90 Chapter 4 Sampling and participant Patients, representatives of patients (e.g. from patient associations), and healthcare providers were invited to participate. The patient associations (“Ostomy Association” or “Foundation Stomaatje”) recruited patients aged 18 years or older who had an ileostomy or colostomy among their members. Patient were selected using purposive sampling to acquire a broad scope and a wide range of perspectives, taking into account sex, age, operation indication, and stoma type.17 To help broaden the perspectives of patients, representatives of the aforementioned associations were also present. In addition, healthcare providers, including doctors or nurses, working in the field of stoma care were recruited from a large university and a teaching hospital in Amsterdam, the Netherlands. This approach ensured a diverse range of perspectives from multiple stakeholders. In total, 23 participants were recruited to assure for a balanced distribution of patients, healthcare providers, and representatives. Participants were assigned to one or multiple focus groups based on their availability. We intended to include between 6 and 8 participants in each focus group interview to ensure every participant had the chance to discuss their experience.18 Insights on the participants’ experiences in stoma care and their perspectives on what a good ‘stoma app’ should entail above the currently available information were collected. Participants had no previous work or care-related relationship with the first author, except for the last author who participated three focus groups. She had a work-related relationship serving as surgeon, not as primary surgeon but involved in supervising care of patients admitted at the surgical wards. The participants provided oral and/or written informed consent and received a travel allowance for participating in the face-to-face interviews. Data collection Four focus group interviews were planned based on a semi-structured interview schedule (see Table 1). The topics of focus groups 1 and 2 and those of groups 3 and 4 were the same. To ensure data saturation and expand upon the insight gained, two additional focus groups were organised to acquire further, detailed information on peer contact and the design of information timeline in the app (see Table 1). The first three interviews were conducted at a large university hospital in the Netherlands, and the last three interviews were conducted online due to COVID restrictions. The first author moderated all six interviews, and had some prior experience in qualitative research. To create a comfortable atmosphere, the participants had 10 minutes to chat with each other before the interviews. The interviewer empowered the participants to speak freely and instructed them not to condemn the other participants. The participants were asked to share their experiences with stoma care and their thoughts on the possible functionalities of the app to solve some of the problems. Questions regarding peer contact and the functionality of the app were more direct. The interviewer interrupted the conversations if the participants drifted too much off topic
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