How was it for us? Experiences of Co-researchers in a Palliative Care Case Study Research Evaluation

Background: Case study research evaluations are widely acknowledged as an optimal approach for examining complex interventions within complex systems. The co-authors undertook a case study research evaluation of a regional palliative integrated care service employing a participatory methodology, wherein academics and practitioners jointly conducted the research. This collaborative approach fostered an equal partnership, allowing co-researchers to collectively guide and execute the case study. However, the experience of participating in such an endeavor has seldom been explored in the literature. The primary objective of this study was to qualitatively explore the experiences of co-researchers involved in a case study research evaluation of a regional palliative care service. Approach: Rooted in constructionist epistemology and adopting a critical hermeneutic approach to analysis, to capture the experiences of co-researchers, a qualitative approach using focus group discussions was employed. This method facilitates open discussions among individuals with similar experiences, allowing them to share their thoughts and insights comprehensively. Data were collected through focus group discussions with co-researchers that participated in the case study research evaluation. The focus group session took place in September 2022. An interview guide was developed that explored in broad terms the key issues involved in the process of the evaluation. These discussions were recorded and transcribed verbatim to ensure accuracy and completeness. Data AnalysisReflexive thematic analysis (RTA) was utilized to analyze the focus group data following Braun and Clarke six-phase process. RTA is a flexible, interpretive method that facilitates the identification, examination, and understanding of patterns within qualitative datasets. Results: Five key themes were generated from the analysis: Learning from the Case Study Process: Both academics and practitioners gained valuable insights from the case study process, enhancing their understanding of palliative care delivery but also the prerequisites of a successful case study, key amongst which is building trust.The Emotional Roller-Coaster: Co-researchers experienced a range of emotions throughout the study, highlighting the emotional investment and resilience required in such collaborative research. Managing Expectations: The study underscored the importance of managing diverse expectations among different stakeholders to ensure smooth collaboration and successful outcomes. Navigating Uncertainty: The challenges posed by external factors, such as the COVID-9 pandemic and a cyberattack, were significant. These uncertainties necessitated adaptive strategies to maintain research continuity. Shared Sensemaking: The collaborative nature of the research facilitated a shared understanding among co-researchers, fostering a unified approach to problem-solving and interpretation of findings. Implications: Based on these themes and experiences, the study offers recommendations for creating an ideal environment that supports and enhances the case study research evaluation approach. Conclusion: Co-researchers perceived case study research evaluation as a highly effective learning tool for comprehending the context and lived experiences of integrated care services by patients, families, and staff. The recommendations provided offer practical guidance for stakeholders interested in adopting the case study approach. By facilitating better preparation, anticipation, and resolution of challenges, these recommendations aim to improve both integrated palliative care service delivery and the experiences of patients and staff.