![]() Assuming that most participants consent to be interviewed, interview data will comprise:Īpproximately 90 interviews with patients (30 patients interviewed on completion of the DAFNE programme and then 6 and 12 months later in a similar study, attrition was negligible). We aim to observe six to eight programmes, each attended by around six to eight patients and two educators. Interviews (around 1 hour) will take place in a setting of the respondents’ choosing (probably at home) and (subject to consent) will be tape-recorded and transcribed in full. individual patients’ accounts will be compared at baseline and 6 and 12 months) to understand factors that may foster/undermine self-care and other issues over time. Interviews will also be analysed longitudinally (i.e. For instance, the accounts of respondents who sustain good glycaemic control will be compared with the accounts of those who do not to understand barriers to/facilitators of self-care post course. Whenever possible, interview data will be linked to psychological and clinical outcomes and comparative analyses undertaken. They will also explore issues arising from an analysis of (1) earlier interviews and (2) initial quantitative data (see The quantitative component). Specifically, interviews will record changes in commitment to self-care (since last interview), barriers to/facilitators of diabetes management (and how and why these have changed), understanding of whether or not the DAFNE approach is being adhered to, types of service contact and support received and unmet needs for support. The follow-up interviews with patients at 6 and 12 months will help to understand why many graduates struggle to retain the benefits of DAFNE training (especially sustaining intensive self-management) and why some fare better than others post course and to explore patients’ perceptions of how they could be better supported long term. A comparative analysis of the staff and patient interviews will be undertaken enabling (possible) discrepancies in their understandings of the aims, objectives and outcomes of the DAFNE programme to be examined. For patients, interviews will also explore if, to what extent and in what ways their needs and expectations were (or were not) met likes/dislikes of the course changes in attitudes towards, and knowledge of, their diabetes and its management perceived needs for future care and other issues arising as a result of the observational research (which cannot yet be predicted). In both cases, observations generated will be used to inform the areas explored and to focus discussions. ![]() ![]() The interviews with staff and patients on programme completion will enable them to reflect on their understandings and experiences of what took place during the course and why. We anticipate, therefore, that most respondents will join the observational research.įollowing completion of each course, the researcher will (1) interview all consenting participants (staff and patients) and (2) undertake follow-up interviews with patients 6 and 12 months later. Any DAFNE participants not giving informed consent will be excluded but our experience shows that respondents quickly forge relationships with the researcher and value their efforts to understand matters from their perspectives. Observational research undertaken in other medical settings has demonstrated that, through spontaneous interactions between patients and/or staff, and as a result of patients’ own priorities and needs (which may differ from those identified by staff), informal patterns of care may arise that diverge from a service’s formal aims and objectives.ĭata will be recorded as detailed descriptive field notes, the standard procedure in observational research. Naturalistic enquiry, in which people and events are observed in situ, is vital to enter the DAFNE ‘black box’ and gain an in-depth understanding of what actually happens and why. The researcher will observe complete DAFNE programmes (six to eight programmes in at least three DAFNE centres).
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