Refining story inquiry as a method for research

People living with Alzheimer's disease: Understanding the emerging phenomenon of retrograde plunge with the story theory-An inquiry method

AIM

This study aims to (1) introduce the emergent concept of the retrograde plunge experienced by people living with Alzheimer's disease and (2) illustrate how nurses can accompany those experiencing this phenomenon, as well as their family and formal carers, using the seven-phase inquiry process proposed by Smith and Liehr.

DESIGN

Discursive paper.

METHODS

After describing the phenomenon and the Story Theory, the 7-phase Inquiry Process presents the fictional story of Mrs. Lurie, a nursing home resident.

RESULTS

Story theory allows nurses to accompany Mrs. Lurie. The emergent concept of retrograde plunge is explained. Different tools such as genograms, story paths and eco-maps are presented. This discussion demonstrates how some perspectives can contribute to a better description of the retrograde plunge phenomenon. The narrative care approach can help give voices to people experiencing retrograde phenomena. The adoption of a perspective that considers embodied language could help to better understand the needs of a person.

CONCLUSION

There is a lack of consistency and uniformity regarding the understanding of the retrograde phenomenon. This impacts the quality of care for people and the scientific knowledge, research and education of healthcare professionals. This issue should be addressed in future studies.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

This article shows how story theory helps nurses accompany those facing a retrograde plunge phenomenon, helps them tell their own stories and finds a way to resolve the situation.

IMPACT

This article paves the way for further developments that must now be realized by the international community of experts involved in the care of people with Alzheimer's disease, from practical, academic and research perspectives.

NO PATIENT OR PUBLIC CONTRIBUTION

No patient or public was involved in the design or drafting of the discursive paper. WHAT PROBLEM DID THE STUDY ADDRESS?: The retrograde plunge is a phenomenon in which people living with Alzheimer's disease return to their past lives and re-experience with certain events. The retrograde plunge is a well-known concept that is poorly described in scientific literature and is sometimes misunderstood by families and professional caregivers. This discursive article explains the retrograde plunge phenomenon experienced by people living with Alzheimer's disease. WHAT WERE THE MAIN FINDINGS?: This article demonstrates how story theory helps nurses and families support people with retrograde plunges. This highlights the lack of consistency and uniformity in this phenomenon, which has implications for the quality of care, education and research. Story theory and the seven-phase inquiry process proposed by Smith and Liehr (in Middle-range theory for nursing, Springer Publishing Company, 2023) help to better understand and explain the retrograde plunge phenomenon. WHERE AND ON WHOM WILL THE RESEARCH HAVE AN IMPACT?: This article advances nurses' knowledge in the different fields of practice, teaching and research. This article proposes links among the retrograde plunge phenomenon, embodied language and narrative care approach; this could offer further ways to develop nursing knowledge. This study has the potential to advance the knowledge of practice and education and offers new opportunities for research.

TRIAL AND PROTOCOL REGISTRATION

There was no trial or protocol registration as this article is a discussion.

The Experience of Adolescents Living With Headache

There is little qualitative literature that addresses the adolescent experience of living with headache. The purpose of this study was to determine the dimensions of the health challenge of adolescent headache; the high points, low points, and turning points of living with headache; and the approaches used to resolve the challenge of living with headache. Story theory was used as the qualitative framework to guide data collection, and story inquiry provided the structure for analyzing the data. The Pediatric Migraine Disability Scale (PedMIDAS) quantitatively measured the impact of headaches on daily functioning. Of the 8 participants, 6 reported moderate to severe disability. From the stories, a theme for the complicating health challenge of living with adolescent headache was "an enduring distress manifested by pain, uncertainty, distancing self from family and friends, challenges with school, and not knowing how to resolve." Themes descriptive of the high points, low points, and turning points included "Contentment with school achievement, supportive relationships, and comforting engagement"; "Interruption in pursuing sports/exercise, time with others, and family relationships"; and "A developing realization, through hope and insight, of the possibilities for moving toward resolution." Stories revealed approaches used to resolve the challenge of living with headache, which included self-management through medication, sleep, and transcendence. The findings offer insight into the challenges faced by adolescents with headache and provide evidence of the importance for developing holistic plans of care that address the individual needs of the patient rather than relying on medication management alone.

Holistic nurses' stories of healing of another

The purpose of this study was to uncover the essence and meaning of healing through narrative accounts of holistic nurses, using a qualitative, descriptive design integrating narrative and story inquiry. Twenty-five stories were collected. Seven stories revealed personal healing and have been published in a prior article. Eighteen stories, the focus of this analysis, revealed healing of another. A hybrid method blending narrative and story guided the overall process for the study. Nine themes emerged describing healing of another within three story segments: The Call to Healing, The Experience of Healing, and Insights. The theme within The Call to the Healing Encounter was Drawn by Compassion to the Vulnerability and/or Suffering of Another. Five themes describe the Experience of Healing: Connection: Cocreating Relationships; Taking Risks and Dealing With Skeptical Colleagues; Use of Modalities and Actions as Tools in Developing Self as an Instrument of Healing; Profound, Ineffable Events; and Using Metaphor and Rituals to Describe Healing. Three themes describe Insights: Mutual Transformation, Change, and Reciprocity; Gratitude for the Healing Encounter; and Leaving a Legacy. The metastory, a reconstructed story created by the researchers, was the final phase of research synthesizing and demonstrating themes of healing of another. Results were compared to existing healing literature.

"No one gets through it OK": the health challenge of coming home from war

Few studies have sought to explore the subjective experience of reintegration for veterans of the current Operations Enduring Freedom/Iraqi Freedom/New Dawn military campaigns, and even less attention has been given to discover strategies used by veterans to overcome difficulties with transitioning from life in a combat zone to life at home. Findings of this mixed-method study describe reintegration challenges faced by a sample of student veterans as well as some of the strategies they used in response to those challenges. This study provides direction for nurses and postsecondary educators to support veterans who struggle with their personal experience of coming home from the war.

Holistic nurses' stories of personal healing

The purpose of this study was to uncover the nature, experiences, and meaning of personal healing for holistic nurses through their narrative accounts. The study employed a qualitative descriptive design with methods of narrative and story inquiry. Participants were nurse attendees at an American Holistic Nurses' Association conference who volunteered for the study. They were invited to share a story about healing self or another. Twenty-five stories were collected; seven were about personal healing, and these are the focus of this analysis. Data were analyzed using a hybrid approach from narrative and story inquiry methods. Eleven themes were clustered under three story segments. The themes within the Call to the Healing Encounter are the following: recognition of the need to resolve a personal or health crisis, knowledge of or engagement in self-care practices, and reliance on intuitive knowing. Themes under the Experience of Healing are the following: connections; profound sensations, perceptions, and events; awareness of the reciprocal nature of healing; inner resolution: forgiveness, awakening, and acceptance; use of multiple holistic approaches; and witnessing manifestations of healing. The themes for Insights are the following: gratitude and appreciation and ongoing journey. A metastory synthesizing the themes is presented, and findings are related to existing literature on healing.

A lifelong journey of moving beyond wartime trauma for survivors from Hiroshima and Pearl Harbor

This study examines 51 stories of health, shared by people who survived the wartime trauma of Hiroshima and Pearl Harbor, seeking to identify turning points that moved participants along over their lifetime. The central turning point for Hiroshima survivors was "becoming Hibabusha (A-bomb survivor)" and for Pearl Harbor survivors was "honoring the memory and setting it aside." Wartime trauma was permanently integrated into survivors' histories, surfacing steadily over decades for Hiroshima survivors and intermittently over decades for Pearl Harbor survivors. Regardless of experience or nationality, participants moved through wartime trauma by connecting with others, pursuing personal and global peace.