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have been diagnosed with endometriosis in the previous five years, have been conducted between March 2016 and March 2017. Participants were recruited by advertisements in social media, a national patient interest group and centres of expertise in endometriosis. The focus groups were organized throughout the country in conference rooms. Semi-structured interviews in groups of 2-6 participants were carried out rather than individual interviews because we expected that the interaction and sharing of experiences would generate more relevant information. The semi-structured approach allowed the participants to talk freely with structured guidance from the moderator, using an interview guide (appendix). The interview guide was based on the literature and experience of the authors, working in the fields of reproductive medicine, qualitative research, and implementation research. The topic guide was a dynamic document, on which topics were added when new items were identified during the interviews. In addition, each participant was asked to complete a short questionnaire to inform the researchers about their age, timeline in their diagnostic process and treatment history and personal suggestions for reducing the diagnostic delay. The group interviews were directed by a moderator (AN or MZ) with a backup for taking notes and process monitoring (MZ, LK or AN). We continued to organize focus group interviews until data saturation was achieved, which was defined as no additional information was gathered during subsequent focus group interviews, followed by one additional session for confirmation of data saturation. The participants received detailed information about the study design and signed an informed consent form prior to participating. Anonymity and confidentiality were ensured.
Data Analysis
The focus group sessions were audio recorded and fully transcribed. The qualitative research software package ATLAS-ti (v7.1) was used to assist in data analysis. We used the grounded theory methodology for data analysis.22,23 First, all transcripts were analysed by two of the authors (MZ and LK) independently by means of line by line open coding. After the individual coding of each transcript, quotation selection and codes were compared, and any discrepancies were resolved by discussion between the two researchers. Remaining differences of opinion were discussed with a third researcher (WN) until consensus was reached. This third researcher, a qualitative research specialist, checked samples of the transcripts for completeness of coding. After coding of all the transcripts, the full code list was analysed by the three coding authors and the researchers who moderated the focus
36 | Chapter 3