title: A standardized approach to qualitative content analysis of focus group discussions from different countries.
abstract: OBJECTIVE
  To describe the methodological procedures of a multi-centre focus group research for obtaining content categories also suitable for categorical statistical analyses.
  
  
  METHODS
  Inductive content analyses were performed on a subsample of 27 focus groups conducted in three different countries, the Netherlands (Utrecht), the UK (Liverpool) and Italy (Verona). The analyses of the subsample of focus group discussions were performed in five steps: (1) independent development of content categories in each of the participating centres, (2) obtaining consensus categories, (3) creation of a manual with coding rules and defining criteria for categories and subcategories, (4) assessment of inter-rater reliability to identify unreliable categories to be revised, and (5) repetition of inter-rater reliability assessment.
  
  
  RESULTS
  The resulting coding system considers five areas: non verbal communication, process oriented expression, task oriented or problem focused expressions, affective or emotional expressions, and physician's personal characteristics. It contains 12 categories of acceptable inter-rater reliability and 41 subcategories.
  
  
  CONCLUSIONS
  The coding procedures show how focus group data, obtained in an international multi-centre study can be analysed in a systematic way combining scientific rigour with the richness of data obtainable from qualitative methodologies.
  
  
  CONCLUSIONS
  The applied procedures may be helpful for multi-centre focus group research on other topics.
authors.affiliation: Department of Public Health and Community Medicine, University of Verona, Italy. francesca.moretti@univr.it
authors.forename: Francesca
authors.initials: F
authors.lastname: Moretti
authors.forename: Liesbeth
authors.initials: L
authors.lastname: van Vliet
authors.forename: Jozien
authors.initials: J
authors.lastname: Bensing
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Deledda
authors.forename: Mariangela
authors.initials: M
authors.lastname: Mazzi
authors.forename: Michela
authors.initials: M
authors.lastname: Rimondini
authors.forename: Christa
authors.initials: C
authors.lastname: Zimmermann
authors.forename: Ian
authors.initials: I
authors.lastname: Fletcher
mesh_terms: D003142:Communication; D003431:Cross-Cultural Comparison; D003627:Data Interpretation, Statistical; D017144:Focus Groups / Q000379:methods*; D006801:Humans; D007558:Italy; D009426:Netherlands; D015588:Observer Variation; D010817:Physician-Patient Relations; D036301:Qualitative Research; D012015:Reference Standards; D006113:United Kingdom