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DOI: 10.1111/hir.12038

Library services and user satisfaction in developing countries: a case study Muhammad Ijaz Mairaj* & Mirza Muhammad Naseer† *Punjab Institute of Cardiology, Lahore, Pakistan, and †Institute of Space Technology, Islamabad, Pakistan

Abstract Background: Punjab Institute of Cardiology (PIC) is a recognised teaching hospital for cardiac care in the Punjab province of Pakistan. PIC has established a library to fulfil the research and information needs of health care professionals. This study aims to evaluate the satisfaction of users with the services of PIC library. Methodology: A purposive sample of 15 health care professionals was selected. A semistructured interview technique based on an interview guide was used for collection of data. The data were qualitatively analysed using a thematic approach. Results: Users of PIC library were satisfied with the library collection, organisation, reference and circulation services, staff attitudes, cooling and heating. They were concerned about library space, hours, furniture and environment, and suggested more availability of electronic library services, newer collections, better Internet access and comfortable furniture. Conclusion: The study proved useful to investigate users’ satisfaction with the services of PIC library. It concludes that the PIC library should maintain and strengthen the services with which users are satisfied, and improve those about which they are concerned. The study will be useful to libraries in other developing countries for improvement in their services. Keywords: Asia, South East, health professionals, hospitals, teaching, interviews, libraries, medical, Pakistan

Key Messages

• • • • •

Allocation of adequate funds for the library on regular basis for adequate collection development, ICT equipment and staff training. Provision of adequate space for the library in the future extension plan of the institute. Provision of the appropriate staff for better services at morning and evening shifts. Librarians to adopt necessary measures to provide electronic services to users and training of library support staff. Libraries should provide suitable and comfortable furniture keeping in mind the availability of space.

Purpose

Significance of the study

The study was conducted to investigate users’ level of satisfaction with the services provided by PIC library and to discover weak areas, which could be improved.

This study is the first of its kind investigating users’ level of satisfaction with the services of PIC library. The main objective of a library is to meet the information needs of its users in the best possible way and for this purpose, a library makes policies and strategies. A library should provide an appropriate collection, services and facilities to patrons to gain

Correspondence: Muhammad Ijaz Mairaj, Punjab Institute of Cardiology, Lahore, Pakistan. E-mail: [email protected]

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Library services and user satisfaction, Muhammad Ijaz Mairaj & Mirza Muhammad Naseer

their satisfaction. This study explores to what extent users are satisfied with the services of PIC library. It has not only offered an opportunity to improve the weak areas in which the users showed their concern, but also provided a chance to further strengthen the areas of services in which the users are satisfied. This study will be useful for library professionals in Pakistan and other developing countries for the improvement in their library services. Introduction/Background It is common in the developed world for libraries to conduct user satisfaction surveys to improve the level and quality of services offered to users. These surveys help in evaluating the strengths and weaknesses of libraries and provide an opportunity to library managers to enhance the user satisfaction. Users’ perceptions and satisfaction about library services have largely been ignored by researchers and practitioners of library and information science in developing countries. This study was conducted to evaluate the services offered by the library of Punjab Institute of Cardiology and the level of user satisfaction. Punjab Institute of Cardiology (PIC) is a recognised tertiary care teaching hospital in the public sector in the Punjab province of Pakistan for the treatment of heart diseases.1 It has well-trained adult and paediatric cardiologists, cardiac surgeons and anaesthesiologists, and provides postgraduate teaching and training to health care professionals in cardiology, cardiac surgery and related disciplines. It was established in 1988 in Lahore, the capital city of Punjab to meet the acute deficiency of cardiac treatment in Punjab in particular and Pakistan in general. PIC has established a Department for Research, Training and Postgraduate Medical Education in order to update doctors with latest research and development in medical sciences. PIC is affiliated with many national and international institutions. A Board of Management, headed by a Chairman with four official and five non-official members, manages the administration of the PIC, The Head of Institution supervises the hospital administration and the Medical Superintendent along with his team is responsible for all matters related to the hospital management and maintains discipline including punctuality, conduct and performance.

The PIC library was established in 1991 with an initial collection of 300 books. Currently, it has a collection of more than 2000 volumes, which covers different medical disciplines especially cardiology, cardiac surgery, anaesthesia and medicine. It also has some general collections of Islamic, social and Pakistani literature. Medical practitioners (faculty and medical officers), postgraduate students, paramedical and administrative staff are the users of PIC library. However, medical practitioners and postgraduate students are the key users of medical literature, while paramedical and administrative staff uses the library for general literature. The library is located adjacent to the auditorium on the first floor and remains open from 8:00 a.m. to 10:00 p.m. daily except Sunday and official holidays. PIC library, like other modern libraries, acquires latest books, print and online journal subscriptions to fulfil the research and information needs of health care professionals. It has Internet connection and is linked with PIC Local Area Network (LAN). It also has access to Higher Education Commission (HEC) Digital Library resources (http://www.digitallibrary.edu.pk/) for peer-reviewed medical and biomedical journals. User satisfaction survey has a positive impact on users as they realise that they are given importance, and efforts are being made to remove the deficiencies and improve the services. PIC library users including academia, practitioners and students highly welcomed the study and considered it an effort to improve the prevailing library services. Literature review A library is an integral part of an academic and research organisation, and users are the key stakeholders who require information. The basic objective of a library or information resource centre is to fulfil users’ information needs. A number of terms like ‘patron’, ‘client’, ‘customer’, etc. are used as a synonym to user. However, ‘user’ is a preferred term.2 Enhancing user satisfaction is integral to a successful service oriented organisation including libraries, because satisfied users remain loyal, have positive feelings and recommend the service to others. It is only possible when library managers keep in contact with users and understand their information needs. Users’ information

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needs and expectations are continuously changing in this age of information and communication technology. Libraries need to update their resources, facilities and services to keep pace with these advancements. Evidence from library evaluation studies has shown that users are the key stakeholders, and their feedback is the most reliable factor in measuring the usefulness and effectiveness of a library.3 Improving the quality of user services is a matter of deep concern for the libraries of the modern age.4 Traditionally, the term ‘user’s service’ refers to the functions of, and interactions within, library public services.5 In order to provide better library services, it is imperative to know how users assess those services, and surveys are a common data collection instrument to investigate users’ needs. Users’ priorities and expectations vary, and a good library makes its best to fulfill the users’ demands in order to achieve the highest level of user satisfaction.6,7 Library and Information Science (LIS) researchers and practitioners are making efforts to understand the ‘satisfaction formation process’ in library users. They believe that along with delivery of quality information, certain information delivery services and/or systems equally contribute to users’ satisfaction. Many research studies have been conducted on this theme in the developed world but an overarching theoretical model of user satisfaction or dissatisfaction has not yet been developed, which is commonly accepted by the LIS community.8 Information and communication technologies (ICTs) have changed the concept of library services. Now users have multiple options for information seeking and prefer to use online information and services. Therefore, libraries are required to use electronic technologies to satisfy their users.9 On the other hand, use of ICTs, especially the Internet, has brought information overload and new challenges for libraries. It has not only facilitated library users with a bulk of information, but also made it difficult for them to select relevant information for their needs. Libraries can meet these challenges by offering more accurate, reliable and targeted information to their users.10 There are opportunities for library and information professionals in the era of information. A reference service is one of the basic services

provided by a library in any organisation. Rather than acquiring a large collection, the quality of the collection and effective reference services are more important. A librarian, who has interpersonal communications skills, understands users’ queries and delivers the required information, can satisfy users in an efficient way.11 Martensen and Ghronholdt12 based on the literature reviewed and focus groups have identified some key determinants to improve the quality of library services, such as electronic resources (e.g. online catalogue, website, databases search systems, etc.), printed collections, other library services (e.g. user courses), technical facilities (computer, photocopier, etc.), library environment (e.g. atmosphere, reading room and library hours) and the human side of user services (e.g. staff knowledgeability, helpfulness and friendliness). Qualitative research methods such as focus group, interviews prove useful tools in measuring user satisfaction. Users’ detailed answers to welldesigned questions provide useful feedback about their experiences regarding the services offered in libraries. This in turn provides deeper understanding about the issues, which matter most to users. Qualitative data about users’ perceptions help library managers make better decisions for improving the library’s performance.13 Research studies have been conducted to investigate user satisfaction with library services in developing countries. The main academic and research library of King Fahd University of Petroleum and Minerals in Saudi Arabia organised a study using a walk through evaluation and questionnaire survey to investigate user satisfaction. The study was based on 22 elements of performance. It recommended better use of library space respecting user privacy by rearranging the reading tables and carrels, replacement of the carpet, renovation of the toilets, new and better exit signs, an identification plan at the entrance of each library’s storey, improvement of AC plant to control the noise level and a need to re-evaluate the safety system.14 Another study based on a questionnaire survey of five major agricultural libraries in Malaysia was conducted to investigate the factors that contribute positively in shaping users’ perceptions of library effectiveness. Findings of the study showed that the adequacy of the

© 2013 The authors. Health Information and Libraries Journal © 2013 Health Libraries Group Health Information & Libraries Journal, 30, pp. 318–326

Library services and user satisfaction, Muhammad Ijaz Mairaj & Mirza Muhammad Naseer

collection, services and facilities positively affected the perception of users. Similarly, involvement of users in material selection, convenient library location, better reference services, participation in user’s education programmes and subject background of librarians also counted for users’ satisfaction.3 Shah and Parmar15 conducted a questionnairebased survey at Government Medical College Bhavnagar, India to examine the satisfaction of students and staff with different aspects of the library services. Findings of the study showed that the library was mostly used for reading textbooks, newspapers, magazines and journals. The users were satisfied with the library collection, circulation services, reference services, opening hours, books organisation and physical arrangement (lighting, tables, etc.). However, they were dissatisfied with the availability of drinking water, overall condition of the library, books, availability of foreign journals, latest information, lack of reference and popular authors’ books and space in the reading room. The study recommended promoting self-directed learning of students for better use of the library. Some research studies have also been conducted in Pakistan to investigate users’ perceptions and satisfaction with library services. Findings of an interview-based study of research students of the library and information science departmental library of Punjab University showed that the majority of respondents were not satisfied with the overall quality of library services. Users expressed their concern about the library collection and its organisation, usefulness of the OPAC, reference services, staff attitudes, furniture, opening hours and noise level. They were satisfied with the registration and circulation services.16 Other research examined user satisfaction with the services of Punjab University Central Library through questionnaire survey and discovered that users were satisfied with the library opening hours, circulation system, photocopying facility, staff attitudes and environment. The study recommended improvement of the membership procedure, the acquisition of reference material, staff competency, Internet facilities, the library homepage and the need of users’ training of library use.17 A research based on a questionnaire survey explored the satisfaction of medical students of

Quaid-e-Azam Medical College, Bahawalpur. Findings of the study showed that users perceived the library resources and services as inadequate. A majority of the users were partially satisfied with staff attitudes, reference services, selective dissemination of information (SDI) services, current awareness services (CAS), indexing, abstracting and other bibliographical services but dissatisfied with the interlibrary loan (ILL), opening hours, user education and translation services. The study recommended better physical facilities, more staff and audio-visual material, library automation and better Internet connectivity to increase the level of user’s satisfaction.18 Other research examined students’ use of the library of Foundation University College of Liberal Arts and Sciences and concluded that the library had inadequate collection, organisation, space and other physical facilities. The study recommended the need to formulate clearly displayed library rules and a large, up to date and better organised collection, and more computers with Internet connections.19 The findings of the studies conducted in Pakistan as mentioned above have also been discussed with the results of this study to understand the local context of the status of library services and user satisfaction. Methodology Medical practitioners and postgraduate students of Punjab Institute of Cardiology as the key users of library were the population of this study. The registered members included 51 medical practitioners and 45 postgraduate students. A purposive sample of 15 medical professionals including eight practitioners and seven postgraduate students was drawn. Eight medical practitioners included two faculty members and six medical officers. Seven postgraduate students included three from cardiology, two from cardiac surgery and one each from medicine and anaesthesia. The respondents who were frequent users of the library and its services were included in the study keeping in view their library visits and material usage. A semistructured interview technique was used for data collection. Reviewing the literature of similar studies, an interview guide was prepared. It helped to keep the interviews focused on the topic of the research.

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An interview check list was also designed to establish similar conditions for all interviewees. The ‘Interview Guide’ and ‘Interview Check List’ are available on the online version of the article. Interviews were conducted by the principal author, and appointments were made before conducting interviews via telephone or in-person to ensure the best availability and comfort of the interviewees. Before interviewing, the respondents were informed about the purpose and importance of the study, format and approximate time period. They were assured that the information provided would be used for research purposes only. The notes were taken during the interview for recording the information. Once the interview completed, the issues discussed were summarised before the interviewees, and notes taken were shared to confirm the accuracy of their responses. Necessary modifications/additions were made when requested by respondents. Data collected through interviews were qualitatively analysed by the principal author, and a thematic approach was used for analysing the data. For this purpose, the information provided was carefully read and summarised. Coding was made to present data in a meaningful form by breaking down, examining, comparing, conceptualising and categorising the data.20 Results and discussion This study explores twelve major areas of library services through interviews. Participants of the study remained focused during interviews and responded freely to the questions asked on different aspects of the library services. Their responses are analysed in the following paragraphs. Library hours Adequate opening hours provide library users with opportunities for study at their convenience. PIC library remains open from 8:00 a.m. to 10:00 p.m. in two shifts (From Monday to Saturday). Eight respondents urged the library management to increase the library opening hours for a further 2 hours, that is, until 12 midnight. Three respondents thought that the existing time period was adequate. However, one of the respondents suggested that during examination periods, the library

should remain open for a further 2 hours. Two respondents proposed that during Juma (Friday) prayer the library should remain open for study purpose, and one stressed to open the library on Sundays also. The study findings validate prior studies conducted in Pakistan at Quaid-e-Azam Medical College and LIS Department of Punjab University (PU) for increasing opening hours of the library.16,18 Contrary to this, the results of the study conducted at PU main library revealed that users were satisfied with the opening hours.17 The reason is that usually the main/central university libraries in Pakistan provide flexible opening hours as compared to departmental or special libraries. Library space A library must have sufficient space to accommodate its users and to provide comfortable working conditions. It must possess adequate space for a reading room and storage space for books and journals, audio-visual materials and staff accommodation. All respondents showed their concern about library space. Twelve respondents found the library space comparatively small. They commonly used the terms of ‘inadequate’, ‘insufficient’ or “congested”. They were of the view that the library must either be extended or shifted to some reasonable place within the institute. Three respondents were of the opinion that although presently the space was adequate, it must be extended in the near future. Furniture Furniture is an important part of a library. Comfortable furniture is essential for providing a conducive environment for study. The majority of the interviewees showed their concern over the library furniture. Twelve respondents found the existing furniture uncomfortable and unsuitable for the study. Three respondents found it comfortable but all respondents stressed the need for comfortable chairs and separate carrels or cabins for individual study. Frequently used terms by interviewees for this purpose were ‘individual sitting arrangement’, ‘separate carrels’ or ‘cabins’. The findings of the study support other studies conducted at LIS departmental library of PU and Quaid-e-Azam Medical College.16,18

© 2013 The authors. Health Information and Libraries Journal © 2013 Health Libraries Group Health Information & Libraries Journal, 30, pp. 318–326

Library services and user satisfaction, Muhammad Ijaz Mairaj & Mirza Muhammad Naseer

Lighting arrangement Lighting is one of the main considerations in library design. Lighting influences user comfort, productivity and perception of space.14 A proper light arrangement is a prerequisite for studying and poor light affects eyes. Seven respondents found the existing lighting arrangements adequate, one found it nearly adequate, and other respondents were of the opinion that the lighting was not good enough and must be improved further. The results are similar to the findings of the study conducted at Quaid-e-Azam Medical College library where users were partially satisfied with the lighting arrangement. The results of the studies conducted at LIS departmental and main PU libraries showed user satisfaction with the lighting arrangement.16,17 Cooling and heating system A pleasant temperature makes it possible for users to continue their study for longer periods. PIC has provided a central cooling and heating system for summer and winter, respectively. All respondents were satisfied with the cooling and heating arrangements for the library. They commonly used the expressions of ‘adequate’, ‘good’, ‘fine’ or ‘OK’. Noise level The library is considered as a silence zone for proper study, and any kind of interference affects the library atmosphere. It is required to establish a library in a place without risk of background interference or noise, and special care is needed in this regard before designing or constructing the library. Eleven respondents expressed that the library environment was not suitable for study as the noise level was too high. The commonly used terms by interviewees were ‘non-academic’, ‘not study oriented’ and ‘disturbing’. Conversations, especially telephonic ones, the interference of outsiders, administrative and related meetings, patient assessments and tea parties in the library disturbed the users. They also noted the need of a separate place for newspaper readers and telephone, and separate carrels for individual study to reduce conversation. The findings are in agreement with the study conducted at LIS departmental library of PU but

opposite to the results of the study conducted at PU central library, which reported user satisfaction with the noise level and environment.16,17 Adequacy of library collection The collection is the foundation of a library and a key source to meet the information needs of users. The studies have shown that an adequate collection is closely associated with the users’ perceptions of library effectiveness,4 and users prefer online journals for information seeking rather than printed copies.13 PIC library has a collection of more than 2000 volumes and subscribes to 12 journals on cardiology, cardiac surgery, anaesthesia and medicine with online access. An Internet facility for users is available in the computer laboratory adjacent to the library and in the research department on the second floor with access to HEC Digital Library. All respondents showed their concern over the limitations of the library’s collection. Frequently used terms by interviewees were ‘not sufficient’, ‘inadequate’ or ‘not enough’. Eight respondents were of the opinion that although most of the existing collection was good, there were not enough copies of key books and a lack of current books. The findings are similar with the prior studies conducted at PU main library and LIS departmental library regarding the inadequacy of library collection especially the lack of current materials.16,17 Two respondents underlined the need for general literature in Urdu and English languages such as the provision of books on general knowledge and other general areas of interest. Nine participants found the journals collection quite useful. Three participants asked the library to consider subscribing to more journals. Six participants also urged the library management to enhance the CDs collection. Nine participants suggested that the provision of Internet access inside the library would be useful. Organisation of the library collection The library is a place where material is provided in an organised manner for user’s convenience and a librarian uses different tools for this purpose. Participants unanimously judged the collection well organised and accessible. The expressions used by different participants in this regard were

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‘well organised’, ‘organised’, ‘convenient to access’, ‘nice and good display’. The findings are opposite to the results of the study conducted at LIS departmental library of PU stating users’ dissatisfaction with the organisation of the library collection.16 Library registration procedure Libraries maintain records of their users in order to contact them whenever required. Ten interviewees found the library registration procedure satisfactory. They considered it ‘fine’, ‘good’ or ‘OK’. Two respondents argued that PIC identity should be used for library registration. Three respondents urged for the introduction of membership cards. The results are in accordance with the findings of the study conducted at the library of Punjab University LIS department.16 Circulation system A circulation service is an important area of the overall library service to allow the usage of material outside the library premises. PIC library issues books and previous years’ journals (two of each at a time) to the faculty members for 1 month and to medical officers and postgraduate students for 2 weeks. These may be reissued once. Current books and journals may be consulted within the library premises. All respondents were satisfied with the existing procedure of circulation. The frequently used expressions by respondents were ‘OK’, ‘fine’ or ‘good’. The results are similar to the conclusions of other studies conducted at PU main, LIS departmental library.16,17 However, eight respondents urged the introduction of a computerised circulation system. One respondent suggested that books must also be issued in the evening. Reference service Users consider library instructions very valuable.13 It is the duty of a librarian to help library users in searching, retrieving, evaluating and locating the required library material and/or use it efficiently to answer their queries in a better way. Therefore, he/ she should be experienced in information literacy (IL). All participants were thoroughly satisfied

with the reference services given, but they were of the opinion that during the leave of the librarian, they suffered in this context, as there was no one to help them. Nine interviewees were satisfied with the support staff for searching and locating the library material. Five respondents were of the opinion that the existing support staff required more training in locating the material. Four participants suggested increasing the staff in the morning and evening shifts. One participant proposed that at least two persons must be available in the morning and evening shifts to assure good services. Two participants suggested that support staff must also have some library knowledge and training. Attitude of library staff Attitude always counts to determine the impression of a person. Library staff should be humble, well behaved and cooperative while serving. All respondents were satisfied with the cooperation and behaviour of library staff while serving and found them ‘friendly’ and ‘helpful’. The findings are similar to the results of the studies conducted at main library of PU and Quaid-e-Azam Medical College.17,18 Three participants urged for employing more staff in the library and proper training of the existing support staff. Two respondents urged the need for a qualified librarian to be available in the evening shift. Suggestions Libraries are established to meet the information needs of people. Therefore, opinions of users always count in improving the library services. Finally, participants were asked if they had any further suggestions for the overall improvement of the library. This question was asked to explore further areas in the users’ mind that need to be addressed for improved library services. Eight respondents urged the need for the provision of a modern photocopier, printer and scanner in the library. Nine respondents recommended the provision of Internet access within the premises of the library. Eight respondents suggested computerisation of library services. All participants advocated providing enough copies for the latest books on cardiology, cardiac surgery, medicine and other related fields.

© 2013 The authors. Health Information and Libraries Journal © 2013 Health Libraries Group Health Information & Libraries Journal, 30, pp. 318–326

Library services and user satisfaction, Muhammad Ijaz Mairaj & Mirza Muhammad Naseer

Ten respondents stressed the need of the provision of reasonable furniture like carrels and comfortable chairs in the library. Seven participants suggested shifting the library to a more spacious place. Eleven respondents showed their concern over the interference of outsiders, meetings, refreshments and patient assessment in the library and demanded the solution of this problem. Six respondents requested for the provision of a prayer room, attached washroom, arrangement for drinking water, carpeting of the library and open access to the library collection. Conclusion This study proved useful to investigate the level of users’ satisfaction with the services of PIC library. It provides an opportunity to understand the perceptions of health care professionals about the library services via detailed interviews. The study shows that a library with an adequate collection and better physical facilities is considered more effective in satisfying its users. A library is required not only to improve its collection, services and facilities in response to the changing needs of library users in a rapidly changing information age, but it also should continue taking their feedback to discover the effectiveness of the resources and services offered. Library users were satisfied with most of the services of the PIC library, especially the library collection and its organisation, reference and circulation services, staff attitude, cooling and heating system. However, they expressed their concerns about library space, hours, furniture and environment. The users also suggested the need of computerisation of library services, a more up to date collection, better Internet access within the library premises and more comfortable furniture. We can conclude that, in the light of the above findings, it is needed not only to maintain and further strengthen the services with which the users are satisfied, but also to improve the library services upon which the users have shown their concern and take serious steps for the solution of identified problems to gain users’ satisfaction. Such studies may be conducted at regular intervals to understand users’ perceptions about the library services that may be addressed to achieve their satisfaction. For a special library having a specified

type of users, interview technique is the better way to investigate their perceptions in detail for better understanding. However, other types of libraries may adopt various methods to investigate users’ satisfaction keeping in view their users and organisation needs. Immediate outcomes and benefits The study helped PIC library staff to identify the core problems that users face in using the library and its services. It provided an opportunity for library staff to take necessary efforts for the improvement on their part and urge PIC administration to make necessary measures where needed regarding the highlighted issues. For this purpose, PIC administration was informed about the survey findings. They were provided with the recommendations in terms of key messages for improvement of the library services. Moreover, they were informed, about the highlighted issues the library staff would address on their part. The administration welcomed the study and agreed to provide its full and continuous support in this regard in future. Some development has already been taken place in the PIC library with the cooperation of senior administration on some of the highlighted issues such as provision of four computers in the library with Internet connections for users; availability of copying equipment including photocopier, digital printer, and scanner, refrigerator, new furniture especially more comfortable chairs for users.

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Journals 2010, 28, 77–81. DOI: 10.1111/j.1471-1842.2010. 00926.x. Akhtar, M. Z. Library services and users satisfaction: department of LIS, Punjab University, Lahore. Pakistan Library & Information Science Journal 2008, 39, 25–34. Ur-Rehman, S., Mahmood, K., Arif, M. & Rafiq, M. Are users satisfied with library services: the case of Punjab University Library. Pakistan Library & Information Science Journal 2009, 40, 22–28. Bhatti, R. & Asghar, M. B. Library services to Medical students Quaid-e-Azam Medical College, Bahawalpur: a case study. Pakistan Library & Information Science Journal 2010, 41, 23–31. Bukhari, M. T. A., Bukhari, M. M. A., Ranjha, N., Ahmad, K. & Naz, F. Use of library by the students of Foundation University College of Liberal Arts and Sciences, Rawalpindi. Pakistan Journal of Library & Information Science 2010, 11, 66–75. Strauss, A. & Corbin, J. Basics of Qualitative Research: Grounded Theory, Procedures and Techniques. Newbury Park: SAGE Publications, 1990.

Received 3 June 2011; Accepted 8 June 2013

Supporting Information Additional Supporting Information may be found in the online version of this article: Data S1 The interview guide used and check list concerning the steps of the interviews for this study is submitted as a separate file.

© 2013 The authors. Health Information and Libraries Journal © 2013 Health Libraries Group Health Information & Libraries Journal, 30, pp. 318–326

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