Are phenomenology and postpositivism strange bedfellows?

Experiences of middle-aged individuals with lower extremity amputation caused by diabetic foot ulcer after disability in China: A qualitative study

AIM

To understand the experiences of individuals who undergo LEA due to DFU after disability.

DESIGN

A descriptive research design in qualitative research.

METHODS

Semi-structured interviews were used in this qualitative descriptive study. Eleven middle-aged patients (45-59 years) who underwent LEA due to DFU were purposively selected and interviewed. Qualitative data were thematically analysed.

RESULTS

Three themes and 10 subthemes were identified. The themes were (1) role function confusion, (2) self-concept stress and (3) unreasonable objective support. Subthemes included (1) weakened career role, (2) family role reversal, (3) social role restriction, (4) over-focusing on appearance, (5) immersion in patient experience, (6) living with faith, (7) polarization of independent consciousness, (8) low perceived benefits of peer support, (9) existence of treatment disruption and (10) poor participation in medical decision-making.

A Critical Comparison of Focused Ethnography and Interpretive Phenomenology in Nursing Research

Choosing an appropriate qualitative methodology in nursing research is a researcher's first step before beginning a study. Such a step is critical as the selected qualitative methodology should be congruent with the research questions, study assumptions, data gathering and analysis to promote the utility of such research in enhancing nursing knowledge. In this paper, we compare focused ethnography by Roper and Shapira and interpretive phenomenology by Benner. Though these methodologies are naturalistic and appear similar, both have different methodological underpinnings. The historical, ontological, epistemological, and axiological philosophy guiding each methodology are described. In addition, the methodological underpinnings of both methodologies and a justification for use in nursing research are provided. This paper will assist future researchers who aim to employ these methodologies in nursing research.

Methodological - Theoretical approach to phenomenological studies on the experience of medication use: A systematic review

BACKGROUND

The study of medication use should include pharmacological, family, and social dimensions to explain how the lived experiences, beliefs, and perceptions of everyone, and their social and cultural environment affects consumption, using for this purpose the qualitative approach.

OBJECTIVE

To conduct a systematic review of the theoretical-methodological approaches to phenomenology to identify studies that allow an understanding of patients' experiences with the use of medications.a.

METHODS

A systematic literature search was conducted following the PRISMA guidelines to identify studies that address phenomenological research on patients' experiences of medications used and to apply them in subsequent studies. A thematic analysis was performed using ATLAS.ti software to facilitate data management.

RESULTS

Twenty-six articles were identified, most of them including adult patients diagnosed with chronic degenerative diseases. The semantic network obtained places Phenomenology at the center as the interpretative referential framework, with three theoretical approaches: descriptive, interpretative, and perceptual under the philosophies of Husserl, Heidegger, and Merleau-Ponty respectively; two techniques to collect data which are in-depth interview and focus groups; and to explore the life experiences of patients and understand the meaning in the context of their lives, thematic analysis, content analysis, and interpretative phenomenological analysis were identified.

CONCLUSIONS

It was evidenced that Qualitative Research approaches, methodologies, and techniques are applicable to describe people's experiences towards the use of medications. Phenomenology constitutes a useful referential framework in qualitative research to explain the experiences and perceptions about the disease and the use of medicines.

"Suck It Up, Buttercup": Understanding and Overcoming Gender Disparities in Policing

Women police officers report elevated symptoms of mental disorders when compared to men police officers. Researchers have indicated that the occupational experience of policing differs greatly among men and women. Indeed, police culture is characterized by hegemonic masculinity, which appears to negatively impact both men and women. The current study examined the contrast between the experiences of men and women police officers. Police officers (n = 17; 9 women) in Saskatchewan participated in semi-structured interviews. Thematic network analysis identified themes related to the experience of policing for both men and women police officers. There were six organizing themes identified in relation to the global theme of Gendered Experiences: (1) Discrimination; (2) Sexual Harassment; (3) Motherhood and Parental Leave; (4) Identity; (5) Stereotypically Feminine Attributes; and (6) Hegemonic Masculinity. Pervasive gender norms appear detrimental for both men and women police officers, as well as the communities they serve. The current results, coupled with the emerging disposition for progress expressed by police services, offer opportunities to develop tailored and focused interventions and policies to support police officers.

Dilthey's philosophy and methodology of hermeneutics: An approach and contribution to nursing science

The purpose of this article was to examine the historical contribution of Wilhelm Dilthey's approach to the philosophy and methodology of hermeneutics in the demarcated context of nursing science. Dilthey's work made a fundamentally significant, yet ancillary, contribution to nursing science. Organically born from a need to deduce Biblical texts, hermeneutics later developed as a means to understand the truth of another's experience, in literal German language referred to as verstehen. A German-born empiricist and devout hermeneutic scholar, Dilthey extended the philosophy of hermeneutics to a methodological approach as a way to recapture expressed meaning of human experiences. His directive work paved a procedural pathway to probe the science of human nature while bound to the appropriate sociohistorical context. Hermeneutic methodology provides a phenomenological-like way to more keenly understand and interpret the whole person. This methodological approach steers a truth-seeking strategy fixed in meticulous and rigorous inquiry. Dilthey transparently recognized the humble fact that there is no true way to wholly grasp another's experience, an inherent limitation of our human abilities. The current paper posits that hermeneutical understanding verstehen can be paralleled to the concept of empathy in nursing. Understanding and empathy are foundational components to the field of nursing as a caring science. The complex yet invaluable philosophy and methodology of Wilhelm Dilthey's hermeneutics is notably relevant and applicable to nursing science as we strive to care for, treat, and heal patients as whole beings.

What can be done to reduce the prevalence of teen pregnancy in rural Eastern Uganda?: multi-stakeholder perceptions

Introduction

The teenage pregnancy rate of 25% in Uganda is worrying though it may seem low compared to 28% in Sub-Saharan countries and West and Central Africa. Young mothers in Uganda risk poor maternal and child health, being isolated, attempting unsafe abortions, failure to continue with school, and poverty. This paper describes perceptions and recommendations of young mothers, family and community members on why the high rate of teenage pregnancies in Uganda and how these can be reduced.

Methods

This qualitative research was conducted from March to May 2016 in six communities within Budondo sub-county (Jinja district), Eastern Uganda. In-depth oral interviews were conducted with 101 purposively sampled adolescent mothers, family members, and workers of government and non-government organizations. Thematic analysis framed around levels of influence within a social cognitive framework was conducted using Atlas-ti (version 7.5.4).

Results

Perceived determinants of teenage pregnancies include: lack of life and social survival skills, lack of knowledge on how to avoid pregnancy, low acceptance/use of contraceptives, neglect by parents, sexual abuse, pressure to contribute to family welfare through early marriage or sexual transactions, lack of community responsibility, media influence, peer pressure, cultural beliefs that promote early marriage/childbearing and lack of role models. Other contributing factors include drug use among boys, poverty, late work hours, long travel distances, e.g., to school, and unsupervised locations like sugarcane plantation thickets. Recommendations participants offered include: sensitization seminars and counselling for parents and girls, closing pornography outlets that accept entrance of minors, using the law to punish rapists, involvement of the President to campaign against early pregnancies, school dismissal before dark, locally accessible schools and job creation for parents to earn money to support the girls financially. Areas for capacity building are: training teachers and community members in transferring empowerment and vocational skills to girls, and construction of homes with separate rooms to support parents’ privacy.

Conclusion

The factors associated with adolescent pregnancy in Uganda fall under individual, economic, social and physical environmental determinants. Recommendations spanning family, community and government involvement can ultimately empower girls, their families and community members, and support collective action to reduce teenage pregnancies.

Needs and Barriers of Teen Mothers in Rural Eastern Uganda: Stakeholders' Perceptions Regarding Maternal/Child Nutrition and Health

For adolescent mothers in rural Eastern Uganda, nutrition and health may be compromised by many factors. Identifying individual and environmental needs and barriers at local levels is important to inform community-based interventions. This qualitative study used interviews based on constructs from social cognitive theory. 101 adolescent mothers, family members, health-related personnel and community workers in Budondo sub-county (Jinja district), eastern Uganda were interviewed. Young mothers had needs, related to going back to school, home-based small businesses; social needs, care support and belonging to their families, employment, shelter, clothing, personal land and animals, medical care and delivery materials. Barriers to meeting their needs included: lack of skills in income generation and food preparation, harsh treatment, pregnancy and childcare costs, lack of academic qualifications, lack of adequate shelter and land, lack of foods to make complementary feeds for infants, insufficient access to medicines, tailored health care and appropriate communications. Using the social cognitive framework, this study identified myriad needs of young mothers and barriers to improving maternal/child nutrition and health. Adolescent-mother-and-child-friendly environments are needed at local levels while continuing to reduce broader socio-cultural and economic barriers to health equity. Findings may help direct future interventions for improved adolescent maternal/child nutrition and health.

van Manen's phenomenology of practice: How can it contribute to nursing?

Phenomenology of practice is a useful, rigorous way of deeply understanding human phenomena. Therefore, it allows research to be conducted into nursing's most sensitive and decisive aspects. While it is a widely used research approach and methodology in nursing, it is seldom addressed and made use of in its practical and applied value. This article aimed to approach the global outlook of van Manen's hermeneutic-phenomenological method to better understand its theoretical background and to address and support the contribution this method can make to nursing, if rigorously applied. For a professional discipline like nursing, van Manen's approach is especially interesting because, in addition to contributing to the body of knowledge of nursing, it provides a special kind of knowledge that allows nurses to act in a more reflective manner, and with tact and skill, in certain situations and relationships that arise in their daily practice. A more in-depth understanding of this research methodology may help nurse-researchers make good use of it and also harness knowledge derived from this type of research. This comes as a result of assuming that phenomenological texts, the final product of the research, have tremendous educational potential for people who read them carefully.

Researching the psychological therapies in prison: considerations and future recommendations

Purpose

– The psychological therapies are widely considered within the forensic literature as holding a useful role in the prison system, however, despite this, very little research into the psychological therapies has taken place. Further, where research is carried out, it is often associated with the need for evidence-based practice (EBP), involving quantification and randomization. The paper aims to discuss these issues.

Design/methodology/approach

– This paper will initially introduce the importance of research into the psychological therapies in prison, followed by a consideration of EBP which can be thought of as the current movement governing research in the psychological therapies in the UK.

Findings

– However, in providing a focused critique of EBP, particularly within prisons, this paper will attempt to pave the way for a consideration of alternative research methodologies and resultant methods in researching the psychological therapies in prisons in the UK.

Originality/value

– Through this it is argued that research within the prison setting should act not to promote interventions and create an evidence-based as such, but to provide an accessible body of knowledge for the psychological therapists working in prisons in the UK.

Perioperative nurses' experiences of communication in a multicultural operating theatre: A qualitative study

AIM

To explore the lived experiences of perioperative nurses in a multicultural operating theatre in Melbourne, Australia.

BACKGROUND

Multiculturalism has become the norm in the health workforce of several developed countries due mostly to immigration. Within an operating theatre setting where good communication is paramount, the presence of nurses and doctors from multiple cultures and different training backgrounds could pose a major challenge.

METHOD

Using a qualitative research methodology underpinned by phenomenology, we interviewed fourteen nurses from different sections of an operating theatre.

RESULTS

From the lived experiences of the participants, difficulties in communication emerged as the major theme. Difficulties in communication affected patient care and the working atmosphere. In addition, social integration appeared to improve communication.

CONCLUSIONS

Addressing the needs of patients from culturally and linguistically diverse backgrounds in the operating theatre continues to be challenging. However, developing a sense of camaraderie and fostering good relationships between staff through regular social gatherings can improve communication and the working atmosphere.

The Meaning of a Positive Client-Nurse Relationship for Senior Home Care Clients with Chronic Disease

Cette étude a exploré la signification d’une relation positive client-infirmière pour les personnes âgées atteintes de maladies chroniques qui reçoivent les soins à domicile. Pour les besoins de cette étude phénoménologique, huit participants âgés de 65 à 86 ont été sélectionnés à partir du Sud-Ouest Centre communautaire d’accès aux soins [or retain as Southwest Community Care Access Centre (SW-CCAC)]? à London, Ontario. Des données narratives ont été recueillies par des entrevues en profondeur capturé sur cassette audio, tout en utilisant un guide d’entretien semi-structuré. L’analyse et l’interprétation des entrevues ont révélé que le sens d’une relation client-infirmière positive de ces personnes âgées englobait deux tendances de sens: avoir de confort, et étant relié au sein de cette relation. Ces deux modèles ont été contextualisés par être une personne âgée avec une maladie chronique et ont été socialement construits à travers l’expérience d’avoir créé un rapport positif. Bien que des recherches supplémentaires sont nécessaires, les connaissances acquises ajouter à ce que l’on sait déjà au sujet de la théorie et la pratique de la promotion de la santé relationnelle pour les personnes âgées vivant avec des maladies chroniques et recevant les soins à domicile.

Unspoken phenomena: using the photovoice method to enrich phenomenological inquiry

Photovoice is a powerful method that is gaining momentum in nursing research. As a relatively new method in nursing science, the situatedness of photovoice within or alongside various research methodologies in a single study remains in a stage of early development. The purpose of this paper is to discuss the photovoice method as a means to elicit phenomenological data when researching the lived experience. While the foundational bases of phenomenology and photovoice differ substantially, the argument presented in this paper suggests that the photovoice method can be successfully used in phenomenological inquiry provided that significant rigour checks are pursued. This includes reflecting upon the origins and understandings of both methodology and method to promote methodological congruency. Data collection and analysis approaches that contribute to phenomenological inquiry using the photovoice method in addition to rigour and ethical considerations are discussed. The use of data generated from photovoice in phenomenological inquiry may fill a void of understanding furnished by limitations of traditional phenomenological inquiry and of spoken language and can enhance understanding of the lived experience, which may not always be best understood by words alone.

Stigma, abortion, and disclosure--findings from a qualitative study

INTRODUCTION

This study qualitatively explores perceptions of women who have experienced abortion care. It explores women's journey through abortion from confirmation of pregnancy to post-abortion.

AIM

The study seeks to understand the implications of these perceptions for policy and practice.

MAIN OUTCOME MEASURES

A qualitative study involving in-depth semi-structured interviews with 17 women, aged between 22 and 57 years, who had undergone legal induced abortion in the UK when they were 16 years or older. Participants were not recruited under the age of 16 because of the ethical and legal complexities of interviewing minors. Additionally, 16 years was deemed to be the most appropriate age as this is the legal age of consent in the UK.

METHODS

Participants were recruited from 12 community contraception and sexual health clinics in two NHS trusts, one in England and one in Wales. Participant recruitment was set at a minimum of 12 and participants were recruited on a "first come first served basis" (i.e., the first 12 who contacted the researcher). The number of participants was raised to seventeen as this was the number deemed to be the most suitable for data saturation in this particular qualitative research.

RESULTS

Women in this study understood abortion as highly taboo and a potentially personally stigmatizing event. These perceptions continued to affect disclosure to others, long after the abortion, and affected women's perceptions of the response of others, including society in general, significant others, and health professionals.

CONCLUSIONS

Women's experiences of abortion may be influenced by perceived negative social attitudes. Health professionals and abortion service providers might combat the perceived isolation of women undergoing abortion by attending not only to clinical/technical aspects of the procedure but also to women's psychological/emotional sensitivities surrounding the event.

Phenomenology as research method or substantive metaphysics? An overview of phenomenology's uses in nursing

In exploring phenomenological literature, it is evident that the term 'phenomenology' holds rather different meanings depending upon the context. Phenomenology has been described as both a philosophical movement and an approach to human science research. The phenomenology of Husserl, Heidegger, Gadamer, and Merleau-Ponty was philosophical in nature and not intended to provide rules or procedures for conducting research. The Canadian social scientist, van Manen, however, introduced specific guidelines for conducting human science research, which is rooted in hermeneutic phenomenology and this particular method has been employed in professional disciplines such as education, nursing, clinical psychology, and law. The purpose of this paper is to explore the difference between the phenomenological method as described by van Manen and that of other philosophers such as Husserl, Heidegger, Gadamer, and Merleau-Ponty. In so doing, the author aims to address the blurred boundaries of phenomenology as a research method and as a philosophical movement and highlight the influence of these blurred boundaries on nursing knowledge development.

Rationalization of indigenous male circumcision as a sacred religious custom: health beliefs of Xhosa men in South Africa

This article presents research findings based on the meaning of indigenous circumcision to Xhosa men in South Africa. In South Africa, male circumcision is a rite of passage from adolescence to adulthood. The country has experienced serious problems associated with the practice of this rite ranging from dehydration to death in the traditional "bush" circumcision schools. A qualitative, endogenous research

DESIGN

"How do you experience having a son who is undergoing the circumcision rite?" The study revealed cultural circumcision as a "sacred religious practice" with five themes, namely (a) readiness of Xhosa families to engage in the circumcision ritual, (b) the act of circumcision and preparation for manhood, (c) the importance of symbolic purity during the circumcision ritual, (d) celebrating acquired manhood, and (5) aspects of manhood and the rejection of clinical care. Secondary to this are health promotion recommendations made for individuals involved in this ritual.

From Husserl to van Manen. A review of different phenomenological approaches

This paper traces the development of phenomenology as a philosophy originating from the writings of Husserl to its use in phenomenological research and theory development in nursing. The key issues of phenomenological reduction and bracketing are also discussed as they play a pivotal role in the how phenomenological research studies are approached. What has become to be known as "new" phenomenology is also explored and the key differences between it and "traditional" phenomenology are discussed. van Manen's phenomenology is also considered in light of its contemporary popularity among nurse researchers.

Three philosophical approaches to the study of spirituality

Since the turn of the century, there has been an expanded interest in the place that spirituality has in nursing practice, education, and research. The purpose of this article is to examine the study of spirituality from the perspective of 3 philosophical paradigms: empiricism, interpretivism, and poststructuralism. The strengths and weaknesses of the paradigms are identified through a review of an exemplar article for each. Each paradigm provides a unique approach to the development of knowledge, and thus makes its own contribution to the understanding of spirituality. It is the researcher's responsibility to identify the appropriate paradigm for the question.

Validity, trustworthiness and rigour: quality and the idea of qualitative research

AIM

In this paper, I call into question the widely-held assumption of a single, more or less unified paradigm of 'qualitative research' whose methodologies share certain epistemological and ontological characteristics, and explore the implications of this position for judgements about the quality of research studies.

BACKGROUND

After a quarter of a century of debate in nursing about how best to judge the quality of qualitative research, we appear to be no closer to a consensus, or even to deciding whether it is appropriate to try to achieve a consensus. The literature on this issue can be broadly divided into three positions: those writers who wish qualitative research to be judged according to the same criteria as quantitative research; those who believe that a different set of criteria is required; and those who question the appropriateness of any predetermined criteria for judging qualitative research. Of the three positions, the second appears to have generated most debate, and a number of different frameworks and guidelines for judging the quality of qualitative research have been devised over recent years.

DISCUSSION

The second of the above positions is rejected in favour of the third. It argues that, if there is no unified qualitative research paradigm, then it makes little sense to attempt to establish a set of generic criteria for making quality judgements about qualitative research studies. We need either to acknowledge that the commonly perceived quantitative-qualitative dichotomy is in fact a continuum which requires a continuum of quality criteria, or to recognize that each study is individual and unique, and that the task of producing frameworks and predetermined criteria for assessing the quality of research studies is futile.

CONCLUSION

Some of the implications of this latter position are explored, including the requirement that all published research reports should include a reflexive research diary.