The redundancy of positivism as a paradigm for nursing research

The intersection between logical empiricism and qualitative nursing research: a post-structuralist analysis

PURPOSE

To shed light on and analyse the intersection between logical empiricism and qualitative nursing research, and to emphasize a post-structuralist critique to traditional methodological constraints.

METHODS

In this study, a critical examination is conducted through a post-structuralist lens, evaluating entrenched methodologies within nursing research. This approach facilitates a nuanced exploration of the intersection between logical empiricism and qualitative nursing research, challenging traditional methodological paradigms.

RESULTS

The article focusing on the "what abouts" of sample size, analytic framework, data source, data analysis, and rigour and methodological considerations, challenging the predominance of semi-structured interviews and the reliance on spoken voice as primary data sources, and re-evaluating the conventional notion of "rigour".

CONCLUSIONS

I advocate for a shift from qualitative positivism towards more interpretive and post-qualitative inquiries, this work proposes new trajectories through interpretive, critical, post-qualitative, and artistic turns in nursing research, aiming to transcend positivist limitations and foster a plurality of perspectives and research as praxis. Implications emphasize the need for nursing researchers to expand methodological horizons, incorporating visual and artistic methods to enrich understanding and representation of health experiences, moving beyond positivist norms towards a more inclusive and ethically sound research paradigm.

The Role of Philosophical Tools in Nursing Research

The objective of this article is to illustrate the importance of the role philosophy and its tools play in the designing and undertaking of nursing research and its importance to be understood by the practicing researcher to ensure the selected methodology and the tools used provide the framework for obtaining reliable and valid answers to their research questions. The article discusses the three major paradigms (Positivism, Interpretivism, and Pragmatism) which have characterized much of health-related research together with a set of essential and practical tools with no metaphysical assumptions that will hopefully provide an explicit framework and a nomenclature which can be applied as we proceed through the research process.

"What Can I Do to Not Have This Life"? A Qualitative Study of Paternal Postnatal Depression Experiences among Fathers in the United Kingdom

Understandings of paternal postnatal depression (PND) in fathers from the United Kingdom (UK) have received limited attention, particularly in view of changing dynamics of contemporary parenthood. To rectify this, eight UK fathers with PND took part in one-to-one interviews, with Interpretative Phenomenological Analysis used to understand their lived experiences. Our findings demonstrate that UK fathers with PND experienced extremely distressing emotions, including anger and misery, after their babies are born. Their working practices were highly relevant to their fatherhood, with working considered a key responsibility and a source of stress, but also a "legitimate" escape from the home. Fathers' relationships with their partners were experienced as less intimate and conflicted. Fathers often hid their feelings to protect their partners, but also reported their partners as being aware of their challenging and difficult emotions. Healthcare providers should be professionally curious about fathers' mental health and consider the assistance of mothers in identifying cases of paternal PND.

Patient experiences of a care transition intervention for Veterans to reduce emergency department visits

OBJECTIVES

Care transition interventions (CTIs) are used to improve outcomes after an emergency department (ED) visit. A recent randomized controlled trial of a Veterans Health Administration (VHA) CTI titled Discharge Information and Support for Patients receiving Outpatient care in the ED (DISPO ED) demonstrated no difference in repeat ED visits. However, changes in health care utilization are not the only measures of a CTI worth evaluation, and there is interest in using patient-centered outcomes to assess CTIs as well. To inform future CTI design and outcome measure selection, the study aims were to understand how patients experienced the CTI and what elements they valued.

METHODS

This was a qualitative study of participants randomized to the intervention arm of the DISPO ED trial using semistructured interviews. The interview guide included questions about clinical health and other issues addressed by the study nurse, the most and least helpful aspects of the intervention, and impacts of the intervention on their perceptions of self-management. Interviews were analyzed using directed content analysis.

RESULTS

Our sample comprised 24 participants, with average age of 61 years, 58% male, and 50% Black or African American. We identified six major themes related to (1) experiences during the intervention and (2) elements they valued. Patients reported clinical health coaching recommendations covering a wide range of topics as well as care coordination actions such as appointment scheduling. Valuable elements of the intervention highlighted personal characteristics of the study nurse that promoted a sense of interpersonal connection and empathy in their interactions.

CONCLUSIONS

Intervention users described assistance with care coordination as well as clinical concerns. We identified aspects that were highly valued by the participants, such as interpersonal support and empathy from the interventionist. These findings suggest the need for more comprehensive nonutilization outcome measures for CTIs to capture the patient's perspective.

Implications of philosophical pragmatism for nursing: Comparison of different pragmatists

Pragmatism emphasizes practical consequences and empirical explanations rather than introspective contemplations. However, the arguments of pragmatists are not uniform, as shown by the four prominent pragmatists presented in this article. The major difference between them is that Peirce and Haack acknowledge an objective truth, whereas James and Rorty do not. Thus, for a fuller understanding of the pragmatist view of our knowledge, both camps must be consulted. In the nursing field, pragmatism is occasionally referred to as a guiding philosophy. However, the influence of James and Rorty has been greater than that of Peirce and Haack on pragmatists, which may risk leading to a skewed understanding of pragmatism by nursing scholars. Still, the four pragmatists share naturalism, which rejects a metaphysics that defines the nature of knowledge before our enquiry and emphasizes experience and practice. Pragmatic naturalism can help ensure that nursing theory does not deviate from clinical practice. This article also explores the broad adaptability of the ideas of all four pragmatists to philosophical issues in nursing, such as mixed-methods research, epistemic relativism and realism. By showing that pragmatism can be relevant and stimulating to each of these topics, the article demonstrates that the different approaches to pragmatism can provide more inspiration for nurses and nursing researchers in the future.

Illustrating a novel methodology and paradigm applied to Emergency Department research

AIM

To provide a practical example of how a novel methodology and paradigm was applied to a mixed methods study exploring the healthcare experiences of Australian adults who frequently use emergency department services.

DESIGN

Discussion Paper.

DATA SOURCES

We explored published literature discussing philosophical and methodological issues related to mixed methods research. Literature searches were performed between July 2019 and February 2021.

IMPLICATIONS FOR NURSING

Phenomenology is a powerful methodology to explore the lived experience of research participants, but it is not without limitations. Mixed methods phenomenology allows nurse researchers to bring further clarity to their research phenomena, however, including phenomenology in mixed methods studies may be seen to be philosophically incompatible. The philosophical metaparadigm of dialectical pluralism provides nurse researchers with a new coherent methodological and philosophical framework for combining participants' descriptions of lived experience with a variety of data collection methods. It is effective when working with transdisciplinary research teams, and stakeholders representing diverse values and disciplines.

CONCLUSION

Complex healthcare environments require sophisticated, flexible research approaches. This paper presents mixed methods phenomenological research combined with the metaparadigm of dialectical pluralism providing a methodological framework that can support multifaceted nursing research.

IMPACT

The combination of mixed methods phenomenology and dialectical pluralism represents a novel solution for nurse researchers to articulate a research methodology and philosophical paradigm reflecting the complexity embedded in everyday nursing practice. This methodology offers a unique approach to exploration of challenging clinical and patient scenarios with multifaceted elements, and overcomes theories of philosophical incompatibilities between divergent methods.

Guideline for incorporating the Delphi method in the evaluation of nursing theories

Objective:

to describe a guideline for the use of the Delphi method to evaluate nursing theories, from the perspective of internal validation.

Method:

a methodological study, targeted at the development of a guideline for the use of the Delphi method in the evaluation of nursing theories.

Results:

the Delphi method, principles of collective wisdom and levels of proficiency are used in the production of a guideline for organizing, searching, selecting and coordinating the activities of theoretical evaluators in teams. It distinguishes three phases for the theoretical evaluation process: Preparatory Phase (PP); Intermediate Phase (IP) and Theory Evaluation (TE) phase, incorporating Delphi-type selection procedures; search, selection and classification of judges/evaluators for the theory; definition of criteria for carrying out rounds and maintenance or removal of units of the theory evaluated.

Conclusion:

the developed guideline was able to adapt the elements of the Delphi method as a favorable strategy for the internal validation of nursing theories.

Four philosophical images of man and nursing from Krąpiec's perspective

The article describes Mieczysław Albert Krąpiec's perspective on four classic philosophical images of man and the resulting theoretical and practical implications for the nursing profession. The first three images, namely man as a set of elements, man as a soul imprisoned in the body and man as a rational animal, are regarded by Krąpiec as reductionist anthropologies and are thus inadequate for nursing. The first image reduces man to a biological element. The second one reduces man to a soul and treats a body as something an obstacle in personal development. The third image absolutizes reason in man. While the body is not rejected in this image, it is viewed as an indifferent mass. The last image, which regards man as a person, is an adequate image for nursing. The exceptional character of man emphasized in this image is determined by the following personal qualities: the ability for cognition, freedom, love, religiousness, dignity, subjectivity to law and completeness. These characteristics reveal the specificity of personal being in both the body and the spirit. By viewing man as a person, a nurse discovers a wide range of possibilities of providing effective help to the patient.

The Association between Researchers’ Conceptions of Research and Their Strategic Research Agendas

Purpose

In studies of the research process, the association between how researchers conceptualize research and their strategic research agendas has been largely overlooked. This study aims to address this gap.

Design/methodology/approach

This study analyzes this relationship using a dataset of more than 8,500 researchers across all scientific fields and the globe. It studies the associations between the dimensions of two inventories: the Conceptions of Research Inventory (CoRI) and the Multi-Dimensional Research Agenda Inventory—Revised (MDRAI-R).

Findings

The findings show a relatively strong association between researchers’ conceptions of research and their research agendas. While all conceptions of research are positively related to scientific ambition, the findings are mixed regarding how the dimensions of the two inventories relate to one another, which is significant for those seeking to understand the knowledge production process better.

Research limitations

The study relies on self-reported data, which always carries a risk of response bias.

Practical implications

The findings provide a greater understanding of the inner workings of knowledge processes and indicate that the two inventories, whether used individually or in combination, may provide complementary analytical perspectives to research performance indicators. They may thus offer important insights for managers of research environments regarding how to assess the research culture, beliefs, and conceptualizations of individual researchers and research teams when designing strategies to promote specific institutional research focuses and strategies.

Originality/value

To the best of the authors’ knowledge, this is the first study to associate research agendas and conceptions of research. It is based on a large sample of researchers working worldwide and in all fields of knowledge, which ensures that the findings have a reasonable degree of generalizability to the global population of researchers.

Research paradigms and the politics of nursing knowledge: A reflective discussion

A standard view would suggest that research is a neutral apolitical activity. It neutralizes external pressures by its fidelity to robust scientific methods. However, politics is an inevitable part of human knowledge. Our knowledge of the world is always mediated by human priorities. What matters is therefore a contested and political debate rather a neutral accumulation of factual data. How researchers manage this varies. Research paradigms are one way in which research engages with knowledge. They frame knowledge within epistemological and ontological philosophies. In this paper, I will explore this view in relation to neo-positivism, qualitative research, Foucault and critical realism. I will argue that if nursing knowledge is to be effective it needs to acknowledge the political, particularly in the context of neoliberalism. Healthcare systems are having to cope with a social world increasingly dominated by market fundamentalism, extreme levels of inequality and a rise in xenophobia. These forces are undermining the provision of ethically sound health care, misdirecting research practice and contributing to a discourse of dehumanization. These forces need to be challenged politically and I will argue that epistemologically diverse approaches, alongside a realist ontology can provide a way forward for nursing research.