The use of secondary qualitative analysis to establish domains of patient-centred care in people with long term conditions

AIMS Secondary qualitative analysis (SQA) is increasingly used in social research. It involves using pre-existing data to investigate a new research question. However, the method remains problematic and ill-defined. This research aims to describe in detail the use of SQA to identify domains of patient-centred care from experiences of people living with long-term conditions and highlight the advantages and limitation of SQA.;
METHODS The primary data is a collection of narrative interviews from Health Experience Research Group, University of Oxford. Five chronic conditions were chosen for analysis;
Rheumatoid Arthritis, Type 2 Diabetes, Asthma, Heart Failure and Epilepsy (100 interviews). A literature review informed the development of a primary coding framework; a set of anticipated domains. By means of Heaton’s (2000) five categories of SQA, this study falls into the categories of Supra-analysis, Amplified analysis and Supplementary analysis.;
RESULTS Interviews were coded using a modified grounded theory approach, looking for both anticipated and emergent themes. Constant comparison was used to refine the coding
framework. This was done after each interview and included the addition of new codes in the framework and merging, expanding and relating codes. A codebook was created, and this, together with analytic memoing helped to determine the point at which data saturation had been reached. The second step of the SQA involved further in depth analysis of the codes extracted from interviews. A visual mindmap technique was used to seek analytic depth in the data and gather new insights and interpretations. The main concerns of SQA are ‘lack of contextual knowledge’, access to ‘the bank of knowledge’ and ‘fit of data’ to the new research question. However, there is great potential for re-analysing material and SQA saves considerable time, which allows for deeper analysis and understanding of the primary data. Ethical approval may also not be required and further investigation will not burden participants.;
CONCLUSIONS SQA is a useful, cost-effective method which decreases respondent burden. It is beneficial for the researcher to be aware of and address limitations of this method before commencing analysis. Results from SQA will inform the development and evaluation of a Patient Reported Experience Measure for people with Long-term conditions.