interviewees who are successfully recruited in time for their interviews conducted and the analysis of their interview results for key themes and at which point the clarification and confirmation questions should be asked. In this regard, Brown et al. reported that, "Data saturation was reached following the 11th interview. During the 12th interview, key themes were explored for clarification and confirmation" (p. 94). Because it is anticipated that fewer than 12 interviewees will be able to be successfully recruited based on the eligibility criteria for this study compared to that used by Brown et al. (e.g., the Brown et al. study consisted of living unpaid kidney donors only while this study will seek to interview both paid donors [by necessity these subjects will all be from Iran or Pakistan] and unpaid donors from anywhere), a review of the transcript will be conducted following each interview rather than every two, and the final interview will be identified and then used for the clarification and confirmation steps. The reliability results of the coding will be achieved by having a faculty member or classmate with comparable research interests review the results and provide their own version of the coding for comparison and the results reported in the data analysis. This approach is congruent with Neuman (2003) who reports that intercoder reliability is "The agreement among or dependability of several different content analysis coders. A type of equivalent reliability" (p. 537).

2.

Examine the expected outcomes of your research and how you would implement any changes.

People are motivated to donate organs for a number of reasons, with the most salient in the West being related to kinship bonds and general altruistic motives while in Iran and Pakistan, such motivations include economic incentives as well. Although several of the resources that were reviewed indicated that Iran was the only country in the world where legal organ donation existed, Statz (2006) reports that, "It is illegal to sell or buy a human organ in all developed nations, but it is legal in Iran and Pakistan" (p. 1677). The few studies and editorials concerning the practice used in Iran that were available all expressed some degree of moral outrage at the practice in these Middle Eastern countries while simultaneously suggesting that the success of Iran in particular in providing a framework in which desperate kidney organ recipients were able to find an appropriate match efficiently and safely was worth further examination. It is expected that the outcomes of the proposed study will generally find a need for donor counseling given the emotional and physical enormity of the donation and transplantation procedure from the perspective of many donors. Any surgery is a fearful thing for many people, of course, and losing a kidney for the donor and receiving one by the recipient will have lasting implications for both. Therefore, it is expected that the proposed study will find commonalities with the findings of the Brown et al. (2008 study that determined there was an additional need for pre- and post-operative counseling as well as a need for ongoing emotional support among the kidney donors they surveyed. Although it will not be possible to provide an across-the-board comparison between paid and unpaid donors concerning certain factors such as the percentages of kidney donors who are closely related to their recipients because legally paid donors do not live anywhere besides Iran, it will be possible to measure other common factors based on key words and general themes. For instance, the interviewees in the Brown et al. study were shown to share high levels of altruism and faith; in addition, all of the subjects did not regret the kidney donation. These findings were congruent with those in a recent analysis by Statz (2006) that determined, "The system for procuring organs in the United States is based on altruism, where potential donors have to opt in to the system in order for their organs to be donated" (p. 1677). Other findings of the Brown et al. study will also make interesting and useful points of departure for comparing paid and unpaid donors as well. For instance, these researchers emphasize that, "It is noteworthy that all were assessed from a psychosocial perspective that explored specific areas such as psychological and emotional stability, family history and family dynamics, absence of coercion, relationship to the recipient, understanding of and attitude to donation, and support networks" (p. 94). The elements of "absence of coercion" and "relationship to the recipient" will be of particular interest in comparing interview results from paid donors living in Iran compared to unpaid donors living elsewhere (or in Iran as well if for some reason any of the donors are unpaid such as in the case of a close family member).

3.

Identify a method to evaluate your findings following the implementation phase of nursing research.

The method to be used in the proposed study to evaluate the findings would involve a selection of representatives from both the paid and unpaid kidney donors interviewed in the initial round of interviews. A series of follow-up questions would be presented and the donors' perception of the effectiveness of the counseling regimens used would be assessed using a series of Likert-scaled questions such as, "All of my questions and concerns about the surgical procedure were answered completely in a way that I could understand," and "If I had it to do over again, I would," and so forth. An open-ended commentary opportunity will also be used to solicit any additional insights and observations the donors may have concerning their donation experience.

Annotated Bibliography

Brown, J.B., Karley, M.L., Boudville, N., Bullas, N., Garg, A.M. & Muirhead, N. (2008). The experience of living kidney donors. Health and Social Work, 33(2), 93-94.

This recent study of kidney donations in provided the general framework for the proposed study as well as the initial semi-structured interview questions that would be used to identify additional themes, common metaphors and key words in subsequent interviews. The interview guide at Appendix A will be used to probe further in… [END OF PREVIEW]

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