SPLASH Study is underpinned by the paradigm of interpretivism. Using this paradigmatic underpinning enabled the researcher to identify a purely qualitative methodology, using semi-structured interviews to explore caregiver perceptions. The subsequent addition of qualitative descriptive/contextual questionnaire data, was used to strengthen credibility and provide greater contextual understanding of study findings without distracting from the study’s interpretivist underpinning.

This study’s interview topics and subsequent guide were developed from the International Classification of Functioning, Disability and Health (ICF; WHO 2001), following an iterative process of public engagement and response to their feedback. The researcher grouped similar ICF categories together in order to identify the main overarching themes which were then discussed with parent caregivers. This resulted in a list of six topics: health, function, welfare, connections, support and night-time. It is important to understand that although specific question examples are given within the topic guide, the iterative nature of the semi-structured interviews allowed for the flow of the interview to be led by each participant, whilst also allowing for development of new questions as participants raised specific topics which had not been pre-empted by the researcher; these questions were then included in subsequent interviews. Examples of these unexpected topics include social inclusion/exclusion, emotions, and nutrition.

The contextual questionnaire, also underpinned by the ICF (WHO 2001), asked participants about their caring role, the level of involvement they have in the care-receiver’s life, their biopsychosocial needs (e.g. diagnoses, communication support needs and level of care), and the type of hydrotherapy they receive.

A convenience sample of self-selected volunteer caregivers was recruited through public advertising (posters/leaflets/social media) and via a Diverse Abilities (charity) gatekeeper. Participant interviews were booked on a first come first served basis; no preference was given to any particular caregiver type. There was no pre-determined sample size for this exploratory study, as recruitment continued until data saturation was reached. It was agreed that the researcher would determine data saturation when no new major themes developed from two consecutive interviews, in each of the three caregiver types (paid carers, informal caregivers and health/social care professionals). Interviews were analysed sequentially to enable saturation to be identified. Twenty-three caregivers participated in the study: five family caregivers, nine health-professionals, eight paid caregivers and one volunteer caregiver.

In response to the Covid-19 pandemic, the methods were adapted to enable online/virtual data collection in the form of an electronic caregiver questionnaire and virtual semi-structured interviews using videoconferencing. The electronic questionnaire took participants no longer than 10mins to complete, and they were given the choice as to which videoconferencing platform they preferred to use. Most interviews lasted around 40 minutes.