Development and description of a model for incorporating “indigenous” postnatal care practices into midwfery healthcare system

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The interview process

On arrival at the setting for different population groups for focus groups and indepth individual interviews, the researcher greeted the participants with a smile, demonstrating a warm welcome to build a mutual and trusting relationship. The researcher introduced herself to the different population groups and encouraged the members of each to introduce themselves and get to know each other. The explanations regarding the title, nature and purpose of the study were also introduced to the participants. They were assured about anonymity and confidentiality during and after the study, encouraging them to become more comfortable and express different opinions and perceptions of the phenomenon being studied.
Permission to use an audiotape and take field notes was also obtained from the participants. On commencement of the focus groups and in-depth individual interviews the researcher made sure that the environments were free from noise and interruptions and switched on the audiotape. The following questions were used as a guide during the interviews:
 What are your perceptions and experiences regarding the incorporation of “indigenous” postnatal care practices into midwifery healthcare systems?
 How can we incorporate “indigenous” postnatal care practices into midwifery healthcare systems?
The role of the researcher during the interviews was to facilitate the process in a permissive and non-threatening environment. The researcher also ensured that all the participants were actively involved and participating during the study (Kasturirangan & Krishnan, 2004:147). Dominant behaviour was avoided during the interviews. The researcher probed deeper to encourage the participants to express their experiences and perceptions, and took field notes to back up the audiotape recordings.
The number of focus group interviews for each population group was determined by data saturation. For the postnatal patients, family members‟ data saturation was reached during the second focus group interview, for the traditional birth attendants it was also reached during the second focus group interviews. During focus group interviews the researcher encouraged the participants to interact with each other, formulate ideas and talk about the incorporation of “indigenous” postnatal care practices into a midwifery healthcare system (Burns & Grove 2009:515).
In order to encourage active participation and involvement during interviews the researcher explained to participants that she was there to learn from the group members and not as an expert. The researcher also avoided over-dominance (Burns & Grove 2009:515) and displayed good communication and listening skills, mutual respect, neutrality and a non-judgmental person. The assistant moderator and moderator were included in the interviews (Burns & Grove 2009:515).
Towards the end of the interviews the researcher ensured that the participants were not left with unfinished stories, by asking questions such as “could you explain a bit more?” The researcher also stressed that the information would be kept confidential and they would receive fair and equal treatment throughout the interview process. Data was collected until data saturation was reached (Burns & Grove 2009:353). At the end of the focus group and in-depth individual interviews the researcher thanked the participants for being actively involved and participating during the study and for the information they provided. After giving a vote of thanks the researcher switched off the audiotape.

PHASE THREE: MODEL DEVELOPMENT AND DESCRIPTION

Model development, and description was based on the findings of Phase One (concept analysis) and Two (exploration and description of the perceptions and experiences of postnatal patients, family members, traditional birth attendants, registered midwives, midwifery lecturers and the maternal and child healthcare coordinators. Conceptualisation of the concepts identified during phase one and two was conducted following the conceptual framework by Dickoff, et al. (1968: 423). This method consists of six aspects: Agency: Who or what performs the activity?; Patience or recipiency: Who or what is the recipient of the activity?
Framework: In what context is the activity performed?, Terminus what is the end point/purpose of the activity? Procedure: What was the guiding procedure, technique, or protocol of the activity? Dynamics: What was the energy source for the activity, whether chemical, physical, biological, mechanical or psychological, etcetera?. A detailed description of model developmentis provided in Chapter Five.

CONCEPT ANALYSIS PROCESS

Concept analysis was selected as a suitable method during analysis of the concept „incorporation‟. According to Walker and Avant (2005:63), concept analysis is “the process of examining the basic elements, structure and functions of a concept”, whilst for Beckwith, Dickinson and Kendal (2008:1833) it is “a branch of empirical linguistics, as it contains the assumption that a definition of a term may be found which pertains to its representation in a natural language”. The reasons for choosing concept analysis during model development were that it rendered very precise theoretical as well as operational definitions for use in model development and research Walker and Avant (2005:74). It also enabled the researcher to clarify concepts that are similar (model case) to it (Rodgers & Knafl 2000:78). Lastly, concept analysis has been useful in model development and nursing language development (Walker & Avant 2005:74).

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