Africa Health Research Institute, Durban, South Africa.
School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa.
BMC Med Ethics. 2019 Jul 8;20(1):47. doi: 10.1186/s12910-019-0383-9.
This article discusses our reflections on ethical and methodological challenges when conducting separate interviews with individuals in dyads in the uMkhanyakude district, South Africa. Our work is embedded in an ethnographic study exploring care relationships between adolescents and their older carers in the context of a large-donor funded HIV programme. We use these reflections to discuss some of the challenges and present possible management strategies that may be adopted in conducting dyadic health research in resource-poor settings.
Drawing from the relational agency, three rounds of separate interviews and participant observation were undertaken with dyads of adolescents aged between 13 and 19 and their older carers aged 50+ from October 2017 to September 2018. A reflexive journal was kept to record the interviewer's experiences of the whole research process. We identified methodological and ethical challenges from these data during the thematic analysis.
A total of 36 separate interviews were conducted with six pairs of adolescent-older carer dyads (n = 12 participants). Five themes emerged: recruitment of dyads, consenting dyads, confidentiality, conducting separate interviews with adolescents and older carers, and interviewer-dyad interaction. We also illustrated how we dealt with these challenges.
Results from this study can guide the recruitment, consenting and collecting data for health studies that employ a similar form of enquiry in LMICs. However, ethical and methodological challenges should be recognised as features of the relationships between cross-generation dyads rather than weaknesses of the method.
本文讨论了我们在南非乌姆坎夸德地区对个体在对偶关系中进行单独访谈时所遇到的伦理和方法学挑战的反思。我们的工作是嵌入在一项民族志研究中的，该研究探讨了在一个大型捐赠者资助的艾滋病毒项目背景下，青少年与其年长照顾者之间的照顾关系。我们利用这些反思来讨论在资源匮乏环境中进行对偶健康研究可能面临的一些挑战，并提出可能的管理策略。
从关系代理的角度出发，我们在 2017 年 10 月至 2018 年 9 月期间对乌姆坎夸德地区年龄在 13 至 19 岁之间的青少年及其 50 岁以上的年长照顾者进行了三轮单独访谈和参与式观察。研究人员保留了一份反思日志，记录访谈者在整个研究过程中的经验。我们从这些数据中进行主题分析，确定了方法学和伦理方面的挑战。
共对六对青少年-年长照顾者对偶关系进行了 36 次单独访谈（n=12 名参与者）。出现了五个主题：对偶关系的招募、对偶关系的同意、保密性、对青少年和年长照顾者进行单独访谈以及访谈者-对偶关系的互动。我们还举例说明了如何处理这些挑战。
本研究的结果可以为在 LMIC 中采用类似形式调查的健康研究的招募、同意和数据收集提供指导。然而，应该认识到，这些挑战是跨代对偶关系中关系的特征，而不是方法的弱点。
