To conduct this study, in the first stage, a qualitative approach of the grounded theory of Corbin and Strauss, version 2015, will be used. In this study, the researcher will try to understand and explain the care process by the Companion midwives during childbirth in interaction with Companion midwives and working midwives and gynecologists. Also, the researcher will try to use unstructured observations and open and deep interviews (methodology - to get a deep and rich understanding of what these participants experienced), and by reflecting the facts and statements from the voice of the participants bring them to the ears of others (linguistics). This study seeks to discover the care process of Companion midwives during childbirth, which is affected by their interaction with the surrounding environment (doctor, midwife, ward officials, pregnant mother and her family. After receiving the approval of the ethics committee and sampling letter; the researcher will be went to Sampling environments (interviews will be conducted in Mashhad midwifery Consulting offices, public and private Mashhad hospitals, or in places based on the wishes of the participants). In order to achieve data saturation from targeted sampling with. Maximum variation sampling strategy for Companion midwives in terms of age, work experience, employment status, education level, working in a public or private hospital and in the case of mothers admitted to the maternity hospital in terms of Number of pregnancy, type of delivery, duration of labor, birth agent and in the case of midwives and officials, it will be used according to their position. In order to conduct official interviews, first, explanations will be given about the objectives of the study, in order to obtain the consent of the people to conduct the research. After communicating with the participants, a suitable time and place will be determined for the interview. With prior coordination, the researcher will also be present, in during the presence of Companion midwives in Maternity ward or consulting offices. Also, the researcher will sometimes enter the maternity ward as a trainer for midwifery students in the morning and evening shifts.
The researcher will try to gain the trust of the participants by cooperating in the implementation of midwifery procedures and patient care and will also observe while doing the work. To record field notes while in the department, the researcher is content to write down the key points of the observations along with the time and date and will complete his notes as soon as possible. During the observation, if a question arises for the researcher, he tries to answer the question using interviews and informal conversations during the observation. In order to access information, the selection of key informants will be purpose-based. Data collection will continue until a rich description of the phenomenon of continuous care by Companion midwives is reached.
The main method of data collection in this research will be a semi-structured in-depth interview using open questions. In order to deepen the interview and make it more complete and obtain richer data based on the type of responses of the participants, exploratory or investigative expressions will be used. Interviews will be conducted in one or two or more times according to environmental and time factors and other factors. The duration of the interviews depends on the willingness of the interviewee to continue the interview and fully present his ideas. In all interviews, the interview will begin with a general question that will be slightly different according to the type of participant. The interview will start with general questions and with the least possible structure from the Companion midwives. For example, "Tell me about your experience as a Companion midwife?" And gradually, the questions become more specific during the research process, so that specific concepts can be investigated in more depth. For example, these questions will be asked, "When you go to the delivery room for maternal care, what kind of care do you give to mothers? Or what do midwives and specialists do during your presence? What are your experiences of dealing with them?" based on the answers and data Appeared from the participant, clarifying and deepening interview questions such as "Tell me more about this... and then with exploratory questions such as "What for example", "What does that mean", "What do you mean by... What is? What does this mean? "Please explain more" continues. At the end of the interview, the participants will be asked to explain the conversation or important point that they did not say and needs to be raised. Finally, with some other open questions such as: anything else don't agree? If you remember something after I left, or if you change your mind about what you said, you can contact me again, the interview will be terminated. From other contributors Questions will also be asked. For example, the question to hospitalized mothers will be like this: "How was your experience of giving birth with a Companion midwife?" Or the specialists or midwives working in the hospital will be asked this question, "How are your experiences with the presence of a Companion midwife?"
These types of general questions allow participants to freely describe their understanding and experience. Also, questions in this field will be asked from family members and other people who will probably be interviewed based on theoretical sampling. Another tool for data collection in this study will be field notes, which will be used to document observations and data analysis. Observation is suitable as a complementary method for collecting data and explaining unspoken behaviors. Observation in the field creates an opportunity for the researcher to identify and understand the behavior and the context that leads to its occurrence (27). The researcher will take notes of what he sees, hears or thinks and experiences (how to sit, talk, facial expressions and other observations that we cannot record through sound recording - field notes), and at the first opportunity later will record the interview. Also, every idea that comes to the mind of the researcher while reading the interviews or codes will be written down (note writing). The interviews will be recorded by a tape recorder and written permission will be obtained from the participants before recording their voices. Immediately after the end of the interviews, all of them will be transcribed word by word from the tape recorder. It may be necessary to change and modify the interview guide with the progress of research and the gradual construction of categories which will be done
Inclusion criteria (Companion midwive)
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Willingness to cooperate and participate in the study
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Having at least one year of experience as a Companion midwive
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Having the necessary ability to provide experiences
Data analysis
In this study, from the beginning of the research, data collection and analysis process will be done simultaneously. The interview file with the participants will be listened to several times to get a general understanding of it. In the following, the interviews will be written word by word. MAXQDA software version 2010 will be used to manage and organize data. For data analysis, the coding paradigm of Strauss and Corbin 2015 will be used. Due to the more systematic method of coding and analysis, the clarity of the research question in advance, more attention to the role of the researcher in the latest version and personal interest, the researcher chose the Corbin and Strauss 2015. Therefore, in the present study, the content analysis of the conducted interviews will be a regular and continuous process of data comparison, and for this, a five-step process including Identification of concepts, development of concepts according to their characteristics and dimensions, data analysis for context, bringing the process into the analysis and integration of categories (28).
Four criteria are used to evaluate the trustworthiness of the collected data based on Lincoln and Guba's Criteria (1985) (Credibility, Dependability, Confirmability, Transferability ((29, 30).
Sample size and sampling method
In Grounded Theory, purposeful sampling (based on purpose) is used; because the goal is to choose people who are a rich source of information so that they can actively participate in the study and help the researcher to better understand their life and social interactions (28). In qualitative research, it is not possible to determine the sample size beforehand and it is determined during the study. The end of sampling will be when no new classes or suitable themes emerge and the main classes are sufficiently developed in depth and variability (31). In the present study, theoretical sampling is a part of the data collection and analysis process, which is used to fill the classes and develop the theory and continues until saturation is reached.