Data analysis
A pragmatic approach with an ontological approach of subtle realism was adopted during data analysis33. Framework analysis as described by Spencer et al34 was selected because it facilitates looking into the participants’ perspectives about an external existing reality. The method of analysis allows for an objective and transparent interpretation by setting forward existing knowledge and literature as a framework for organizing emerging data. Constructs included in the topic guide were used as a framework to organize the data for further indexing. The process includes five stages: 1) Familiarization; 2) Identifying thematic framework; 3) Indexing; 4) Charting; 5) Mapping and interpretation.