208 Chapter 10 were eligible to be a CoReAL patient partner. We used a maximum variation sampling strategy, ensuring diversity in age, gender, and the severity of AL based on the International Study Group of Rectal Cancer (ISREC) definition and classification 14. Severity of AL ranged from small abscesses treated with antibiotics, to peritonitis requiring admission to the ICU. NonDutch or non-English speaking patients were excluded. Subsequently, the lead researcher (DH) shared the study details via email and obtained written informed consent. Purposive sampling continued until data saturation was reached, defined as the point at which no new information or themes emerged from the data 15. Data collection One-on-one semi-structured interviews were conducted online to ensure the capture of in-depth individual perspectives on specific topics, while also allowing participants the freedom to express any additional information they wished to share. The interview guide (Supplementary S1) was developed by two authors (DH and MK), with input from experts in colorectal surgery, qualitative research and patient-centered research. The guide included three core content areas: diagnosis, treatment, and impact. Participants’ demographic characteristics (e.g., age, gender) and clinical data (e.g., type of surgery, AL treatments) were obtained during the interview. All interviews lasted approximately one hour and was conducted by the lead investigator (DH) on an institutional version of Zoom. DH is a female physician who was completing a PhD at the time of the interviews and had undergone formal training in qualitative interviewing with assistance from an experienced qualitative researcher (MK). She had no prior clinical relationship with any of the participants. Verbal informed consent was obtained before commencing each interview. While the interview guide was not pilot tested, it was iteratively refined after three interviews. Data analysis The interviews were audio recorded,transcribed verbatim, and deidentified before analysis. Two researchers (DH and MBos) extracted and analyzed the data manually using Braun & Clarke (2006)’s thematic analysis approach 17, 18. Analysis was data-driven, with no preexisting coding scheme or theoretical framework applied. The researchers read the first five transcripts and independently coded them by identifying and marking relevant sections within the text and subsequently allocating a code to each section using a qualitative analysis software (ATLAS.ti, Berlin, Germany) 19. Emotions were described using an emotion/feeling wheel 20, 21. All codes were compared, and a coding tree was created to inform the analysis of the remaining transcripts (Supplementary S2), which was discussed with the larger team. Any discrepancies in coding were resolved by consensus or consulting the senior researcher (MK). Throughout the analysis process, new codes were iteratively added to the coding tree as appropriate. All coded segments were analyzed, and similar concepts were grouped into themes. Saturation was assessed on an ongoing basis using a saturation grid and considered to have been reached when two consecutive interviews produced no new themes 22. The
RkJQdWJsaXNoZXIy MTk4NDMw