JCPSLP Vol 19 No 1 2017

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JCPSLP Volume 19, Number 1 2017 21
2004). Finally, the 16 subthemes, which emerged from
grouping similar comments, were clustered into three major
themes. The first author transcribed and coded all of the
samples, and later the second author coded a randomly
selected 40% of the participant utterances against the 16
subthemes. The rigour of coding was confirmed with an
interrater reliability of 93 per cent for the 16 subthemes
between the two authors.
Results
This pilot study investigated Aboriginal families’ experiences
of attending paediatric SLP services. The participant
responses fit into three major themes of “client and
caregiver”, “impact of the health service” and “community
and Aboriginal culture”. The subthemes associated with
each of the major themes are listed in Table 2. An overview
of themes and possible solutions are outlined in Table 3,
and are explored in the following sections. Procedure
The first author arranged and conducted nine interviews,
while the second author arranged and conducted one, to
ensure the interviewers did not have a clinical relationship
with the participants. This was necessary so as to ensure
that the caregivers felt comfortable, and were able to
discuss their engagement with the SLP service with a
clinician who was not providing services to the child. In
each case, the relevant author contacted the participant to
organise a time for the phone interview to occur. Some
participants were willing to complete the interview on initial
contact, whereas others identified a later convenient time.
The interviewer introduced herself, ensured that the
caregivers had read the information about the study and
answered any questions they had before commencing. The
interviewer first outlined that the focus of the phone call was
to get feedback about the things that had made it easy for
their family to attend SLP services. Second, the interviewer
identified that participants were free to talk about factors
that were relevant to their experiences with SLP services
and that some questions may be asked by the interviewer
along the way. The participants were also informed that
they were able to abandon the interview at any point and
that notes would be taken which they were able to review.
The semi-structured telephone interviews (Shuy, 2002)
took approximately 10 minutes and enabled participants
to raise issues that were relevant to them (Bowling,
2002), while also allowing for a conversational approach
which has been successful with indigenous participants
internationally (Kovach, 2010). In order to avoid a structured
interview format, not all questions were asked of all
participants and the questions that were asked were
dependent on responses by caregivers and flowed on from
their comments. The interviewer made online, verbatim
transcriptions of pertinent key comments and statements
by the participants.
Analysis
Analysis was conducted using qualitative analytic
procedures for interpretative phenomenological analysis,
which involves examining how people make sense of
experiences (Smith & Osborn, 2008) and has previously
been used in Aboriginal health research (Shahid, Bessarab,
Howat, & Thompson, 2009). First, each written transcript of
key comments was read numerous times by the first author
to become familiar with each transcript. Second,
participants’ comments were allocated to subthemes.
Analysis involved constant comparison and testing of
subthemes against the data by the author (Joffe & Yardley,
Table 1. Participant demographics
Characteristics Participants (n = 10)
Participant’s gender 9 female, 1 male
Participant’s
relationship to child
9 parents, 1 foster carer
Child’s gender 9 female, 1 male
Child’s age (school or
preschool)
9 preschool, 1 school
Child’s communication
disorder
6 speech sound disorder
1 expressive language delay
3 speech sound disorder and language delay
Table 2. Themes and subthemes identified in
participant responses.
Theme Subtheme
Client and
caregiver
Changes to child’s communication observed
by caregiver
Awareness of service
Expectations of service
Commitment of caregiver
Child or caregiver’s experience with SLP
Child’s receipt of attention
Caregiver skill acquisition
Impact of the
health service
(individual
clinician and
organisational
factors)
Flexibility
Relationship
Location and physical access
Outreach services (e.g., in home or preschool)
Multiple services in one location
Community and
Aboriginal culture
Changes to child’s communication observed
by others
Others’ perceptions of child
Aboriginal staff and resources
Community awareness of SLP
While participant responses spanned the three themes,
the first theme (perceptions, experiences and skills of the
client and caregiver) emerged strongly. Example responses
from each theme and subtheme are provided, and the
specific interview identifier is provided in parentheses (e.g.,
Interview #2 presented as (2)).
Theme 1: Perceptions, experiences and
skills of the client and caregiver
Changes to child’s communication observed by
caregiver
Caregivers reported positive changes in their children’s
communication (and confidence): “We’re understanding a
whole lot more” (2); “Doing the speech, we make a game of
it. It really builds up his confidence when he knows he can
do it” (7).
Awareness of service
Participants described the ways that they found out about
SLP services: “Someone suggested the lady [speech-
language pathologist] that we went to” (2).