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permit the researcher access to the centre to undertake the investigation. Thismight have occurred through a lack of understanding on the part of theadministrators of the nature of the research; the relevance of the researchtowards potential solutions to the problem, or apprehension about the use towhich the findings might be put. It was thus considered necessary to firstsecure the co-operation of the administrators by fully discussing the aims of theresearch with them beforehand in order to allay any such fears and avoidmisunderstanding.Free download from www.hsrcpress.ac.za(ii)Units of analysisBecause of the ethical issue concerning the confidentiality of doctor-patientinteractions, it was decided not to seek access to consultations. This left aproblem, however, of how to convert the social activity of consultations into aresearchable phenomenon. It was decided to focus analytically on the entireencounter process. The nature of the interaction between patients and doctorswould be extrapolated from subjects’ retrospective accounts of consultations.In terms of the analytical units schema of Lofland (1971), focus wouldtherefore be on the setting of the encounter process; the relationships of thesubjects with their doctors; the participation of the subject in the interactionwith their doctors and in the entire setting, and the meanings that theinteraction had for the subjects. The acts and activities of the subjects, as theywere reported by the subjects or observed, would be viewed as “managed”social activity. This would provide a view of the strategic nature of thesubjects’ actions, in terms of the presentation of their selves, and wouldfacilitate an appraisal of the extent to which they were able to ward off possibleinsults to their self-images.(iii)Problem of “measurement”The measurement of the degree to which the self-images of the subjects hadbeen degraded, or the phenomenon of depersonalisation, presented amethodological problem both in terms of definition and quantification. Theterm “depersonalisation”, which may differ in the abstract and the concretesenses, fails to specify covert feelings and overt actions that accompany theprocess. It was decided to base the observational parameters on the broaderrubric of “patient satisfaction”, defined as the degree to which the expectationsthat elderly patients have of the health care which they receive, and what theyfeel to be important in the process of care, are met.No research study can avoid the problem of bias and this issue was particularlysalient in the present study. Firstly, the choice of the problem area and themethods meant that one side of the medical interaction (in this case the patient)would be emphasised at the expense of the other (the doctor and207