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Thesis presented in partial fulfilment of the requirements

for the degree of Master of Nursing Science

in the Faculty of Medicine and Health Sciences

Stellenbosch University

Supervisor: Mrs Talitha Crowley

Co-supervisor: Professor Anita van der Merwe

March 2016

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By submitting this thesis electronically, I declare that the entirety of the work contained

therein is my own, original work, that I am the sole author thereof (save to the extent

explicitly otherwise stated), that reproduction and publication thereof by Stellenbosch

University will not infringe any third party rights and that I have not previously in its entirety or

in part submitted it for obtaining any qualification.

Date: March 2016

Copyright © 2016 Stellenbosch University

All rights reserved

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The application of these steps is discussed below.

3.10.1 Step 1: Transcribing of all interviews conducted with participants then

reading and re-reading of transcriptions

The researcher transcribed the interviews herself, manually, as soon as possible after the

interview. Sandelowski (1994) in Mackenzie (2009:26) explains that verbatim quotes

enhance the credibility of the study, as data that would be used for analysis are an accurate

account of the participants’ words. The researcher also read through the transcriptions and

compared the transcriptions to the audio recordings. Transcriptions were read and re-read to

gain a sense of the whole. Bracketing was done by the researcher to avoid possible bias and

to ensure the subjective experience of the phenomenon by the participants is described and

captured. The researcher identified previous experiences and opinions and beliefs such as

the experiences with women refusing to test children post-delivery; and information obtained

from facility support groups for women living with HIV and set them aside. Member checking

(participant validation) was done with four of the participants, as the other six participants

were not available at the time. In addition, transcriptions were checked and compared to

audio recordings by the study supervisor to ensure their credibility. Thereafter the

researcher thoroughly read the transcripts, and re-read the transcripts to become familiar

with the data and as described, by Sanders (2003:294), to gain a sense of each participant’s

description of the experience.

3.10.2 Step 2: Extracting significant statements pertaining to the phenomenon under


Statements that were directly related to the lived experiences of women diagnosed with HIV

in the antenatal period in a rural setting were identified by the researcher as significant

statements that related to the phenomenon. The significant statements identified in the

transcripts and verbatim phrases were manually highlighted in-text.

In Colaizzi’s method, significant statements are extracted and numerically entered into a list

to assemble all significant statements. A total of 450 significant statements were highlighted,

but remained in-text to stay true and retain the integrity of each participant’s story. Dierckx

de Casterlé, Gatsman, Bryon and Denier (2011:362) state that the content from each

interview is unique and different from other interviews. This process allowed further

immersion in the data.

3.10.3 Step 3: Creating formulated meanings

The researcher then formulated meanings for each significant statement. A total number of

85 meanings were formulated. The study supervisor and researcher discussed the

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formulated meanings and cross checked the meanings to the significant statements. The

researcher and study supervisor agreed upon the meanings as the meanings were cross

checked to the significant statements in context, to ensure the rigor of the study.

3.10.4 Step 4: Aggregating formulated meanings into sub-themes and themes

The 85 meanings were placed in groups of similar meaning to develop theme clusters.

Sixteen sub-themes were further grouped into four emergent themes. These themes, sub-

themes and formulated meanings are illustrated in chapter 4 (Tables 4.1 and 4.2).

3.10.5 Step 5: The development of an exhaustive description

All the resulting ideas were then integrated into a comprehensive description of the

phenomenon. The exhaustive description was presented by the researcher in a narrative

form by integrating the themes, and sub-themes into a description that creates an overall

structure that contains all the essential elements of the phenomenon. The narrative form was

sent to my study supervisor for validation. A few alterations were suggested regarding the

themes and sub-themes and adjustments were applied to the narrative.

3.10.6 Step 6: Identifying the fundamental structure of the phenomenon

In this step, a reduction of the findings is done in which redundant and misused descriptions

are removed from the overall structure. Themes were described in context, using sub-

themes and formulated meanings with attachment of significant statements to validate the

description in context. The structure was reviewed by the study supervisor. The structure of

the phenomenon was illustrated in chapter four as the findings of the study. The structure

was examined for any repeated, misused or overestimation of findings and none were found.

The essence of the phenomenon, as it relates to each of the study objectives, is also

described in chapter 5.

3.10.7 Step 7: Returning to the participants for validation

The description of the essence of the phenomenon, including the themes and sub-themes,

was taken back to six participants to provide the participants with the opportunity to examine

the findings as described by the researcher and to validate whether the themes and sub-

themes were a true reflection of their experiences. The researcher individually showed the

participants the themes and sub-themes and discussed these with them. Participants

accepted the framework and did not have any information to add. Four of the participants

were not available for validation. The participants also stated that the description of the

themes and codes comforted them in the sense that they realized that there were other

women in the same situation who had experienced the same or similar realities.

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Appendix 6: Declarations by language and technical editors

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