T HE PHASE OF CONNECTING

This phase refers to the discovery of themes and patterns, making linkages between categories, developing models and generating new theory. Techniques for doing this is for example creating maps and diagrams and from this suggest new connections and patterns, visualization of concepts and categories, use of data matrices, writing short stories or developing vignettes from the data (Crabtree & Miller, 1999).

In this phase I went deeper into the data material and connected several of the different areas. The original areas could in some cases represent subcategories. I changed some of the answers that appeared to fit somewhere else than where I

originally intended. I tried out different alternatives as to which area to apply different answers. As a working example, I will illustrate this process in the following. Many of the respondents listed ”relatives” as an important area. This was a subject that stood out in my first read-through, and it seemed obvious to have this as a separate area. There were quite a bit of differences in the descriptions of what was important

about the relatives. For instance, the students had to include the relatives when dealing with the patient, know how to communicate with the relatives, they should have insight in the psychological issues the relatives had to deal with in a difficult situation, they needed to follow up on the relatives after the patient died, the relatives could give valuable information about the patient and make it easier to give the best possible care to the patient. My first suggestion was to formulate the area: ”How to relate to the relatives.” Two aspects in how to relate to the relatives stood out, so I decided to have 2 subcategories: 1) ”The relative as a collaborator and a resource for the patient” and 2) ”The nursing student as a resource and caregiver for the relative”.

Another area I worked on at this time was about the interaction between the student and the patients, this was also an area that was mentioned a lot. I tried different formulations to catch what it was really about, it dealt for the most part with different aspects of communication and how the students own values and attitudes would have an impact on the interaction with the patient. I discovered that I had to split up a lot of these answers because in a lot of cases the patients and their relatives were both referred to in the same answer. For instance, ”how to communicate with patients and their relatives”, or ”be supportive towards both the patient and their relatives in a difficult situation”. I got the notion that in many cases, the patients and the relatives were seen as a unit, and that the main issues were the same in both groups. The answers circled around how the students should relate to both relatives and patients and the interaction and cooperation in between the three groups. I decided to make a linkage between the two areas and like many of the respondents, view the patients and their relatives as a unit. The new area was now formulated ”Interpersonal skills in regards to patients and their relatives”. Subcategories were ”Interaction and

communication with patents and their relatives” and ”Personal qualities and

experiences”. This is an example of how the areas could change as I re-read and went deeper into the data material. What at first stood out as an obvious area wasn’t

necessarily what I ended up with. Another example of this is the area of mental health issues. Originally the answers describing mental health issues were linked to the area of symptom management. The thinking behind this was that the body and mind go together, and psychological reactions like anxiety and grief are normal reactions to a

life threatening disease and can be viewed upon and attended to in the same way as physiological symptoms. However, there were different aspects of this matter that could not be related to symptom management, like existential questions and the attending of quality of life. I decided to view the area of mental health as a separate area, because this in a better way would reflect the content of the answers given by the respondent.

Like in White et al’s (2001) study I wanted to present the findings in tables. Before I could make the tables I had to make some decisions on how to handle the data. As explained earlier, all answers were ranked from 1-5 according to importance, where

“1” was viewed as the most important. I kept the ranking in each answer the same in both split answers. To illustrate one answer is this, originally ranked as “3”:

“Good knowledge on how to relieve symptoms. Basic values and knowledge about the spiritual dimension.”

I split this one answer into two separate answers, both ranked as “3”:

• Good knowledge on how to relieve symptoms.

• Basic values and knowledge about the spiritual dimension.

The consequence of doing it this way is that all together I had more different answers, each with a ranking, even though the original answer had only one ranking connected to it.

Even though I end up with more rankings than what was originally given me by the respondents, the fact still is that both statement nr. 1 (Good knowledge on how to relieve symptoms.) and statement nr. 2 (Basic values and knowledge about the spiritual dimension) are originally ranked as “3”.

Another issue was that some of the respondents did not rank their answers. Some might have forgotten, but others made comments on the survey sheet that it was difficult to rank the answers, as they were all equally important. I decided to include all the data in the analysis process were I found and described the different areas to

not lose any information. All data is consequently a part of the analysis of the findings and conclusions. However, there was a problem when I wanted to make tables showing how many of the respondents had listed the different areas, and how they were ranked. The tables’ main purpose is not to be able to generalize, but to give an overview on how many of the respondents who listed the different areas and how they ranked them. From 140 respondents just a few were not ranked, so I decided not to include the non-ranked answers in the tables and the calculations in them. Not so much information was lost, and the tables themselves don’t say anything about what the areas are actually about. In the description of the areas, the non-ranked answers are included.