Combined Glaserian grounded theory and thematic analysis of paramedics attending their own families
Overview
It is widely accepted as ethically advisable that healthcare practitioners do not treat their own family members, to avoid any impact on their professional objectivity, patient autonomy, and informed consent (1–4). This topic has been explored in research across other fields of medical practice in the past decades (3–8). However, no research currently exists exploring the experiences of paramedics attending their own families.
This is particularly problematic as while in other areas of healthcare it is often feasible to organise other practitioners to care for family-patients, this is regularly not practical in paramedicine – the time-critical nature of the work and limited number of available practitioners often precludes seeking alternative treatment without risking significant patient detriment. This project aims to provide baseline data on the experiences of these practitioners.
This study has concluded and the results published.
Wilkinson-Stokes M, Kellermeier M, Whitfield S. ‘Send everyone, it’s my son’ – Combined Glaserian grounded theory and thematic analysis of paramedics attending their own families. Paramedicine. 2023;0(0). doi:10.1177/27536386231178961
You can view the published paper here:
https://journals.sagepub.com/doi/full/10.1177/27536386231178961
Research question
What are the experiences of paramedics attending their own families in the course of their profession?
Method
Qualitative thematic analysis and Glaserian grounded theory
Am I eligible to participate?
You are eligible to participate if:
You are, or were at the time, employed as a paramedic.
In the course of your role as a paramedic you have attended, or been dispatched to attend, your own family.
You are still eligible to participate if you were dispatched to your own family, but did not attend for any reason (either by being diverted to another case, or by choosing not to attend).
You are eligible to participate if the incident occurred in a volunteer or student capacity.
However, exclusion criteria also apply. You are not eligible to participate if:
You provided medical services to your own family outside of your formal role (such as being home and off-duty when an emergency occurred). This study specifically focuses on incidents that occurred in the course of employment.
You provided medical services to your friends or other people known to you who are not your own family. This study aims to only explore incidents with those you know well, and limiting to family members is one method of achieving this.
What does participation involve?
You will be asked to participate in a single audio-recorded online interview, up to a maximum of 60 minutes in length.
The interview will be semi-structured. That means that there will initially be a series of 3 closed questions to establish your eligibility, followed by a series of 11 open-ended questions that allow you to elaborate on your experience. The interviewer may ask you to elaborate or provide minor prompts for clarification.
How much time will this take?
The interviews will run for a maximum of 60 minutes. Within this timeframe, you are free to be as concise or elaborate in your responses as you choose. It is expected that the majority of interviews will take below the maximum allocated time.
What happens after the interview?
After the interview, the audio will be transcribed into text. You have the option of being provided with a copy of this text and of identifying any transcription errors for correction.
Following this, the audio file will be securely stored, and the text file de-identified. All text files will then undergo a process known as coding, where key themes are identified and collated. This will then be used to produce an academic paper, which will undergo peer review and be published in a reliable journal. You have the option of being provided with a copy of the final research article.
What will happen with my data?
During interviews, you will be asked direct questions about your experience and how you responded to the situation.
This is likely to involve the disclosure of personal information about your family member’s medical episode, how you performed in this situation, and you felt.
To minimise the risk of personal information being recognisable, all information will be de-identified following data collection, and all participants will be allocated a participant number which will be used to identify their data. All data will be stored on a single secure research computer. Data will not be released or transferred elsewhere without your explicit permission. As per the National Health and Medical Research Council recommendations, data will be retained for 5 years after publication and then securely destroyed.
Please note, we may contact you after the interview to seek your permission to use a specific quote in published research. This is entirely voluntary and will not affect your participation in the research in any other way.
Are there any risks?
The risk of this study has been independently assessed by the Griffith University Ethics Committee. However, there are two key risks you should be aware of.
Firstly, during the interview, you will be asked direct questions about their experience and how they responded to the situation. This may potentially trigger a negative reaction in association with the memory. To minimise the risk of negative psychological impact, you will have full right to withdraw from the study at any point up to conclusion of the interview. This includes part way through the interview. This right to withdrawal is explicitly stated in the Participant Information Form and again in the pre-interview statement. You will also be provide with information on appropriate support services, should you require them.
Secondly, every effort will be made to ensure that published information will not include any specific information that may be used to identify you. However, due to the rarity of the events being investigated, the possibility that a reader familiar with the circumstances is able to identify a particular participant remains plausible.
Why should I participate?
This study will be the first ever conducted on the experiences of paramedics attending their own families. If you have ever been in this situation, you have had a rare and unique experience that we hope to better understand. We cannot offer compensation for your time. However, we can offer the opportunity for you to express your personal experience, and for that information to become a valuable part of human knowledge.
Ethics
Griffith University Human Research Ethics Committee approval
GU Ref No: 2022/096
Participant Documents
As the study is concluded, participant documents have now been removed.
Note: There is no requirement for you to print and sign the Consent Form. After enrolment you will be emailed a link to a DocuSign version of the form to complete electronically. If you are unable to complete this for any reason, consent can also be obtained verbally at the commencement of the interview.
Contact
Matt Wilkinson-Stokes
The University of Melbourne
matt.wilkinson-stokes@outlook.com
Steve Whitfield
Griffith University
s.whitfield@griffith.edu.au
References
1. American Medical Association. Treating Self or Family. Ethics. 2022.
2. Medical Board of Australia. Treating people with whom you have a close personal relationship. Australian Health Practitioners Regulatory Agency [Internet]. 2015; Available from: https://www.medicalboard.gov.au/news/newsletters/august-2015.aspx#treating
3. B. Anyanwu E, O. Abedi H, A. Onohwakpor E. Ethical Issues in Treating Self and Family Members. Am J Public Heal Res [Internet]. 2014 May 4;2(3):99–102. Available from: http://pubs.sciepub.com/ajphr/2/3/6/index.html
4. Kerrigan J, Rovelstad S, Kodner IJ, La Puma J, Keune JD. All in the family: How close is too close? The ethics of treating loved ones. Surgery [Internet]. 2011 Mar;149(3):433–7. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0039606011000122
5. Kamerow D. Doctors treating their families. BMJ [Internet]. 2014 Jun 26;348(jun26 7):g4281–g4281. Available from: https://www.bmj.com/lookup/doi/10.1136/bmj.g4281
6. Nik-Sherina H, Ng C-J. Doctors treating family members: A qualitative study among primary care practitioners in a teaching hospital in Malaysia. Asia Pacific J Fam Med. 2006;5(2).
7. Hutchison C, McConnell PC. The ethics of treating family members. Curr Opin Anaesthesiol [Internet]. 2019 Apr;32(2):169–73. Available from: https://journals.lww.com/00001503-201904000-00010
8. Dusdieker LB. Physicians Treating Their Own Children. Arch Pediatr Adolesc Med [Internet]. 1993 Feb 1;147(2):146. Available from: http://archpedi.jamanetwork.com/article.aspx?doi=10.1001/archpedi.1993.02160260036018