Philosophical ponderings on qualitative research methods in nursing

"Trying to Find North": Fathers Voice the Nature of Their Bereavement

Fathers' lived experience of bereavement is not well understood. This article presents findings from a Heidegerrian phenomenological study, which aimed to describe fathers' bereavement. Fathers' bereavement is a life-long journey along which a father navigates through devastating and traumatic loss with great strength; has profound grief that mirrors the profound love he has for his child; chooses to live life with intention and engages in meaningful activities that create purpose aimed at honoring his child, continuing his child's legacy, and using his own suffering for the good of others; is anchored by a continuing bond of love that fuels an ongoing relationship with his child; and needs a supportive community to sustain him as he travels down the healing road where it is possible to find faith, hope, and love while being forever transformed by loss. Findings amplify fathers' voice so nurses gain a deeper understanding of their experience.

The Lived Experience of Ambulatory and Perioperative RNs Displaced During the COVID-19 Pandemic: A Phenomenological Study

During the patient surge associated with the onset of the COVID-19 pandemic in the spring of 2020, perioperative and ambulatory RNs at an acute-care specialty orthopedic hospital were redeployed to medical-surgical inpatient nursing units to care for patients with the disease. The purpose of this phenomenological study was to describe perioperative and ambulatory RNs' experiences during the redeployment. We used purposeful sampling to obtain representatives who worked routinely in perioperative (including postanesthesia care) and ambulatory settings before redeployment. Data saturation was reached after eight in-depth interviews that yielded rich descriptions of the nurses' experiences. Most participants indicated that the fundamental structure of the experience involved being "thrown into a war without weapons" and needing to find ways to fight. The results of this study provide a unique contribution to nursing literature and may assist nurses and leaders in the future.

Development of a post discharge telecare program for premature infants in Covid 19 era: Protocol for a mixed methods study

BACKGROUND

Post-discharge care of premature infants is an important goal that can provide a safe transition for these infants from the hospital to the home setting, especially who has undergone significant changes during Covid19. Most premature infants experience complications because of routine hospital care termination after discharge because of limitations and barriers that Covid can create for the infant and the parents. It is necessary to develop a program that provides ongoing care for these infants. Telecare is one feasible option that can be used to implement this program. The study aims to develop a post-discharge telecare program for premature infants in the Covid era in Iran.

MATERIAL AND METHODS

This is an exploratory mixed-methods study that will be conducted by Qualitative-quantitative methods in three consecutive phases at Isfahan University of Medical Sciences in January 2022. In the first phase, a qualitative study will be conducted to identify and determine the needs and strategies in the Covid 19 era to promote premature infant care after discharge. The data will be collected through deep semi-structured interviews. Participants (parents, physicians, and nurses) will be selected by purposive sampling methods, and the conventional content analysis method will be used for data analysis. In the second phase, the identified infants' and parents' needs as an initial draft of the program will be prioritized and confirmed by the modified Delphi method and a panel of experts. The final program will be developed in this phase. In the quantitative third phase, the confirmed program will be implemented as a semi-experimental study that uses a telecare strategy. Finally, we will evaluate the effectiveness of this telecare program.

RESULT

A program that uses qualitative and quantitative methods can provide evidence for promoting premature infant health after hospital discharge in Covid 19 era.

CONCLUSION

We anticipate that this program will promote knowledge and empower health team members, especially nurses, to provide ongoing telecare for premature infants.

A scoping review of Q-methodology in healthcare research

BACKGROUND

Q-methodology is an approach to studying complex issues of human 'subjectivity'. Although this approach was developed in the early twentieth century, the value of Q-methodology in healthcare was not recognised until relatively recently. The aim of this review was to scope the empirical healthcare literature to examine the extent to which Q-methodology has been utilised in healthcare over time, including how it has been used and for what purposes.

METHODS

A search of three electronic databases (Scopus, EBSCO-CINAHL Complete, Medline) was conducted. No date restriction was applied. A title and abstract review, followed by a full-text review, was conducted by a team of five reviewers. Included articles were English-language, peer-reviewed journal articles that used Q-methodology (both Q-sorting and inverted factor analysis) in healthcare settings. The following data items were extracted into a purpose-designed Excel spreadsheet: study details (e.g., setting, country, year), reasons for using Q-methodology, healthcare topic area, participants (type and number), materials (e.g., ranking anchors and Q-set), methods (e.g., development of the Q-set, analysis), study results, and study implications. Data synthesis was descriptive in nature and involved frequency counting, open coding and the organisation by data items.

RESULTS

Of the 2,302 articles identified by the search, 289 studies were included in this review. We found evidence of increased use of Q-methodology in healthcare, particularly over the last 5 years. However, this research remains diffuse, spread across a large number of journals and topic areas. In a number of studies, we identified limitations in the reporting of methods, such as insufficient information on how authors derived their Q-set, what types of analyses they performed, and the amount of variance explained.

CONCLUSIONS

Although Q-methodology is increasingly being adopted in healthcare research, it still appears to be relatively novel. This review highlight commonalities in how the method has been used, areas of application, and the potential value of the approach. To facilitate reporting of Q-methodological studies, we present a checklist of details that should be included for publication.

The lived experience of family members who care for children with cancer: An interpretative phenomenological approach

PURPOSE

This study aimed to explore the lived experiences of family carers in the care of children with cancer.

METHOD

A phenomenological hermeneutic approach was conducted, informed by the philosophy of Martin Heidegger. Fourteen interviews were conducted with family members: mothers (n = 9), grandmothers and fathers (n = 5). Fourteen family carers were voluntarily enrolled from a public children's oncology department in Bethlehem in the Occupied Palestinian Territories. Interpretative Phenomenological Analysis (IPA) was used to analyze the data.

RESULTS

Three major themes emerged from the data analysis. The first theme was the caring experience, which included three subthemes: changing priorities over time, information given about children's illness, and parents suffering due to treating irritable children. The second theme was the challenges to effective care, which illustrates the most significant challenges faced during caring, including the effects of family relations and emotional support. The final theme was around the support system; family carers found several resources to support them in their children's care, including other parents' experiences with similar diseases, the hospital environment, and their religious beliefs.

CONCLUSIONS

This study informs parents and healthcare providers about the daily lived experiences of family carers. Healthcare providers can fulfil a significant role in giving emotional support and relief to family carers. However, they will need continuous practise to equip them with the communication skills they require to deal with the family carers in these difficult situations.

O retorno ao trabalho de mulheres após a experiência do câncer de mama: uma metassíntese

Resumo Introdução: o câncer de mama (CM) é a neoplasia mais comum em mulheres no mundo e o número de casos vem aumentando na população economicamente ativa. Por isso, o retorno ao trabalho após CM tem despertado interesse da comunidade científica. Objetivo: sistematizar e sintetizar os estudos qualitativos que abordam a experiência do retorno ao trabalho após o CM. Métodos: metassíntese qualitativa com busca dos estudos primários nas bases ASSIA, BIREME, CINAHL, Embase, PsycInfo, SciELO, Scopus e Web of Science. Foram localizados 779 artigos, dos quais, nove atenderam aos critérios de seleção. Resultados: seis conceitos de segunda ordem foram gerados: os efeitos da doença na reabilitação; questões financeiras; medo de recidivas; apoio da família, amigos e profissionais de saúde; e mudanças do significado do trabalho após CM. Conclusão: o retorno ao trabalho não deve se limitar aos aspectos relacionados aos obstáculos e facilitadores da reabilitação Os “mundos da vida” evidenciados nos fatores contextuais mais abrangentes revelam que o enfrentamento do retorno ao trabalho implica no aprimoramento do suporte às trabalhadoras no ambiente de trabalho, na vida familiar, na relação com os sistemas de saúde e seguridade social e na esfera individual, a fim de prevenir aposentadorias precoces e incapacidade prolongada.

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.

Conducting phenomenological research: Rationalizing the methods and rigour of the phenomenology of practice

AIMS

To offer a complete outlook in a readable easy way of van Manen's hermeneutic-phenomenological method to nurses interested in undertaking phenomenological research.

BACKGROUND

Phenomenology, as research methodology, involves a certain degree of complexity. It is difficult to identify a single article or author which sets out the didactic guidelines that specifically guide research of this kind. In this context, the theoretical-practical view of Max van Manen's Phenomenology of Practice may be seen as a rigorous guide and directive on which researchers may find support to undertake phenomenological research.

DESIGN

Discussion paper.

DATA SOURCES

This discussion paper is based on our own experiences and supported by literature and theory. Our central sources of data have been the books and writings of Max van Manen and his website "Phenomenologyonline".

IMPLICATIONS FOR NURSING

The principal methods of the hermeneutic-phenomenological method are addressed and explained providing an enriching overview of phenomenology of practice. A proposal is made for the way the suggestions made by van Manen might be organized for use with the methods involved in Phenomenology of Practice: Social sciences, philosophical and philological methods. Thereby, nurse researchers interested in conducting phenomenological research may find a global outlook and support to understand and conduct this type of inquiry which draws on the art.

CONCLUSION

The approach in this article may help nurse scholars and researchers reach an overall, encompassing perspective of the main methods and activities involved in doing phenomenological research. Nurses interested in doing phenomenology of practice are expected to commit with reflection and writing.

Returning to Work after Liver Transplant: Experiencing the Roadblocks

Liver transplant has been the treatment of choice for people with end-stage liver disease since the mid-1980s. The theme of returning to work after liver transplantation emerged from the data of a phenomenological study examining the lived experience of people with liver transplants. Thirteen liver recipients were interviewed using a semistructured approach. Only one of the first nine participants was able to return to work after the transplant; therefore, the last four participants were purposely chosen because they had been able to return to work. The possibility of losing health insurance benefits and disability benefits prevented many participants from working. Those able to return to work had professional careers that afforded them flexibility in their work schedule. Some implications for health professionals lie in the area of healthcare and health insurance policy change. Avenues for health insurance reform could be explored in an effort to empower the transplant recipient.

Relational and embodied knowing: Nursing ethics within the interprofessional team

In this article we attempt to situate nursing within the interprofessional care team with respect to processes of ethical practice and ethical decision making. After briefly reviewing the concept of interprofessionalism, the idea of a nursing ethic as ‘unique’ within the context of an interprofessional team will be explored. We suggest that nursing’s distinct perspective on the moral matters of health care stem not from any privileged vantage point but rather from knowledge developed through the daily activities of nursing practice. Because of their position vis-à-vis patients and families in everyday clinical care, nurses cultivate ethical knowledge of at least two forms: (1) relational knowledge; and (2) embodied knowledge. Through the integration of these forms of knowledge, nurses develop a unique moral perspective and can make a meaningful contribution to the realm of ethics in interprofessional care.

Emotional violence among women in intimate relationships in Botswana

A Heideggerian hermeneutic phenomenological approach was used to investigate the lived experience of women in Botswana who had experienced emotional abuse in intimate relationships. Hermeneutic phenomenology is concerned with the human experience as it is lived. Ten educated Botswana women who had formal employment and have been in intimate relationships for longer than ten years, narrated their life experiences with abusive men. Extensive interviews took place over a six month period. Sociocultural practices in Botswana emerged as salient factors that contribute to emotional abuse and predispose women to mental illness. Entwined in these cultural practices are issues of age, ethnicity, payment of lobola (bride price), financial standing, change of name, and relocation to the man's residence. Education and employment seem to worsen the abuse. Depression and anxiety are common results of abuse. Understanding how the sociocultural factors perpetuate abuse can assist nurses in the way they provide health care services to women.

Tai Chi and older people in the community: A preliminary study

This paper outlines a qualitative exploratory study of the individual experiences of older people who practise Tai Chi for health. The study aimed to identify factors that influence the attraction of Tai Chi for older people. Participants were recruited from a selection of Tai Chi clubs in the north of England. Participant and non-participant observation of a selection of Tai Chi practice sessions was undertaken along with interviews with 7 older people. Findings show that individuals who practice Tai Chi report a variety of immediate and lasting physical and mental benefits. Being part of a group that both learns and practises Tai Chi together appears to be important to the experience and awareness of the spiritual nature of Tai Chi was also reported. It is argued that older people who practise Tai Chi may have a particular view on ageing, health and well-being that the activity of Tai Chi allows them to express and future study intends to investigate this in more detail.

Lived experiences of family caregivers of mentally ill relatives

AIM

The aim of this paper is to report a study conducted to explore the meanings of the lived experiences that Chinese family caregivers in Malaysia ascribed to the care they provided to relatives with severe and persistent mental illness.

BACKGROUND

In the past, many researchers have used quantitative approaches to explore the experiences of family caregivers of relatives with severe and persistent mental illness. However, the results of these studies have been far from conclusive because of serious methodological flaws. In addition, a large majority of these studies were conducted in western cultures, and it has been difficult to transfer the results to family caregivers in oriental cultures.

METHOD

The philosophy of Martin Heidegger underpinned the study. Qualitative data were collected mainly through in-depth interviews with 19 criterion-selected Chinese family caregivers of relatives with severe and persistent mental illness in 2002.

FINDINGS

We present the emergent themes reflecting the meaning structures of managing, enduring, and surviving the day-to-day experiences of the Chinese family caregivers. The impact of the stigma of the relatives' mental illness on family caregivers and families is pervasive and strong. As a result, family caregivers tried to avoid talking about their relative's mental illness with extended family or friends in order to protect their families from 'losing face'. In addition, most family caregivers believed that adopting positive behaviours and attitudes helped them cope with caregiving.

CONCLUSION

Mental health nurses need to help Chinese family caregivers to cope with the stresses and stigmas of their relatives' mental illnesses through psychosocial education or family intervention, and to provide them with culturally-congruent care. They should also educate the public about mental health and ill health through health promotion and education.

Novice Faculty: Encountering Expectations in Academia

New faculty rarely are prepared educationally or experientially for multiple roles and expectations. This phenomenological study was designed to uncover the meaning of the new faculty experience. A purposeful sample of nursing faculty, who were in their first year in a new position, were interviewed to gain an understanding of their experience. A hermeneutical method of data analysis revealed common meaning in the experience of new faculty. The focus of this article is on one theme--expectations--from the distinct perspective of the novice faculty participants. Novice faculty had expectations of what their new role would involve from their prior experience as students, and they perceived expectations of them by other faculty and students. With limited experience in academia, novice faculty described how they tried to put their own and others' expectations into perspective. The stories of these novice faculty reveal inadequacies in the ways new faculty are prepared and mentored. Implications arising from this study encourage revisiting the practices surrounding the preparation and retention of new nursing faculty.

Negotiation of HIV preventive behaviors in divorced and separated women reentering the sexual arena

The purpose of this study was to understand divorced and separated women's experience of negotiating human immunodeficiency virus (HIV) preventive behaviors when resuming sexual activity following long-term monogamous relationships. A little-studied but large group, these women are at risk for sexually transmitted diseases, have low rates of protective behaviors, and have not been targeted for prevention education. Seven women entering a sexual milieu altered by the presence of HIV after at least a 10-year period of monogamy comprised the sample. A descriptive phenomenologic methodology incorporating Colaizzi's method for data analysis revealed four themes: (a) keeping the magic, (b) Am I an adolescent or an adult? (c) holding on to self, and (d) gender perspectives. These women's words help to illuminate their issues regarding HIV prevention, guiding further nursing research and HIV preventive educational interventions.

The critique of Heideggerian hermeneutical nursing research

Within the past decade, over 25 research reports claiming to be based on Heideggerian interpretive phenomenology have been published in the nursing literature. This article reviews this research focusing on two critical issues. First, do the reports reflect a convergence of researcher understanding and participant narratives as called for by the Heideggerian tradition? Second, do Heideggerian ideas inform and enrich the studies' findings? The review reveals wide variations with regard to how these two issues are reflected in published reports. The author recommends that Heideggerian nurse researchers (a) seek to create a new narrative literature that allows for flexible and creative presentation of interpretive findings, while demanding adherence to sound interpretive scholarship, and (b) strengthen their partnerships with philosophers and other scholars so that ideas from Heideggerian interpretive phenomenology and other sources can not only guide their methods, but enrich their findings.

Identifying outstanding clinical nurses: the 'star' shines in oncology

There are some oncology nurses who are special. They are 'good' nurses but they are more, somehow they 'shine'. They are 'stars'. Many nurses will identify the same nurse as a 'star' but what makes a nurse a 'star'? Twelve semistructured interviews were conducted in which oncology nurses were asked to describe an oncology nurse who stood out in terms of clinical practice. The 'star' nurse was easily and readily recalled and described by participants. Analysis revealed 21 grouped themes relating to the 'star' nurse. Each theme was allocated to one of four headings: 'Nurses' ways of Being; Doing; Knowing; and Giving and Receiving' (Stiles, 1990). The 'star' nurse is professional, committed and caring; delivers excellent nursing care both basic and technical; is knowledgeable; has advanced communication skills, and establishes strong relationships with clients and peers. From this, it is clear that caring and psycho-social aspects of care are only part of the make up of the 'star' nurse, and that the complexity of the 'star' nurse has not been highlighted in the literature.

The experience of nursing home life

This study explored the articulate resident's experience of nursing home living. Using an ethnographic approach, data was collected through progressive, in-depth, open-ended interviews and participant observation from two 80-bed nursing homes in New South Wales. Employing purposeful sampling, eight key informants were selected concurrent with data collection and analysis according to the adequacy of information and appropriateness of subjects. Four major themes emerged from the data: (i) against my will, (ii) living in a public domain, (iii) cultural implications of living with others, and (iv) the impact of nursing home residency. Findings indicate that whilst some residents find the experience acceptable, for others the experience is both constraining and dehumanising.

Pattern recognition as a nursing intervention with Japanese women with ovarian cancer

This article explores the process of pattern recognition, contained within Newman's theory of health as expanding consciousness, as a nursing intervention with adults with ovarian cancer. The process of the nurse-client interactive pattern revealed four nonlinear phases: the client-nurse mutual concern, pattern recognition, vision and action potential, and transformation. Most participants found meaning in their lives and experienced personal growth in expanding consciousness.

Violence against ex-wives: anger and advocacy

Researchers on violence against women have failed to reveal any studies that provide definitive explanations for the violent behaviors of certain males. However, violence against women has been known to occur as a result of unusually potent situational stressors, regardless of the male's propensity toward violence. Some of these situational stressors occur during the process of marital separation and divorce, particularly in relation to disputes over child custody, support, and access. In this paper I report on a second-level analysis of a set of studies in Australia aimed at examining the experience of separating parents who did not gain custody of their children. One of the dominant themes that emerged in the initial analysis from the male cohort was the real or vicarious violence that pervaded the men's interactions with their ex-spouses. These men, from a range of socioeconomic backgrounds and age groups, freely discussed episodes in which they had either planned, executed, or fantasized about violence against their spouses in retaliation for real or perceived injustices related to child custody, support, and/or access. In many cases, these thoughts and actions were reinforced by the encouragement of other males. To a lesser extent, women also reported violent inclinations induced by the situation. The implications for those advocating for women and families are clear. There is a need to understand the experience of marital separation from the perspective of both spouses as a basis for family counseling. We must also heighten awareness of the need to educate young people away from an "ownership" model of marriage and relationships, which is counterproductive to the personal development of both partners. Equally important is the need for all health professionals to advocate for changes that would help to correct injustices in the family court system, many of which are related to gender issues.

Returning to work after liver transplant: experiencing the roadblocks

Liver transplant has been the treatment of choice for people with end-stage liver disease since the mid-1980s. The theme of returning to work after liver transplantation emerged from the data of a phenomenological study examining the lived experience of people with liver transplants. Thirteen liver recipients were interviewed using a semistructured approach. Only one of the first nine participants was able to return to work after the transplant; therefore, the last four participants were purposely chosen because they had been able to return to work. The possibility of losing health insurance benefits and disability benefits prevented many participants from working. Those able to return to work had professional careers that afforded them flexibility in their work schedule. Some implications for health professionals lie in the area of healthcare and health insurance policy change. Avenues for health insurance reform could be explored in an effort to empower the transplant recipient.

Nursing research methodology: transcending Cartesianism

Nurses involved in research are concerned with methodological issues. This paper explores the Cartesian debate that has polarized the discourse on nursing research methodology. It is argued that methodologies exclusively based on objectivism, one pole of the Cartesian debate, or subjectivism, the other, do not provide nurses with adequate research foundations to understand the complexity of the lifeworld of nursing practice. This paper provides nurse researchers with an alternative methodological perspective, Gadamerian hermeneutics, which is in harmony with the clinical world of nursing practice.

Images and sensations of war: a common theme in the history of military nursing

We analyzed interviews with 22 military nurses who had served in wars or conflicts since World War II, up to and including Operation Desert Storm. Using a method of hermeneutic phenomenology, we found several common themes in the interviews. In this article, we report on the theme Images and Sensations of War. Within that theme, the subcategories sights, sounds, and other sensations (climate and weather, taste, smell, and comfort) were discovered. We categorized the images and sensations as pleasant, unpleasant, and horrible. The findings from this analysis may be useful to professionals who recruit military nurses, provide ongoing military training, help military nurses return to civilian life, and treat posttraumatic stress syndrome. Furthermore, the findings could be used as a basis for future quantitative studies to determine how widespread this theme is in larger groups of military nurses.

The Pinwheel Model of Bereavement

The Pinwheel Model of Bereavement is a process-orientated model of grief which recognizes loss as a unique lived experience. The model and relevant nursing response are described using Margaret Newman's nursing theory of health as expanding consciousness. The model is based on research by Carter (1989) and clinical experience. The contextual theme for the model is "personal history." Six core themes are: being stopped, hurting, missing, holding, seeking, and valuing. Three meta themes are change, expectations, and inexpressibility. Capacities for "being with" the bereaved are identified for the practice of nursing.

An in-depth study of triangulation

Multiple triangulation is an approach to research which is becoming increasingly popular among nurse researchers. It is an attempt to improve validity by combining various techniques in one study. Provided that the researcher is well informed, the approach can be successful. However, the issue becomes clouded because in their excitement some nurse researchers seem to have forgotten that the roots of research stem from one of two paradigms, or world views. This has led to the suggestion that paradigms may be combined, and has caused the validity of multiple triangulation to be called into question. In an attempt to unravel the muddle this paper describes multiple triangulation and goes on to suggest where the confusion has occurred. It concludes that multiple triangulation is a valid technique providing that researchers remember that their work will always be influenced by a single paradigm.

Partnership in care: parents' views of participation in their hospitalized child's care

This paper describes parents' experiences of participation in their hospitalized child's care on a general surgical paediatric ward. The findings indicate that parents chose to participate because of concern for the child's emotional welfare. Influencing factors included sense of parental duty, past experiences with hospitals, and concern for consistency of care. Parents' readiness to care was encouraged by a supportive family network, support from other parents, familiarity and experience with care. Parents were willing to adapt their parenting skills in order to be able to care for their child at home and were willing to perform more care provided it did not cause pain for the child, had the nurses' approval and increased their confidence and competence as carers. Lack of information, non-negotiation of roles, inadequate facilities, feelings of anxiety and loneliness were the difficulties parents experienced.

The ethics of qualitative nursing research

Nurse researchers conducting qualitative studies need to be acutely aware of the unique ways ethics, both nursing and research ethics, affect all phases of the qualitative research process. Decisions about what to study, which persons will be asked to participate, what methodology will be used, how to achieve truly informed consent, when to terminate or interrupt interviews, when to probe deeply, when therapy or nursing care supersedes research, and what and how case studies should be documented in the published results are all matters for ethical deliberation. This article seeks to examine some of the less obvious, yet very important, ethical concerns that nurses face throughout the research process and build a common core of values that can lead to meaningful process and socially responsible research results.

The status of students undertaking the basic nursing course

This is a report on a study that was conducted on the controversy about the student status of students undergoing preparation for becoming professional nurses. One view says there is, the other view says there is no supernumerary status in South African institutions for nurses' education. A survey was conducted on a purposive sample of 34 ex-student nurses who had recently completed their basic nursing course. An interview guide was used, which yielded qualitative data. In pursuit of verification and triangulation a questionnaire was sent to a sample of 160 professional nurses in randomly selected nurse education institutions in the four provinces of South Africa. Analysis of findings showed that due to different interpretations of the concept--supernumerary--there was divergence in the opinion of respondents as to whether the current student status is or is not supernumerary.

The lived experience of grieving the loss of an important other

The purpose of this study was to uncover the structure of the lived experience of grieving the loss of an important other using Parse's research methodology. Parse's theory of human becoming provided the nursing perspective for the study. Five participants described their experience of grieving the loss of an important other through dialogical engagement with the researcher. The researcher dwelled with the transcribed descriptions and through the processes of extraction-synthesis uncovered the structure of the lived experience of grieving the loss of an important other as an anguished suffering in devastating void amidst consoling movements away from and together with the lost one and others while confidently moving beyond personal doubts. Linked to the major concepts of Parse's theory through heuristic interpretation, the structure was abstracted as valuing the connecting-separating in transforming. The study adds to knowledge about grieving and expands Parse's theory of nursing. Recommendations for practice and further research are offered.

Nursing knowledge and human science: ontological and epistemological considerations

This article examines the meaning of human science in relation to extant nursing knowledge. The origins of the human science tradition are traced to the philosopher Wilhelm Dilthey, who challenged the dominance of the positivist perspective for generating knowledge of the human lifeworld. Specific ontological and epistemological criteria for human science are proposed. Four nursing frameworks, Paterson and Zderad's humanistic nursing, Newman's model of health as expanding consciousness, Watson's human science and human care, and Parse's theory of human becoming, are found to have consistencies and inconsistencies with the human science tradition. It is proposed that the human science perspective is present in and will continue to be reflected in the evolution of nursing science.

Nursing science as an interpretive discipline problems and challenges

The idea of reconstructing nursing science upon phenomenological or hermeneutic foundations faces difficulties in generating a truly theoretical element in a science thus based. This reflects the nature of the intentional concepts used to describe and explain human subjectivity within those approaches. The methodology of Alfred Schütz was explicitly designed to solve this problem, but seems, in one reading, to have only very limited scope, and in another reading to misapply the term "theory". Besides, it embodies an unduly passive construal of the hermeneutic stance. These results indicate that the phenomenological and hermeneutic approaches should be supplemented with a "third person approach" in nursing science.