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            This chapter discusses the general definition of the
topics as well as their application to the study. The topics included are
research design, general and applied methods of inquiry, description of study
participants inclusion/ exclusion criteria, research setting, confidentiality,
informed consent and ethical considerations, data collection plan, data
analysis plan, and methods to establish rigor and trustworthiness and integrity
of data.


A phenomenological research
attempts to understand the perception, perspective, and understanding of people
toward a particular situation (Van Manen M.,1990).
Generalizations are then formulated based on multiple perspectives of the same
situation. In other words, phenomenological research study directly examines
and describes a phenomenon as consciously experienced without considering
causal explanations (Van Manen M.,1990).

Qualitative research deals
with the development of concepts which could help in the understanding of social
phenomena in natural (rather than experimental) settings. It provides due emphasis
to the meanings, experiences, and views of all participants rooted in first-hand
accounts, truthful reporting, and quotations of actual conversations (Pope & Mays 1995) (Van Manen M.,1990).
Furthermore, it explores issues, understands phenomena, and answers questions
by analyzing and making sense of unstructured data (QSR
International, 2014). It does not manipulate variables, introduce
treatments, or impose operational definitions of variable on the participants.
Rather, it lets the meaning come out from the respondents and relate it to
their behavior.


and Applied Methods of Inquiry

Phenomenological inquiry concentrates
on the experiences of people in relation to a phenomenon and how they are
interpreted (VanManen M. 1990). An interview is usually
performed with a group of individuals who have personal knowledge of the situation
or experience. It tries to find answers to two general questions (Moustakas, 1994) (Creswell, 2013): What have you
experienced? What influenced your experiences? Documents, art, and other
observations may also be used to gather data. These data are read and reread to
collect themes that are subsequently grouped to form clusters of meaning
(Creswell, 2013). This process would allow the construction of the universal
meaning of the event, situation or experience to have a deep understanding of
the phenomenon. (A [email protected] Site, 2013)

of Study Participants

study involves ESRD patients undergoing dialysis in Aklan who are selected
purposively. Purposive sampling technique is used in qualitative research in
order to gain meaningful awareness of the effects of the phenomena being
studied. The participants describe their experiences, providing varying
accounts of the phenomenon, to attain a profound understanding of the lived

            The criteria for the selection of the participants are
displayed below:

            Inclusion Criteria:

resident of Aklan for at least five years.

aging 18 years and above.

with ESRD and undergoing dialysis for more than 3 months.

Exclusion Criteria:

who are not willing to participate.

under the age of 18.

who are not residing in Aklan for at least five years.

who are mentally-challenged.

that have been diagnosed with ESRD who undergo dialysis for less than three months.


            The study is conducted at Dr. Rafael S. Tumbokon Memorial
Hospital Dialysis Department, Kalibo, Aklan. It is chosen as the research
setting because of its accessibility to the researcher and participants. The
interview, about 45 – 60 minutes long for each participant, takes place in a
comfortable and confidential environment.

Informed Consent/ Ethical Considerations

            The Chief of Hospital, Head and Advising Physician of the
dialysis department of Dr. Rafael S. Tumbokon Memorial Hospital in Kalibo,
Aklan are approached and informed about the purpose of the study through a
letter of request for participation. The researcher asks for their consent to
conduct the study and to interview participants who are willing to partake in
the study. The participants are properly informed of the purpose, risks, and
advantages of their participation in the study. A confidentiality clause
stating their right to a) exclude their names in the written reports, b) keep
the recorded materials confidential and be heard solely by a third party
transcriber, and c) withdraw from the study any time, is included. All
participants should agree to the terms and conditions of the study before
signing the informed consent.




            Data are gathered from the narrative descriptions of the
participants. This is through an in-depth interview and observation utilizing
field notes and audiotape recording (as permitted). Interviews are conducted
through a face-to-face conversational unstructured interview. Interview starts
with small talks in order to establish rapport with the respondents. Once the
respondent feels comfortable enough, the signed consent is again explained. The
interview focuses on the description of lived experiences of the patients, written
or oral self-report, observation of their behavior, and even their aesthetic
and artistic expressions (including art, music, narratives, drama, poetry,
dance, or film) (Dr. Janet Waters, 2017).

Open-ended questions are
asked. Participants are encouraged to give a full description of their
experience, including their thoughts, feelings, images, sensations, memories –
their stream of consciousness – along with a description of the situation in
which the experience occurred. Clarification of details in the self-report or
interview may need to be asked. If so, follow up questions are again asked for the
further description of details without suggesting what is looked for (Dr. Janet Waters, 2017). At the end of the interview,
the phone number of the respondents is asked to inform them of a possible
follow-up meeting or ask for feedback on the research findings.


            This study uses the phenomenological data analysis
procedural steps by Colaizzi (1978) to describe
the analytical procedure of data set and description of data collection.

the phenomenon of interest.

            The participants are asked to share
their experiences from the diagnosis, treatment, and management of the whole

the descriptions of the phenomenon.

  The descriptions of the phenomenon of the
participants are extracted from the interview with the aid of audiotape and
field notes.

the descriptions of the phenomenon.

In this step, significant
statements of each participant are reviewed through transcription of the
recordings verbatim. Bracketing is made to ensure validity and rigor of the

the original transcripts and extract significant statements.

During this process, significant
statements and phrases are highlighted and then sorted out in an analysis

to spell out the meaning of each significant statement.

Meanings are formulated
from the significant statements. Each underlying meaning is coded in one
category as it reflects an exhaustive description. The formulated meanings are
then compared with the original meanings to maintain the consistency of

the aggregate formalized meanings into clusters of themes.

The formulated meanings are
grouped into categories that reflect a unique structure of clusters of themes.
Each cluster of theme is coded to include all formulated meanings related to that
group of meanings. After that, groups of clusters of themes that reflect a
particular vision are integrated together to form a distinctive construct of
theme (Mason, 2002). After merging all study
themes, the whole structure of the phenomenon, “lived experiences of ESRD patients
undergoing dialysis” is obtained.

an exhaustive description.

All evolving themes are
defined through in-depth descriptions. The findings are thoroughly examined to eliminate
overestimated, misused, or redundant descriptions from the overall structure.
Some amendments are applied to establish a clear connection between clusters of
theme and the extracted themes. Ambiguous structures are also eradicated to strengthen
the whole description.

to the participants for validation of the description.

The findings are validated
using “member checking” technique. This is through returning the
research findings to the participants and discussing the results with them. The
views of the participants on the results are acquired directly through either
phone calls or face-to-face conversation.

new data are revealed during the validation, incorporate them into an
exhaustive description.

In the case when the
participant adds new data upon validation, these data are processed through
exhaustive description.

to Establish Rigor

Qualitative research
methodology has been criticized for lacking justification, transparency, and
rigor that is attributed to the weak data collection and analytical tools being
used. This consequently impairs the integrity of the findings, and the study,
in general.  Therefore, it is universally
accepted to adopt different techniques from quantitative researches to further
improve rigor and uphold high standards of the discipline, such as the

Reflexivity: It is the
process of reflecting critically on the self as a researcher (Lincoln et al
2011). That is, being open about own strengths and shortcomings, and able to weigh
up the consequences in connection to the study (Tracy
2010) (Baillie L (2015). For instance, as researchers could
significantly influence, consciously or unconsciously, how the data are
collected and analyzed, their non-verbal communication (which is linked to
their emotions) could shape what the participant discloses during
semi-structured interviews.

Peer debriefing: It
involves the collaboration with other researchers to compare findings. This
reinforces the credibility as peers may spot errors of fact, biases, convergence
between data and phenomena, competing interpretations, and the emergence of
themes (Billups,2014).

Prolonged engagement in the
research setting: In order to equalize the bias of the researcher and
profoundly understand the perspectives of the participants, it is apt to spend
adequate time in the field and focus on the aspects of setting and phenomenon. (Wallendorf& Belk, 1989) (Billups,2014)

Triangulation: It is not
relevant for all studies. Phenomenological studies are often based only on
interviews to elicit understanding about lived experiences, conducted with a
specific group of participants by a single researcher. Other qualitative
studies may use multiple sources and methods to collect data, increasing
confidence in findings since the research question has been explored from
different perspectives. While similar findings from different sources may
provide reassurance, the absence of a particular finding from one type of data
does not mean that it should be refuted, as each data set provides a ‘snapshot
of the entire picture’ (Ryan-Nicholls and Will 2009). Different
methods, data or researchers often do, and perhaps should, yield different
results (Tracy 2010). Despite these caveats,
many researchers consider that triangulation supports the quality of their
research, where congruent with their methodology (Baillie
L (2015).

Member checking: It is
performed to reexamine the data collected and how they are interpreted by the
researcher. This is an opportunity for the respondent to authenticate their
statements so as to fix any mistakes as early as possible. (Gigi DeVault, 2017)

Examining negative or
exceptional cases: It is recommended that researchers analyze negative cases,
where data contradict the emerging pattern (Meyrick 2006, Pilnick and Swift
2011). Researchers should continue to return to the data throughout analysis
and pay attention to the exceptions in the data (Baillie
L (2015).

Audit trail: It is the
blueprint of the study that outlines detailed procedural records (including the
rationale of the process), which is kept by the researcher. This is accessible
to other researchers so as to build up the reproducibility and confirmability
of the study. (Billups,2014)

Rich description: Providing
rich description could help readers decide whether the research is transferable
to their setting. To evaluate the transferability of the findings reported, the
researchers should review the setting and participants in the study, in order
to ascertain whether the research findings can improve the study. Rich
description also strengthens the audit trail by providing a transparent and
detailed account of the sampling method and decisions made, so that the readers
could assess whether the actions and decisions of the researchers are reasonable
(Baillie L (2015).

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