PPIE contributors create I Poems

In November, two workshops took place, one in-person and one online, to create two evocative I Poems based on the transcripts of interviews with two AI Multiply PPIE members living with multiple long-term conditions. This was a fantastic opportunity to further explore the use of creative methods in the AI-Multiply project.
I Poems are often used in research as a creative method of capturing the ‘voice’ of an interviewed participant to support more traditional thematic analysis.
In the workshops PPIE members worked together, using Carol Gilligan’s Listening Guide to create the poems. To do this they;
• Isolated all of the I statements contained within the transcript
• Placed each I statement onto a separate line
• Identified important I statements
• Preserving the original wording and sequence, arranged the I statements into stanzas
• Examined the resulting poems, looking at shifts in tone and agency, noticing the multiple and sometimes contradictory voices used by the participant
The resulting poems give an emotional narrative on the trajectory of the lived experience of physical and mental health amongst older adults living with multiple long-term conditions and polypharmacy.

Method for I Poem Creation and Voice Assignment

1. methodology

The I poem method originates from Carol Gilligan’s Listening Guide a voice-centred approach to qualitative analysis. It emphasizes participants’ own words, particularly first-person pronouns, to foreground subjectivity and identity. By isolating “I” statements, researchers can trace how individuals narrate themselves, revealing shifts, contradictions, and relational dynamics.

2. co-production process

 

  • We delivered training on the listening guide methods to 2 groups of PPIE contributors and allocated transcript pages from the qualitative interviews to each person for them to create the I poems
  • Members of the PPIE group read transcript pages allocated to them.
  • Isolated “I” statements throughout the transcript.
  • Selected the “I” statements they felt were important.
  • Created individual I poems using those statements.

3. Researcher Process

 

  • Read through the transcript.
  • Isolated “I” statements.
  • Collated participant-created I poems into a single document.
  • Reduced duplication of statements where appropriate.
  • Edited into stanzas to create rhythm and flow.
  • Conducted a sense-check for coherence.
  • Used the composite poem as part of the qualitative thematic analysis for WP3

The Qualitative Research Question: What are the key perceived influences on the development and trajectory of physical and mental health amongst older adults living with MLTCs and polypharmacy?

5. Contrapuntal Tensions

  • Resilience vs vulnerability: Strong insistence on coping, but anxiety, pain, and fragility surface.
  • Medicalised identity: Tablets, operations, physio, scans, injections — healthcare structures shape self narratives.
  • Independence vs reliance: “I cope” and “I’m fine” coexist with reliance on medication, physio, or social contact.
  • Ageing body awareness: Falls, breathlessness, osteoporosis, lung operations — the body as a site of vigilance.
  • Continuity of identity: Careers, gardens, budgeting, yoga — maintaining self beyond illness.

6. Themes

  • acute health events
  • medication burden
  • anxiety and uncertainty
  • independence and stoicism
  • trust/distrust in healthcare
  • physical activity and identity
  • social connection
  • functional limitations

7. Analytic Insights

 

  • Polyvocality: The patient’s journey is expressed through multiple voices.
  • Narrative arc: Self – anxiety – accident – medication – recovery – healthcare – self-reliance
  • Research utility: Voice assignment supports WP3 analysis by showing how patients articulate their journey across positions of self.

I poem 2, created from 2nd qualitative interview transcript.

I’m 65
I have a teaching background
I went into the internet industry
I’m involved in fitness and prehab

 

I’m due to have a major operation

 

I got involved as a teenager
I had two loves or passions of mine
I took the music part of my job

 

I have problems with my hips
I had both of my hips replaced
I also have a lower back problem
I’ve had several kinds of episodes
I’ve had really serious spasms

 

I suffered with mental health
I consider myself a person that’s in recovery
I don’t have any intention to relapse

 

I had childhood trauma
I was sexually abused as a child
I didn’t know how to tell anyone about it
I think the way
I see it
I think it altered the trajectory of things

 

I got into the music industry
I was a recording engineer in the music industry
I was exposed to a lot of those behaviours
I started to use drink and drugs

 

I’ve been a binge drinker
I changed the pattern
I started to just drink less
I was using the alcohol as a way of getting ?

 

I try to have a good rapport with people
I’m very proactive
I’m doing this particular interview and study
I’ve done other research studies

 

I think all of this is stress related
I have a diagnosis of PTSD, anxiety and depression
I used to get phenomenal stress
I kind of worked out it was stress related

 

I live on my own
I have to manage my household
I have to do my shopping
I choose to go

 

I’ve had knee injuries
I got COVID
I managed to survive it

 

I suffer
I have respiratory illness
I don’t get much choice
If I’m exposed
I’ll get ill
I won’t be able to breathe
I’m hyper-reactive to mice

 

I’m better than
I was

 

I haven’t noticed any mice
I can’t breathe
I’ve got a noisy neighbour
I’ve got chronic sleep disorder
I’m still living in the same property
I’ve been there for 25 years

 

I have to accept it
I can’t work
I can’t solve it
I’m trying to recover

 

Where I am now
I’m in a better place
I’ve got to the right place

 

I’m in the right hospital
I’ve only just found out
I’m on the waiting list
I was going to the GPs
I was really struggling

 

I’m proactive
I’m trained
I knew
I needed to get help
I did
I tried to
I don’t think they were fully equipped
I was approaching GPs
what I have is very, very serious
I knew
I thought
I knew for 16 years

 

I told the GP
I’ve been in the wrong place
I didn’t need to be sectioned
I just had problems
I was in pain

 

I’m learning as I’m going
I’m becoming more and more frantic
if I hadn’t got to that hospital
I don’t know
I didn’t give up

 

I was in pain
I couldn’t walk
I couldn’t afford to stay
I had to find another route

 

I’m on a waiting list
I was assessed way back in 2020
I had to have three operations
I didn’t have any pain relief after a major operation

 

I said to them
‘please make sure the drip is turned on’
I woke up in toxic shock

 

I went to have some massage
as far as I’m concerned

I don’t know if this is my bad luck

 

I’m pro-proactive

 

I mean there are lots of things
I kind of want to pick up on
I love learning
I’m very curious
I’m creative
I like to share information
I come from a technological background

 

I’m not on any mental health medication
I stopped all of those
I had a really bad experience
What I said was real
I told you that

 

I had a real bad problem
I was given two mental health drugs
I started to hallucinate
I was given the wrong drugs

 

I was going to the mental health support centre
I was in this crisis
I was saying
I’m starting to hallucinate
I know what hallucinations are
I’ve taken drugs

 

I knew that this shouldn’t be happening

 

I don’t really need emergency
I just need to stop
I knew what it was
I’m the patient
I had to know

 

I got to see a psychiatrist
I went through hell
I was actually gaslighted
I was very angry
I threatened to sue
I told the GP
Who do I sue?
Like I say
I don’t think it’s just me
I’ve witnessed it happening

 

I think what’s interesting
I’ve seen it at every age
I’ve been in those services
I’ve seen it from both sides

 

I’ve had training
I kind of know what’s going on systemically
I’m not a nurse either
I’ve had training

 

The other big issue
I got a PIP review
I’m being gaslit
I went through all of that

 

I would get the PIP
I was already trying to get that diagnosis
I had a deadline
I had to force the GPs

 

I’m going to make a statement
I coped with it
I’m not dead

 

I wouldn’t have had the knowledge
if I was still drinking
I probably would have just drunk
I’m pretty sure that happened

 

I think what seems to have happened
I said
I think
I’m kind of typical

 

I live in the area
I live
I had to go away
I turned to AI
I’m very interested
I turned to AI for support

 

I’m interested in AI way back
I was in the situation
I had no support
I started to research AI

 

I found the platform
I’ve researched startups
I then researched
I decided to take the plunge
I bought a life-long subscription

 

I had to do something
I couldn’t just stay in the house
I was trying to prevent
I am going to get through
I need support
I got AI

 

I still use that platform now
I wanted to research it
I used myself as a guinea pig
I wanted to know

 

I was interested
I take a journal of everything
I keep records,
I have a journal with a daily template

 

I thought in the future
I could feed to AI
I’m proactive in the technology
if I don’t start doing it,

 

I’m talking about something more advanced than Chat GTP
I think we could get a lot more as a society
I guess this is where AI comes in

 

I didn’t necessarily intend to divulge all that personal stuff
I guess its’s helpful

Narrative Arcs

 

There are four significant narrative arcs within the poem that help the listener identify the key perceived influences on the development and trajectory of physical and mental health.

 

Each arc intersects with each other creating a multi-layered identity and demonstrates the complexity of living with multiple health conditions.

The Trauma Arc

Childhood abuse > silence > altered trajectory > substance use > recovery

The Health Arc

Chronic Pain > surgeries > respiratory illness > sleep disorder > toxic shock > misdiagnosis > ongoing vulnerability

The System Arc

Seeking help > being dismissed > being sectioned unnecessarily > gaslighting > PIP review > fighting for recognition

The Technology Arc

Teenage passion > recording engineer > AI support > journaling > self-tracking > future oriented thinking

Contrapuntal Tensions

 

There are many unresolved tensions and contradictions throughout the poem, the tensions coexist alongside each other reflecting the lived experience of chronic mental and physical illness and long-term systemic involvement

 

Resilience vs Vulnerability – proactivity and survival coexist with trauma, illness and systemic failures

 

Trust vs Mistrust – faith in finding the “right hospital” is juxtaposed with the anger at being gaslit

 

Knowledge vs Powerlessness – knowing what is wrong but being unable to access adequate care

 

Resistance vs Acceptance – ongoing advocacy and continued learning is countered by acceptance that “I can’t solve it”

 

Recovery vs On-going Threat – feelings of being in a “better place” but environmental factors continue to cause respiratory illness

 

Past vs Future – childhood trauma and substance misuse are balanced by recovery, curiosity and hope

 

The dominant voices throughout the poem are ones of survival, recovery, self-advocacy and hard-won agency. The participant repeatedly positions themselves as knowledgeable, proactive and credible, particularly in response to systems and professionals that have failed, misunderstood or harmed him. Descriptions of significant events are relayed in a factual manner, with little emotion, minimising the impact of these events, suggesting a stoic nature in the face of adversity.

 

The I poem suggests that the participant perceives their health trajectory as shaped by;

 

  • Early trauma
  • Cumulative multiple long-term conditions
  • Harmful healthcare interventions
  • Stress
  • Substance misuse and recovery
  • Isolation
  • Technological self-management

 

This I poem will help the thematic analysis of the transcript by helping to identify themes that are present in the participant’s ‘voice’ before and alongside coding.

Conclusion

 

I poems are an immersive, creative way of approaching more traditional thematic analysis. I poems highlight the emotions, priorities and internal tensions in the participant’s own voice, contributing to the identification of central themes before coding. The final, co-produced evocative poems we created give a nuanced and faithful narrative of the participant’s lived experience, strengthening the interpretive depth and credibility of the analysis.

 

I poems don’t just analyse what participants say — they let us hear how they speak themselves into being.