152 Chapter 5 validity. Additionally, Salminen et al. [60] discusses a lack of transparency as one of the challenges of creating personas, but we are confident that the rigorous described iterations show how the personas were generated and therefore decrease the lack of transparency. Our findings described the development and validation of four personas that can be used as an empathic handover and communicate with designers of management staff about the needs of MHNs regarding oral health. Based on data from a variety of sources, including the literature, contextual interviews, and semi-structured interviews, we identified and presented unique oral care perspectives, the main barriers, needs, suggestions for interventions, and site conditions, which were synthesized through four personas. These four personas were manually created because there are no average or stereotypical MHNs [60]. From a strict scientific point of view, we recognize a possible issue with external validity [41]. However, persona creation may be considered more like a data-synthesis activity rather than a data-analysis activity. This means that, based on data, (design) researchers build personas to display relatable and authentic members of a target group, since it serves designers better to have a specific person to empathize with when designing new interventions [42]. Thus, although personas should be based on accurate data, ultimately, they serve a design process; they are not tools to meticulously represent a whole population in all its characteristics. Furthermore, our results showed that people recognized Monica in their work, but nobody recognized themselves as Monica. This can be explained as evidence that working with personas has added value: this may allow for the collection and interpretation of data in a way that reveals insights beyond social desirability. This study was carried out among a sample of MHNs distributed in various parts of the Netherlands (north, east, west, and south). The participants were representative in terms of sex, age, and educational level in nursing. While the number of interviews was modest, we were confident we reached data saturation, as no new information was retrieved in the last four interviews. The ecological validity of the personas and their elements was confirmed in this sample of participants after the second session of semi-structured interviews (n= 19), which meant that we were confident that widely recognized profiles of MHNs were established. One related issue in the creation of personas is that there are no empirically validated guidelines (e.g., as to how many personas should be created) [60]. For this research, we
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