Data generation and analysis
Data were generated over 9 months and from three sources:
in-depth interviews, an open-ended questionnaire and two
participatory action research (PAR) mixed-gender research
groups (equalling eight contact hours).
The second author undertook in-depth interviews with the
24 participants and these were informally conducted in
participants’ homes. Guiding questions were: How has
asthma affected your life? Give an example of an incident
or episode with asthma that really affected your life, What
has changed in your life since you were diagnosed with
asthma? What strategies do you employ to manage your
asthma? Where and how did you learn about these strategies?
Is there anything that would help you in the future to manage
your asthma that is not available now? These questions
resulted in the development of a story line for each participant.
In addition, the shape of the story was influenced by
questions of the type ‘look, think and act’ (Stringer 1999).
Table 1 Recruitment sources
Sources Contact Actual
Radio interviews 7 7
Advertisements in local newspapers 7 5
Referrals from asthma educators 9 7
Public asthma awareness sessions 3 3
Royal District Nursing Service
‘Driving Force’ magazine
1 1
Leaflets from pharmacies 1 1
Total 28 24
T. Koch et al.
486 2004 Blackwell Publishing Ltd, Journal of Advanced Nursing, 48(5), 484–492
‘Looking’ referred to the exploratory phase, in which
participants were asked to tell their stories about living with
asthma. ‘Thinking’ was stimulated when the interviewer
asked them to reflect on their story: ‘What is happening
here?’ and ‘Why are things as they are?’ The ‘acting’ phase
occurred when participants were asked to think about aspects
of their asthma self-management that they would like to
change or share with others. Most of the one-to-one
interviews lasted 1 hour, and all were tape-recorded and
transcribed verbatim.
Eighteen participants volunteered to join a PAR group.
Family and friends were also invited, and six partners
attended. Due to the large number of people participating,
two separate groups were convened. We have published
details of the PAR methodology previously (Koch & Kralik
2001, Koch et al. 2002) and therefore here we will only give
an overview of the approach.
During the PAR meetings, the facilitator (first author) gave
an overview of the study and assisted with setting ‘norms’ in
collaboration with the group. A document that contained a
preliminary analysis of interview data was presented to
participants at the first PAR group meeting. Discussion took
place around each of the themes and validation of findings was
noted. In an effort to extend group discussion, the ‘look, think
and act’ (Stringer 1999) framework was displayed on a slide
and this cyclic process explained to participants. The explanation
was as follows: ‘Let us look at what is going on in your
life, let usthink about this (reflect) and then let us consider what
can be done to improve things (act)’. This cyclic process
encouraged participants to investigate their problems and
issues systematically, formulate experiential accounts of their
situations, and devise plans to deal with the issues identified.
We held two PAR meetings with each of the two groups and
the intent was to develop collaboratively a model that would
enable self-management of asthma for older people. Participants
shared their stories about living with asthma, and were
encouraged to engage in discussion and dialogue, develop
mutually acceptable accounts that described their experiences,
and talk about ways they managed their condition. They were
encouraged to talk about their ‘self’-management and explore
what they could do to improve this, thus leading to individual
or group action. PAR meetings were transcribed concurrently
by a skilled research coordinator.
At the first PAR meeting with each group, we asked
participants to take home a questionnaire with two items:
‘What is asthma?’ and ‘What is self-management?’ We
received 14 replies and analysis of the questionnaire data
followed the procedure outlined below.
The three authors read the transcripts and analysed data
collaboratively. We analysed for self-management claims
raised by participants (Guba & Lincoln 1989). The process of
analysis was an adaptation of Colaizzi’s (1978) framework,
and the steps were to:
1 Read the text in order to understand it as a whole. This
took some time and required careful re-reading of the
interviewer’s notes to provide context to the interview text.
2 Extract significant statements about the phenomenon
being studied. Statements were cut and pasted into a separate
document and re-read.
3 Develop clusters within individual interviews. Statements
were arranged according to common themes within the
context of each interview.
4 Integrate clusters into a broad description of the phenomenon
being studied. Six key themes provided the
context of the issues, barriers and self-management strategies
of older people living with asthma.
5 Validation of findings with participant. The six main
themes were presented, with corresponding significant
statements, to the PAR group participants for comment
and validation.
Analysis of the PAR group data was also concurrent to
ensure prompt feedback of issues to participants, thus
creating the opportunity to build our (participants’ and
facilitators’) understandings collaboratively. We consider
that rigour was enhanced because the actual voices of
participants were included in the text (Koch & Harrington
1998) so that readers can assess the authenticity of the voices.
The final study report was given to all participants and
further validation of findings occurred at a third meeting
arranged once the study was completed.