85 Professionals’ perspectives of a Challenging Rehabilitation Environment participants were then asked to share their perspectives on CRE. The chair asked open-ended questions based on the topic list to keep the conversation going. To increase the internal validity, participants were also asked to share their perspectives on subjects that were not included in the topic list but which they considered important regarding CRE. On average, the duration of the focus groups was 110 min, and they were audiotaped and transcribed verbatim by L.T. Transcripts were not returned to participants for comments, but at the end of every focus group, the chair presented a verbal summary and checked its accuracy with the participants. Workshops Four 50-minute workshops were held at two Dutch national congresses in the field of rehabilitation. Each workshop started with a presentation by L.T. about the results of the review on CRE.11 Participants were informed of the purpose of this qualitative study, and after the presentation, the participants split into groups of 8 persons on average. In these groups, they discussed one of four questions compiled by the researchers regarding CRE. L.T. and B.B. guided these discussion rounds, and participants were asked to summarize the results of their discussion on a flipchart and present them to the other participants. These flipcharts were digitized and used as an input for data analysis. Data Analysis Parallel to the data collection, we performed a thematic analysis to identify, analyze, and report patterns in the data.14,18 For coding of the data, ATLAS.ti version 7.5 was used. L.T. familiarized herself with the data by reading and re-reading the transcripts, after which initial themes were identified using an open-coding approach. These initial themes were checked and coded by B.B. and E.D. to determine inter-rater agreement. Differences in the coding were discussed by L.T., E.D., and B.B. until an agreement was reached. Each initial theme was described in a memo. The identified initial themes were combined into main themes with associated sub-themes. The connections and contradictions between the initial themes were 4
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