An ethnography of humor, ritual and defiance in a cancer care setting

Ethnographic research in healthcare - patients and service users as participants

Purpose: This discussion paper provides an introduction and overview of Ethnography as a qualitative research methodology and outlines its usefulness in understanding the experiences of patients and service users during their healthcare journey. Ethnographic research provides an insight into the group being studied. In this paper that author suggests that ethnography can provide an insight into the behaviours, thoughts and feelings of a patient group.Methods: Research methods used in ethnographic research have been outlined and discussed along with some of the possible methodological and ethical issues that might occur when carrying out an ethnographic study with a group of patients.Results: This paper discusses some of the potential results of an ethnographic study with patients and how ethnographic research can be used to study the experiences of patients.Conclusion: the author draws together some lessons that can be learnt and some possible applications of ethnographic research in healthcare settings with patients. Implications for rehabilitation are also proposed.IMPLICATIONS FOR REHABILITATIONEthnography is a simple and effective qualitative research methodology for studying groups of people with a common enterprise or experience, ethnography studies the culture, behaviours and norms of the group.Ethnography is a useful research methodology to understand the experiences of patients and service users during their healthcare journey. It can provide information about what it is like to have a particular medical condition or diagnosis and the norms and behaviours of patients with this condition. Ethnographic data allows the patient's voice to be heard. Data from ethnographic studies of patient groups can be used for service improvement within health and social care.

Making work visible in a breast cancer support business

Purpose

Breast cancer support businesses, retail stores selling mastectomy-related products, are playing an expanding role within healthcare in the USA. As commercial spaces separate from the medical settings where most cancer treatment occurs, these businesses have been largely overlooked in studies of medical care providers and their experiences. The purpose of this paper is to seek to bring to light the meanings and dimensions of the care work provided by breast cancer support staff to newly diagnosed patients.

Design/methodology/approach

This project employed an ethnographic approach centered on the workers at one breast cancer support business. The first author carried out participant observation over a 20-month period and supplemented the observations with staff member interviews.

Findings

The analysis of field notes and interviews revealed two themes or purposes as central to the employees’ understanding of their work: defining the organizational setting as a nonmedical space and balancing image enhancement with comforting care. The findings show how values of client-centered care can be enacted in a for-profit healthcare setting.

Research limitations/implications

This study is limited to one for-profit support business in the southeastern USA.

Practical implications

Mastectomy supply businesses appear to offer a kind of support that patients may not be finding elsewhere or at the particular time they need it. Thus the study holds relevance for practitioners and health policy makers who are seeking to develop more comprehensive care for surgical patients within the established healthcare system.

Originality/value

This study gives a detailed picture of breast cancer support work, including the value premises and meanings it holds for support workers.

“Resisting the Ban”

Purpose

The purpose of this paper is to present an evocative story “Resisting the Ban” which illustrates the ethical and pragmatic issues that nurses face when contending with smoking ban policies in inpatient psychiatric settings.

Design/methodology/approach

The creative story “Resisting the Ban” was developed based on an organisational auto-ethnographic approach. The story was crafted through employing creative writing techniques and through framing and critiquing memories via several theoretical frames.

Findings

The story illustrates how smoking ban policies have created pragmatic and ethical issues on wards. The work practices of nurses have changed as have their relationships with patients. The liberties of involuntary patients have also been infringed.

Research limitations/implications

This approach can illuminate links between acts of resistance and issues associated with public policies.

Practical implications

The effects of smoking bans need to be considered more carefully particularly in relation to their effects on workers and patients. The social meaning of the smoking bans needs closer investigation. Policy needs to be recrafted so that it better addresses the liberties of involuntary patients. Also ward nurses need to be able to carry out their roles in a manner which is consistent with their values.

Social implications

Public policies, such as smoking bans, can produce negative consequences maligning relationships, practices and cultures. Critical auto-ethnography provides a means of understanding issues that have resulted from problematic policies.

Originality/value

Scholarly work conducted on the relationship between everyday resistance in workplaces and public policies is rare. This study offers new “insider” insights into the negative effects of a smoking ban policy in psychiatric inpatient settings.