Using the 'pictor' tool in research with patients and informal caregivers affected by advanced disease: benefits for researchers and participants.

Qualitative research in advanced disease frequently asks research participants to describe complicated, emotionally sensitive situations and experiences. People may find it difficult to express these experiences, and a challenge for health care researchers is to utilise methods that allow detail to be elicited effectively, whilst still providing protection to participants. Pictor is a tool that has been used effectively in research on health professionals experiences of collaborative working in primary health care (Ross et al., 2005; King et al., 2010). Based on the principles of phenomenology and Personal Construct Psychology, Pictor is used to help elucidate the world of the participant through the creation of a visual chart which then forms the basis of the ongoing research interview. This tool has been modified specifically for this participant group and involves participants thinking of all the people, services, or other factors that have been involved in some way with regard to their current situation, which are then written on arrow-shaped Post-it® notes. The participant is asked to arrange these on a large sheet of paper in a way that helps them to describe their experiences, utilising the direction of the arrows and the space on the paper to demonstrate something about the different relationships with the various people involved. There are no rules except the participants must include themselves and, if appropriate, their main informal caregiver. The created Pictor diagram then becomes the basis for the ongoing interview. This modified tool is proving valuable in helping potentially vulnerable participants to reflect on, explore, and share their experiences. The benefits of using this tool have been multifaceted both for research participants and the research process. Using examples from ongoing research on people directly affected by advanced progressive disease who are receiving support from multiple sources, this poster will explore the use of the modified Pictor tool as a means to assist the research interview when patients and carers are the participants.