A summary of all interviews and focus group was made to identify overall meaning . Content analysis of the transcriptions was performed concomitantly by constant back
and forth from codes and categories to raw data (verbatim excerpts). A comprehensive coding grid that evolved as new categories linked selleck inhibitor to the study theme emerged from the data was used. The coded content relating to study theme (ethical issues) was then grouped into categories (by JB and AR) and discussed with the research team until consensus was reached about essential meanings. Quotes were identified based on the following system: R (relative), S (stroke client), ID number, T1 (Time 1), T2 (Time 2). Characteristics of participants at Phase 1 are presented in Table 2. Relatives (n = 25) were aged between 31 and 72 years,
nine of whom were interviewed at both times (following discharge from T1 [acute care] and T2 [rehabilitation]) for a total of 34 interviews. Stroke clients (n = 16) were aged between 37 and 76 years, ten of whom participated at T1 and T2 (n = 26 interviews). Participants SGI-1776 in the focus group (Phase 2) for relatives (n = 5) were aged between 43 and 66 years, three of whom were women. Participants in the stroke client focus group were mainly men (n = 3/4), while participants in the health professional focus group were mainly women (n = 4/5). For the latter, a variety of disciplines were represented from throughout the continuum of stroke care (acute care, in-patient rehabilitation, out-patient rehabilitation), including a nurse, a physiotherapist, a speech language pathologist, a social worker, and a specialized educator, while the two facilitators were occupational therapists. Four main themes relating to ethical issues emerged from the interviews:
(1) overemphasis of caregiving role with an unclear legitimacy of relative to also be a client; (2) communication as a key issue to foster respect and a family-centered approach; (3) availability and attitudes of health professionals as a facilitator or a barrier to a family-centered approach; and (4) NADPH-cytochrome-c2 reductase constant presence of relatives as a protective factor or creating a perverse effect. If there was an overarching theme, it would be about the tension between the dual roles of relatives with a predominance of the caregiving role mainly as being a source of information “Let me tell you, sometime I had the feeling they were not communicating the information to each other because they were asking over and over the same questions” (R10T1) and a blurred legitimacy for relatives to receive services as a client “…I told myself, I better stop asking questions, because I feel, I feel I’m getting on their nerves … I didn’t want to become irritating, you know” (R7T1).