Visualizing the invisible: applying an arts-based methodology to explore how healthcare workers and patient representatives envisage pathogens in the context of healthcare associated infections

Abstract

Background: While efforts to enhance healthcare workers' knowledge and behaviours in the prevention and control of healthcare-associated infections (HAIs) have been considerable, little is known about how staff visualize pathogens and their relationship to HAIs. This study, therefore, sought to explore how healthcare workers envisage pathogens in the context of HAIs. Method: Ten hospital-based healthcare workers and two patient representatives participated in a workshop combining risk identification, making activities and in-depth interviews. This methodology was informed by Sullivan's Dimensions of Visualization framework. A descriptive cross-case analysis approach was used to summarize and synthesize the data. Results: Few of the participants reported actively visualizing pathogens in their mind's eye; however, the study elicited mental images of pathogens from all participants and all were able to create related models during the making activity. Conceptions appeared to be influenced primarily by microbiology and infection control campaigns. Conclusion: Our adaptation of Sullivan's Dimensions of Visualization framework proved useful in structuring this initial enquiry and merits wider application and evaluation by qualitative health researchers.

Keywords::

• healthcare associated infections
• qualitative data analysis
• focus groups
• interviewing
• infectious diseases
• visualization

Acknowledgements

We wish to thank the NHS staff and patient representatives who gave their time to take part in the study and our other partner organizations (NHS Education for Scotland and Health Protection Scotland). We also wish to thank a number of key people who helped to make enactment of the study possible, namely: Emma Hoctor; Geralynn Walsh; Jan Clarkson; Joanne Grant; Gordon Burnett; Claire Lennon; Professor Jacqui Reilly and Helen Maitland.

This research was supported by funding from The Arts and Humanities Research Council and the Scottish Funding Council as part of the Healthier Scotland initiative.