title: Exploring representations and experiences of case-management users: towards difficulties and solutions to leading qualitative interviews with older people with complex living conditions.
abstract: BACKGROUND
  By matching needs to resource services, case management could be a useful tool for improving the care of older people with complex living conditions. Collecting and analysing the users' experiences represents a good way to evaluate the effectiveness and efficiency of a case-management service. However, in the literature, fieldwork is very rarely considered and the users included in qualitative research seem to be the most accessible.
  
  
  OBJECTIVE
  This study was undertaken to describe the challenges of conducting qualitative research with older people with complex living conditions in order to understand their experiences with case-management services.
  
  
  METHODS
  Reflective analysis was applied to describe the process of recruiting and interviewing older people with complex living conditions in private homes, describing the protocol with respect to fieldwork chronology. The practical difficulties inherent in this type of study are addressed, particularly in terms of defining a sample, the procedure for contacting the users and conducting the interview. The users are people who suffer from a loss of autonomy because of cognitive impairment, severe disease and/or psychiatric or social problems. Notably, most of them refuse care and assistance.
  
  
  RESULTS
  Reflective analysis of our protocol showed that the methodology and difficulties encountered constituted the first phase of data analysis.
  
  
  CONCLUSIONS
  Understanding the experience of users of case management to analyse the outcomes of case-management services requires a clear methodology for the fieldwork.
authors.affiliation: Epsylon, Université de Montpellier, France; Biodémographie de la longévité et de la vitalité (équipe 4, INSERM U 710), 34298 Montpellier Cedex 5, France. Frederic.balard@gmail.com.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Balard
authors.forename: Stéphanie Pin Le
authors.initials: SP
authors.lastname: Corre
authors.forename: Hélène
authors.initials: H
authors.lastname: Trouvé
authors.forename: Olivier
authors.initials: O
authors.lastname: Saint-Jean
authors.forename: Dominique
authors.initials: D
authors.lastname: Somme
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001290:Attitude; D019090:Case Management / Q000458:organization & administration* / Q000592:standards; D003142:Communication; D003704:Dementia / Q000523:psychology; D005260:Female; D006801:Humans; D007258:Informed Consent; D007407:Interviews as Topic / Q000379:methods* / Q000592:standards; D008297:Male; D017060:Patient Satisfaction; D011320:Primary Health Care / Q000458:organization & administration* / Q000592:standards; D036301:Qualitative Research; D012111:Residence Characteristics