JCPSLP Vol 19 No 1 March 2017

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.

Table 1. Participant demographics

Participants (n = 10)

Characteristics

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) Child’s communication disorder

9 preschool, 1 school

6 speech sound disorder 1 expressive language delay 3 speech sound disorder and language delay

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 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

Flexibility Relationship Location and physical access Outreach services (e.g., in home or preschool) Multiple services in one location

Impact of the health service (individual clinician and organisational factors)

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).

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JCPSLP Volume 19, Number 1 2017

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