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Chapter two: Method
2.1 This research used focus groups, supplemented by a small number of in-depth telephone interviews to gather information on what was important to patients in Scotland about the care they received. Focus groups were the preferred method as they allowed interaction between participants and a relatively large number of patients to be involved in the study. It was however difficult to organise a focus group on GP services in Stornoway, due to the remote nature of participant's locations, therefore in-depth telephone interviews were carried out.
Focus group coverage
2.2 The groups were designed to cover rural and urban populations, areas of high and low deprivation, have roughly half men and women and be broadly representative of age (see table 2.1). The groups looking at long term conditions also contained people who were registered as being disabled. Groups were held in mornings, afternoons and evenings to allow for participation by working and non working members of the population.
Table 2.1 General focus group location and topics
Health Board | Location | Topic | Population and Deprivation |
|---|
Lothian | Edinburgh | Inpatients | Urban deprived |
Lothian | Edinburgh | Long-term conditions | Urban deprived |
Lanarkshire | Motherwell | Long-term conditions | Accessible rural, least deprived |
Borders | Melrose | Long-term conditions | Accessible rural, least deprived |
Glasgow | Glasgow | General Practice | Urban deprived |
Forth Valley | Falkirk | Inpatients | Accessible rural, least deprived |
Forth Valley | Falkirk | General Practice | Accessible rural, most deprived |
Western Isles | Stornoway | Inpatients | Remote rural, least deprived |
Western Isles | Stornoway/Benbecula | General Practice | Remote rural, most deprived |
2.3 An additional two focus groups were carried out in June and July 2008 to cover people of Black and Minority Ethnic Groups and people from particular religion and faith groups.
2.4 For the faith and religion group, carried out in Inverness, the group included patients with the following religions/faiths: Baha'i Faith, Buddhism, Christianity (Catholic and Protestant), Hinduism, Islam, Jehovah's Witnesses, Judaism, Mormonism, Paganism, and Sikhism.
2.5 The BME/ethnicity group, carried out in Glasgow included people from the following backgrounds Indian, Pakistani, Bangladeshi, Sudanese and Turkish.
2.6 We also carried out six interviews in Edinburgh with people who were either lesbian, gay, bisexual or transgender.
Recruiting patients
2.7 Patients were recruited for the groups using a variety of methods. The recruitment methods we used aimed to include as many people as possible that were not already involved with patient and public involvement activities. Patients were recruited principally using posters and leaflets distributed in local communities e.g. in libraries and shops. Where the response to the leaflets and posters was slow, information sheets were also sent to patient groups. Priority was given to patients who were not, for example, on patient and public involvement committees. Examples of the posters used for inpatients, long-term conditions and primary care are shown in Annex I.
2.8 The religion and faith focus group was organised through contacts at the Scottish Inter Faith Council and the BME/ethnicity group through REACH Community Health Project in Glasgow.
2.9 Before taking part in the focus groups, patients were given an information sheet explaining the nature and purpose of the group and then asked to sign a consent form, shown in Annex II. The consent form covered the following: that patients had read the information sheet and had the opportunity to ask questions, that participation was voluntary, that the group could be audio-taped, that photographs could be taken and that that they could be contacted in the future about carrying out a videotaped interview.
Participants
2.9 Three focus groups were carried out with people that had recently been in hospital as inpatients. A total of 20 people attended the groups, which were held in Edinburgh, Motherwell and Stornoway, with 12 women and 8 men included. The participants were aged from 34 to 75 years. The reasons for people being admitted to hospital as an inpatient included: meningitis, Crohn's disease, road traffic accident, broken bones, breast and bone cancer, hip-replacement and various cardiac conditions including having a pacemaker fitted.
2.10 Three focus groups were run for people with long term conditions. A total of 24 people attended the groups, which were held in Edinburgh, Motherwell and Melrose. The participants were aged from 26 to 83, and included people with the following conditions: osteoporosis, diabetes, asthma, angina, COPD, vasculitis, Dystonia, macular degeneration, Crohn's disease. All of the groups included people who were registered as being disabled.
2.11 Two focus groups were carried out with people about their experiences of General Practice Services, in Glasgow and Stirling. An additional four telephone interviews were carried out with people in remote Western Isles locations. A total of 18 people were included, 13 women and 5 men. The participants were aged from 24 to 75 years. An additional 20 participants were included in the equality strand groups and interviews.
Focus group methods
2.12 Focus Groups were facilitated by an experienced researcher from Patient Perspective. The groups each followed a topic guide, with a separate guide for inpatients, long-term conditions and general practice services. The topic guides that were used for the research are shown in Annexes III - VIII.
Analysis
2.13 The focus groups and interviews were transcribed. Each discrete comment was identified and manually coded and the coded comments then sorted into related themes.
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