The setting was in Oklahoma where physician supervision
is required only for prescriptive authority for schedule
III-V and formulary drugs. Recruitment of study participants
began after the study was approved by Texas
Woman University’s institutional review board. A purposive
sample of NPs practicing in primary health care was
obtained by posting a notice on the Oklahoma Nurse Practitioner
Association website. Network sampling was also
used to recruit by asking early respondents for referrals
and directly contacting NPs known to the author. Consequently,
participants came from a broad swath of practice
settings. Informed consent was explained and obtained
from participants; and, to ensure confidentiality, each participant
chose a code name known only to the participant
and to the investigator.
Rigor was achieved through the trustworthiness criteria
that included credibility and dependability, confirmability,
transferability, and authenticity (Holloway & Wheeler,
2006). The criteria of credibility and dependability were
met by peer debriefing, prolonged engagement, and persistent
observation. Peer debriefing was carried out using
a PhD graduate with experience in hermeneutic research.
A draft copy of the data analysis was supplied to the peer
to reanalyze in order to detect bias, subjectivity, and explanations
that were not substantiated or did not fit with
the interpretations. Prolonged engagement was achieved
by immersion into the data and related literature. Reading,
rereading, and returning repeatedly to the textual data as
well as literary sources gave sufficient time to minimize
distortion of the data that might be caused by inappropriate
subjectivity. Persistent observation was achieved by
staying focused on understanding the meaning of autonomy
in participant language and sorting out those parts that
were obtrusive. Additionally, at the conclusion of transcription
and data analysis, follow-up contact was made
with participants via e-mail to ensure that the text and
findings still reflected their meaning of autonomy. An audit
trail was used to fulfill confirmability. Purposive sampling
and rich-thick description of the participant’s context were
used to establish transferability. Authenticity was demonstrated
by accurately reporting the participant’s thoughts
and ideas. Lastly, Gadamer’s (2006) criterion of correct understanding
was demonstrated through harmony between
the overall meaning and individual parts.