Data analysis
Interview transcripts were analysed by two researchers (GJ; RH) using a reflexive, inductive thematic analysis approach (18) to identify ‘semantic’ (i.e. surface, explicit) and ‘latent’ (i.e. implicit or underlying) themes.(19) Repeated listening to the audio recordings enabled initial familiarisation with the data then each researcher independently conducted line-by-line coding, identified key words, phrases and sentences (20) and used these to identify data driven themes (21). Coding was iterative and refinement of themes and subthemes evolved inductively over the course of the analysis.(22) A team-based approach to coding was used(19) in which discrepancies were discussed and themes and subthemes refined until shared understanding and agreement was reached. (23) Measures used to assure the trustworthiness of the analytic process included discussion between the two researchers to facilitate constant comparison, refining and defining themes and categories (24, 25), until a point of theoretical saturation. A third researcher (JJ) then assessed the themes for face validity. The contribution of the wider research team in coding and categorisation checks, and discussion regarding the influence of the research context, ensured the credibility, confirmability and dependability of the analytic process (26).