The aim of a loosely-structured or “semi-structured” interview is to invite consumers to tell their own story, in their own words. The role of the interviewer is to listen actively and with empathy, clarify and seek additional information when appropriate, and ensure that all the key issues and areas are explored by the storyteller.[29]
Some interviewees will appreciate being asked prompting questions, as this provides a structure for their story and their thinking. Others will feel comfortable to tell you their story with little, if any, prompting.
The stages of the patient life journey are the topics that every interviewee should be invited to talk about, with prompting questions built around those topics.
| Interview topics | Includes, for example | Examples of possible prompting questions |
|---|---|---|
| About you | Overall health, work and family situation, any personal characteristics that might impact on health or healthcare experiences (such as age, gender, ethnicity, culture, rural/regional/remote/urban location, SES status) | How would you describe your health, overall? What sorts of health services do you use? |
| Prevention | Preventative health behaviours, staying healthy, | Do you do anything in particular to stay as healthy as you can be? |
| A change in health | First symptoms, a pregnancy, ageing, an accident. | When did you first notice that something in your health had changed? What did you do about that, if anything? |
| Seeking health assistance | Visiting a GP, attending accident/emergency, going to hospital, attending an allied health professional | When did you first seek help from a health professional? |
| Information seeking | Searching websites, asking family or friends | Where did you go for information? |
| Diagnosis | Diagnostic tests and imaging, referrals, diagnostic procedures, being told the diagnosis | Can you tell me about how you came to be diagnosed? |
| Treatment | Hospitalisation, treatment as an outpatient, medicines, devices, allied health treatment, | Tell me about your treatment? |
| Life with a condition | Self-care, secondary prevention, medicines and treatments, mental, emotional and physical wellbeing, impacts on work and community participation, family and home life. | Has much changed in your life as a result of your condition? Do you anything different now, to look after your health? |
| Key messages | Overall impressions, key recommendations for change, what mattered most. | If a friend of yours was diagnosed with same condition, what would you tell them to prepare for? If you could change any one thing about your care, what would that be? |
As you are listening to someone’s story, keep in mind the aspects of patient-centred care, and the health system and service issues detailed in the Patient Life Journey Framework. You don’t need to ask directly about these issues. If they are important to a consumer, they are very likely to discuss them without being asked, especially because the semi-structured approach to interview involves you encouraging people talk about what has been important to them. It is often more powerful if consumers raise these sorts of issues themselves, rather than at your prompting. However, asking directly can encourage people to discuss things they might otherwise overlook. You may like to incorporate some prompting questions that invite people to talk about their experience of some of these issues. Below are some examples of how you could do this.
| Patient-centred care domain | Prompting question |
|---|---|
| Coordination of care | Would you describe the relationship between the different services/professionals that treat your condition? Who makes decisions about your care and treatment? |
| Continuity of care | What happened after you left hospital? Who looked after your health? Did the hospital or other services follow up once you were back home? |
| Informed consent | Did you know what to expect before you had the treatment/procedure? Were there any surprises? |
| Access to health services | Have you always been able to access the service when you needed to? |
| Respectful care and treatment | Thinking about all the different health professionals you’ve dealt with, how would you describe your relationship with them? |
| Overall experience of care | Is there anything that’s worked especially well in the care you’ve received? Is there anything that hasn’t worked well? |
We include an example interview guide at the end of this resource (Template 3: Example Interview Guide). Whether you use this example guide, adapt it or develop your own, here are some tips for developing a questionnaire that meets the needs of interviewers and interviewees:
References:
[29] Sewell, Meg (2013) The use of qualitative interviews in evaluation (University of Arizona: Tuscon);