Abstract
(A) Invited Keynote Papers
What Lies Beyond the Narrative Horizon?: The Spiritual Dimension in Critical Qualitative Research
School of Education, Indiana University, Bloomington, In, USA
A deep exploration of what the term “critical” implicates in critical theory and critical ethnography takes us much further than the practice of social and cultural critique. It reveals profound implications with respect to issues and themes long treated primarily within spiritual traditions. These make a long list, including the nature of consciousness, the self, self-other relations, meaning, knowledge, truth, certainty, love, self-realization, paradox, the limits of reason and representation, and much more. This talk will explore such connections, arguing that spirituality is deeply and necessarily entailed within the core philosophical structures of contemporary critical theory and related research practices. Of course, “spirituality” is a term used in diverse ways within diverse traditions. Certain aspects of theistic traditions can be understood and appreciated, with some reinterpretation, through contemporary critical theory. But the closest connection that this philosophical and methodological orientation has with extant spiritual traditions is found with the Chan and Zen Buddhist schools of China and Japan, some of the philosophies associated with yoga in India, and some of the teachings we find in Sufism and Western mysticism. These are spiritual traditions that emphasize practices rather than beliefs.
The spiritual content in critical theory can be uncovered in a variety of ways, but in this talk the role that narratives play in the construction of self, other and world will be emphasized. Narratives are chronic to everyday human life and thought. Narratives are, and must be, primary objects of study in qualitative research projects. Yet narratives ultimately fail to fulfil those features of human desire that drive their chronic construction and reproduction. Nietzsche called this aspect of human motivation the “figurative drive.” The figurative drive is related to Hegel's writings on consciousness in which the desire for recognition is a constituting structure of self-awareness. It is related to the concept of self-actualization as promoted by the humanistic and transpersonal schools of psychology. The ultimate and necessary failure of the figurative drive to realize its telos through the very production of “figures”—narratives and pre-narrative structures in thought—is well illustrated in de-construction, poststructural writings on signification, and the philosophy of repetition. These streams within Western thought provide mirrors, representational mirrors, of spiritual practices whose goals include freedom from representation.
“The narrative horizon” is an expression meant to signify where knowledge as representation ends, where explicating the implicit toward the explicit terminates, where reason stops but points ahead. Its sense will be explained more precisely in this presentation. It is deeply implicated in the concept of “critical” core to critical methodological theory and it is something with which all people, in everyday contexts of life, must implicitly come to terms. What lies beyond the narrative horizon cannot be articulated for essential reasons, yet this is a good time, historically and culturally, to start talking about it, to include it in our methodological theories. Doing so requires use of words like “spirituality” which should be reinstalled within legitimate academic discourse. Understanding others as deeply and openly as possible, acknowledging what we cannot understand about them, and doing research with ethics, morality and empathy all invoke the question of what lies beyond the narrative horizon.
The Best and/or Worst of Times? The Uncertain Future of Qualitative Research
Centre for Research into Sustainable Health Care, School of Health Sciences, University of South Australia, Adelaide, SA, Australia
Currently there are two parallel universes in which we as qualitative researchers find ourselves working in. The first is a universe that is expanding. This is one in which qualitative research continues to push methodological and substantive boundaries thereby moving into new and exciting spaces. This enables the exploration of a vast array of substantive foci in many different discipline and practice areas. The second universe, by comparison, is one that is contracting. This is the universe where we find increasing prominence of neo-liberal influenced audit cultures. In this universe rhetoric about, and emphases on, evidence and “hard” numeric data has permeated the communities and contexts in which we research<@151>for example government departments, educational institutions, service providers and business. Tensions emerge for qualitative researchers when these universes touch, intersect or at times collide! There is a danger that the gains made by qualitative researchers will be eroded by the need to survive the often competing demands emanating from such tensions. In this sense, qualitative research faces a very uncertain future. Choices that we make both individually and collectively as qualitative researchers about how to navigate such tensions are critical. Making these choices, and even more crucially, ensuring that there is the possibility of being able to make and have such choices, is one of the greatest challenges for qualitative researchers with respect to ensuring a future for qualitative research.
Getting the Picture: Seeing the Visual in Qualitative Research
School of Business, Victoria University of Wellington, Wellington, New Zealand*
The so-called qualitative turn over the last twenty-five years has achieved a great deal. However, despite this progress, a striking and significant blind spot remains. That is, in an increasingly visual world, why have qualitative researchers tended to shy away from analysing the visual image? This presentation will examine some of the reasons for this oversight. It will also look at some notable exceptions of qualitative empirical work that has made visual representation a central pre-occupation. The presentation will close by issuing five key challenges to conference participants aimed at encouraging them to see the visual dimension in their research.
(*at the time of the conference—now, School of Business, University of Auckland, Auckland, New Zealand)
The Contested Terrain of Action Research as a Qualitative Method
St Bartholomew School of Nursing and Midwifery, City University, London, UK
This paper argues that whilst qualitative research is gaining wider acceptance in the evidence-based practice movement, the value and contribution of action research is frequently ignored. The paper begins by exploring the contested terrain of action research as a qualitative method, highlighting its central tenants and potential links with both qualitative and quantitative research. Next it argues the need for mixed method approaches to evaluating change in practice, highlighting the particular contribution of qualitative research. Finally, it explores the need for research to be both user and provider controlled, exploring the opportunities and challenges that this implies for qualitative researchers. Drawing on research from a variety of applied disciplines (health and social, education and business) the case is made for a vision of evidence-based practice that is less focused on the interests of academic researchers and more on the everyday needs of service users and providers.
The Ethics of Evidence
Faculty of Nursing and International Institute of Qualitative Methodology, University of Alberta, Edmonton, Al, Canada I have argued that the use of statistical evidence—of the reliance on statistically significant events to initiate change—is unethical. The ultimate ethic is responsive to possible harm, not to actual harm. Of course this is the fundamental principle underlying health prevention and promotion, but policy is only now being formulated in high risk areas, such as aviation “near misses” and in the prevention of drug errors in medicine, to change policy before lives are lost. These policy changes are based on qualitative analysis, and use qualitative evidence.
In this presentation I extend the notion of the ultimate ethic and qualitative evidence into the area of patient falls. Policy has been lax in creating change in environmental safety for the fall prone patient, and quantitative evidence lacks the detail essential for communicating the actual problems of mobility to create change. In this presentation, I will demonstrate the power of qualitative evidence in revealing fall risk.
Standing on the Shoulders of Giants—The Potential of Meta-Ethnography and the Synthesis of Qualitative Research
* Heath Services Research, School of Nursing and Midwifery, University of Southampton, UK
** Applied Health Care Research, Institute of Health and Social Care Research, Peninsula Medical School, UK
We begin this address by asking the simple question “why synthesise qualitative research?” Firstly, we suggest, researchers and readers of qualitative studies need to develop a cumulative evidence base of the findings of qualitative research. If we seek to move research forward by standing on the shoulders of giants it would help to know where those giants are and to build better maps of the terrain that we view from their shoulders. Secondly, those of us working in applied areas, such as healthcare—where systematic reviews of quantitative research evidence are commonplace—are increasingly concerned to ensure that qualitative research is represented in reviews and decision-making.
In the first case, qualitative synthesis can be a stand-alone activity, and in the second it may be conducted in conjunction with the synthesis of other kinds of research. In this address, we examine the synthesis of qualitative research as a stand-alone activity by describing two syntheses we have conducted, with colleagues in the UK, focusing on how people take (or do not take) prescribed medicines, and how people seek medical help when they have cancer symptoms. Both these pieces of work used a particular synthesis method—meta-ethnography. We describe both studies, looking at what meta-ethnography is and its potential for use in health care and policy related research, and we review the limitations of the method. We discuss concerns about the difficulties encountered searching qualitative literatures, the thorny question of “quality” appraisal, and the importance of expertise. We also address the critics of meta-ethnography—from those who find the term problematic, through to those who argue that synthesis inevitably results in de-contextualisation.
We move on to consider the potential for the synthesis of qualitative with quantitative research evidence by outlining four broad approaches, one of which may incorporate a version of meta-ethnography. We discuss whether qualitative syntheses should be supplementary or integrative and consider alternative approaches that might allow us to combine qualitative and quantitative research findings.
We conclude by outlining the possibilities of synthesis—which we see as an opportunity to bring together literatures and to increase the rigour of qualitative work. We are, nonetheless aware that qualitative synthesis is at an early stage of development, and that perhaps this business of standing on the shoulders of giants should not be tackled by novices.
(B) Concurrent Papers
The Use of Photographs in Research with People with Dementia
Queensland University of Technology and The Prince Charles Hospital, Brisbane, Qld, Australia E-mail:
Photographs are often used as teaching aids and book illustrations, but are rarely seen in journal articles when research is reported. Yet they are a way of sending a powerful message. The advocates of people with dementia need every powerful tool they can muster.
The disease of dementia robs people of their dignity as damage to their brain increases. The cohort of people with late-stage dementia are an especially vulnerable group and one expected to increase to what has been called “epidemic” proportions in the next decade. The need to inform both health professionals and the public about the conditions suffered by these people is vital.
I have been using photography to enhance qualitative research with this group of people since 1995. This paper will discuss the ethical and moral dilemmas that can be raised in taking photographs or videos of this population. However, it will argue that photography is vital for information, teaching and proof of conditions that are suffered by people with dementia. It will go on to provide details of those relatives and friends who have willingly posed with their family member or friend, even at the point of death. It will provide evidence that, in a recent study, all relatives of people with dementia who had been chosen to be included in a study about the introduction of palliative care, agreed to audiovisual consent and felt that by doing so they were contributing. One response to this effect was: “anything that can help people know about this dreadful disease.” Photographs have allowed me to spread the message about the needs of people with dementia and this paper will justify that position.
Methodological Issues Associated with Interviewing Qualified Indian Registered Nurses Seeking Registration in the United Kingdom
European Institute of Health and Medical Sciences, University of Surrey, Guildford, Surrey, UK E-mail:
This paper examines various methodological issues that arose in a study examining the experience of “adaptation nurses” within the United Kingdom [UK]. These nurses initially trained outside the UK and were seeking registration as Registered Nurses in the UK. To do this they needed to complete a short period of supervised practice. In order to gain data that would primarily inform local training arrangements, semistructured interviews were undertaken with twenty adaptation nurses at a small group of residential care homes. All these nurses had initially registered in India and were female.
Substantial methodological issues emerged within the interviews concerning the reliability of the accounts given by the adaptation nurses. Of particular concern was their largely positive account of their experience of supervised practice that contradicted accounts given by managerial staff and nurses who had already completed their supervised practice; they reported that adaptation nurses frequently find their training physically and emotionally demanding. This contradiction raised important issues about the suitability of “the interview” used in the study to collect valid and reliable data.
Numerous issues were identified that could have affected the quality of the data. These issues included the invidious position of the adaptation nurses as “outsiders” to UK society, seeking entry; the identity of interviewer as white, male and English; and difficulties related to the use of language. These issues were understood in relationship to wider phenomena relating to globalization and the adverse effects of past colonialism.
To address these issues, the theoretical basis of the interview was reviewed and amendments were made to its implementation. These amendments included the use of techniques that offered the adaptation nurses reassuring inferences about the interview and the use of additional data from previous adaptation nurses and managers about the experience of adaptation nurses.
Laughing It Off: Uncovering the Workplace Experience of Aged Care Nurses
School of Commerce and Research Centre for Gender Studies, University of South Australia, Adelaide, SA, Australia E-mail:
Residential aged care facilities provide 24-hour nursing care to frail, elderly people. Registered and enrolled nurses, predominantly female, are responsible for the clinical care of residents with multiple medical problems. Feminist economists are studying marketised care services, such as nursing homes, as the intersection of the performance of “care,” traditionally unpaid and provided within families by women, and “work” as a paid means of earning a living. Feminist economists have sought to understand the nature of caring labour, what differentiates it from other forms of labour, and how staff providing paid care negotiate the intersection between “care” and “work.”
During interviews for research towards a doctoral thesis investigating how aged care nurses experience their care work, nurses understated the conditions in which they worked. It was my personal experience working as a registered nurse in residential aged care facilities that enabled me to identify this trend, making it necessary for me, as the researcher, to understand how nursing culture impacted on the way nurses described their work.
To do this, I have developed a “toolbox” of reflexive methods comprised of analysis of both metaphors of nursing and emotion expressed as laughter during interviews, and autoethnography. Adding my own voice facilitated a two-tiered analysis of the effect of workplace culture: that of the nurses interviewed and my own different lens generated by studying economics to Honours level.
Situated in an interpretive paradigm grounded in a feminist epistemology, these pluralist methods have enabled me to make explicit some of the effects of gendered socialisation roles and their importance for understanding marketised caring labour. This combination of methods has significance for uncovering workplace culture in other forms of marketised caring and contributes to feminist methodology by providing a combination of methods useful for researching the impact of gender socialisation roles on women at work.
Reflecting on Reflexivity: Discussion of Reflexivity in Peer-Reviewed Articles
Department of Health Sciences, University of York, York, UK E-mail:
Whilst the use of “checklists” for quality appraisal has been questioned, most of the quality criteria aligned with qualitative methods include reflexivity as a core component. Reflexivity refers to an awareness of the ways in which the researcher and the research process may have influenced the data collected and the interpretations made. The importance of the researcher as the “research tool” in qualitative methods cannot be understated, therefore, it might be expected that authors of qualitative reports would provide the reader with sufficient reflective information in order to make a judgement regarding the influence they may have had on the study design and the findings they present. This study aims to consider the way in which authors approach the concept of reflexivity and how this is manifested in peer-reviewed articles.
All qualitative (and mixed methods) papers from three major journals published in 2004 were identified through on-line screening of abstracts (and the methods section of the papers where necessary). The journals were purposively sampled to encompass both “generalist” clinical journals together with a journal that, whilst having a medical focus, was more aligned to the disciplines that historically use qualitative methods. Therefore, we selected the British Medical Journal, Social Science and Medicine and Journal of Advanced Nursing. A data extraction sheet was developed in order to systematically collect information from all of the identified papers. Data were collected on all aspects of reflexivity, including, whether any literature on reflexivity were cited, researcher biographies, or where there was any discussion of the potential impact on study design and findings.
Reflexivity was poorly addressed by authors. The variation between different journals and the disciplinary background of authors, in relation to the engagement with reflexivity will be highlighted. Consideration will be given to the implications of this lack of attention to reflexivity in the quality reporting of studies. Possible reasons for the observed lack of reflective accounts will be discussed
A New Opportunity: Cognitive Therapy as a Qualitative Research Tool
School of Nursing, University of Queensland, Brisbane, Qld, Australia E-mail:
The main tenet of Cognitive Behaviour Therapy (CBT) is that thoughts pass through a person's mind automatically and often have a huge impact on how the person feels. CBT is an extremely fast acting therapy that has proven efficacy in treating the symptoms of mood disorders such as depression and anxiety; facilitating understanding of feelings; and promoting personal growth. However, the use of CBT techniques in qualitative research has been under-utilised. This paper discusses how techniques of CBT can be applied by researchers to facilitate bracketing, data collection and analysis in qualitative research.
Development of Knowledge—Closeness and Distance
Centre of Practical Knowledge, Bodø University College—Mo i Rana, Norway E-mail:
In fieldwork, the subject's understanding is essential in the development of knowledge. A risk often associated in the field is that the researcher may tend to over or under identify with the subject's attitude and point of view. This is referred to as too large a difference or lack of difference. If the distance is too large, the researcher does not get close enough to the subjects to get their point of view in their own environment. If there is a lack of distance, the researcher can be influenced by the subject's attitude and point of view. A challenge in fieldwork is to observe and integrate both in closeness and at a distance.
Parts of fieldwork in a nursing home and hospital will be done in spring 2006. The purpose of the study is to make the nursing students practice visible. The aim of the study is to develop knowledge about nursing students' practice. Methodical considerations concerning closeness and distance are significant in this matter.
Students and researcher meet in dialogue in the field. I, as a researcher and nurse, will bring with me experience into the field. The experience influences what I see and how it applies to the nursing field. In the study, the purpose is to make the students experiences visible, not the researchers. The challenge becomes: how to make the students experiences visible? The students' experiences are the starting point for development of conception.
It is, therefore, necessary I practice both closeness and distance analyses. If not, the distance between “close-experience” and “distant-experience” conceptions in nursing practice can be too small. The knowledge developed would be of little use for the practice.
The presentation will be based on my study. Challenges concerning closeness and distance in development of knowledge will be elaborated in the presentation.
Synthesizing Qualitative Research: The Production of Evidence
Monash Institute of Health Services Research, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia E-mail:
It is clear that with the archiving of qualitative data sets and the concern to ensure that the findings of qualitative research are not ignored for inclusion in the broader corpus of knowledge about any field that models of synthesis are rapidly being developed. This paper critically examines these models in terms of epistemology, the politics of pragmatism in the era of evidence and the use of qualitative methods in policy contexts. Conclusions are drawn about the utility of these models for qualitative researchers in the fields of health and education.
Of Research Themes and Family Narratives: Critical Ethnography and Collaborative Research in a Program of Rural Health Studies
College of Nursing. University of New Mexico, Albuquerque, New Mexico, USA E-mail:
Rural communities often experience disproportionate rates of illness, injury, poor educational outcomes, low income, attainment of health insurance, health care access, and self-reported health status, relative to urban counterparts. Multicultural rural elders in the southwestern U.S. are particularly marginalized because of historical, cultural, geographical, and norm-related factors. The author's current project, funded by the National Institutes of Health (NIH), builds upon an earlier pilot study in the same region. Combining the conceptual and methodological features of critical ethnography and community-based action research, the researcher aims to analyze definitive indicators of health disparities for these elders, and to construct preliminary explanatory models based on their definitions of health, cultural variations, and perceptions about the health care system. Three rural counties in the region comprise the setting for this two-year investigation. Stringer's Look-Think-Act approach informs the work, and preliminary findings reflect the combined efforts of community stakeholders and the research team. Emerging domains of need for the elders include the escalating cost of prescriptions, transportation deficits, geographic and social isolation, lack of affordable housing and assisted living facilities, and inadequate primary/specialty care. Concurrently, rich family narratives of life experiences in the rural areas arise in the course of inquiry. Research efforts focus on accurately analyzing and addressing the significant health and social disparities identified by the elders, and assisting community members to effectively manage the growing population of elderly residents. Special efforts are underway to help communities identify existing assets/strengths, and to facilitate the linkage among local, regional, and national resources to improve the tenor of health and quality of life for older people.
Qualitative Research: An Anthropologist's Account
Department of Anthropology, Bangabasi Evening College, Kolkata, India E-mail:
Qualitative method of research has long been in practice in anthropology particularly in the form of participant observation, though qualitative methodology has undergone some fundamental changes in terms of its goal and content. Qualitative research in anthropology has actually been born out of the need to understand the “other,” it continued in the form of ethnographic presentation of social marginalisation documenting the lives of people (“adjacent others”) who live on the margins of a society that is hostile to them. Now its primary concern is to give voice to the “other” i.e. people's authentic self-expression. Present paper attempts to make a journey through the various phases in the history of the development of qualitative research methodology in anthropology as well as the future of this research methodology in our discipline.
(Re)Telling the Qualitative Tale: Opportunities and Challenges in the Use of Multi-Media Performance in the Analysis and Presentation of Ethnographic Research Data
School of Education, University of Durham, Durham, United Kingdom E-mail:
The methodological application of arts-based approaches to educational research, while still arguably part of the leading edge of qualitative research, have in the past 10 years become more established particularly within North America and Australia. In the main however these undertakings have tended to be confined to the use of educational research data in one specific artistic milieu for example photography or drama, undertaken by a researcher/artist familiar to working in that field.
The distinctive, developmental and “cutting edge” feature of this paper/DVD presentation is that it reports—through showing as well as telling—the author's attempt at using multi-media arts-based performance as a way of analysing and presenting ethnographic research data. In 2005 the author took a set of “traditional” qualitatively derived ethnographic research data (namely interview transcripts and tapes from a UK inner-city early years initiative, in which he was engaged as the principle researcher) and asked a group of community-based artists (music, sound, video, visual and performing arts) to represent the data as an integrated multi-media performance piece. The performance was subsequently staged in a theatre in front of—or more accurately in the midst of—an interdisciplinary arts-based research conference audience. The aim of the session was to explore through showing the holistic way in which educational research and the visual and performing arts can embrace each other to engender a culture of feeling and meaning and in so doing evoke new ways of knowing.
The performance was videoed and followed by an audience and performer discussion of the opportunities and challenges posed. The author proposes in this paper/DVD presentation, to share and show this work and to engage a wider interdisciplinary audience in the debate it raises for qualitative methods research.
Contextualizing the Survey: Linked Trajectory of Method Triangulation in a Study on HIV/AIDS in India
Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Groningen, The Netherlands E-mail:
The marriage of qualitative and quantitative methods has never been easy. The challenge is in the way we triangulate the methods. Method triangulation has been largely used to combine insights from the qualitative and quantitative methods but not to link both the methods. In this paper we suggest a linked trajectory of method triangulation. The linked trajectory aims to first gather individual level information through in-depth interviews and then present the information from the in-depth interviews as vignettes in focus group discussions. The vignettes are used as a projective technique to stimulate discussion. In the focus group discussions we validate information obtained from in-depth interviews and gather emic concepts that arise from the interaction. We thus capture both the interpretation and the interaction angles of the qualitative method. Further, using the qualitative information gained, a survey is designed. In doing so, the survey questions are grounded and contextualized. We employed this linked trajectory of method triangulation in a study on “Risk assessment of HIV/AIDS among migrant and mobile men.” Fieldwork was carried out in Goa, India. Data come from two waves of studies: first explorative qualitative study (2003); second larger study (2004–05) including in-depth interviews (25), focus group discussions (21) and a survey (N = 1,259). Majority of the concepts found in the qualitative data were also visible in the quantitative data. As an example we present two concepts perceived severity of HIV/AIDS and the cultural heuristic of vigilance to show how these concepts emerged from the data. The former came from theory but was constructed different empirically and the latter emerged as an empirical concept. The linking of the methods acts a measure of validation of information at each level. The linked trajectory of method triangulation can provide both completeness and confirmation of information.
A Comparison of Two Qualitative Approaches to the Analysis of “Fall Diaries” Completed by Older People
* Faculty of Health and Social Care, London South Bank University, UK
** School of Health Professions & Rehabilitation Sciences, University of Southampton, UK E-mail:
Recent guidelines have advocated the use of self completed prospective diaries to record falls, in studies aiming to evaluate the effectiveness of falls prevention interventions for older people. We used this method in a randomised controlled trial evaluating the impact of a home based exercise programme on falling rate in 142 people with Parkinson's Disease with a history of falls (mean age: 72 years, males: 60%).
In this paper, we compare two approaches to the qualitative analysis of falls diaries, using data from our trial. The first approach, a content analysis, generated categories of detailed description around circumstances of falls (for example, the category “Reasons for Falls” included the codes “general difficulties,” “PD movement difficulties,” “environment,” “cognitive”). This type of analysis is amenable to quantification, and has informed the development of epidemiological information about falling.
The second approach to analysis described in this paper, informed by Foucauldian discourse analytic principles, focused attention on how participants subjectively positioned themselves in relation to falls, through their diary accounts. For example, in considering “Attribution of causes,” the descriptions varied in terms of agency, with some participants describing themselves as responsible for their fall (e.g. “Inattention”), whilst other descriptions suggested little or no control (“Legs gave way”). This latter analysis illustrates how older people can actively fashion representations of themselves through accounts about illness events.
Whilst content style analyses of diaries predominate within the falls literature, we argue that other postmodern interpretative strategies have the potential to recast diary accounts in novel and potentially illuminating ways. Such analyses contribute to theory about representations of falling, health and self. They also have practical application, one example being the potential for increased uptake of falls prevention initiatives, through attention to discourses about ageing in health promotion material.
Nailing Down a Nebula: What is “Community” in a Case Study of Community Participation in Health?
School of Health Sciences, Massey University, Palmerston North, New Zealand E-mail:
Community is often identified as the future for health care but this is reliant on understanding what community is. There is a considerable body of literature providing multiple ways of defining community, including people who live in a geographical location, as the social interaction of groups of people, or about the common links and identities held by groups, or all three (Hillery, 1955). In spite of this literature the concept remains nebulous when those definitions are applied to community as the subject of research. As Denzin and Lincoln (2000, p. 3) state “qualitative research is a situated activity that locates the observer in the world.” What, therefore, is the situation of community?
In this paper I will explore the complexities of “nailing down” the concept of community into a strategy for sampling within a qualitative inquiry of community participation in health. This strategy needed to be broad enough so that it did not pre-empt the community defining itself in multiple ways, but specific enough to accommodate the ethical approval requirements of identifying potential participants. It is the application of concepts, such as community, into research practice which provide us with the opportunities and challenges for qualitative research.
Thought and Action: Combining Narrative and Video as Research Methods to Explore Peoples' Everyday Experiences
* Waitemata District Health Board, Auckland, New Zealand
* Auckland University of Technology, Auckland, New Zealand E-mail:
Phenomenology is the practice of exploring, looking to reveal what is not immediately obvious about a given phenomenon and describing the experience in a way that shows the richness of what is not readily apparent (van Manen, 1990). This interpretive approach peers behind the ordinary and the everyday-ness of what it is to be human, making it stand out, revealing and acknowledging the hidden traces which show its existence. Traditional methods involve transforming a verbally expressed experience into a written description and discovering the essential notions. Thus, it is an approach which is reliant on language and discovering the underlying meaning of what is said or its context.
This presentation describes a method that has pushed the boundaries of phenomenological methodology, through the use of video footage that was interpreted alongside the six participants' narratives. Videos provided a valuable supplement to stories about participants' everyday experiences of living with adult onset dyspraxia (a perceptual problem that impacts on people's ability to carry out daily activities), allowing the researchers to re-watch the life situation and find richer understandings and description of the person's lived experience. This form of close observation generated different experiential insights than was gathered from the interview narrative, and offered powerful records of real-world, real-time actions and events. The videos captured the raw poignancy of how the experience actually was. The purpose was not to evaluate the videos against the narratives, but to have the participants “telling and showing” the experience, thus giving considerable depth to the data gathered.
Excerpts from videos of participants, engaged in everyday activities, and a range of approaches used to interpret the written and visual data in will be presented. Questions of the rigour and believability will be discussed in relation to incorporating video footage into phenomenological methodology.
Impressions: Visual and Emotive
Department of Marketing, Faculty of Business and Economics, Monash University, Melbourne, Vic, Australia E-mail:
Derived from visual data that was gathered for a large qualitative project which investigated the consumption habits of families, this paper will address a number of research design issues. Firstly it will ask the question: how useful is visual data to the qualitative researcher? The answer will draw on the experiences of the researcher in this project and will explore some of the intensities that participants feel when engaged in qualitative research. In this instance, the participants were invited to take pictures that they felt expressed their interests and experiences of consumption. Importantly for this discussion, it was the visual data that clearly displayed the emotional engagement of the participants and underscored, or amplified, the verbal exchange of the interview data. Then, the implications of this for analysis and the presentation of results will be discussed. On the basis of this discussion, the paper will ask how researchers can best go about obtaining useful and relevant visual data. In particular, this section will raise issues around how to introduce this activity to potential informants in order that the data those informants gather can fully integrated into a triangulated data gathering design.
Teaching Qualitative Research Methods: Engaging the Sensory Self
Department of Public Health, Adelaide University, Adelaide, SA, Australia E-mail:
The conduct of qualitative research engages the researcher in an exploration of self at a number of levels. The challenge, therefore, for those teaching qualitative research methods is to teach in ways which explicate the diversity and complexity of theoretical perspectives, methodologies and methods, while also engaging the students as reflexive novice researchers.
In this paper we propose a solution to the challenge of teaching qualitative research methods. Drawing on our experience teaching qualitative research methods to undergraduate health science students, we will describe a method of teaching that engages the sensory self through an understanding of Howard Gardener's theory of Multiple Intelligences. In particular, we will describe how we appeal to all five senses in our teaching of qualitative research methods through the use of art, music, literature and food.
Realising the Potential of Bricolage Design: Consistency among the Assumptions of the Research Components is Crucial
* Massey University, New Zealand
** University of Tasmania, Australia
*** Munich University of Applied Science, Germany E-mail:
Bricolage is a research paradigm with the potential to elevate the outcomes of qualitative research to new levels of rigour and complexity (Karunaratne, 1997). Two interrelated premises are crucial to realising this potential: interdisciplinarity and synergy of various theoretical paradigms, methodologies and methods. This paper focuses on the synergy criterion and illustrates bricolage as a process of selecting and integrating the most appropriate theoretical frameworks, methodologies, and methods for the phenomena under investigation. It does so with explicit consideration of their assumptions and the underlying consistency that provides the rationale for their selection. We illustrate this process by discussing the development of an innovative research design for exploring experiences of German migrants to Australia and New Zealand throughout their migration process (emigration-immigration-settlement, return). In this holistic study design we combine three different theoretical paradigms (salutogenic/wellness paradigm, social interactionism, and social constructionism in narrative theory), three methodologies (grounded theory, ethnography, and prospective longitudinal approach) and four different methods (episodic interviews, participant observation, diaries, and reviews of historical and contemporary migration literature and statistical data).
We will identify the theoretical paradigms that typify most migration research, discuss the value of synergising the selected alternative theoretical frameworks, and outline the implications of their assumptions for the design of the present study. Following a discussion of how the integration of the selected theoretical frameworks addresses gaps in the migration research, we justify the selection of the various methodologies and methods. The aim is to illustrate the interconnectedness between theoretical paradigms, gaps in the literature, research questions, methodologies and methods in the development of the bricolage design. We propose that when combining theoretical frameworks, methodologies, and/or methods as bricolage, consistency among the fundamental assumptions of the theoretical paradigms, methodologies, and methods is crucial and needs to be made explicit.
The Ethical Trials and Tribulations of Accompanying Participants through a Major Life Transition
Massey University, New Zealand
University of Tasmania, Australia
Munich University of Applied Science, Germany E-mail:
While codes of ethical conduct or ethical guidelines set by professional bodies and/or ethics committees can provide a very useful ethical framework, the often complex and process-based nature of qualitative research can mean that researchers encounter specific ethical issues that challenge the scope of these codes/guidelines. This paper discusses such ethical challenges that have arisen during our study as result of using an innovative qualitative research design combining grounded theory and ethnography in a longitudinal approach that involves accompanying participants during a challenging part of their life (migration). This approach means researcher-participant relationships are deep, ongoing, and changing; participants can be very vulnerable; and difficult situations can emerge suddenly. Balancing these interacting research features with methodological rigour results in highly complex ethical issues related to living in the participants' home (e.g. maintaining confidentiality in a fluid circle of contacts in participants' home and work environment, obtaining approval of sensitive work environments [hospitals]); directly experiencing participants' issues (e.g. visa rejection, issues between partners); unearthing of issues through questioning (e.g. traumatic experiences, unsound relationships); maintaining participants' interest in participating (e.g. their writing of diaries, second visits); and participants' perception of the researcher as a friend. These issues were complicated by the principal researcher being a German migrant to New Zealand and Australia. Her having accomplished something the participants were pursuing and having migration knowledge raised issues regarding whether to and how much the participants should be assisted psychologically and/or practically, and regarding power differences and equality. In presenting the paper, we will discuss the role of building and maintaining trusting and equal relationships; of open negotiation of the nature of participation; of the need for sensitive, honest and thoughtful re-negotiation; and of non-judgement and detached compassion in resolving these ethical issues.
Phronesis and the Novel Approach to Organizational Inquiry
Dept. of Accounting, Finance and Management, University of Essex, UK E-mail:
In this paper, we outline an approach to organizational inquiry which is grounded in Aristotelian phron?sis; practical knowledge or wisdom. The phronetic approach is directed at informing action, taking account of the particulars of events and their context, and of the value-rationality and situational ethics of organizational actors. However, it should not be considered a-theoretical and equated with “common sense.” Through surfacing multiple complex perspectives on issues, and integrative critical analysis of and reflection on these, the aim is development of meso-theories that will enable actors' own choices about future action, based upon informed selection between options.
The possibilities of the phronetic approach have been presented by various authors (e.g. Calori, 2002; Flyvbjerg, 2001, 2003; Ruderman, 1997), and Flyvbjerg (2001) has proposed alternative approaches to undertaking phronetic research. Most involve extensive resource commitment, due to the need for embedded-ness in context and engagement over time. One approach presented (Flyvbjerg, 2001) involves analysis of relevant archival materials and accounts. In considering how the approach might be applied in teaching organization theory and analysis, we propose an alternative form of “social archive,” that of the literary novel.
Our use of novels as tools for phronetic inquiry within organizations does not draw upon theory of literary criticism, but rather, upon the use of “lay reading” (de Vault, 1990), and interpretation according to the readers' values and assumptions. In encouraging students and organizational actors to read novels, we see the possibilities for engagement with complex and ambiguous phenomena and for critical reflection on the accounts presented by different characters, on how authors are implicated, and on the readers' own assumptions.
In this paper, we present initial findings from an empirical study in the use of novels as tools for exploration of concepts such as “culture,” “structure” or “power” in management education.
Reporting Qualitative Research by Creative Nonfiction
School of Educational Studies, La Trobe University, Melbourne, Australia E-mail:
Creative nonfiction arose in the 1960s when it was called “The New Journalism.” Within the last decade it has become popular and quite common in the United States. Creative nonfiction tells a story using facts, but uses many of the techniques of fiction for its compelling qualities and emotional vibrancy. Creative nonfiction doesn't just report facts; it delivers facts in ways that move the reader toward a deeper understanding of a topic. Creative nonfiction requires the skills of the storyteller and the researcher. Creative nonfiction writers must not only understand the facts and report them using quotes, they must also see beyond them to discover their underlying meaning, and they must dramatize that meaning in an interesting, evocative, informative way—just as a good teacher does.
In the three editions of the Handbook of Qualitative Research edited by Norman Denzin and Yvonna Lincoln, Laura Richardson reports that she finds qualitative research reports boring. Reporting qualitative research results via creative nonfiction is very likely to make reports much less boring. The paper will describe and illustrate various fiction techniques used to write creative nonfiction. Truth and rigour in creative nonfiction will be discussed.
Mother/Daughter Intergenerational Interviews: Exploring the Transmission of Family History within the Framework of the Well Child/Plunket Book
School of Health Sciences, Massey University, Auckland, New Zealand E-mail:
The uniqueness of the relationship between a mother and daughter offers the researcher an opportunity to explore interactional patterns across generations, modes of transmission of family history and intergenerational communication in the context of gender. The use of mother/daughter intergenerational dyads to explore the familial context of the Well Child/Plunket Book has elicited a depth of information that would not have been gained in a standard individual or even focus group interview.
In 1920 the first child development record books (now commonly known in New Zealand as the Well Child/Plunket Book) rolled off the presses of Whitcombe and Tombs Ltd in Dunedin. The Well Child/Plunket Book has remained a mainstay of well child practice in New Zealand since that time. Many mothers have kept their books and handed them on from generation to generation—usually to their daughters. Exploring the history of the Well Child/Plunket Book has resulted in the collection of a diverse range of data including oral interviews, archival data and a collection of child development record books dated from the 1920s to 2005. The oral interviews themselves have included individual, focus group and mother/daughter intergenerational dyads.
This presentation focuses on the mother/daughter intergenerational interview process and reflects on the interaction between mother, daughter and interviewer as a means of data generation.
“Focus Group Can Be Fun”: Use of Activity-Oriented Questions
Department of Psychiatry, The University of Queensland, Brisbane, Qld, Australia E-mail:
In recent years, interest has grown in the use of focus group discussions and, nowadays, they are recognized as a valuable method for qualitative data collection. Despite its increasing popularity, focus group is not an easy option and moderators must find the right way to approach participants to achieve good-quality data.
Exercises (or activity-oriented questions) are pleasant and productive supplements to verbal questions. They provide a different way of offering information and bestow a special benefit especially for those more reflective participants who are less comfortable with immediate verbal responses and need extra time for thoughts or prefer to sketch out their ideas. Some scholars sustain the utility of exercises to focus the attention of the group on the core study topic and also to make subsequent comparative analysis more straightforward. The author regards these strategies particularly useful with young people, who may be bored after a sequence of verbal questions (consequently losing concentration), and also for their tendency to act out and express their feelings and ideas in more active ways than adults. Sensitive topics may also look less threatening when discussed through practical and enjoyable tasks. Following these considerations, the author will describe various focus group techniques such as, for instance, free listing, rating, ranking, pile and picture sorting, story telling, role-playing, and projective techniques, providing suggestions for their use during group discussions.
The author will exemplify some of these activity-oriented questions, illustrating their application in her recent research project with 18–24 years old students, where she moderated focus group discussions on the topic of youth suicide.
Maintaining Dignity and Managing Stigma in the Interview Encounter: The Challenge of Paid-for Participation
* School of Health and Social Development, Deakin University, Melbourne, Vic, Australia
** Department of Psychology, University of Portsmouth, United Kingdom E-mail:
The interview is both popular and problematic in social research. This paper describes and problematises interviews from a study conducted with impoverish elderly men and women. Participants were interviewed about social exclusion, poverty and growing old and were paid $20 for each of two interviews. In this study, the interview became a way for participants to manage the presentation of self and the stigma of poverty by limiting disclosure and resisting researcher questioning. Paid-for participation was double-edged in that it provided funds for impoverished participants, but the payment modified the exchange of free and open discussion. Some participants started the interview by asking when the interview would end. Others resisted exploring issues raised by the interviewer. Some managed information giving by engaging in well-rehearsed, stylised account of their lives.
The participants' consent and their willingness to talk freely and openly are often taken for granted. The interview can range from a co-constructed discourse between the interviewer and interviewee to the interview as a monologue by the interviewee. We posit that the understanding we seek from interview data cannot ignore the problematic nature of this social encounter. The monological “interview” prevents the interviewer from engaging in dialogue, the result of which may be a limited exploration of the participant's narratives.
In this paper we will demonstrate, with examples from the transcripts, the various strategies that were used by participants to gain agency over the process whilst at the same time maintain enough of a semblance of conversational genre to make paid-for consent and participation legitimate. We see this as an interesting methodological event that should inform analysis, interpretations and the validity of interview texts rather than a problem with the interviewee. We contend that these acts of resistance are part of all interview encounters.
Heterotopia: An Ontological Metaphor in Epistemological Practice
School of Social Sciences & Liberal Studies, Charles Sturt University, Bathurst, NSW, Australia E-mail:
This paper opens with a brief consideration of Bhaskar's (1989) notion of the epistemic fallacy. This suggests that positivist epistemological practices have largely constrained disciplinary accounts about what can be known regarding personhood. The concept of heterotopia is introduced and employed primarily as a means for addressing this limitation. Foucault (1984/1998) considered heterotopia to be a space “both real … and utterly unreal” (p. 179) as well as a process involving “a kind of contestation … of the space in which we live” (p. 179). Significant potentials open up for constructing personhood and furthering our understandings of the relationship between method and theory by conceptually positioning heterotopia as a preferred ontological metaphor in epistemological practice. This is realised by two movements: the first acknowledges that, by design, heterotopic methods are unable to provide absolute certainties or essential truths about people because of an inability to furnish monologic outcomes; and second, that methodological work is a process through which meaning is developed influencing the outcomes of research. This point is reminiscent of Vygotsky's (1978) distinction between method as tool-for-result or tool-and-result. In understanding method as tool-and-result one can begin to address the epistemic fallacy by purposively acknowledging implicit theoretical influence and explicating the conditions through which certain research practices are maintained. The example forwarded here considers how citizens are discursively constructed in sentencing legislation directing the practice of incarceration in the Australian State of Queensland. The research involves a discursive analysis of the relevant legislation, the Penalties and Sentences Act (1992), along with interviews sourced from young males who had experienced this form of State-sanctioned exclusion. Foucault (1980/2000) called for “the will to discover a different way of governing oneself through a different way of dividing up true and false” (p. 233). Heterotopic methods may provide the discursive resources to engage the ontological multiplicities involved in situated constructions of personhood.
Looking to the Future: Information upon Which to Plan Future Service Initiatives that Address the “Human Costs” of Breast Cancer Amongst Black Minority Non-English Speaking Women
City University—St. Bartholomew School of Nursing and Midwifery, London, England E-mail:
The National Cancer Alliance (2002) has indicated that black minority ethnic (BME) populations experience difficulties in accessing information about cancer and healthcare services. In order to address this complex issue, a qualitative exploratory research project is being undertaken to determine how BME women with breast cancer have accessed cancer information and subsequently healthcare services. In a preliminary study, it was found that a range of views exist amongst healthcare professionals, voluntary agencies and community groups about the provision of cancer-related information for BME populations in East London (Cox & Lanceley, 2002/2003). Cox's and Lanceley's research concluded that statutory and voluntary agencies involved in cancer care need to address the issue of information provision with cultural sensitivity. Despite the fact that all patients find if difficult to access information about cancer (Leydon et al, 2000) BME women face a number of additional challenges. We believe these include difficulties in accessing appropriate information as well as dealing with culturally specific (often negative) attitudes about breast cancer. Subsequently the rate of recovery from breast cancer, if treated, is lower amongst BME women in East London.
In this paper findings from Phase One of the research will be explicated. Ways to target BME women and health professionals and community leaders using a range of approaches will be described. Issues associated with interviewing non-English speaking BME women will be considered. It will be noted that traditional written information has been found to be ineffective at reaching those most in need and does not address more sensitive issues such as the stigma that exists about breast cancer in different communities. The findings from this research will provide information upon which to plan future service initiatives that address some of the “human costs” of breast cancer amongst BME women.
Representing the Collaborative Process and Multiple Authorial Voices in Qualitative Research
Educational Research and Evaluation, Virginia Tech, Blacksburg, Virginia, USA E-mail:
It is rare to encounter multiple-authored texts where collaborators are explicit about the roles they played in constructing the text or to find the kind of reflexive narrative that offers readers a glimpse of how interdisciplinary collaborators integrated diverse viewpoints. The issue is of central concern to collaborators who aspire to acknowledge equal contributions and for those using action or participatory research who struggle to avoid disenfranchising co-researchers.
Richardson (1994) and Hertz (1997) identify poly-vocalism as a form of experimental social science writing. “Voice” refers to how authors represent themselves in publications (Hertz, 1995, 1997). Poly-vocalism refers to representing multiple perspectives in a dialectical textual form. It is a form of reflexivity where authors strive to weave an acknowledgment of multiplicity in a text. Representing the different voices of participants is a form of poly-vocalism that has received considerable attention in the methodological literature and one that I am not pursuing in this paper.
The purpose of this presentation is to provide some examples of how collaborators have represented multiple authorial voices. The presentation illustrates how some social scientists have used alternating first person accounts, reader's theatre, interviews, and other forms of script formats to embody pluralistic discourse.
Substantial increases in virtually all disciplines in publications with multiple authors raise questions about the fundamental meaning of authorship and conventions for attributing multiple authorship. Achieving poly-vocal texts challenges academic writers to more fully embody themselves in their texts and to be reflexive about the process used to co-construct texts.
Producing Knowledge: Ethics and Counselling Research
School of Education, University of Waikato, Hamilton, New Zealand E-mail:
As counsellor educators, our teaching involves both professional practice and research. For us the practices of research and of counselling are closely interwoven. Both projects, counselling and research, begin, we believe, with attending to the ethics of knowledge production. Narrative approaches in counselling emphasise a collaborative and generative process of storying with clients. The storying draws on the lived histories clients bring, including the politics that produced those stories, as well as their own hopes and intentions for their futures. A concern for the politics of knowledge production is thus present in both how we conceive of counselling as a discipline, that is the macro-level project, as well as how we participate in particular therapeutic conversation, that is at the micro-level. In research, similarly, it is both in the design of a study, and in the to and fro of research conversations in communities, that the politics of our practices are expressed, and for which we are accountable.
This paper explores the braided strands of social theory we call on in both research and counselling practice, drawing connections between the fields. We introduce the conceptual tools of power relations, discourse and positioning theory, witnessing positions, language as constitutive, participatory consciousness, non-colonising practice, and we show how we use these conceptual tools in the production of research projects and processes. We illustrate the theory with examples of practitioner research that have used these conceptual tools to take seriously the ethics of knowledge production. Examples of practitioner research will include studies of: Obsessive Compulsive Disorder; negotiating values in abortion counselling; spinal cord injury; Samoan counsellors; cochlear implants for people with hearing disability; Pakeha counsellors and Maori knowledges; honesty practices in a Muslim school community.
Critiquing Critical Research: Resistance, Reliance and Rightfulness
School of Nursing and Midwifery, Monash University, Churchill, Victoria, Australia E-mail:
Despite espoused commitment to continuous quality improvement, occupational health and safety and the urgency of nursing workforce challenges, particularly retention, there has been a palpable tension within the research arena to undertaking research from a critical perspective. The ethics and merit of critical research has been challenged; namely the legitimacy of researching the vulnerable and relatively powerless, asking politically loaded and directional questions, relying on and heeding the voice of participants, and the rightfulness of adopting an approach that might distress, raise awareness, or empower those being studied. I argue that a critical approach to research does not mitigate ethical research; rather it has an ethical drive of its own and can generate substantial knowledge and rightful insight to individuals, groups and phenomena that are usually taken-for granted, ignored, distorted, exploited or unjustly misrepresented. This paper draws on findings of a Victorian nursing study to highlight how a critical approach to research can contextualize and rightfully give voice to a vulnerable and relatively powerless group such as nurses. Under the auspices of administrative efficiency and devolved responsibility nurses at the clinical coal-face have borne the brunt of administrative initiatives imposed without regard for their impact on nurses and nursing work. I argue that a critical methodology is best suited to critiquing outcomes from the nurses' perspective, and in particular, to ascertaining the unintended and hidden consequences and liability of change. Nurses describe their routine work day, the compromises they regularly or sometimes make to balance workload, client needs and the resources available, and provide insight to the legacy and risks of being stretched to capacity.
Ethical Challenges in Using Photography in Cross- Cultural Research
Department of Educational Psychology, University of Stellenbosch, South Africa E-mail:
Globally language represents a complexity in multi-lingual societies and constrains researchers who seek to do research in vulnerable societies. In cross-cultural research the likelihood of a researcher speaking the same language as the research community is rare, making access to the multi-layered worlds in which research subjects function, more complex. Interviewing and observation as data collecting methods is both language dependant. In educational research complacency exists with a methodology that gives researchers unilateral decision-making power over methods and representation (Lassiter, 2001). In the word-orientated world that the qualitative researcher finds herself in, a critical stance about these traditional qualitative methods is long overdue.
In my research with vulnerable communities (Daniels, 2003) I experienced the constraints of word-orientated tools and how meanings could become lost through translation. Because of these constraints I started exploring the potential of visual-oriented data. In this paper I argued that visual data could provide the key to validating knowledge about marginalized communities. Photography as a method is found to be especially effective in research contexts where a researcher has to cross into an unfamiliar culture, ethnicity and language. I discuss the ethics of using visual data methods in decoding the multi-layered worlds of vulnerable informal settlement women whose circumstances were beyond my life experiences as researcher. I explored visual research for its potential in producing scientific knowledge and its value as reflexive tool in a politically volatile community. Finally, I reflect on the challenges that the method poses for cross-cultural research.
Shades of Grey: Reflections on Researching Indigenous Australian Issues
Forensic Psychology Research Group, Centre For Applied Psychology, University of South Australia, Adelaide, SA, Australia E-mail:
This paper contains our reflections and responses to a recent research project which sought to understand the meaning of anger in Indigenous Australian prisoners. Throughout this project the authors became increasingly aware of the essential ambiguities inherent in Indigenous research practice: the potential for our research to reproduce inequities and contribute to the colonisation of knowledge, the demands for academic accountability, the juxtaposition of world views and the central importance of difference. Our aim throughout this project has been to examine our responses to the process of indigenous research practice. This paper contains reflections that may assist others who might embark on indigenous qualitative research and those interested in theorizing the production of knowledge.
Surfing the Word: Some Steps Towards a New Interpretative Approach in Qualitative Marketing Methods
Department of Marketing, Monash University, Melbourne, Victoria, Australia E-mail:
This paper presents a new qualitative methodology for the collection and interpretation of data from subcultural groups for the purposes of gathering detailed information for marketing application.
The qualitative methodology interfaces effectively with the interpretative framework created through the work of Roland Barthes. The data collection method presented here is designed to penetrate the connotative and evocative effects of language and the role of language in the formation of cohesive group identities, amalgamated through shared or complicit discursive understandings. Therefore, this method uses text and words as the foundation for generating expansive discourse among interviewees where they effectively create their own narrative of constructs and experiences. By mapping this self-constructed narrative, it is possible to identify key issues, constructs and feelings within a textual and verbal framework.
The interpretative framework adopted in this research does not draw from classical marketing methodology, stemming largely from poststructuralist theory advanced by French critical theorist and semiologist, Roland Barthes (1915–1980). Barthes' work on the symbolic nature of language and the web of meanings contained within discourse provides the necessary interpretative framework for this research. Barthes' theory of the text (a term intended by the broadly understood as any product of culture, whether it be literature, advertising material, brand names etc.), its clear relationship with language and the variable meanings that can be apprehended from the symbol enables further critical evaluation of the impact of the marketing text when delivered to subcultural groups, the manifold series of receptions that such texts might initiate and the texture of consumer readership.
This new model is intended to shift marketing discourse away from its current reliance on visual imagery to a figural, discursive regime in which consumers (and marketers) can participate in a complicit cultural discourse of consumption. The application for the revised model will also be discussed with particular attention given to subcultural activities such as the surf and sailing communities in which issues of internal identity through discourse and “jargon” play a key role to the cohesion of the consumptive and active group.
Texts and Contexts of Narrations about Deviant Actions. Positioning, Genres and Narrative Socializations
Department of Developmental and Social Psychology, University of Rome “La Sapienza,” Italy E-mail:
Paper summarizes main findings we obtained in a recent study about modalities of narrative reconstructing deviant actions. The whole project started from an attempt to show a constructivist approach to criminological and psychological-social research.
Objectives are related to two areas: first, we asked if it was possible to delineate patterns of narrative and communicative contents which are shared and consolidated and they give coherence and credibility to accounts released by authors of deviant actions. Specifically, we asked if there are qualitatively valid differences in narratives that referred to different crimes. Secondly, we were interested to search for the presence of shared narrative structures in non inquisitive penal contexts' accounts. Specifically, we were interested to know if any difference exists according to different crimes and actor experience in the field of deviance.
We conducted 34 narrative interviews with prisoners held in two prisons in Rome (Rebibbia and Regina Coeli). Their narrations were analyzed by means of the software ATLAS.ti and according to the Evaluation model of W. Labov. Participants were divided into three groups according to their experience in deviant activities (professionals, intermediates, novices: Matthews, 2002); also, they were divided into four groups according to the type of crime they committed (homicides, robberies, drug crimes, burglaries).
Results show that important differences are embodied into narrative reconstruction according to both type of crimes committed and actor's experience. As for crimes, interviews revealed the presence of real “narrative genres” which are related to prototypicity that every crime has in lay epistemology: according to Evaluation model, robberies are somewhat similar to real stories; actors narrate robbery experiences with greater internal coherence, and stories of robberies include all criteria which define a “good story.” As for actor's experience in a particular field of deviance, interviews highlight the phenomenon of “narrative socialization,” a developmental process by which professionals (with a history of many crimes and long periods of imprisonment) tell about their crimes more completely, complexly and coherently than intermediates and novices.
Exploring the Socio-Emotional Needs and Problems of and Life Skills Needed by Early Adolescent AIDS Orphans: A Qualitative Study
* Department of Social Work & Criminology, University of Pretoria, South Africa
** Department of Social Work, North-West University, Mafikeng Campus, Mabato, South Africa E-mail:
HIV/AIDS is currently an epidemic disease that has become a global problem and has profound social, economic and demographic effects. The impact of HIV/AIDS on children is seen most dramatically in the wave of AIDS orphans that has grown to 15 million worldwide (UNICEF, 2005: 3). According to Frost (2005:1), Africa's Child (2005:1) and The Report on the Global AIDS Epidemic (2004:1) the worst orphan crisis is in sub-Saharan Africa, where 12 million children have lost one or both parents to AIDS. By 2010, this number is expected to rise to more than 18 million with an estimation of 1,5 million children orphaned as a result of AIDS in South Africa alone (Avert, 2005:1; UNAIDS, 2004:1).
Against this background the purpose of this paper will be to report on the findings of a qualitative study that was undertaken to explore the socio-emotional needs and problems of and life skills needed by early adolescent AIDS orphans in the South African context. Special attention will be given to the challenges posed by interviewing AIDS orphans and their caregivers as vulnerable groups regarding the sensitive issue of AIDS orphanhood.
In the context of a qualitative paradigm the phenomenological design was utilised. Qualitative information was collected through semistructured interviews with 40 respondents including 20 AIDS orphans, 10 caregivers and 10 social workers who are professionally involved with AIDS orphans.
The empirical research findings confirmed that HIV/AIDS has forced vast numbers of children into precarious circumstances, putting them at high risk of becoming infected with HIV. AIDS orphans are especially vulnerable to HIV infection for a host of social and economic reasons including poverty, sexual exploitation, violence, and lack of access to HIV information and prevention services. The consequence of this is that these children are often socially isolated, stigmatised and deprived of basic social services. The findings further confirmed deficiencies in life skills which contribute to the vulnerability and exploitation of these children.
The Phenomenological Experience of Workplace Bullying
International Affairs, University of Stellenbosch, Bellville, South Africa E-mail:
The purpose of this research is to describe phenomenologically the experience of workplace bullying as it applies to the life-world of situated South African professional persons.
Discrimination and bullying in the workplace are both examples of dysfunctional behaviours that have a serious impact on the social fabric of an organisation. While discrimination is clearly defined in terms of current labour legislation, more subtle forms of this behaviour are being experienced in the workplace. Clear evidence that indicates that both discriminatory and bullying behaviour can have a negative impact on the bottom line, is emerging. As the actual costs in terms of reduced productivity, high levels of staff turnover and decreased levels of customer service become apparent, an increasing number of managers are starting to recognise the seriousness of the issue. This has provided the necessary impetus to focus on the business case, and organisations are beginning to search for ways to deal more effectively with the problem.
Current approaches for dealing with this problem in the workplace tend to be rather superficial, as organisations do not deal with the underlying individual behaviours and attitudes. Bullying is not a passing problem and what is highlighted in this research is the juxtaposition of the needs of the organisation and those of the employee. Hopefully this will encourage managers and organisations to initiate measures aimed specifically at preventing workplace bullying from occurring and to rehabilitate its victims.
Presenting bullying as a purely interpersonal issue may prevent organisations from examining and reflecting on wider practices and their impact on employee well-being. Furthermore, in some occupations and organisations, some of the predefined negative acts are expected as part of the culture and therefore not considered bullying. In other instances employees may be hesitant to label themselves bullied, since the word “bullied” may have connotations of failure and self-blame.
The phenomenological investigation made use of interviews to allow the phenomenon, workplace bullying, to unfold. Six themes emerge in the investigation, centring on spatially, critical incidents, stigmatisation, manifestation of isolation, presence of toxic leadership style, presence of intense trauma and seeking meaning.
Allowing the use of the term “bullying” for everyday experiences could be trivialising the act of bullying and may impact negatively on some individuals enduring extremely abusive experiences. Thus this may serve to undermine the voices of victims of bullying. In addition, a common assumption within the literature has been that the chief executive, human resources manager or the board is unaware of bullying in the workplace.
Phenomenological Interviewing: The Family as Participant
Division of Health Care Practice, Auckland University of Technology, Auckland, New Zealand E-mail:
Data collection within a phenomenological study demands close and constant orientation to the phenomenological maxim “the things themselves.” The researcher therefore must determine the best method of capturing the lived experience of participants in a way that is compatible with the ontological and epistemological focus of the research. Most phenomenological researchers conduct individual participant interviews however this approach is questionable when conducting research with families. Using my experience of family group interviewing in a study that explored the experience of relationship between health practitioners and families who have a child with chronic illness this paper will describe the factors to be considered before undertaking family group interviews. The paper will describe the close attention required to not only the principals of phenomenology but also the context and prevailing philosophies influencing the study topic. It will also describe the special methodological considerations necessary particularly in relation to determining a definition of “family,” the interview approach and process, and ethical considerations. The paper will show how that while challenging, the family group interview is an appropriate and effective method for the phenomenological researcher.
What Are Some of the Challenges?
School of Public Health, La Trobe University, Bendigo, Victoria, Australia E-mail:
As health researchers we need to investigate a wide range of topics to enhance our understandings of the many issues that affect health and well-being in today's society. Much of the health research undertaken today involves face-to-face encounters with participants using qualitative methodologies. There is a growing recognition that undertaking qualitative research can pose many difficulties for researchers. However, very little research has focused directly on the experiences of researchers whilst undertaking qualitative research and the issues that their involvement in the research raises for them.
To investigate these issues, one-to-one interviews were conducted with 30 qualitative health researchers. A grounded theory analysis of the interview transcripts revealed that researchers can face a number of particular challenges whilst undertaking qualitative research. Some of difficulties identified included issues relating to rapport development, use of researcher self-disclosure, listening to untold stories, feelings of guilt and vulnerability, leaving the research relationship and researcher exhaustion. These results will be discussed and some recommendations for researcher self-care for those involved in qualitative research will be made.
The Intermediate Zone: Opportunities and Challenges for Qualitative Research Across Cultures
School of Health, University of New England, Armidale, NSW, Australia E-mail:
Introduction
Qualitative research with informants who are in the “intermediate zone” between home and host culture is more common with globalisation nowadays, and is a challenging research strategy. In Australia, post-graduate doctoral students in public health from developing countries are deluged with literature and technology appropriate to Western cultures. When they return to their home countries, they face the task of transposing the knowledge they have gained to suit a totally different set of conditions. The action research described here was aimed at helping students develop work skills more appropriate to their home-country requirements.
Methods
Thirteen students participated in weekly discussion groups within the framework of health issues they were likely to face in their home cultures. The discussions were taped and transcribed. Analysis of the texts was in the sociological tradition, in order to understand the experience of the students in this complex intercultural context.
Findings
The students encountered the following difficulties in gathering useful and applicable knowledge in relation to the development of transferable skills:
language barriers (e.g. comprehension of prescribed texts; and scholarly writing in English); cultural barriers (e.g. insensitive treatment; difficulty in coping in a foreign environment; and inappropriate course contents and doctoral thesis topics. •
Conclusions
The symbolic interactionist perspective and qualitative analysis of the intertextual data of the group process provide credibility in understanding the ambiguous position (the “intermediate zone”) post-graduate students from developing countries are in. They are involved in detailed work, the meaning of which changes for them as they move from home to host culture and back again. Challenges were to analyse the data, taking into account both language and culture barriers; and propose a better approach to providing education across cultures as efficiently and effectively as possible.
Understanding Chronic Pain Complicating Disability: Finding Meaning Through Focus Group Methodology
School of Nursing, Queensland University of Technology, Brisbane, Qld, Australia
School of Nursing, Griffith University, Brisbane, Qld, Australia
E-mail:
Over the past few decades a major paradigm shift has occurred in the conceptualisation of chronic pain as a complex multidimensional phenomenon. Yet, pain experienced by individuals with a primary disability continues to be understood largely from a traditional biomedical model, despite its inherent limitations. This is reflected in the body of literature on the topic that is primarily driven by positivist assumptions and the search for etiologic pain mechanisms. Conversely, little is known about the experiences of and meanings attributed to, disability-related pain. Thus the purpose of this paper is to discuss the use of focus group methodology in elucidating the meanings and experiences of this population. Here, a distinction is made between the method of the focus group and focus group research as methodology. Typically, the focus group is presented as a seemingly atheoretical method of research. Drawing on research undertaken on the impact of chronic pain in people with multiple sclerosis, this paper seeks to theorise the focus group in arguing the methodological congruence of focus group research and the study of pain experience. It is argued that the contributions of group interaction and shared experiences in focus group discussions produce data and insights less accessible through more structured research methods. It is concluded that a biopsychosocial perspective of chronic pain may only ever be appreciated when the person-in-context is the unit of investigation.
Finding the Answers with Application of Systems Methodology to Contemporary Health Promotion in Schools
School of Health Sciences, University of South Australia, Adelaide, SA, Australia E-mail:
This paper identifies the numerous ways that system methodology can be used within a health promoting framework, specifically within the school food service setting. A systems perspective is both a theoretical framework and approach that is predominant to qualitative inquiry. Interpretivism is central to a systems perspective as it seeks to understand the system as a whole that is both greater than and different from its parts (Checkland 1999; Patton 2002). The effects of the behaviour of the parts on the whole depend on what is happening to the other parts. Changes in one part may lead to changes among all parts and the system itself (Patton 2002). The school setting is an ideal “looking glass” through which the “system” can be viewed. Specifically, the current “Health Promoting Schools” framework used in many Australian schools which promotes “a whole school approach to healthy eating” adopts a sustainable health premise (NHMRC 1996) and determines the basis of the systems framework applied in this research. The Health Promoting School systems model describes three areas of influence; 1) the school curriculum, 2) the school ethos and 3) the school community. The model is underpinned by certain dimensions of health being interconnected and these dimensions influence, and are influenced by, the environments in which we live (NHMRC 1996). While this paper focuses on the school food service environment within the Health Promoting Schools framework this research has broader implications for health promotion areas. Furthermore it will add to the body of knowledge in the emerging area of system methodology.
Using Life History Narratives to Understand Men's Bodies and Masculinities
School of Health Sciences, University of South Australia, Adelaide, SA, Australia E-mail:
The use of life history narratives historically has not been regarded highly as a qualitative research method of choice. While it must be recognised that the use of life histories have increased over the past decade much of the research has focused on individuals in mid life and beyond. However, life history narratives offer so much more. It is the intention of this paper to identify ways in which life history narratives can be used with a range of ages specifically using men and body image as a template to highlight its purpose and function. The paper will draw on life history data from over 200 men aged between 18 through to 85 years and come from a range of identified groups such as young heterosexual males, young gay males, eating disordered men, elite sportsmen and ageing, retired men to name a few. The life histories have been attained to capture the meaning of masculinities for these groups of men with respect to their bodies. In this instance life histories allow us to develop insights as to where these men have come from with regard to their conception of masculinities. This has important implications for understanding men in general particularly in connection with issues relating to health. Therefore, while the life history narratives focus on men and their bodies, the research method has far reaching significance for researchers working with specific cohorts where meanings and constructs have developed over time. The paper will identify the main issues confronting men and their bodies as well as provide ways in which other researchers can use life histories in their own research. It is envisaged that researchers might begin thinking about using life history narratives as their qualitative research method of choice where circumstances exist for its possible use.
Balancing Competing Expectations: Ethical Dilemmas in the Qualitative Study of Clinical Decision-Making
Department of Sociology, University of New Brunswick, Fredericton, NB, Canada E-mail:
This paper is based upon my fieldwork experience in two urban hospital emergency departments. Substantively, I was interested in how physicians carry out their day-to-day work, their clinical decision-making, in the context of an increasingly bureaucratized and technology dependent environment. By immersing myself in that environment I was able to both observe the process of clinical decision-making as it happened and to later discuss that process through the use of unstructured interviews with the physicians involved. While I thought I had prepared myself quite well for the pitfalls and problems one inevitably encounters in the research process, balancing the competing expectations of the parties involved proved to be much more challenging than I had anticipated. On the one hand there were the hospital administrators who granted me access to their institutions. On the other were the physicians who work within those institutions and whose orientations to their work are often at odds with those of the administrative element. And last, but certainly not least, are the patients who have an entirely different frame of reference. All parties, myself included, had an agenda meaning that we all had preconceived notions about the research process—what would happen, how it would happen and what the outcome would be. Balancing these competing expectations meant that I was faced with ethical dilemmas that could only be resolved in the moment. Consequently, while professional ethics are necessary, codes of ethics cannot definitively answer all of the questions that emerge in the course of fieldwork—they cannot make all our decisions for us. And because we cannot codify morality, we must achieve a personal balance among the obligations to our profession, to society, to the pursuit of knowledge and, more importantly, to the people whose lives we study.
The Potential of Ethnography in Brand Management Research: Seeing the Invisible
* Business Administration Program, Trent University, Peterborough, Ontario, Canada.
** University of Stirling, Scotland, UK. E-mail:
In the era of post-modern consumption where economies have shifted from industrial to experience economies, marketing management adapted itself by shifting its focus from transactional to relationship marketing. Consequently, brand management skills have had to widen their focus—from developing and sustaining physical product attributes (the tangibles) to developing and sustaining product meanings (the intangibles). Just as developing and sustaining meaning among humans is encapsulated in the concept of culture, brands have also become living entities seeking to form cultures through multidimensional relationships that go beyond traditional customers to include a multitude of stakeholders<@151>leading to the formation of societies in the form of cults, communities, etc.
As the concept of culture takes central stage in branding, this paper proposes that ethnography has the potential to be the dominate tradition of inquiry in brand management research as it provides the most appropriate methodology (and consequently the best tools) to systematically and meticulously interpret a culture. Additionally, the flexibility of the ethnographic tradition allows the adoption of other qualitative/quantitative traditions of enquiry to assist in transforming the thorough descriptive interpretations into illustrative realities. In other words, literally ethno-graphing can help transform human behaviour from an invisible to a visible state that empowers managers with a hands-on approach to build and nurture brands.
Using a case of a grocery retailer brand, the paper demonstrates the proposed potential of ethnography in brand management research. A five-month participant observation study, in conjunction with the adoption of the grounded theory analytical technique, reveals that a retail brand culture can be metaphorically modelled in the visual form of a tree. The paper concludes that the Tree pictorial power provides a road map that simply and coherently guides retailers to build and manage their brand identities.
Reconstructing the Thoughts to Come
Sociology, Friedrich-Alexander University, Erlangen-Nürnberg, Germany E-mail:
In a globalizing world it should be an important and attractive objective of social science to keep in touch not only with established lines of thought but also with those “in the making.” But how does one discover and describe upcoming paradigms, when they can only be found in the “interstices” of the established discourses and networks?
The talk that is proposed here wants to show the usefulness of qualitative methods for sifting out developing worlds of thought. Illustrated by the results of several empirical projects in the globalizing religious landscape of present day Germany it will try to demonstrate how a combined approach of methods like qualitative network analysis, participant observation, narrative interview techniques and others can systematically be applied to that aim.
Based on the theoretical perspective of the sociology of knowledge in the tradition of Karl Mannheim and Berger/Luckmann we will describe the example of the “Wanderers,” a religious paradigm of growing popularity among lay Christians in Germany. “Wanderers” are not (yet) a religious movement, but they are far more than just “individualized” spiritually interested people. Their individual religious “ways” are based on a shared frame of reference that enables them to communicate about the bodily and emotional experiences that constitute their primary fields of contact to the spheres of the “divine.” This frame of reference is gradually developing into a line of thought that denies the various religious traditions their claims of exclusive validity and their rights to divide the field of religion among them. The “Wanderers” are an excellent example of a “worldview” in the making. We will try to show how qualitative methods provide a reliable approach to worlds of thought that are not yet considered satisfactory or not even perceived by the established discourses—but may be soon.
Exposing Risk: Ontological, Ethical and Practical Challenges of Researching Suicide Care in Multiple Inpatient Mental Health Units in New Zealand
* School of Nursing, Christchurch Polytechnic Institute of Technology, Christchurch, New Zealand
** Division of Health Care Practice, Auckland University of Technology, Auckland, New Zealand E-mail:
This paper examines the relationship between methodology, theory and ethical issues emergent from an ethnographic study of two hospitals that examined the question “How is care constructed for suicidal people in mental health acute inpatient units.” Three issues will be considered in this paper.
First, the decision to use multiple sites in the study was primarily to protect the researcher (the first author) when exposing clinical practice from within his discipline in a country with relatively few mental health inpatient units. While the use of multiple sites provided useful comparative data, it raised ethical and data saturation challenges.
Second, attempts were made to include potential participants who were hostile to the research. Some clinicians considered the research question axiomatic and therefore redundant, and also thought the methodology of ethnography to be ontologically valueless, a positioning that appeared to replicate the positivist epistemology underpinning the majority of suicide research. The utilisation of “refusal to participate” as data raised additional ethical issues.
Finally, the planning stage of this study exposed the anxiety of some members of local ethics committees in allowing interviews of suicidal persons, unless those persons were deemed “low risk” by inpatient clinicians. The process of screening potential interviewees revealed issues with the “essentialising” nature of categories of risk. Whilst these issues provided valuable data about the values and beliefs underpinning suicide care, they also posed ethical challenges during the interview process. The researcher had guaranteed to pass on to inpatient staff any immediacy of risk of patient interviewees, but the content of most interviews revealed that the construction of categories of risk were contradictory to the fluidity of suicidal thought. This data proved useful in considering the ontological place of risk categories, but also posed ethical challenges.
Qualitative Research: The Opportunities and Challenges Presented to Rural Researchers in Australia
* School of Health, University of New England, Armidale, New South Wales, Australia
** School of Social Science, University of New England, Armidale, New South Wales, Australia E-mail:
Qualitative research conducted in rural locations presents a range of unique dilemmas and barriers for researchers. This paper will highlight the work of two extensive qualitative research studies currently being conducted in rural New South Wales, Australia. It will examine how these dilemmas and barriers were overcome. These studies were conducted using different methodologies and sampling populations, yet they encountered similar difficulties against the backdrop of the vast rural geography of northern New South Wales.
The complexities surrounding rural community memberships are unique and therefore have a major impact upon recruitment of participants. This factor, coupled with geographical barriers, makes decisions about sampling in rural communities complex. Our experience has shown that people in rural areas are reluctant to participate in research as they infrequently see any results or benefits from their participation. In addition, minority groups may be reluctant to participate in research and Indigenous people continue to be mistrustful of research (National Health & Medical Research Centre, 2003).
Population disparities, a lack of infrastructure, including transport and access to technology compound the issues of recruitment and data collection. These complexities are issues, not only for the researchers, but also for the participants who desire to be involved in research.
Although the two research studies highlighted in this paper explored vastly different areas: Sexually Transmitted Infections (STIs) and the social impact of workplace reform, they were similar in many of the recruitment issues. It was only the good rapport between the researchers that helped overcome many of the researcher issues. However, the issues surrounding individual participation remain problematic adding another dimension to succeeding in rural qualitative research in Australia.
Ascribing and Resisting Guilt in Everyday Talk
* School of English, Media Studies and Art History, University of Queensland, Brisbane, Qld, Australia
** Centre for Literacy Language and Communication Studies, School of Education and Professional Studies, Griffith University, Gold Coast, Qld, Australia E-mail:
This paper explores the way notions of guilt are negotiated in every day contexts through reasoned practices of categorisation and comparison with ideal typical behaviour. The work of Drew and Atkinson (1979) on rape trails highlights the degree to which notions of guilt or innocence are overwhelmingly organised through ideal categorial behaviours. These behaviours are mapped onto the actual members' character through evaluation, warranted action and immediate context. Obviously, notions of guilt and degrees of guilt are not restricted to courtrooms and are indeed a part of routine everyday practices when engaged in ascribing, evaluating or resisting notions of culpability or responsibility for actions. In this paper we draw upon the methods of Membership Categorisation Analysis in combination with Conversation Analysis to explore the way appeals to guilt or innocence are locally organised through various methodical language practices that draw upon forms of categorial knowledge predicated through categorial and individual comparisons of action.
Specifically, in this paper, we look at the ways that guilt is negotiated or resisted in two routine conversations: one in which Karen describes mothering practices and distance herself from accusations of guilt by talking her actions as the actions of “anybody” and therefore not available as evidence of her guilt, and one in which friends apportion guilt around an event using local knowledge despite a criminal conviction being secured.
This paper also serves as a detailed demonstration of the value of MCA and CA in explicating the routine category work that locally produces and reproduces social order.
Gillian and Esther's Never Ending Story: Adventures in the Realm of Action Research
Faculty of Education, The University of Auckland, Auckland, New Zealand. E-mail:
Esther and Gillian are the central characters in this story taking their first tentative steps into the drama that is action research. They each embarked on an exploration of an aspect of their own practice within a teacher education establishment. In parallel approaches, Esther explored process drama pedagogy while Gillian investigated questioning strategies, raising interesting interdisciplinary connections.
As the pages turned they endeavoured to discover ways in which to improve their practice. The evolving scenes involved series of investigative cycles in which both fledgling researchers discovered exciting things about their own practice [and the dramatic world of action research].
The realm of action research is often described as messy throwing into the path of the main characters tensions and dilemmas which need to be understood in order for them to move forward. Often these tensions and dilemmas challenge the researchers to move with trepidation out of their comfort zones and to confront their own practice. As the central character in the action research story this can be an exciting but also an emotional experience. The outcome and plot of the story is not determined when the researcher begins but unfolds along the way. Throughout the journey other characters were critical in ensuring our practice was informed at journeys end. These characters often worked in collaboration with us to plan the direction of our journey, identify obstacles and share in significant moments of discovery.
Throughout this action research story, the challenges presented opportunities to reflect upon and refine our practice. As we walk you through some aspects of our story we will discuss highlights we've encountered on the journey thus far.
Five Aspects Meal Model (FAMM)—A Concept for Decreasing the Gap between Theory and Practice in Nursing
* Centre for Nursing Science, Örebro University Hospital, and Department of Caring Sciences, Örebro University, Örebro, Sweden.
** Centre for Nursing Science, Örebro University Hospital; Department of Caring Sciences, Örebro University, Örebro, and CECAR, Neurotec-Department, Karolinska Institutet, Stockholm, Sweden.
*** Centre for Nursing Science, Örebro University Hospital, Örebro, Sweden, and Institute of Nursing and Health Sciences, University of Oslo, Oslo, Norway E-mail:
The culinary arts place great emphasis on the combination of practical skills, science, working methods and artistic content.
FAMM is a model used to develop the manner in which the meal is served and includes the aspects of the room, the meeting, the atmosphere, the product and the management control system. FAMM is the basis for the educational program and even the department's library is organized after it. Can the FAMM model be useful in nursing practice and education?
Methods: Application of FAMM model in nursing.
Results: The room: The meal takes place in a room where the customer meets the serving staff e.g. restaurants. Nursing interventions also take place in a room in the hospital, the patient's own home or a public arena when the ambulance team cares for the sick or injured.
The meeting: Service and its quality influence the meeting between the staff and the guest. Individualized care is fundamental and the way in which patients are met can be crucial to their experience.
The atmosphere: Restaurants with good atmospheres are places where guests feel comfortable and at ease. For patients, the medical interventions are important as well as the atmosphere of the caring environment.
The product: In a restaurant the combination of the food and drink make up the product. In nursing, the “product” is the treatment and nursing intervention whether it is medical, surgical or psychiatric.
Control management system: The administrative system consists of leadership, economics, legal aspects as well as logistics. This system works “backstage” and is generally not observable by the guests or the patients.
Discussion
The holistic approach of the FAMM model is useful in nursing practice and education. In nursing, providing good quality care and service that is not only practical and productive but also ethical and aesthetic requires knowledge.
Making the Personal, Political—Using Autoethnography as a Method in Mental Health Nursing Research
* James Cook University, Cairns, Qld, Australia
** Griffith University, Brisbane, Qld, Australia
*** University of Western Sydney/Western Sydney Area Health Service, Sydney, NSW, Australia E-mail:
Autoethnography is method that aims to connect the researcher's personal self to the broader cultural context. Evocative writing, where the writer shares personal stories on their own experiences, is used to extend understanding of a particular social issue. Stories convey lessons, embody experiences and connect people, perhaps inspiring a collective identity and commitment to change. In this way, an issue which may have previously been considered personal becomes political. Although autoethnography is increasingly used within social science research, it is newly emerging in mental health nursing research. In this presentation the authors, all mental health nurses, discuss the particular resonance that autoethnography combined with narrative inquiry has for mental health nursing research. We use one particular study into the experiences of adult children of parents with psychosis to illuminate insights and issues that may be helpful to other researchers considering a design to powerfully evoke the personal experience so that it is moved into the realm of political and practical change.
Advancing the Impact of Practice Research
School of Social and Cultural Studies, Massey University, Auckland, New Zealand E-mail:
“Good” research aims to not only achieve project outcomes, but to advance theoretical understanding, shape policy or inform practice. As such, the results of research projects appear in many forms, but are most commonly reported in scientific journals or reports of an academic nature. This is certainly important and significant and one would expect this to remain expected practice. However, in the applied disciplines, one can't help to ask at times not how many reports can be done, but how many lives will be improved by the findings of a particular (sometimes hugely funded) project.
Governments around the world have been facing increasing demands for greater accountability and efficiency in their public investment in research. In fact, organizations on the whole that fund research are under increasing pressure to demonstrate that they provide “value for money.” Practitioners in the applied sciences are increasingly expected to integrate practice activities with scientific “evidence.” In fact, it has become a matter of survival for a great many practitioners in applied disciplines to become involved in evidence-based practice in the organisations where they are working. Yet, while these approaches of accountability provide important impetus to practice, it neglects to address the question of how we advance the impact of research in practice.
This paper aims to use the Buxton and Hanney Payback Framework (1996) to discuss the potential impact of practice research and to identify challenges and opportunities in advancing the impact. As part of this discussion, the following elements will be explored:
research production (ensure that users' needs are identified) capacity building (ensure knowledge transition and diffusion of innovations) product development (translate research results into practical applications for “users” of research) well-being benefits (aim to improve the lives of those we research) broader economic benefits (understand the effects of policies and programmes)
Embodied Interpretation: A Novel Method for Disseminating Qualitative Research Findings
Institute of Health & Community Studies, Bournemouth University, Dorset, United Kingdom E-mail:
The broad context for this paper is a concern about the value and utility of qualitative research, the “so what?” of research findings. One important direction that arises out of this is: how can qualitative research findings be made more “friendly” to non-research audiences? The challenge is to find interesting and more novel strategies for disseminating findings in creative and innovative ways.
The aim of our paper is to share with the audience the story of a developing research programme that focuses on the communicative concern of qualitative research. The specific emphasis explores how qualitative findings can be transformed in evocative ways so that they can have a useful impact for the users of services, while still retaining their rigour. The development of a method of “embodied interpretation” draws upon Van Manen's ideas about the value of evocative writing and Gendlin's understanding of language as a bodily sensed phenomenon. Our paper will outline the rationale and method of this approach, and illustrate some of the potential benefits with reference to a case study of caring for a loved one with Alzheimer's. We recount how “embodied interpretation” was used as a method that transformed and communicated qualitative research findings to an Alzheimer's carer's support group. This experience resulted in some reflections and modifications about the importance of dialogue and ownership by carers. The emerging dissemination method has resulted in complementing the communicative value of “embodied interpretation” with a modified action research strategy that is informed by phenomenology. The paper concludes with some thoughts about the added value of dialogue and ownership by users as a way of acknowledging the unique, local experiences and meaningful variations that individual users bring to their resonance with evocative shared themes.
Negotiating a Critical Agenda: Strategies for Physical Education Teacher Education
School of Health Sciences, University of South Australia, Adelaide, SA, Australia E-mail:
Stories capture the richness and nuances of meaning in everyday existence and give insight into the complexity of our experiences and understandings. They can evoke a response in the reader, which moves them beyond the literary experience to a more “lived” and situated experience. Through stories, taken-for-granted ordinary events can be explored and critically examined.
In this research a number of strategies including “physical stories” and guided reflection were used with pre-service physical education teachers in an attempt to foster more critical and inclusive approaches to the teaching of physical education. The strategies in this study were used to illustrate the complex processes that inhibit or enhance an individual's relationship to physical activity. They served to identify discursive, social and institutional practices, which supported the development of a physical identity for some young people while powerfully denying it to others. Pre-service physical education teachers were asked to respond to these strategies in multiple ways as well as constructing their own stories around teaching and learning in physical education.
It was concluded that a more complete understanding of young people's physicality could develop from recognition of the complex interrelationships that occur between school, culture and physical experiences. Storytelling allows some insights into these complexities and can foster critical thinking in pre-service teachers by establishing an emotional connection to the storyteller and thus a deeper appreciation of “lived experiences,” which might sit outside their own.
Constructing Portraits of Health and Well-Being in the Everyday Lives of Families
Department of Anthropology, University of California, Los Angeles, USA E-mail:
How does one go about studying health and well-being in dual-career middle-class families living in southern California? Existing research concerned with health and well-being in relation to everyday family life rarely examines the on-the-ground processes through which matters of well-being and health become part of daily life. Further, there is no interdisciplinary research that attempts to build an integrated picture by drawing on diverse methods and sources of data relating to health and well-being in family life. The project undertaken by the Center for the Everyday Lives of Families (CELF) at the University of California, Los Angeles, presents a unique opportunity for advancing understanding on both of these fronts. Video recordings of everyday family life are at the heart of the CELF project (approximately 20–25 hours of video recording for each of the 32 participating families). At the same time, the CELF project was designed to draw upon a number of other methods, including several semistructured interviews relevant to individual and family health and well-being. Data from other methods, reflecting the diverse disciplinary perspectives of our research team, can also be used to pose and address questions relating to health and well-being in the family context. In this presentation, the focus is on how these diverse sources of information can be used to construct “family health portraits” (or, more fittingly, “working family health and well-being portraits”). These family portraits provide a basis for addressing specific questions and topics about health and well-being in everyday life, and a basis for comparative research, including research carried out in other cultural settings.
Workplace Culture of an Operating Room: An Insider's Perspective
Griffith University, Gold Coast Queensland, Australia E-mail:
Background: The capacity of some people to manage workplace stress effectively has been linked to positive outcomes such as work satisfaction and longevity of employment. In nursing, where attrition rates are on the rise, particularly in some of the high stress specialties such as the operating room, it becomes important to recognise aspects of workplace culture that influence a person's ability to adapt to the demands of stressful and volatile environments.
Objective: This ethnographic study explored the social microcosm of an operating room to describe elements of workplace culture that influenced the integration and socialisation of nurses into this environment, and to explore which elements influenced the development of resilience in operating room nurses.
Methods: During a six week field work engagement, data were gathered through field notes, interviews with key informants and a journal to diarise internalised assumptions associated with the culture and context. The dialectic tensions between the “emic” and the “etic” perspectives which underpinned the participant-observer role are highlighted throughout the presentation. Data were analysed thematically.
Results: Three themes related to primacy of knowledge and competence, social order and situational control were important cultural indicators in this highly specialised milieu. The level to which members were able to assimilate and meet role expectations depended on the amount of knowledge and experience they possessed.
Conclusions: The culture of the operating room is anchored to the core features of specialist knowledge and experience. Collaboration, peer support and social order are exercised through various forms of team communications. The extent to which members are permitted to participate depends on their ability to competently perform under pressure. Culturally imposed peripheral participation maintains the social order of the operating room and may adversely impact on the ways in which members integrate and adapt in this technocratic environment.
Cultivating the Qualitative Borderlands: Educational Poetics and the Politics of Inclusivity
University of Georgia–Athens, GA, USA E-mail:
Qualitative research has extended the boundaries of legitimate knowledge by including the insights of “subjects,” valuing the voices of groups that have been excluded from telling their stories, seeing the complex ways researchers may be positioned in relation to other research participants, and becoming more diverse in their views of validity and reliability. Gitlin argues that these extensions have been a powerful force in furthering a politics of inclusivity within the knowledge production process. While this politic is argued to be important and critical in the development of qualitative methodologies, Gitlin claims it is time to look at what might lie on the other side of a politics of inclusivity. He does so by using an emergent form of inquiry he calls educational poetics. Moving to the borderlands between the educational and aesthetic communities, this political humanist form of inquiry is centered on having commonsense become an object of inquiry with the purpose to fostering relations of freedom. When successful, educational poetics can enhance a deep politic that looks at the foundations that constrain our ability to think, act, and imagine a world quite different from the one we participate in currently. With educational poetics used as a comparative foil, the boundaries of a politics of inclusivity are thought to include: a) the lack of focus on the way knowledge producers participate in the reproduction of the limiting effects of commonsense, b) how some qualitative forms of research may leave in place various hierarchies as they make the “center” more inclusive, and c) the need to do more to escape some of the seductive aspects of everyday politics that bind us to the past and limit our human potential to revision and act on a world in ways less dependent on the dominant codes, categories, and images that inform cultural life.
The Power of the Image: Enriching Qualitative Research with Digital Photography
School of Library and Information Studies, University of Alberta, Edmonton, Canada E-mail:
In addition to traditional methods of qualitative research designed to explore individuals' experiences in a variety of social settings, textual scholars have examined photographs and other visual representations to illuminate the discourses of social life. More recently, qualitative researchers have started to account for the complete social scene surrounding individuals' situations (e.g., by observing hospital waiting rooms in addition to interviewing patients), yet few scholars have made full use of digital photography, video or other mechanisms for analyzing local contexts. Photography is one method documented in recent visual ethnographic approaches (e.g., Wagner 2002), but additional work is needed to fully explore its value. Digital photography allows exploration of the holistic experiences of individuals and groups by documenting the social and physical settings that inform the attitudes and behaviours revealed by more direct methods, such as interviews.
Although photographs have a long history in fields such as anthropology, digital photography provides immediate opportunities for analysis and engagement with individuals and settings under study. This paper showcases two studies that used digital photography to analyze individuals' experiences in different social settings. The first examines 18 undergraduate students' experiences of the university as an “information space,” where participants and the researcher toured campus taking photographs of spaces affecting the academic success of those students. The photographs serve as visual diaries of the interviews, and of participants' interactions with the academic library, computer labs, and other relevant spaces. The second study explores 24 public library users' experiences with libraries' internet stations, focusing on those individuals' experiences of digital literacy (e.g., developing feelings of personal mastery with new technology). Photographs of those public spaces were used to inform interpretation of data gathered in interviews with these participants. The findings that emerged from these research studies demonstrate how digital photography can enrich qualitative research.
Linking Research and Academic Communities with Policy Makers
* CRC for Asthma and AIRmed, The Alfred Hospital & Monash University, Melbourne, Vic, Australia
** Monash Institute of Health Services Research, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic, Australia
*** Department of Pharmacy Practice, Monash University, Melbourne, Vic, Australia
**** Centre for Adolescent Health, Royal Children's Hospital & The University of Melbourne, Vic, Australia
***** Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Vic, Australia E-mail:
The CRC for Asthma Limited was established in 1999 under the Australian Commonwealth Government Cooperative Research Centre Program. It was a joint venture between two medical research institutes, three universities, two pharmaceutical companies and the New South Wales Department of Health. The Centre was funded by the Commonwealth and the joint venture partners who committed to providing resources of almost $40,000,000 over seven years.
One of the objectives of the CRC for Asthma was to improve the quality of life of people with Asthma and their families by increased understanding, by practical prevention and by more effective, individually designed treatment. This objective was met by the funding of a predominantly qualitative project “Consumer priorities for Asthma Care.”
The “Consumer Priorities” project investigators consisted of a multidisciplinary team of respiratory physicians, an epidemiologist, a pharmacist, a health sociologist, and a consumer advisory group. Outcomes from this study challenge many current social and medical viewpoints and have revealed gaps in the optimal care of asthma from both the perspective of patients and their doctors. Project findings, which have been widely published locally and internationally and also incorporated into guidelines and clinical recommendations, have resulted in a change in the attitudes of many clinicians and the nature of their clinical practice.
Exploiting the Power of the Image: New Directions in Cross-Disciplinary Qualitative Research
* Centre for Public Culture and Ideas, School of Nursing and Midwifery, Griffith University, Qld, Australia
** Faculty of Creative Industries/Business, Queensland University of Technology, Brisbane, Qld, Australia E-mail:
Visual ethnography is emerging as a powerful way of doing qualitative anthropological research in a society characterised by an increasing emphasis on the visual image and the ubiquity of photographic technology. However, an institutional distinction still tends to be drawn between the “academic” work of the anthropologist using photography as a data collection tool and the “artistic” work of the professional photo-documentist, and further between photographic images produced by researchers and those of the anthropological subjects themselves. This paper describes the outcomes of a project that attempted to break down some of these boundaries through collaboration both between an anthropologist and a photo-documentist, and between researchers and subjects in producing and interpreting photographic images. It will discuss the project in terms of theoretical debates within both ethnography and the visual arts, and suggest implications for future work that seeks to exploit the power of the visual in qualitative research.
The Influence of Setting on Findings Produced in Face to Face and Online Focus Groups: A Discourse Analysis Perspective
Faculty of Psychology, Catholic University of Sacred Heart, Milan, Italy E-mail:
Introduction and Research Objectives: Situated within the debate concerning online qualitative research practice, and its suitableness to inquire sensitive topics, the study attempts to describe how the setting shapes the conversational features of the discussion and influences the data construction process in online discussion groups. This paper outlines the results of a research that compared, in a discourse analysis perspective, face-to-face focus groups with different formats of online focus group conducted on topics with a different level of social-sensitiveness (HIV risk perception, alcohol abuse, smoking behavior).
Research Design
We conducted 24 focus groups:
8 about HIV-AIDS risk perception and coping strategies (2 face to face; 2 chats; 2 forums; 2 forums plus chat) 8 about Alcohol abuse (2 face to face; 2 chats; 2 forums; 2 forums plus chat) 8 about Smoking behavior (2 face to face; 2 chats; 2 forums; 2 forums plus chat)
Sample
192 participants Aged 18 to 25 years and living in Italy.
Strategy of Analysis
Discourse and Conversational analysis Content analysis
Main Findings: Our findings seem to confirm the hypothesis of a main difference between a face-to-face discussion setting and an Internet-mediated one and the major suitableness of online focus group to inquire social sensitive topics. Furthermore, the study reveals interesting differences among the forms of online focus group considered, in terms of both thematic articulation of discourse and conversational characteristics of group exchange. These characteristics seem to be partially independent on the topic of discussion, even if they are particularly outstanding when the discussion is focused on a more social sensitive topic (as HIV risk perception). This characterization seems to be important for the situated choice of the tool, according to the research topic and its objectives.
Disclosure of HIV Status: Experiences and Perceptions of Persons Living with HIV/AIDS and Nurses in Five African Countries
(1) Potchefstroom campus, North-West University, South Africa
(2) National University of Lesotho, Lesotho.
(3) University of Swaziland, Swaziland.
(4) University of California, USA.
(5) University of KwaZulu-Natal, South Africa.
(6) Muhimbili University, Tanzania
(7) University of KwaZulu-Natal, South Africa.
(8) University of Malawi, Malawi. E-mail:
Most health literature seems to favor disclosure by people living with AIDS. But it could be that to disclose is not always a good thing. Individuals who are aware of their sero-status are frequently confronted with the important albeit difficult decision of whether to disclose their sero-status to others. Using the information on disclosure from research into perceived HIV/AIDS stigma in five African countries, as seen by persons living with AIDS (PLWA) on the one and nurses on the other hand, the authors focus on perceptions of status disclosure experiences as described by these two groups of respondents. The results were obtained from 39 focus group discussions held in five countries: Lesotho, Malawi, South Africa, Swaziland, and Tanzania. The critical incident method was utilized during the focus groups. Focus groups were conducted in the local languages of the five countries and translated to English. The structure of the results is based on the three temporal dimensions of status disclosure, which are experiences before the disclosure, the process of disclosing and responses during and after disclosure, as well as the additional sub-categories and relationships among these dimensions constituting the process of disclosure. Literature is utilized throughout to verify the findings. This study shows that PLWA feel that to disclose their status does not really have many benefits as the risks of stigma and discrimination for PLWA are just too high at this time. Health-care workers should be more aware of the implications of the advice they give PLWA to disclose their status or not.
Understanding the Lived Experience of Lymphoedema through Heuristic Inquiry
Faculty of Nursing and Midwifery, University of Sydney, Sydney, NSW, Australia E-mail:
The aim of this paper is to discuss how heuristic inquiry, as explained by Moustakas (1990), can be used to make available the personal and emotional experience of illness. This approach was used in my PhD thesis to explore the experiences of people who develop lymphoedema as a consequence of the treatment of cancer. A methodology that took account of the embodied being was seen as essential for this study, as was one that included my personal experience, reflections and insights. Heuristic inquiry, a form of existential-phenomenology, was selected to be the most appropriate method for use because it incorporates both of these central considerations. The focus of heuristic inquiry lies on the reflective examination of the meaning of subjective perceived human lived experience and the physical, social, and historical context of that experience.
Heuristic inquiry assumes the experiencer's perspective of being-in-the-world. It is the experiences of the self that stand as the methodological starting point of the investigation. The uniqueness of this method is the extent to which it brings to the fore the personal experience, reflections and insights of the researcher, together with the experience of others who have personal experience with the same phenomenon. This theoretical validation of situating the self in research is an important consideration so that my story is not seen merely as a self-indulgent affirmation (Probyn 1993). It joins the growing genre of research that takes as its subjective matter the lived experience of the researcher (Reinharz 1992, Denzin 1992, Neilson 1998).
The paper outlines the process of heuristic inquiry as described by Moustakas (1990), the procedures I used, with particular attention to data collection techniques, in-depth conversational interviewing and the method of data analysis.
Qualitative Methodologies in the Rural Indigenous Context—Respecting Culture: Telling Stories of Suicide Prevention in Rural Communities
Rural Clinical School, Flinders University of South Australia, Adelaide, SA, Australia E-mail:
This paper explores a challenging external evaluation process to bridge across cultural boundaries. The project tells a story about rural communities as they develop and implement local strategies to prevent suicide. It follows our journey in search of methods to collect meaningful data and reveals the successes and struggles encountered. We address the question: “How do we maximize cultural sensitivity as white women doing an evaluation on young aboriginal men about a topic like suicide prevention?”
Flinders University Rural Clinical School was engaged by the South Australian Department of Health to conduct the external evaluation on the Suicide Prevention Initiative for Country South Australia. There were 7 country regions involved in the project. Each region was responsible for establishing local action plans with their main target group, young men in particular young indigenous men.
Recognising the history of research being “done to” indigenous people the importance of building relationships, showing respect and a willingness to learn was foremost in our minds. Our challenge was to find ways to achieve this as an external agency evaluating suicide prevention programs given suicide is such a psychologically and socially complex issue. The ability to achieve a degree of trust and rapport with the communities, the elders, the individuals, their families and the service providers in short time frames is examined.
Recognition for indigenous evaluation to be grounded in methodologies such as action research which engage in high levels of participatory processes is well documented. A process of reflexive practice is also strongly promoted. The ability to be open to new approaches with the aim of community inclusion confronts the traditional exclusivity in academic culture of research expertise.
By sharing experiences and fostering a collaborative culture we can learn from communities and we can undertake more meaningful research.
Logics, Knowledge and Action Research
University of Southern Denmark, Institute of Educational Research and Development, Kolding, Denmark E-mail:
“Workplace logics” signify attitudes that employees express in close interaction, formal decision-making and collaborative interventions. The term covers a metaphorical “mental context” rather than a mathematically coherent understanding of social control mechanisms that influence interlocutors in cooperative activity. Workplace logics relate to future-oriented choices that employees make so as to obtain targeted production goals. But logics also hold an explanatory potential. They enable for the researcher to account for social systems that need to be designed before they are acted on. The objective for analysing workplace logics is to turn attention away from language and focus on action. Successful action research outcomes facilitate for individual and organizational learning, the latter of which is rarely fulfilled in contemporary research.
“Confounding Variables” or the Key to Understanding What's Really Going On?
* Thames Valley University, London, UK
** Glasgow Royal Infirmary, Glasgow, UK
**** Northeastern University, Boston, USA E-mail:
The use of methodological triangulation has been widely discussed in the past (Punch 2005). The debate incorporates the fairly straightforward use of multiple data collection strategies at one end of the scale; through the sequential use of inductive and deductive methods; to the complexities of integrating qualitative and quantitative approaches into some kind of unified, methodological whole.
This presentation will focus on the degree to which triangulation has enhanced the outcomes of CHART, a large, two year, multi-centre study, commissioned by the Department of Health (England) in 2003. This study explored the effectiveness of using Statistical Process Control Chart (SPCC) feedback as a means to motivate healthcare practitioners to improve their infection control practice and, as a consequence, reduce the incidence of MRSA in the twenty five participating hospitals.
It is generally accepted that rates of MRSA infection and colonisation are closely related to basic infection control practices such as hand hygiene. The process by which an infection spreads however, is a complex, multi-factorial, phenomenon and for this reason the research team incorporated both qualitative and quantitative dimensions into the study methodology in order to measure the effect of the SPCC feedback process and to gain detailed insight into the context in which the feedback process occurs.
CHART has vividly highlighted the extent to which the effective prevention of healthcare associated infections such as MRSA, is dependent not only on the introduction of efficient, valid, organizational processes such as SPCC feedback but crucially, also on factors such as leadership, role modelling, communication, motivation and the dynamics of interpersonal and inter-professional relationships. In particular the key role played by the ward manager has been illustrated, along with important implications for the relationships established between medical and nursing staff.
Demystifying Qualitative Data Analysis for Public Health Students: A Three Stage Process to Thematic Analysis
School of Public Health, Griffith University, Queensland, Australia E-mail:
The catch-cry for an evidence-based approach to practice across disciplines, including public health, has become the norm. As a consequence of the drive for informed practice, the worth and role of qualitative research to building grounded understanding of social phenomena has received greater recognition and acceptance. Thus, it is widely acknowledged that the public health graduate requires a solid foundation in research methodology including a firm grasp of quantitative and qualitative research methods. Interestingly, while complete courses, or large parts thereof, focus upon quantitative data methods and statistics there has been relatively limited attention to training students in qualitative research methods generally and, more specifically, qualitative data analysis techniques. Yet, qualitative data analysis represents a difficult, complex and time consuming undertaking that is nearly inaccessible for the uninitiated. The purpose of this paper is to present a qualitative data analysis process that has been developed to facilitate student understanding of the process. The process comprises three stages and offers a structured, concrete strategy for qualitative data analysis. The proffered process serves to demystify qualitative data analysis and thereby make both qualitative data analysis and, perhaps most importantly, the use of qualitative methods more viable for public health graduates as they take up practitioner roles across the public health workforce.
Using Grounded Theory in Masters Degree Dissertations
Homerton School of Health Studies, Cambridge, England E-mail:
Researchers should select a research approach that best matches their research question and when the focus of interest moves beyond experience to process and life changes grounded theory is suggested. However this is a time consuming method as the researcher needs to move beyond thematic analysis and data saturation to full development and integration of categories around a core concept with the achievement of theoretical saturation. This poses problems for the master's degree student whose research must be completed within a relatively short time scale. This paper acknowledges that many claims to have used grounded theory in published literature are false, however it has been suggested that the quality of research should be judged by the findings and the means by which they were generated Sandelowski and Barroso (2003). This paper addresses the methodological errors in published grounded theories and suggests how each of these may be addressed within master's degree research. The result can be a rigorous study that has used the grounded theory method and has potential for further development.
Exploring Disclosure of Long Term Illness: Ethical Challenges for Researchers
Royal College of Nursing Institute, Oxford, UK E-mail:
Conducting research among people with long term illness is important because the number of people living with a long term condition in the UK is high: around 17.5 million. Exploring disclosure of illness among this illness group is particularly important because the decision whether or not to disclose information about illness to others may be a key factor in self-management.
Existing research suggests the reasons for choosing to disclose an illness to others remain unclear and complex. Some long term conditions are associated with stigma e.g. HIV/AIDS, Epilepsy, Mental Health. This can prevent disclosure of illness due to fear of others negative reactions to knowledge of their illness. The effects of disclosure may be positive and result in greater support for the person. However, the effect of disclosure may be negative because the person to whom it is disclosed may not know the best way to respond. The appropriate response of the researcher who is investigating disclosure of illness is therefore important.
The ethical criteria which must be met in order to protect patients participating in research are clear. However, the ethical issues associated with protecting researchers conducting research on potentially sensitive topics such as disclosure of illness are less clear. For example, existing studies on disclosure of illness do not outline the ethical implications of researching the phenomenon of disclosure of illness from the researchers as well as the participants' perspective.
This paper will discuss the ethical challenges I have faced and anticipate from the perspective of a researcher undertaking a doctoral study exploring disclosure of long term illness. The issues raised and the implications of disclosure of information about illness will be discussed. Appropriate dissemination of the findings of the study, implications for recruitment to the study and issues around non disclosure of illness will be discussed.
The Visual Reflexive Journal: Developing Reflexivity through the Research Journal
Liverpool John Moores University, Liverpool, United Kingdom E-mail:
The Visual Reflexive Journal (VRJ) is a mixed media, multi-textural document that challenges chronological diary writing within established monomodal (Kress 2001) practices of journal keeping within a research context. The VRJ is a methodological tool that has evolved out of, and contributed to, the development of a practitioner enquiry doctoral research project concerned predominantly with the teaching of cultural diversity in Initial Teacher Training (ITT).
There are six distinct types of journal considered in this paper informing the development of the “visual reflexive journal.” In considering these I argue that the format of the document directly influences the nature of the engagement it is employed to support. The dominance of text based entries within the research journal is problematic within the field of visual research and while the artist sketchbook is able to support visual and reflective accounts it is equally inadequate in developing reflexivity per se. The VRJ has been developed to collect and collate a range of raw and mediated data in written and pictorial form including reflective and reflexive notation (written and visual).
This presentation provides an opportunity to consider the role of the VRJ in the broader context of research journal writing and in relation to developing reflexivity in education based research.
Four levels of reflection are identified to support the analysis of the exemplar material within the visual presentation that accompanies this paper illustrating the evolution of the VRJ and the considering its appropriateness as a methodological tool.
Translating the Nouns into Verbs: Research Artistry in Action
* Faculty of Health Sciences, The University of Sydney, New South Wales, Australia
** The University of Western Sydney, New South Wales, Australia E-mail:
This paper explores “research artistry in action”; it takes the words creative and critical as applied to qualitative research and presents a series of research projects, which have translated these nouns into living research strategies that are relevant to current and emerging research contexts. Creativity for instance relates to blurring boundaries between different research approaches, the use of creative devices and images in research and improvisation of new research strategies. Critical refers both to researching with a heightened (critical) awareness and to researching in a critical social sciences frame of reference. Research artistry will be likened to jazz playing which exemplifies artistry that is both individual and communal. In such playing there is a combination of the creative and supportive inputs of each player/researcher performs in dialogue with the “fifth player” as described by Andresen and Fredericks (2001) in relation to collective, artistic practice endeavours. This artistry epitomises the powerful synergy and creativity that can be generated when a creative and authentic group of individuals combine their talents in a process of responding to each other, learning from each other and improvising around the emerging theme. Behaviours and abilities that were competent become liberated and expanded.
Crossing Regional Boundaries: A Derived Etic Methodology
Auckland University of Technology, Eastern Kentucky University, and Chiang Mai University E-mail:
Controversy exists about the epistemological feasibility, ethics and trustworthiness of cross cultural methods. Nonetheless, practice disciplines transcend cultural boundaries and require knowledge that serves culturally diverse clients. In particular, core constructs of the helping professions, including notions of health, care, rehabilitation and occupation have proved to be problematic when Western understandings are imposed on other peoples.
This presentation reports a collaborative international study of older women's food-related occupations in Auckland New Zealand, Richmond in Eastern Kentucky, and Chiangmai Province in Northern Thailand. It includes an overview of the multidisciplinary history and epistemological challenges of cross-culturally comparative methods.
The study demanded a research method that would honor the authentic perspective of participants, while supporting the examination of concepts across cultural groups. The method required researchers native to each of the three regions to collect and analyze data from their region. 336 single spaced pages of focus group data was generated from the three regions. Eight codes that crossed all regions were developed with input from all teams, and all data was coded by two researchers using Ethnograph. To preserve the emic perspective of participants, the native researcher teams analyzed the coded data of their region. Subsequently, each code was discussed by the combined team. Out of this discussion, themes that crossed regional sites were developed for that code, and the unique emic perspective of each regional team was written up. This process was completed for eight codes, before synthesizing the primary similarities and differences across the three regions within several discovered themes. The effectiveness of this method depended on face-to-face discussion within emic teams and across the international collaborative, allowing time to find language to accurately describe culturally embedded understandings, and egalitarian participation across all teams. The presenters bring for discussion the following question: Was this internationally comparative method sufficiently trustworthy?
Finding a Different Story; Using Qualitative Research Methods to Expand the Facts and Figures
La Trobe University, Wodonga, Victoria, Australia E-mail:
Much has been written in the literature concerning the differences in epistemology between positivist and naturalistic forms of inquiry. Despite this, there is growing support for mixed methods approaches particularly as researchers seek extended and deeper answers to their research questions.
This paper, drawing on a study of gender and social capital, will provide an example of a mixed methods research approach. The author will demonstrate, through the discussion of both quantitative and qualitative findings, how such an approach can provide a stronger and more powerful discussion. This paper will outline the two stages of data collection. It will provide examples of two different types of stories told by two different types of data.
One of the criticisms levelled at research that produces only quantitative data, is that the data can become over interpreted. Quantitative findings presented in isolation often lack the narrative to inform such interpretation. The author argues the advantages of complementarity, contradiction and enhancement when qualitative findings are considered alongside quantitative. When presented together, the greater power of the qualitative picture is evident.
Conducting a mixed methods study is not without its challenges. This paper will provide an overview of some of these challenges, focusing on data collection and data analysis. Substantial amounts of time need to be devoted to both tasks. The author will highlight her experience here, arguing that the choice to spend equal time on each form of data collection required considerable vigilance. Despite this, the author will argue that it is worth the effort.
The paper will conclude by arguing that some research questions may best be answered using a combination of data collection methods. Whilst quantitative data may assist in providing the big picture, it is the personal story, accompanied by thoughts and feelings that bring depth and texture to the research study.
Biting the Hand that Feeds You? Ethical and Personal Challenges in Undertaking Research about One's Own Professional Practice
Genetics Education and Health Research, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
Department Paediatrics, The University of Melbourne, Melbourne, Australia
Centre for the Study of Health, The University of Melbourne, Melbourne, Australia
Genetic Health Services Victoria, Royal Children's Hospital, Melbourne, Australia
E-mail:
Many pregnant women have screening tests to determine their risk for having a baby with Down syndrome. Women at increased risk (>1 in 250) are offered diagnostic sampling procedures such as amniocentesis which has a 1 in 200 chance of causing a miscarriage. There is no treatment for Down syndrome, a condition that results in severe intellectual disability, and the majority of pregnant women who receive a diagnosis choose to terminate the pregnancy.
Genetic counselling can provide education and support to pregnant women and their partners in order to facilitate autonomous choices about amniocentesis (Hodgson & Spriggs 2005). Little is known about the genetic counselling process or how it is experienced by women and to address this, as part of a PhD, the author (a genetic counsellor) undertook a qualitative research project “Women's experiences of prenatal genetic counselling.”
Prenatal genetic counsellors were involved in planning the project and they also assisted with recruitment for the study. Data consisted of 21 genetic counselling sessions performed by 6 different genetic counsellors. All sessions were audio-taped, transcribed and analysed for content, interactions and themes.
This paper describes the challenges of both researching within one's own professional environment and in presenting findings that critique existing practice.
Findings revealed a wide variation in content of sessions, counselling styles and, in some cases, poor counselling technique as well as a lack of discourse about necessary and sensitive topics such as termination of pregnancy. The ethical and personal implications for both researchers and participants will be discussed.
Advancing Science: A Methodology for Testing Inductively Derived Theories
* Loyola University, Marcella Niehoff School of Nursing, Chicago, IL
** University of Miami School of Nursing and Health Studies, Coral Gables, FL E-mail:
Aims/Objectives: Theory generation using the classical grounded theory method provides conceptualizations of phenomena from the perspective of the true experts—those individuals who experience the phenomena directly. These grounded theories are traditionally seen as the “end-point” and are not subjected to further testing. If these theories are to inform and guide evidence based practice, it is essential that testing of the hypotheses generated during theory development are subjected to testing. One barrier to testing inductively derived theories has been the lack of measuring instruments that accurately represent the theoretical concepts as experienced by the participants. The objectives of this presentation are to 1) discuss the dilemma of untested theory, 2) outline a strategy for quantitative testing of inductively derived theories, and 3) present the results of two independent examples of this theory testing strategy.
Research Design, Sample and Methodology: Both studies used a model testing research design. Data were collected from recently discharged hospitalized adults in one study, and bereft parents who had donated their child's organs at the time of death in the other study. Both studies used convenience sampling and data were collected using empirically derived measures to operationalize the major concepts of each theory.
Data Analysis: Quantitative model testing was accomplished using structural equation modelling.
Study Findings: In both studies, the inductively derived theoretical representations provided a good fit of the model to the data.
Discussion and Implications: The use of empirically derived measures coupled with model testing procedures provides researchers with tools to test relationships and hypotheses generated during theory development, while remaining true to the conceptualizations of the major elements of the theory. The methodology, tested in two independent studies, provides researchers with a new approach for theoretical knowledge testing.
It's a 5 Hour Flight to Our Research Site! National, Multi-Site, Qualitative Research through a Website? An Evolving Interface
Psychosocial Health Research Program, Central Queensland University, Rockhampton, Qld, Australia E-mail:
The use of an interactive, secure and flexible website has been pivotal to the effective and efficient running of a national multi-site research program. Coupled with the use of new technologies such as digital dictation and transcription, online dynamic calendars and central secure electronic document stores, the combined technologies have increased research output, information accountability and usability, decreased transcription and document handling costs, logistic issues and redundancy issues. Additionally, the publicly available “front end” increased research exposure and dissemination of current and previous research projects. It also facilitated increased collaboration and accessibility to research and other institutions both nationally and internationally. Future changes to the website involve increasing user interactivity, automation and streamlining work processes. Technologies used and the combination of such technologies will be discussed along with future directions.
“Coming Together”: Participatory Inquiry and Community Development Work—Analogous but Not the Same!
Centre for Psychological Studies, Department of Social Sciences and Humanities, University of Bradford, England E-mail:
Primary healthcare is recognised to be pivotal in terms of improving the health of communities. Yet, it is explicitly acknowledged that factors outside direct medical intervention are crucially important. In the United Kingdom community development projects are currently part of the public health strategy aimed at tackling the underlying social causes of ill health. The defining characteristics of community development work around inclusivity, active participation and communities collectively identifying needs within a democratic framework fit well with qualitative research and a commitment to “participatory inquiry” (Shaw, 1999). While the philosophical values of community development and certain qualitative research approaches may be analogous the challenge for researchers is to somehow, appropriately represent the broad spectrum of community development work in a way that does not lose its energy and multiplicity. However, those who commission health research have certain expectations around what counts as data and what might be used to “measure” the part played by funded interventions such as community development projects. This paper will endeavour to present the unfolding story of a research process where shared philosophical ideals enabled formal procedural requirements and a priori expectations to become dilemmas to be solved rather than barriers to progress.
Words Versus Numbers: The Place of Qualitative Approaches in Simultaneous Mixed-Methods Research
Department of Nursing, Tajen University, Taiwan
Nursing Research and PD, University of Ulster/Royal Hospitals Trust, UK
Institute of Nursing Research, University of Ulster, UK
E-mail:
Background: Qualitative research is a form of social inquiry that focuses on the way people interpret and make sense of their experiences and the world in which they live. Historically, “paradigm wars” have dominated debates about the most appropriate research design in any study. However, in the current healthcare climate it is important to find the most appropriate research methods that will achieve the best evidence-based outcomes from studies. For example demonstrating outcomes from health education is difficult through the use of any single research design. To fully understand patients' adaptive experiences during and following a health education programme, there is a need to move away from strict adherence to single paradigms and employ mixed-methods research. In the simultaneous mixed study qualitative data were used to enrich the bare bones of statistical results.
Aims: To explore the analysis of data: combining, interpreting and weighing of textual and numerical data in mixed-methods research projects. To exemplify the place of qualitative approaches in a simultaneous mixed-methods study of psycho-social state with stroke patients participating in a health education programme.
Research example: A semistructured interview method is the method of choice for certain types of problems such as investigating the psychosocial reactions of patients with stroke. It is an adequate method to collect qualitative data from stroke patients in mixed-methods study. Interviews and questionnaires were used simultaneously. Three questionnaires were used to collect quantitative data from 40 stroke patients. Interviews were conducted with fourteen patients from this sample group using quota sampling. Quantitative data was first analysed to establish a model to explain the relationships among patients perception of family support, social support, psychological reactions, and power. The semistructured interviews complemented the quantitative-method-bound results, with the merging of qualitative-method-bound data providing an indication of changes in each patient and an in-depth understanding of what these changes meant to the person.
Conclusion: The authors have proposed an opportunity of qualitative approaches in simultaneous mixed-methods research as a way to enhance the development of evidence in nursing research. The usual image of mixed analysis is putting meat on the bone. The conceptual analysis of all qualitative data available about the phenomenon of psycho-social adaptation among stroke patients participating in a health education programme enabled the integration of the understandings of patients' experiences and their world.
Health Visitors' and Midwives' Perceptions of their Role in Promoting Bilingualism
School of Nursing, Midwifery and Health Studies, University of Wales Bangor, UK E-mail:
The majority language of Wales is English and most speakers of the indigenous Welsh language are bilingual. This places them amongst the majority of the world's population who are also bilingual, affording distinct cognitive and social advantages (Baker, 1985). Compared to the perilous state of other minority languages, Welsh is enjoying a revival. The percentage of the population that speaks Welsh has increased from 18.6% in 1991 to 21% in 2001 (National Assembly for Wales, 2003). This is mainly attributable to the Welsh Language Act (1993) and the establishment of the Welsh Language Board (WLB), which aims to reverse the language shift in Wales and increase the number of Welsh speakers.
One of the WLB initiatives, entitled “Twf,” encourages families to raise their children to be bilingual. Twf emphasises the importance of developing bilingualism from an early age and of using Welsh in the home. Amongst other strategies, Twf encourages midwives and health visitors (HVs), who have contact with all prospective and new parents, to include positive messages about bilingualism in their work. To date, this strategy has enjoyed varied success and in some areas has been met with resistance from healthcare professionals.
As part of a three-year national study, we conducted a series of 6 focus group interviews with midwives and HVs, to establish their perceptions of their role in promoting bilingualism. The interviews lasted approximately 1 hour and were audio-taped and fully transcribed. Thematic content analysis was used to order, describe and interpret the data. An independent researcher read a sample of transcripts, trailed the decision process and scrutinised the identified categories to enhance the truthfulness and consistency of the study.
In this paper we will discuss the methodology, share the results of the study and consider the implications for Twf, the WLB and reversing the language shift.
Students' Letters as a Tool for Demonstration and Evaluation of a Course in Qualitative Methodologies
Israel Center for Qualitative Methodologies, Ben-Gurion University of the Negev, Beer-Sheva, Israel E-mail:
The qualitative methods course for graduate and doctoral students at Ben-Gurion University of the Negev (Israel) has developed a tradition according students an opportunity to reflect on their experiences during the course and ensuring course continuity from one year to the next.
In the two-semester course, each student is required to carry out case study research on a subject of choice, wherein course content parallels students' progress with their assignments. The final assignment calls for a full report of the study conducted, as well as a letter to the following year's students, informing them about the course. No rules are imposed regarding these letters except an anonymity requirement. During the first session of the following year's course, each student reads one of the letters and attempts to determine the information that may be derived from it concerning the course, instructors and writer. Analysis of the content and structure of the letter demonstrates the nature of qualitative research and the content and structure of the course.
Initial analysis of 160 letters written by students in various disciplines between 1998 and 2005 reveals that students differentiate between courses providing knowledge only and those in which they undergo personal experiences and a reflective process that adds a significant dimension to learning. Three principal observations are evident: 1) Students who experience a meaningful reflective process during the course heartily invite new students to join it. 2) The reflective process appears more significant than course content. 3) Understanding and practice of data analysis is a critical crossroads for most students. Those who carry it out successfully undergo empowerment and personal growth, while those who fail experience uncertainty and despair. Student letters serve as an innovative didactic tool for rendering the qualitative research process tangible, as well as a tool for course evaluation.
A Literature Review to Determine Key Attributes to Construct an Analytical Grid to Analyse Learning Web Games in the SAGE Project
* Université Laval, Quebec, Canada
** Télé-université/SAVIE
*** Université du Québec à Montréal
**** Université d'Ottawa E-mail:
The SAGE Project has been settled to develop generic expertise of e-trainers in producing games for their learners. Frame games (FGs) aim to support any kind of learning that can be done with games. FGs aim to adapt specific contents from various trainers into learning objects of on-line training (synchronous and asynchronous context). The project has been designed for in-training teachers, teachers, community trainers, business manager, business trainer, notably from New Brunswick, Quebec and British Colombia in Canada. One of the SAGE project goals is to create a new frame game to be able to make a new educational Web Game in health education. That new learning Web game will allow us to test many variables regarding different aspects of the impact of game on learning in the field of health education. Prior to build that learning Web game, it has been important to find the characteristics which make a game being a game and a learning game a tool to learn. So, the first stage of that research has been a literature review to determine the key attributes of games and learning games. Those attributes had been used to construct an analytical grid for educational Web games. Then forty Web games had been analyzed with that tool to determine the most interesting Web Games. Herein, we will present that grid and the results of the analysis of the games in terms of what we will keep in mind to choose the new FG needed to create the new Web Game.
How Do Families Reconstruct Positive Caregiving Experiences in Long-Term Aged Care?: Hermeneutic Interpretation in Process
School of Nursing and Midwifery, Research Centre of Clinical Innovation, Griffith University, Brisbane, Queensland, Australia E-mail:
Most family caregivers feel that they are failing their relatives by admitting them to a nursing home. The decision to institutionalise a family member is often a final desperate step after previous efforts to maintain a relative at home have broken down. Being able to recreate a valued identity as a family caregiver following the placement of a relative is vital.
Reconstructing meaning through seizing possibilities for positive caring emerged as a significant aspect of a hermeneutic phenomenological study of family caregiving in nursing homes. Hermeneutic analysis of in-depth interview transcripts and observation field notes of 14 family caregivers experiences of caring uncovered 5 shared meanings: accommodating new and different ways of caring; feeling a part of the nursing home community; learning to care in stress-reducing ways; seeing the whole picture; and learning to seize possibilities for self.
This paper will demonstrate how Heideggerian philosophy provided direction to reveal how meaning in everyday caregiving was disclosed, and Gadamerian philosophy shaped the process of generating understanding of such meaning from an interpretation of the stories shared. Detailed parts of family caregivers stories, those parts defined as significant by the narrators, will be merged with the researcher's interpretation of the meanings embedded in the stories shared.
Findings will be discussed in terms of the empowering process family caregivers experience as they discover ways of setting up positive possibilities to continue caring within nursing homes. The implications of such findings provide a justification for the promotion of a shared ideology of care that recognises, and gives equal status to, pathophysiological, psychosocial and interactional ways of knowing. Ideological change will be examined in terms of the value of accessing family knowledge and expertise and articulating the need to develop caring partnerships which empower family caregivers to redevelop a sense of future which is viewed with hope, strength and positive anticipation.
In the Vicinity of Interviews
University of Auckland, Auckland, New Zealand E-mail:
This paper is concerned with the “goings on” in the “vicinity” of research interviews. I focus particularly on identities and relationships that may be generated by the very possibility of an interview. I suggest that the prospect of an interview has the potential to stir up images that speak to social differences between an interviewer, potential subject and others in the research setting.
I suggest that as researchers we may be inclined to “background” what goes on “round about” our interviews, including the commentary of friends or coworkers of those we interview, while foregrounding material and processes related to the interview itself. Indeed, while there is a substantial body of literature addressing the interview as the primary research tool in the social-sciences, there is far less about the way interviews may be taken up either side of that bracketed–off time and place.
I illustrate responses from the vicinity of research interviews with examples from my PhD field -work in a large New Zealand department store. I focus on those responses that potentially confront and reproduce social differences between interviewer, subject and the subject's friends and coworkers in the store. Thus I draw attention to a range of socially differentiated positions that were thrown up around interviews. For example in one instance, as my subject and I left the sales floor and moved toward the interview room, I was cast in the role of an official escort, my subject acted the part of frightened client/customer/patient and her coworkers became the loved ones, anxiously waving goodbye. Thus, I argue that responses from the vicinity of interviews can sometimes be as eloquent and as instructive for the inquiry process as interviews themselves.
Action Research May Change the (Health Care) World, but What About Its Professional, Clinical and Scientific Value?
Institute of Nursing and Health Sciences, University of Oslo, Oslo, Norway E-mail:
In this paper we draw on experiences from three different action research projects in Norway and Denmark which used diverse action research approaches to contribute to quality improvement within different parts of the health care sector. One project introduced a new kind of institutions, teaching nursing homes, at the Norwegian health care scene. Another sought to develop ways of empowering practical nurses, nurse aids and RNs within the primary sector, and the third developed a prototype for moving experts from the hospital to the patient's home by way of technology. All three projects were successful in contributing to significant changes at the political level, at the organizational level and/or in clinical practice. At the same time the projects exposed or generated actual or potential power struggles in terms of who controlled the change processes, who “owned” the projects and their significant experiences as well as the right to define success and failure. From a research perspective, this may cause difficult ethical, collegial, professional and scientific dilemmas. Through its location at the borders between political, organizational, clinical and research praxis, action research may be at the crux or at the margin of the scientific enterprise. In this paper we'll discuss these issues and reflect on the possibilities of exploiting this position constructively to increase the impact of qualitative research on the health care sector.
Strategies in Assessing Postoperative Pain—A Qualitative Perspective
* Professor and Head of School of Nursing Science, North-West University, South Africa
** Nursing Student, Department of Health Sciences, University of Skövde, Sweden
*** Nursing Student, Department of Health Sciences, University of Skövde, Sweden
**** Nursing Student, Department of Health Sciences, University of Skövde, Sweden
***** Professor, Department of Health Sciences, University of Skövde, Sweden and Department of Health Care Pedagogics, Göteborg University, Sweden E-mail:
The incidence of patients reporting postoperative pain remains high indicating unnecessary suffering in spite of the available effective pain relief treatment. The purpose of this study was to identify and describe the strategies used in the assessment of postoperative pain among registered nurses. A qualitative, phenomenographical study was conducted in a 950-bed academic hospital complex. Surgical nurses (n=12) were carrying out pain assessment of postoperative patients (n=36) in pain. Data were collected using a detailed interview before, during and after pain assessment and indicating the estimated pain intensity in a Visual Analogue Scale (VAS, 0–10mm). From the qualitative analysis five strategies (a) how the patient looks, (b) what the patient says, (c) a focus on listening to patients, (d) what to look for, and (e) what to do for patients were identified, as well as five experienced related categories. According to the VAS ratings the nurses significantly underestimated the patient's ratings. This indicates that we have an important task in education of nurses, but also other health oriented professional education to influence the students in order to ensure quality pain management.
Proulx: A Systemic Approach to Describe, Interpret and Evaluate Inter-cultural Interactions
* School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
** Division of Nephrology, Dept. of Medicine, Kingston General Hospital, Kingston, Ontario, Canada E-mail:
Inter-cultural communication is an emerging discipline, rooted in linguistics, anthropology, sociology and psychology. Understanding the complexities and impact of inter-cultural communication is becoming a necessity in social, political and institutional realms in the attempt to address human diversity and the dynamic relationships of cultural systems. Inter-cultural communication directly relates to interactions between cultures and not merely the juxtaposition of cultures in the same environment, which is often demonstrated in the collection, analysis and reporting of research. This paper presentation will introduce the systemic approach proposed by Jacques Proulx regarding inter-cultural interaction and discuss how this model can facilitate qualitative research to describe, interpret and evaluate intercultural dialogue. Three key components in Proulx's model include: the situation, the context, and the individual (culture, role and representation) contributing to the interaction and how each component relates to the interaction in question. Specific illustrations from an instrumental case study which investigated the impact of relocation to an urban health care facility for life-sustaining hemodialysis on the illness experience and quality of life of Cree individuals living with end-stage kidney disease will be demonstrated will the multiple perspectives elicited from the HD patients (N=3), their health care providers [nurses (N=3), nephrologists (N=3)] and Native support workers (N=3). The aim of this discussion is to prepare qualitative investigators to utilize Proulx's proposed model of inter-cultural interaction while 1) providing insight into the layers of culture orientations within the research context, and 2) developing their inter-cultural awareness. Examination of the dimensions associated with inter-cultural communication will not only strengthen the integrity of intercultural dialogue within qualitative research but also enhance cultural competencies of investigators.
Development of Mixed (Qualitative and Quantitative) Methods for Measuring Economic Empowerment of Women in Japan
Graduate School of Human Sciences, Osaka University, Japan E-mail:
This is an attempt to apply so-called mixed-methods (qualitative and quantitative research methods) to analyze changes in one's empowerment. Women's empowerment has become popular subject among practitioners and academia in development studies lately. Empowerment, as a part of capability approach by Nussabaum and Sen, is holistic in that it deals with economic (income enhancement and purchasing power increase) to non-economic aspects (decision-making power, social consciousness, etc.). We have seen some evidence over influences of economic empowerment on women's empowerment; however, these efforts face with difficulty in terms of data gathering and measurement of empowerment progress and changes.
In Japan, gender issue slowly receives attention among general population, partly because of its declining number of children. Yet, perceptions sheared among Japanese are still shaped by traditional views based on strong patriarchal thought. In order to see if gender matters for social change in Japan, some research might be helpful to grasp if there are any effects of women's empowerment?
One of such cases was found among women's self-help organizations called women's workers collectives. This paper will examine if there are any effects of workers collectives on women's empowerment at individual, households, and organizational levels, based on primary data gathering made by the author in Sapporo, Hokkaido in 2005. It also presents a way to test how economic empowerment induces non-economic empowerment.
The Advantages of Reflexive Notes as Objective Data in an Observer-Participant Longitudinal Study
School of Health, Nursing and Midwifery, The University of Paisley, Scotland. E-mail:
Morse (1999) advises an “armchair walkthrough” prior to undertaking a research project. This involves becoming aware of the types of data collection techniques that can be used to inform and shape a project before undertaking a study. Some authors however, argue that new researchers should “jump in,” and learn about research methods, and data collection and management, during the process of their studies (Robson, 2002). However, learning during the process may lead novice researchers to discount valuable information that they had not recognised as data.
This paper discusses the relevance and use of data gathered from a reflective diary, newspaper articles and reflexive field notes as suggested in the literature (Van Maanen, 1988; Wengraf, 2001; Whitehead, 2004). The opportunity of finding out about what counts as data, can both enhance note taking and prevent valuable information from being rejected by the researcher as subjective and/or anecdotal.
During a four-year qualitative doctoral research study, the author conducted a pluralistic evaluative study. The focus was on the experiences of older people, who were living in a hospital, whilst waiting for a place in a care home. During the four years, the author spent a year visiting patients who were living in this transitional state.
The whole study involved eight components of data collection, three of which were
A reflective diary (kept monthly over four years) Newspaper Articles Reflexive field notes, (which had been recorded immediately after each visit to the ward)
In keeping with the nature of qualitative research, one method of data collection led on to another as different types of information were needed to answer the three research question posed.
This paper discusses how the use of such data became invaluable as objective data in the final analysis of the thesis on inappropriate hospital bed occupancy.
Models of Action-Based Research: Legitimate Variations on an Action Research Theme?
School of Nursing and Midwifery, University of Southampton, UK. E-mail:
The aim of this paper is to critically examine different approaches to research which claim to be related to action research, with a view to developing different models of action based research. Whilst action research is a broad church, it will be argued that it is also appropriate to designate other research endeavours as “action based” as long as they fulfil certain key principles.
The legitimacy of variants will be debated by reference to four empirical research projects which illustrate quite different design features, processes and ways of working. Two are linked completed studies of the use of “communities of practice” to bring together different stakeholders including citizens and service user advocates, one to develop health services of particular importance to older people in primary care (Lathlean and le May 2002) and the other in secondary health care, focusing on dermatology and audiology services (Le May, Lathlean and Myall 2002). The third is an “action-based” study of a novel approach to the organisation of nurse and midwifery education (known as “locality commissioning”) (Lathlean and Myall 2005) and the fourth is an “interactive” evaluation of a programme for the preparation of “nurse registrars” as trainee consultant nurses in emergency care in hospitals and the community (Lathlean, Surridge and Horwood 2005). The first phases of the latter two projects will be reported on.
The positive outcomes as well as the methodological challenges of these projects will be presented, and their desire to utilise action research principles and practice will be interrogated. It is hoped that at the conclusion of this paper, the discussion of the different models will provide both theoretical and practical insights into the further development of action research, especially in health and social care.
Achieving Collaboration between Researchers, Health Service Providers and the Lay Community in Action Research: Experiences from a UK Study
School of Nursing and Midwifery, University of Southampton, UK E-mail:
The aim of this paper is to a) illuminate factors that facilitate effective collaboration in the initiation and operation of action research involving different key stakeholder groups and b) to highlight the benefits that arise from this collaboration. It will draw on findings from a recently completed action research study (Elsey 2005) into the processes of facilitating community participation in a health and regeneration programme in the UK. The study was funded by a local health services provider (a Primary Care Trust (PCT). The authors will highlight the issues arising from the collaboration between the PCT, the School of Nursing and Midwifery in which the research was academically supervised and the lay community in which the research was situated.
Factors facilitating effective collaboration included dialogue with all parties by an experienced research project co-ordinator in order to agree a realistic focus and outputs from the study, as well as formal structures such as a selection panel and an advisory group on which all stakeholders were represented. During the operation of the project, the action research study had at its core a group of seven co-researchers including health service employees, community health workers of different managerial levels—many of whom were resident in the locality—and a community member. The participatory style of the action research approach facilitated close collaboration within the group. This collaboration had a number of beneficial outcomes: for example, it led to deep reflections on the nature and processes of community participation; it helped to challenge non-resident participants' less empathetic attitudes to the community, it tempered feelings of disillusionment and stimulated the group to persevere with attempts to encourage participation within a challenging regeneration area.
By highlighting our experiences of successful collaboration, this paper will offer important insights into action research project planning and delivery in health services research.
Duplicity and Integrity: Ethics and the Moral Enterprise of Feminist Research
School of Human and Health Sciences, Division of Psychology and Sociology, University of Huddersfield, Huddersfield, England E-mail:
The issues covered in this paper arose from recent research exploring the construction of domestic violence within health services in the United Kingdom (Lavis, Horrocks and Kelly, 2005). The research developed a feminist Foucauldian discursive approach (combining feminist theory, Foucauldian discourse analysis and positioning theory Davies and Harré, 1999, 2001) to explore issues of power, knowledge and language on the provision of services for women. Underpinned by a commitment to feminist ethics, qualitative, depth interviews were carried out with a range of participants, including “elite” key informants within health services, health professionals and women who, having experienced domestic violence, accessed health services. In considering reflexively the experience of individual interviews the authors became aware of the interactive requirement to be different with and for individual participants. Drawing on Coffey's (1991) notion of fieldwork as “identity work” we explore the ethical implications of constructing and performing different “research identities” within the commitment to feminist research as a moral enterprise (Mauthner et al, 2002). We suggest that whilst such identities can be viewed within feminist research as being responsive to the individual needs of specific participants, they can leave the researcher with the experience of being “duplicitous.” In exploring the tensions inherent within these two vantage-points we consider some of the ways in which feminist researchers may negotiate these tensions with integrity.
Qualitative Research with Clinical Populations: Towards an Articulation of the Field and Methodological Matters
* The University of Sydney, New South Wales, Australia
** The Royal Hospital for Women, Sydney, NSW, Australia E-mail:
This paper examines the use of qualitative research methods for data collection with clinical populations. The paper will review the growing use of qualitative methods in the health disciplines and reports on emerging trends and issues. The use of qualitative approaches in health care research as an adjunct to traditional scientific, biomedical and psychometric design, or as the only method of data collection and analysis will be explored. A number of issues arising from this increasing popularity are raised. In particular, the paper explores the appropriateness of qualitative approaches in this context. It articulates some possible defining parameters that go to the questions of rigour, clinical accountabilities, ethical considerations and the use of qualitative methods for researching clinical populations. Of particular interest is the question of the theoretical backgrounds for such work, the reporting of study outcomes and the clinician-researcher interface.
Prescribing Promotional Targeted Drugs: Qualitative Study of Influences on Thai Physicians
Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen, Thailand.
Faculty of Nursing, Khon Kaen University, Khon Kaen, Thailand.
University of New South Wales, Sydney, Australia.
Ministry of Public Health, Nonthaburi, Thailand.
E-mail:
Objectives: To explore Thai physicians' perception toward promotional targeted drug (PTD) prescribing and the factors that influence them to prescribe a PTD.
Methods: A qualitative study was conducted using various data triangulation approaches including documentary analysis, in-depth interviews of physicians as well as other key informants in the pharmaceutical industry, and participation observation in medical conferences. In order to obtain the theoretical sampling and saturation during the data collection and analysis, approaches in Grounded Theory were applied.
Results: Overall, the physicians had a positive perception toward the PTD itself in terms of the innovative product profile that could benefit the patients. Nevertheless, most doctors were concerned about the cons of prescribing PTD including the long-term safety of PTD and issues related to the entangling relationship between doctor and pharmaceutical industry, especially when the pharmaceutical companies spent a lot on marketing PTD. The individual doctor's prescribing pattern could be explained as his/her defence mechanism when facing the conflict between professional and ethical practice, which forms the basis of our newly developed—“Symbiosis Ethical Balance Model.” Factors related to prescribing PTD were intricate, multidimensional and could vary with different types of patients, practice site, and physician's background.
Conclusions: Based on the grounded empirical data using various qualitative methods, we could uncover the complex PTD prescribing phenomena by providing insights into how the physicians make sense of their PTD prescribing; their exposure to tactical promotion activities; and the situational defensive responses of physicians in their real practices, which are not easily reflected by the traditional quantitative research approach. Our Symbiosis Ethical Balance Model elaborates the interplay of factors influencing physicians' prescribing behavior of PTDs, an understanding of which is essential for developing practical policies in order to promote rational drug use and curb increase in drug costs in Thailand.
Tensions and Challenges: Developing a Model to Respond to the Ethical and Methodological Difficulties of Conducting Research with Adults with Dementia
* Primary Care Nursing Research Unit, King's College London and University College London, UK
** Primary Care Nursing Research Unit, University College London, UK
*** University of Southampton, UK
**** University of Hertfordshire, UK
***** University College London, UK E-mail:
Background: An ageing population, together with increasing costs in health service provision and long-term care, have led to a policy focus on the development of evidence-based health and social welfare services for older adults in developed countries (Drennan et al 2005, Department of Health 2004, Australian Institute of Health and Welfare 2004, European Commission 1999, Health Canada 1996). However, the need for research to support evidence-based policies presents challenges.
In particular, the involvement of older adults with dementia is problematic because of a common, but erroneous, belief amongst researchers that such adults automatically lack the ability to provide meaningful consent (Mozley 2004, Buckles et al 2003, Guinn 2002). Arguably, this is, in part, because traditional theoretical foundations of consent (principally Kantian and Millean views of autonomy) have given rise to a ritualised focus on the cognitive capacity of individuals to weigh up risks and benefits and to reach a rational decision (Assiter 2005, Dewing 2002). The result of this ritualistic approach is to exclude by default the voice of older adults with dementia from contributing to research and related service development: creating an ethical and methodological tension.
What this paper adds: This paper will engage critically with the dominant Western model of informed consent through the application of post-modern and post-structural theories. An argument will be made to suggest that current approaches to consent place too great an emphasis on intellectual competence at the expense of wider, interpersonal concerns and abilities. It will draw on the experience of the authors in conducting two current UK research studies that have involved older adults with dementia. A practical model process of seeking consent derived from the studies will be presented to identify an inclusive approach that enables the voice of older adults with dementia to be heard within research.
References are available from the first author on request.
Doing Cross-Cultural Research: Opportunities and Challenges for Qualitative Researchers
School of Public Health, La Trobe University, Bundoora, Victoria, Australia E-mail:
Globally, cross-cultural research has become increasingly essential. In multicultural societies like USA, Canada, United Kingdom and Australia, there has been an increasing number of people from different cultural, ethnic, and linguistic backgrounds, and hence, the provision of culturally sensitive care is no longer a luxury but “a necessity.” This leaves health professionals with the challenges of developing an appropriate knowledge base, and it is suggested that knowledge of culturally appropriate care can only be obtained by research. This necessitates cross-cultural research methodology that incorporates cultural awareness. Leininger (1995) contends, “without cultural awareness, researchers tend to impose their beliefs, values, and patterns of behaviour on cultures other than their own.” In this paper, I argue that cross-cultural research is an essential tool for advancing cultural awareness of health beliefs and practices of diverse cultural groups. But, doing cross-cultural research is not a simple task and without difficulties. In this paper, I will discuss salient issues relating to cross-cultural research including cultural sensitivity, language and the use of bi-cultural researchers, access to the research participants, ethical issues and informed consent, and culturally sensitive research designs.
Applying the Instrumental Case Study Design
* School of Nursing Sciences, James Cook University, Cairns, Queensland, Australia
** School of Nursing, Family and Community Health, College of Social and Health Sciences, University of Western Sydney, Sydney, New South Wales, Australia E-mail:
The case study is contemporary, contextual and holistic with respect to both the phenomena of interest and the chosen research location. The case study is congruent with the qualitative tradition of data collection (interview and observation), data analysis (context dependent, holistic data analysis) and report writing (first person voice and the product is a case study). Thus the case study is characterised by the qualities of discovery of regularities (thematic generalisation) and comprehension of meaning. This paper extends the work of the authors on case study as a bridge across the paradigms (Luck, Jackson & Usher, in press). We explore the relevance and application of a simultaneous mixed method instrumental case study design, or triangulation mixed method instrumental case study design in the “real world” locale of a busy remote and rural Australian Emergency Department (ED). We will delineate how the use of unstructured participant observations, structured observations, semistructured and unstructured interviews provided contextual ED specific understandings of the strategies, assessment and sequelae of violence towards nurses. We will discuss our rationale for further informing this instrumental case study with ethnographic fieldwork methods and in doing so will examine how other methods could be likewise employed via case study as a bridge across the paradigms. Issues of identifying the “case” versus “a case of,” the boundaries of the case, selecting data sources, and contextualising the case will also be examined.
Critical Discourse Analysis of Terrorism and “Just” War: Teacher Educators' Perspectives
National-Louis University, Chicago, Illinois, USA E-mail:
The problems of violence may remain obscure to Sorel (1999), yet they seem to become more transparent as some of us study and experience them to the extent we could never have imagined. Violence appears to be a common denominator of our times. What is the nature of violence? How do ordinary Americans respond to the acts of violence, terrorism, and war? How do young adults make sense of violent events in schools, on college campuses, and in the world at large? How does higher education prepare public school teachers and administrators to deal with occurrences of violence? What are the moral stakes of citizenship in times of political crises and threats to democracy? These and others questions constitute the argumentative discourse of the paper that draws from selected writers on political philosophy, socio-linguistics, educational theory and methodology, such as H. Arendt (2005, 1998, 1994, 1970), R. G. Collingwood (2005, 1999), J. B. Elshtain (2003, 2002, 2000), G. P. Gee (1999), B. Johnstone (1996), G. Sorel (1999), S. M. Stanage (1975), A. Wierzbicka (1996), and others.
Critical discussions focus on Arendt's notions of power and polis, the nature of violence, and the banality of evil; on Collingwood's concepts of barbarism and civility, language and discourse as use, meaning making, and acting; on Elshtain's controversial moral position on war, among others. The connections are further made between the critical argumentative discourse on violence, terrorism, war, peace, civility, and education and the corresponding socio-linguistic discourses as they have been outlined by several American teacher educators. The analysis extends to the debates on the relationship between knowledge, power, and language. The resulting critical interpretations emphasize the interplay of action (praxis) and speech (lexis) as hopeful possibilities of democracy. The paper problematizes the notions of civic and moral responsibility and urges educators to become more engaged political and social activists.
The Sounds of Silence: Perceptions of Prostate Cancer and Its Treatment
School of Nursing & Midwifery, The University of Newcastle, Australia
Department of Radiation Oncology, Newcastle Mater Hospital, Newcastle, Australia
E-mail:
Prostate cancer is the most common internal cancer in Australian men. One in eleven will develop prostate cancer by the age of 75 years. The incidence and mortality figures for prostate cancer are very similar to those for breast cancer in women. Its asymptomatic nature, and lack of systematic screening, means that prostate cancer is often not diagnosed until it has spread. The “silent” presentation of this cancer, and the silence that surrounds it within the community, have contributed to a dominant narrative of prostate cancer that prevents more open discussion and community education.
Aims: To provide insight into community perceptions, knowledge and attitudes related to prostate cancer, and to compare these with the experiences and lessons learned by men with recent diagnosis of prostate cancer and their wives/partners.
Methods: Single, semistructured qualitative interviews (and two focus groups) were conducted with community volunteers (n=44), men with prostate cancer (n=18), and their wives/partners (n=9). Thematic analysis was undertaken by the first-named author.
Findings: The key findings focus on:
community perceptions that reveal lack of knowledge, misconceptions, and male attitudes of awkward silence and veneer of toughness; patients' and their wives‘/partners' experiences of lack of perceived choice, the pivotal role of the patient's age, and the impact of phrases used by medical specialists; and the contrasting dominant narratives of prostate and breast cancer, and the role they play in shaping community perceptions and attitudes.
Methodological implications of conducting research on a sensitive topic, including couples in individual interviews, and attempting to increase participation by members of ethnic minority groups will also be discussed.
Telling Their Stories—Telling Our Stories: Physicians' Narratives of Experiences with Patients Who Decide to Forgo or Stop Treatment for Cancer
School of Nursing and Midwifery, The University of Newcastle, NSW, Australia
School of Social Work, Ben Gurion University of the Negev, Beer-Sheva, Israel
E-mail:
Current evidence suggests that medical and other staff often feel uncomfortable, troubled, and even distressed when dealing with patients who make decisions that run counter to medical advice. This is especially so in the context of oncology where rejection of medically prescribed treatment can be perceived as a giving up on life or denying oneself the possibility of cure. Aims: This paper is derived from a larger cross-cultural study in which the aims were to explore how adults with cancer decide to forgo or stop active treatment, and how close family members and participating staff construct and respond to the patient's decision. On this occasion, we will report on the experience of oncologists in Australia and Israel when dealing with patients who choose not to start or, at some point, stop treatments such as radiation or chemotherapy.
Methods
Single, semistructured qualitative interviews were conducted with practicing oncologists, focusing on experiences with patients who decide to forgo or stop active treatment for cancer. Interviews were recorded, transcribed, and those conducted in Hebrew analysed in the original and later translated into English. Thematic analysis was undertaken by the two authors, working individually and engaging in joint analysis and interpretation of data. Most of the analytical work was completed jointly during a two-week residency at the International Institute for Qualitative Methodology, Edmonton, in July 2005.
Findings
The key findings focus on (1) the physicians' construction of patients and their decisions in terms of binary opposites as: young/old; curable/incurable; rational/irrational, and (2) the physicians' response to patients' decisions in subjective ways: by being uncertain; being afraid; and being concerned for the self. The challenges of conducting a qualitative project that crosses cultural, linguistic, professional, and philosophical boundaries will also be addressed.
Traumatic Transcriptions: Emotional Issues for Research Assistants Collaborating on Difficult Topics
Sociology, University of Lethbridge, Lethbridge, Alberta, Canada E-mail:
This paper derives from two qualitative research projects on which graduate student researchers have collaborated. The first is an oral history/archival document project describing the experiences of individuals with developmental disabilities who were institutionalized and often involuntarily sterilized in a total institution during the mid 1960s to late 1980s. The second is a qualitative interview-based study of the challenges women with disabilities experience in raising their families, with a particular focus on gaps between the promises of policy and the delivery of supports. In each of these projects, students have engaged in transcription and coding of data.
Both of the projects involve highly upsetting materials: the transcripts and textual data are replete with violence, isolation, poverty, frustration and reports of trauma. Student researchers were asked to write journals on their experiences of working on these projects, and group discussions were held to deal with the fallout of working with such materials. The records from these journals and group discussions are mined to examine the strengths and weaknesses of doing group research, and the responsibilities for, and possibilities of, team research leaders in providing emotionally safe research environments for research assistants.
Discourse Analysis and Alcohol and Other Drugs Research- On a Successful Marriage
Faculty of Education and Health Sciences, Charles Darwin University, Darwin, NT, Australia E-mail:
Recent qualitative research cumulatively indicates that young people's actual drinking experiences, especially those involving high volumes of consumption, differ substantially from professional formulations of the same events (See for example, Beccaria & Guidoni, 2002; Sheehan & Ridge, 2001). The way binge drinking is socially constructed among young people is almost in direct opposition to the way the same phenomenon is constructed in research and professional literature.
The gap between young people's experiences and professional discourse threatens to thwart efforts to promote safer alcohol consumption practices, so much so that researchers and health professionals have recently been criticised for contributing to the failure of young people to identify binge drinking as harmful (Goodhart, Lederman, Stewart & Laitman, 2003). In order to overcome this problem and to design more effective public health messages that will resonate with the target audience it is necessary to have an in-depth understanding of the way young people construct drinking. In particular it is important to identify the types of discourses that normalise harmful patterns of consumption (Goodhart et al., 2003). The identification of these discursive constructions has important implications for current health promotion strategies (Gillies, 1999).
This paper proposes an alternative to mainstream research methods commonly employed in the alcohol and other drugs field, as a way to enhance our understanding of drinking, or any drug taking for that matter, from the consumers' perspective. One of the research frameworks most suited to gleaning this kind of information is Edwards and Potter's (1992) Discursive Psychology. The paper details how this framework can be successfully applied to the study of alcohol and other drugs.
Although the information presented relates almost exclusively to binge drinking, the same principles can be applied to study of any type of drug use.
Effectiveness of the Participant Observation Method in Addressing the Complexities of Communication and Decision-Making Processes for Pain Assessment and Management
School of Nursing, The University of Melbourne, Victoria, Australia E-mail:
Despite increasing technological advances patients continue to experience pain in the postoperative setting. Research methods used in previous pain studies tend to involve surveys, retrospective audits of patient charts, and interviews. Past research has rarely been carried out in the actual clinical setting, which would take into account the complexities of pain control. The participant observation method allows for these complexities to be captured systematically as they are happening. This method also enables the researcher to examine how participants act, behave and interact, so that meanings of everyday experiences can be constructed.
This paper critiques the potential usefulness of the participant observation method by drawing upon a single group, non-comparative study, which examined how nurses managed patients' pain in the postoperative context. Six nurses who were involved in direct patient care in one of two gastro-surgical wards in a public teaching hospital, were randomly selected to participate. The participant observation period comprised a fixed two-hour segment, and each nurse was observed on three different occasions. Follow-up interviews were also conducted.
The study demonstrated complexities associated with communication and decision-making processes influenced pain assessment and management. Communication processes occurred through interactions with health professionals, and policy and protocol concerns. Formal communication through the multidisciplinary ward round tended to be somewhat fragmented, as the medical consultant rarely sought out the bedside nurse to make decisions about patients' treatment. Nurses had good knowledge of unit policies and protocols for pain management and while attempting to enforce them, they spent considerable time encouraging their medical colleagues to abide by these guidelines. Furthermore, nurses made complex decisions, which extended beyond administering analgesics.
By using a participant observation method, the study identified how the complexities of the context influenced the organisation of pain management, the results of which can form the basis of future interventional work.
Coping with Stigma by Women whose Partners Died of AIDS
North West University (Mafikeng Campus), North West Province, South Africa; Democratic Nursing Organization of South Africa (DENOSA) E-mail:
The study conducted by the researcher in her master's degree, “experiences of widowhood and beliefs about the mourning process of the Batswana People,” revealed that women are stigmatized, discriminated against and shunned by society. This isolation is due to the cultural beliefs that make coping with widowhood a difficult and painful process for the widow.
This process is currently observed to be more painful, due to the stigma of HIV and AIDS associated with that of widowhood. The aim of this study is to explore and describe the experiences of coping with stigma by women whose partners died of AIDS, and to develop a programme to assist these women to cope with the stigma associated with their having had a relationship with an infected person who died of AIDS. The study is conducted in the context of the North West Province in South Africa. The methodology followed is a qualitative, phenomenological research design. The study is conducted in two phases. The first phase consists of the in-depth interviews with participants in order to explore and describe their experience of coping with stigma.
The outcome of phase one and the literature provides the information that will assist to formulate a programme which will be evaluated in phase two. Phase two design is a case study design for the development and evaluation of a programme for coping with stigma by women whose partners died of AIDS.
Data analysis is done according to an open coding method (Creswell, 1998:48). The findings of the first part of the study are that women feel treated differently because people keep asking them “how they are.” They react with denial, in which case they cite different conditions in which they allege their partners died of, such as hypertension or diabetes. These gossips make the women uncomfortable because they think that they are being suspected of having HIV and AIDS, despite the fact that people cannot prove that. These women also seem to cope by taking extra care of themselves, especially their physical appearance, so that they do not look sick or apathetic. They also talk good about their late partners so that the focus is on that rather than HIV and AIDS.
Conclusions of phase one of this study are that women whose partners died of AIDS experience discrimination, isolation, gossips about their HIV status, as well as blame for being careless. These findings will be used to develop a programme to assist these women to cope with the stigma associated with their having had a relationship with an infected partner who died of AIDS.
A Psycho-Educational Programme for Team Coaches to Facilitate the Mental Health of Managers
University of Johannesburg, South Africa E-mail:
Preventing managerial degeneration is increasingly becoming a corporate priority! Business coaching provides the gateway to intellectual and emotional support and develops managers, thus avoiding managerial derailment and preparing individuals to meet the increasingly complex requirements of today's business environment.
While a substantial part of business coaching involves one-on-one coaching, the need for team coaching is increasing as “world-class” business organizations shifts from “I” to “we.” Business and team coaching is distinct from other types of coaching and calls for additional competencies and expertise. Currently barriers to entry into the coaching profession are non-existent. At best, the coaching certification offered by various self-appointed bodies is difficult to assess, while methods of measuring return on investment are questionable. The low barrier to entry and the limited number of institutions that provide coaching in South Africa will impact negatively on the quality of coaching provided.
The question this research aims to answer is “What should a programme for team coaches consist of to facilitate the mental health of mangers?” The aim of the research being to develop a programme for team coaches to facilitate the mental health of managers.
This paper focuses the themes that emerged in a qualitative, descriptive, exploratory, contextual research design utilizing autoethnography as a strategy. This strategy displays multiple layers of consciousness of the researcher, connecting personal with cultural. It is an attempt at practicing self-reflectivity on the part of the researcher by having a closer look at one's own longings and belonging. Triangulation was achieved through focus groups, individual interviews and naïve sketches with critical reference groups, the results culminated in the design of a programme for team coaches to facilitate the mental health of managers.
Writing for Action Research: Engaging in the Process
School of Nursing and Midwifery, St. Martin's College, Barrow-in-Furness, Cumbria. UK E-mail:
This paper discusses the importance of writing throughout the process of a qualitative action research study. It firstly outlines the key principles of action research including critical reflexivity, practitioner ownership/development, promotion of change, collaboration, development of practice standards and learning communities. It further examines how the writing process helps to maintain these important beliefs as well as promoting validity and reliability and the final outcome in the form of a transparent and meaningful report/thesis. In qualitative participatory action research, attempting to achieve validity and reliability requires a different approach to traditional research (Koch, 1996). The continuous recording and analysis of events, feelings and actions helps to uphold the rigour of the research.
To illuminate the discussion extracts from the research data will be included.
The action research study in question focused on nursing practice conversations in the form of clinical supervision over a period of eighteen months. The thirty-four participants were from a variety of nursing specialities. Data were obtained through reflective diaries, reflective statements, and conversations.
Whilst the study design and findings are important, this paper will focus on the writing process undertaken by the thirty four participants and the principal researcher. This discussion is aimed to help and motivate action researchers to understand the practicalities of writing an action research study.
The Big U Turn: A Methodology and a Method for Understanding the Shaping of Understanding
Auckland University of Technology, Auckland, New Zealand E-mail:
This paper will present the qualitative methodology used and the method formulated in undertaking a doctoral thesis which looked at the question: What is shaping the practice of health professionals and the understanding of the public in relation to intervention in childbirth? A study such as this demanded a methodology underpinned by a philosophical stance that showed how understanding is shaped. The philosophical approach that provided this framework came from Hans Kogler and is called critical interpretative dialogue (critical interpretation). Kogler draws on a number of philosophers and in effect wants to bring together the analytical tools offered by discourse analysis with the insights of hermeneutics (Kogler, 1999). Kogler (1999) claims that through a “methodologically undogmatic amalgam of interpretively gleaned insights and conclusions, phenomenological observations and analytically conceived results and arguments that it is possible to bring to conscious awareness the underlying premises of interpretive praxis” (p. 11). He believes that the most promising methodological path to bring about such awareness is one which mediates between insights developed by Foucault and Gadamer (Kogler, 1999). This paper will present the methodology put forward by Kogler which underpinned this study and the subsequent method developed for carrying out the study and the analysis of the data. A method which provided me as researcher with a sound base and a “user friendly” way to approach and analyse the data and so come to an awareness of that which is shaping practice and understanding in relation to intervention in childbirth.
Embedding Qualitative Methods in an Ongoing UK Clinical Trial
Health Services Research Unit, University of Aberdeen, UK
Social Dimensions of Health Institute, University of Dundee, UK
E-mail:
In health services research there is an emphasis on randomised controlled trials [RCTs] being the design of choice for evaluating the effectiveness of health care interventions, but many trials recruit fewer participants than anticipated. Although much is known about the perspective of clinicians and researchers, far less is known about people's experiences of recruitment and participation in trials.
Qualitative research has significant potential to improve understanding of these issues. For example, not much is known about how people are initially approached to participate in trials, the nature of communication between recruiting trial staff and potential participants, issues under consideration when people are deciding about trial participation, and people's experiences of taking part in trials.
Within the context of this important research area, we report on insights from a study that embedded qualitative research within an ongoing UK multi-centre clinical trial to explore people's experiences of trial recruitment and participation—the trial was comparing medication and surgery for people with gastro-oesophageal reflux disease.
Embedding qualitative inquiry in this way richly illustrated the complexities of trial recruitment and how potential participants' decision-making was highly contingent on the context in which it was experienced, and how they interpreted and made sense of these experiences. For example, using in-depth observations revealed potentially important differences in recruitment procedures across trial centres that were adhering to a basic recruitment protocol. Although this study was not designed to change trial processes “real time,” it did highlight the potential advantages of considering such an approach using qualitative methods as recently utilised in a UK trial to elucidate changes to the content and presentation of trial information.
There is a challenging opportunity for innovation in the integration of qualitative research methods into clinical trial contexts, but it raises methodological and ethical issues that need further exploration.
“A Politics of What”: A Praxiography of Renal Disease in Indigenous Renal Patients
* School of Nursing and Midwifery, Griffith University, Queensland, Australia
** Faculty of Nursing, University of Alberta, Edmonton, Canada. E-mail:
The morbidity and mortality rates of renal disease in Indigenous Australians are significantly higher than those of non-Indigenous Australians, and are increasing. The dominant discourses of renal disease currently predicate this as essentially a client problem, rather than (for example) a health care system problem. These discourses are indicative of the dominant “white” paradigm of health care, which fosters an expectation of assimilation by the marginalised “other.”
In this paper, we draw upon a sociological methodology (the actor network approach) and a qualitative method (discourse analysis) to tease out these issues in Indigenous renal disease. Based on empirical data, we explore on the one hand the requirements of the discourses, technologies and practices that have been developed for a particular type of renal patient and health system in Australia. On the other, we examine the cultural and practical specificities entailed in the performance of these technologies and practices in the Indigenous Australian context.
The meeting of the praxiographic orientation of the actor network approach—which has been called “the politics of what” (Mol 2002)—and the sociocultural concerns of discourse analysis does provide a useful guide as to “what to do” when confronted with issues in health care that currently seems unfathomable. Our praxiographic analysis of the discourse enabled us to understand the difficulties involved in translating renal health care networks across cultural contexts in Australia and to understand the dynamic and contested nature of these networks. The actor network approach has its limitations, however, particularly in the articulation of possible strategies to align two disparate systems in a way that would ensure better health care for Indigenous renal patients. In this paper we will discuss some of the problems we encountered in drawing on this methodology in our attempt to unearth practical solutions to the conundrums our data presented.
Action Research and Musical Methodologies: A Creative Combination
* Faculty of Music, University of Melbourne, Victoria, Australia
** University of Melbourne and Royal Talbot Hospital, Melbourne, Australia E-mail:
Action research has been a popular framework for research within school settings. Preparing students for the work force is a practical endeavour and action research strives towards practical outcomes (Reason & Bradbury, 2001). Participatory approaches are value driven and emphasise qualitative principles such as reflexivity and contextualised understandings. This results in research that is people driven, as are schools. However, one critique of the ideals of action research is the challenges encountered in identifying outcomes or being able to recognize when the research process has come to an end (Stige, 2002). Although the cyclic nature of the research process is frequently elaborated upon, specific detail regarding the analysis of outcomes is sparsely documented.
The presenters encountered this challenge during two research investigations in secondary school settings—one with bereaved adolescents in Ireland, and the second with Sudanese refugees in Melbourne. Because the interventions being investigated were musically based (music therapy group work), a musical analysis technique was utilised to supplement the action research cycle. Specifically, the empowering ethos of action research formed the framework for the research investigations and influenced the development of the projects and the nature of the interventions. The model of musical analysis was used to identify whether or not change had occurred at an intrapersonal level using a tool developed expressly for this purpose (Bruscia, 1987). In both cases, the co-researchers were not verbally forthcoming, due both to the nature of adolescent grief and the language challenges experienced by refugees. Although the level of participation in the groups was high, the ability to verbally reflect on musical participation was low and therefore discussion based models such as focus groups were considered to be inappropriate and disempowering. This mixed method approach will also be used in an upcoming school-based project funded by the Australian Research Council.
Working with Minority Mental Health Service Users: Issues in the Design and Conduct of Qualitative Research
Academic Enquiry Support Unit, Faculty of Health, University of Central England, Birmingham, UK E-mail:
UK research governance in health and social care research emphasises the importance involving members of the populations/communities of interest in every aspect of the conduct of an investigation. Research thus becomes a process of “working with” as opposed to “on” those whose problems are to be investigated. Developing effective working relationships with members of such populations/communities requires considerable investment by the researchers and communities alike. This presentation will present an exploration of the issues involved with particular reference to two current qualitative research projects that examine the views and experience of Black African, Black Caribbean and Irish mental health service users. Examples will be drawn from the methodology of both projects to illustrate the issues discussed.
These issues include the development of sound working relationships with minority mental health service users and how these influence the design and conduct of qualitative research. Mental health service users are frequently labelled as “vulnerable” and by implication incapable of participating in research activities. Attitudes towards members of minority or majority groups can hamper effective team building. Preconceptions need to be confronted and addressed if any meaningful relationships are to be developed. Service users who undertake data collection may have quite different priorities and approaches to those of researchers and negotiation is required to ensure that both parties work together towards mutually agreed goals. In addition, conflicts may arise at each stage of the project because of misunderstandings or the legacy of past experience in which users have helped researchers in anticipations of service changes that have not occurred.
The presentation will close with an examination of the ways in which researchers and service users can learn from one another and propose some guidelines for good practice in future qualitative research.
Obtaining Ethics Committee Approval: Empirical Findings on the Benefits of Participation in Qualitative Research
School of Nursing and Health, Central Queensland University, Rockhampton, Qld, Australia E-mail:
A significant obstacle to conducting qualitative research with vulnerable groups is the often unfounded concerns of institutional ethics committees about the possible harm to participants of open-ended, in-depth, Rogerian-styled interviewing on sensitive issues. One response to the problem is for researchers to have a body of empirical evidence to substantiate their claims of the benefits to participants of such qualitative interviews. The presentation, developed with this strategy in mind, provides empirical findings on this frequently asked and vexed ethical question. The findings are from a five year longitudinal study on paediatric haematology where the parents of children under invasive treatments for life-threatening leukaemia provide insights on their experience with being involved in qualitative interviews. The study, funded by the Financial Markets Foundation for Children and the Royal Children's Hospital Foundation, was conducted in collaboration with the Royal Children's Hospital and Mater Children's Hospital, Brisbane. The results indicate that the parents found the interviews to be a positive experience even though the subject matter focused on the often painful and challenging experience of coping with serious childhood illness. The discussion details the many benefits of qualitative interviews as perceived by participants (such as normalisation, being heard, emotional release, support, empowerment, a reduced sense of isolation, and the opportunity to make a difference), as well as further findings on the factors that need to be incorporated in the research process to ensure such positive outcomes.
Reflections on Meeting the Challenge of Participatory and Narrative Research in Mental Health in Ireland
* Department of Occupational Therapy, University of Limerick, Ireland
** Department of Sociology, University of Limerick, Ireland E-mail:
The voices of those living with enduring mental health problems remain largely hidden in professional and public contexts in Ireland. This can be explained by the exceedingly slow pace of de-institutionalisation in mental healthcare, the dominance of the psychiatric model and clinical research, and the policy failure to protect the human rights of people living with mental illness. However, in the context of an emergent mental health user movement and a more critical policy discourse on mental health, an opportunity arises to set new priorities for mental health policy, implementation and research. The Research Strategy (2005) of the recently established Mental Health Commission calls for a systematic, innovative and qualitative research agenda that not only identifies and takes account of the needs of service users, but one that also facilitates mental health service users to have a “heard” voice. Such research requires to be grounded in a social model of health and be transferable across disciplinary boundaries and practice borders.
This paper will discuss the interdisciplinary dialogue between sociology and occupational therapy around narrative inquiry and participatory models in the context of our research partnership with local mental health user groups in a study that explores the lived experiences of people with mental health problems. The paper will reflect on a number of key concerns: the ethical issues that arise in the context of participatory and narrative research; negotiating the parameters of narrative research, the process of building trust, sharing construction and authorship amongst researchers, co-researchers and participants. Importantly, addressing the challenge of making narratives relevant in practice contexts in the mental health field. This reflexive discussion will conclude with consideration of the shifting policy and cultural context that, at least, rhetorically, appears receptive to this research challenge.
Making Connections between Nursing Practice and Health Care Reform: A New Research Model
Faculty of Nursing and Midwifery, University of Sydney, New South Wales, Australia E-mail:
This paper focuses on a programme of qualitative research that investigates the significance of nursing practice in community cancer care in NSW. The research is designed to explicate the minutiae of nurses' work in the context of current health care reforms in Australia. Contemporary debates demonstrate that the practice of bedside nursing is fundamentally threatened today, and that the most important issue facing nursing today is the need to defend its position at the “proverbial bedside,” wherever that may be. Some commentators argue that the real challenge for nursing today is the need to identify and justify nursing's sui generis contribution to patient care and well-being. We argue in this paper that this is most effectively achieved through finely focused research that is designed (i) to shed light on the complexities and comprehensive nature of nursing work, including rendering visible those aspects of nursing care that have hitherto been difficult to bring into focus, and (ii) to clarify the relationship between these complexities and optimum patient outcomes.
For this programme of research we have developed a new research model to explore the nurse-patient encounter and relationship in depth. This paper demonstrates the effectiveness of this model for identifying the multi-layered nature and significance of the work that registered nurses do in this setting. It also presents a brief analysis of the main findings of the research as they relate to current healthcare workplace reform agendas.
Recruiting Participants for Qualitative Research from Online Communities
College of Nursing, University of New Mexico, Albuquerque, New Mexico, USA E-mail:
The influence of the internet in health and illness experiences can not be overestimated. As increasing numbers of people turn to Internet communities such as bulletin boards, electronic mailing lists (EML), personal homepages, and chat rooms to seek information, support, and to connect with others in similar situations, researchers are turning to Internet communities as recruitment sites. As part of a recently completed study, participants were recruited from EMLs and bulletin boards (BB) to participate in a qualitative study of women living with lupus. Drawing on my experiences recruiting for this study I will discuss challenges and strategies associated with recruiting members of online communities to participate in qualitative research; specifically the role of gatekeepers in accessing online communities, issues associated with list lurkers and posters, and challenges to authenticity when working with a sample recruited from this environment.
The research discussed in this paper was supported by Dean's Research Fund. University of New Mexico, College of Nursing.
Spiralling Between Qualitative and Quantitative Data on Women's Health Behaviors Over the Life Course–Findings from a Unique Multi-Cultural Mother-Daughter Data Set in Israel
The Center for Women's Health Studies and Promotion, Ben Gurion University of the Negev, Beer Sheva, Israel E-mail:
There are many ways to combine between qualitative and quantitative methods in health research. Using findings relating to women's health behaviors over the life course (menstruation, smoking behavior, exercise and breast-feeding) we show how qualitative methods help to highlight the theory of knowledge acquisition as they relate to women's health decisions. A rich data set of 48 semistructured in-depth qualitative interviews with mother-daughter dyads from six ethnic groups (Israeli, European, North African, Former Soviet Union (FSU), US/Canada and Ethiopia). This data set of was analyzed and formed the basis of research questions that were included in a survey of 302 young Israeli women from the ages of 25 to 42 from four ethnic groups (Israeli, European, North African and FSU). For example, what is more influential in women's health choices<@151>their mother's example and suggestions or the norms and behaviors they learn from their ethnic culture and/or peer culture? The results suggest that these influences differ according to the type of health behavior examined. After initial quantitative analyses, further ideas for qualitative analyses emerged and enriched the final results regarding the importance of different types of knowledge that women acquire over the life course. In the end, there were two cycles of analysis as we returned to both data sets to produce a more detailed picture of women's health behavior decisions. This spiral is developed as a model to teach students how to combine and move between qualitative and quantitative methods of inquiry.
What Can Be Learnt from Ibero America? Methodological Issues in Emergent Research and Evaluation
* University of Guadalajara, Mexico
** LJMU, United Kingdom
*** UASLP, Mexico E-mail:
For many years, Ibero American scholars have utilized non traditional methodologies to analyze and evaluate health policies and programs. Until now, however, there has not been a review of the methodological strategies used. The aim of this paper is to review the methodological decisions and strategies used in research and evaluation literature in the health field in this Region. It focuses particularly on emergent approaches (participatory, qualitative, critical, hermeneutical, bottom up, collaborative, transdisciplinary). An Ibero American literature search was performed combining a range of different strategies: data base review, expert interviews and searching the internet. The review process took place from June 2003 to June 2005.
Nearly 60 articles were found; nearly half of them were case studies. Our analysis has focused on their designs, selection of participants, indicators used, data gathering and the analysis. We conclude that Ibero American scholars emphasize more theoretical than methodological issues; and they are concerned also more with data gathering strategies than methodological issues in relation to analysis, design or participant selection. The implications are discussed.
Situational Analysis in Grounded Theory: Finding an Alternative Analytical Path to Foucault
School of Nursing and Midwifery, Monash University, Gippsland Campus, Churchill, Victoria, Australia
School of Nursing and Midwifery Science, James Cook University, Cairns Campus, Smithfield, Queensland, Australia
E-mail:
Grounded theory can be conceptualised as a series of variants that exist on a methodological spiral, reflecting a variety of ontological and epistemological underpinnings. Key to the methodological position researchers assume, are their beliefs about the nature of truth and the tenor of the relationship between themselves as researcher and participants.
Constructivist grounded theory is situated at the latter end of this methodological spiral and is now taking another turn around the upward pitch of postmodernism. Adele Clarke argues for an evolution of grounded theory that is based upon a form of conceptualisation called situational analysis.
Building on grounded theory's central tenets of: theoretical sensitivity, theoretical sampling, constant comparative methods, coding, memoing and diagramming, Clarke pushes grounded theory around the postmodern turn by locating points of articulation between the theoretical positions of Anselm Strauss and Michel Foucault. Clarke then uses Foucauldian discourse analyses of power to explain the interactions that she locates within the three types of maps that are the method of situational analysis: situational mapping, social worlds/arena mapping and positional mapping.
This paper will explore our experience of using situational analysis in a constructivist grounded theory about Australian rural nurses' experiences of mentoring. We will then offer an alternative analytic focus to that of power, whilst at the same time championing Clarke's method of mapping that analyses the situation or social world that is the field of inquiry. Collective action frame analysis will be discussed as a method of discourse analysis in such a mesostructural space—in order to link action and change. Benford and Snow's core framing tasks and, how these are developed, generated, elaborated and finally diffused, will be outlined in relation to our study.
The Development of Constructivist Grounded Theory
School of Nursing and Midwifery, Monash University, Gippsland Campus, Churchill, Victoria, Australia
School of Nursing and Midwifery Science, James Cook University, Cairns Campus, Smithfield, Queensland, Australia
E-mail;
Grounded theory can be conceptualised as a series of variants that exist on a methodological spiral, reflecting a variety of ontological and epistemological underpinnings. Key to the methodological position researchers assume, are their beliefs about the nature of truth and the tenor of the relationship between themselves as researcher and participants.
The metaphor of a spiral seeks to move away from the binary opposition that appears in the literature regarding Glaser and Strauss and Corbin's forms of grounded theory. Rather we take the position that there is room for all and that it is incumbent on the researcher to think deeply about how they view the world before designing a research study that is reflective of either traditional grounded theory or one of the evolved forms.
This paper will trace the development of constructivist grounded theory. Initially Strauss and Strauss and Corbin's work will be discussed in relation to tracing a constructivist intent that arises from Strauss' core commitment to pragmatism and the relationship between process and structure. This will be achieved through examining each of the common grounded theory methods of: theoretical sensitivity, treatment of the literature, coding and identifying the core category through a constructivist lens.
Following on from this, Charmaz's key texts will be explored to identify the ways in which her work lives out constructivism through: treatment of the data and the possibilities for meaning that can be constructed from them, the position of the author in the text, and writing as a strategy to render participants voices in theoretical interpretations.
We will conclude by making a link between the methodological space created by Charmaz and the further evolution of grounded theory around the postmodern turn.
The Power of a Photograph: Considerations of Photography in the Written Ethnography
University of Calgary, Calgary, Al, Canada E-mail:
Community consultation and participation within the research process is recommended when conducting research with aboriginal groups in Canada's northern territories. Photovoice was used within the design of this ethnographic study with pregnant Tlicho women to enable a participatory process. With the disposable camera, pregnant women captured images of their everyday life experiences within their community. Through stories prompted by the photographs, the women articulated personal and collective perinatal health practices within their community. This was done through their lens and encapsulated their insider's look at everyday life, a method of self-representation. Using photographs to capture the lifeways of a particular culture is not new. The way that the camera was used historically by researchers is different than the way it was used in this study by the participants. The evidential nature of the photographs is as attractive today to both the researcher and participants as it was many years ago. In this study, photographs were appreciated for their portrayal of the perinatal experience, the stories the photographs prompted, and for the aesthetic dimension the photographs added to the study. However, photographs in printed literature are worrisome for ethical review boards. This presentation will examine the use of photographs with the aboriginal community, consider the utility and limitations of photographs and photovoice and make recommendations for future research with vulnerable populations.
Researching Birth Spirituality: Expanding the Qualitative Frontier
Centre for Women's Studies, James Cook University, Townsville, Queensland, Australia E-mail:
Research into the spirituality of birthing is by definition problematic. In an evidence-based culture, how is an elusive concept like “spirituality” defined, measured and quantified? The lack of research and literature about the spiritual care and spirituality of the birthing woman denotes a vacuum in both theory and practice. For many women and men birth is something of profound spiritual significance. Many midwives and caregivers intuitively know about birth spirituality; they work with it every day; but their training does little to prepare them to engage with it confidently. In a Western, industrialised context that conceptualises body and spirit as separate, there is need for an integrative mind/body/spirit approach to this phenomenon. Birth is sacred. Like death it is the portal of life.
My PhD aims to explore, document and give voice to women's beautiful spirituality at birth. In this paper, I present my methodological approach to resolving the dilemma of how to research the elusive concept of birth spirituality—an endeavour I liken to attempting to lasso the wind! This is a qualitative feminist study, using a collaborative, interactive approach that weaves together my personal experience, midwives' perspective, a consumer lobby group voice and the narratives of birthing women. Through a combination of auto-ethnography, focus groups and in-depth interviews I take up the challenge of expanding the qualitative research frontier.
Consciousness Raising: The Ethical Challenges of Qualitative Research
Research Centre for Clinical Practice Innovation, Griffith University, Queensland, Australia E-mail:
Research ethics committees assess research applications according to risk. Assessing risk is a judgement that is not based on precise details or rules and as a result social scientists have proposed that ethics review boards have treated qualitative research unfairly. Furthermore, as the vast majority of ethical scandals have been biomedical and quantitative in nature, social scientists have also argued that qualitative research doesn't require the same degree of scrutiny, as they view this approach to research limits participants' risk of harm. Ethics guidelines have also come under criticism as social science researchers argue that the guidelines, which were written for biomedical research, are not appropriate for qualitative research.
This paper makes the case that qualitative data collection methods often challenge the “basic” ethical principles of beneficence, respect for persons and justice and that it may be a lack of understanding of these principles that encourages the view that qualitative research is ethical by its very nature. This paper explores the ethical challenges of conducting qualitative research and in particular with vulnerable populations, such as people with dementia. It is proposed that qualitative research is not immune to ethical challenges and that to maintain ethical practice qualitative researchers must become conscious of such challenges.
Electronic Focus Groups: Enhancing Participation and Collaboration Through the Use of an Electronic Team Meeting System
Divisions of Communication and Education and Information Systems, University of Canberra, ACT, Australia E-mail:
There is increasing interest in the application of information and communications technologies (ICT) to promote collaborative or joint knowledge construction as a part of qualitative research methods. This paper reports on approaches used in the recent research project, Leadership and Learning with ICT, in which the collaborative software Zing was employed to collect data through focus groups. The Leadership and Learning with ICT project was an Australian national research project conducted in 2005, which investigated issues of leadership in the incorporation of ICT in teaching and learning of school students. This research involved 40 focus groups involving 414 consenting participants in 6 states and 2 territories. This paper outlines the qualitative research methods employed for this research and provides reflections on the inclusion of such tools for collecting data. The paper concludes that ICT has the potential to contribute to the suite of qualitative research methods available in school education research. It is suggested that this tool represents a new breed of research approach that promotes participation, collaboration and knowledge construction and has applications particularly in the area of community capacity development.
Will We Remember the Answers? Research with Families and Service Providers
School of Sociology, Social Policy and Social Work, Massey University, Palmerston North, New Zealand E-mail:
The presenters have been involved in qualitative research with families and social service and health providers over the past decade. This paper brings together some of the knowledge gained from this experience and focuses on two key aspects of qualitative research:
Relationship building—here the focus is on understanding how the research impacts upon key relationships with participants and stakeholders. The role of participants in creating the research is explored around an organising theme of how to sustain meaningful relationships throughout the research process and beyond. Ideas about constructing narratives, reciprocity and managing complex relationships are examined.
Creating change through research—here the wider aspects of research relationships and processes will be explored. It is argued that research in social and health settings is often strongly connected to a desire to “make a difference” in the lives of participants and that this creates interesting challenges for researchers and participants alike. Of particular interest is the role of research in forging new partnerships between the clients of social and health service providers and how strategies for building critically reflective practice in agency settings can be a realistic outcome of the research findings. This is strongly connected to understanding about the nature of the client and worker relationship and how researchers respond to developing research processes that incorporate and respond to diverse interests and contexts.
The paper concludes with examples of critically reflective practice in action and identifies how these can be embedded within the context of social service and health delivery. It argues that change can be created through research where practitioners and agencies have a commitment to integrate research into their daily practices and to develop a culture of learning that consciously strives to achieve best practice.
Stakeholder Perceptions of Factors Influencing Tuberculosis Medication Adherence: A Meta-Ethnography
* Primary Health Care Directorate, University of Cape Town, South Africa
** Health Systems Research Unit, Medical Research Council of South Africa, and Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, UK
*** International Health Research Group, Liverpool School of Tropical Medicine, UK
**** Norwegian Knowledge Centre for the Health Services, Oslo, Norway E-mail:
Tuberculosis is one of the largest contributors to the burden of disease in low and middle-income countries, and the number of new cases continues to rise especially among the poor and marginalised groups in society. Poor adherence to treatment is common despite efforts to improve adherence via interventions like direct observation of treatment. We sought to understand patient and provider perceptions of what influences treatment adherence by conducting a synthesis of qualitative research from both low- and high-income settings. Here we report the findings of a meta-ethnography of qualitative studies on tuberculosis treatment adherence.
We searched 19 electronic databases, with the free text terms Tuberculosis AND (adherence OR concordance OR compliance), and located 7814 potential studies for inclusion; the reference lists of retrieved articles were also searched. After review, 37 studies met our inclusion criteria of qualitative studies examining adherence to tuberculosis medication. Two authors independently assessed the quality of these studies on a standard form, and extracted data from a selection of studies. We followed Noblit and Hare's process of meta-ethnography to re-interpret the findings and determine how they related to one another.
Preliminary results indicate that the main spheres influencing adherence from the patients' and providers' perspectives are financial factors, social support, and systemic factors. It seems that financial factors are an overarching factor over all subcategories. We report the full results and discuss the usefulness of meta-ethnographic approach in synthesising findings from diverse qualitative studies and highlight where further research is needed. This synthesis will be used to inform the development of targeted interventions to promote treatment adherence.
Generalizations across Cases: A Strategy for Qualitative Researchers to Handle Voluminous Amount of Data
Sultan Idris University of Education, Malaysia E-mail:
Successful teachers tend to be those who are able to use a range of teaching strategies and who use a range of interaction styles, rather than a single, rigid approach. Strong research support has linked student learning to variables such as teacher clarity, enthusiasm, task-oriented behaviour, variability of lesson approaches, and student opportunity to learn criterion material (Darling-Hammond, 2000). This research focused on, among other aspects, how teachers make pedagogical decisions in classrooms. Selected teachers teaching Malay Language, English Language, Mathematics, Science and History in secondary schools in Malaysia were involved in this study. This research used both qualitative and quantitative methods for data collection and analysis. The focus of this paper will be on the procedures employed by researchers to handle the voluminous amount of data collected for this research. For the phase two of the study, data were collected through interviews, observations of teachers teaching five different school subjects and the narratives written by them. There were an average of twenty teachers for each subject providing qualitative data through interviews, observations and narratives. In total, there were almost 100 teachers who provided the researchers with voluminous amount of data. Inductive analysis procedures were employed to analyze the data. The outline began with a search for regularities—things that happened frequently with groups of people. Patterns and regularities were then transformed into categories into which subsequent items were sorted. These categories or patterns were discovered from the data. Generalizations were made across cases, that is, cases within the same school subject, and also cases across school subject. What could one possibly learn from such an approach? Very often qualitative researchers end up with voluminous amount of data. With no set or rigid procedures to analyze and interpret data, it is the researcher who needs to thoroughly understand the data and develop categories or themes which emerge from the data itself as a guide to analyze the data.
Breathing New Life into Old Bodies of Knowledge: Physiotherapy and New Regimes of Respiratory Practice
School of Physiotherapy, Auckland University of Technology, Auckland, New Zealand E-mail:
Physiotherapists have been treating people with respiratory disorders since World War I. Until recently, this has involved the assessment and treatment of established medical and surgical conditions. In the last ten years a small number of specialist practitioners have pioneered the treatment of a new kind of problem; that of Breathing Pattern Disorders (BPDs).
BPDs are a syndrome of symptoms associated most commonly with disorders of the sympathetic nervous system. They have been reported across age groups and cultures but predominate in European, working age men and women of the professional classes.
BPDs, by another name, have been seen before however. Indeed the history of “overwork” conditions, neurasthenia, railway spine, etc. goes back at least to the mid-1850s and most especially the rest-cure methods of Dr Silas Weir Mitchell.
The methods that Weir Mitchell pioneered are significant not only because of their function as an oppressive form of restraint, but also because they were the primary form of treatment pioneered by early physiotherapists who were seeking to establish themselves within orthodox health care.
Drawing on data from a PhD study into physiotherapy as a disciplinary regime, this paper explores the reasons why respiratory physiotherapists are once again turning to nervous disorders and the management of work stress. I hypothesise that physiotherapists are utilising BPDs as a vehicle to explore new territories outside of conventional, orthodox health care practice—responding to a shift in the nature of contemporary health care from traditional binaries of health and illness and towards risk and responsibilisation.
A Pregnant Pause: Drugs and Having Babies
Australian Catholic University, St Patrick's Campus, Melbourne, Vic, Australia E-mail:
Mood swings, unpredictable behaviour, itinerant, pregnant and nursing a chemical dependency, make for a melting pot of human emotions. And it's into this melting pot, I delve to meet the challenges of this research project. I am a third year PhD student; this study explores the effectiveness of the obstetric, emotional and allied health requirements of chemically dependent pregnant women who attend the Transitions Clinic at the Mercy Hospital for Women, Heidelberg, Victoria. The women are aged between 18 and 35 and may be addicted to heroin, cocaine, marijuana, recreational and party drugs.
Collecting data from this cohort of vulnerable women is fraught with ethical dilemmas. Does mandatory reporting legislation apply in the research setting, and if it does, how does that impinge on the confidentiality the women are promised when they agreed to take part in the study? And what of the ethics of interviewing these participants when they are under the influence of hard drugs? How does the researcher handle the issue of informed consent when it appears anything but, (especially when she has a legal qualification)? Where does the researcher “stand” when a participant confesses to lying to a government agency? And when the participant keeps an interview appointment, but is nursing a broken wrist that she is attempting to hide. Do you proffer assistance or, mindful of her dignity, proceed with the interview?
I have found that the role of researcher/friend can become blurred: I have, from-time-to-time, acted in the role of confidante, counsellor, social worker, mother and nurse, as well as a critic of porn films.
The research design is by way of a critical ethnography with a feminist perspective underpinning the theoretical framework of the study. The aim of a feminist approach is to develop a trusting, confidential, comfortable and non-judgmental environment, promoting open reciprocal interactions between the researcher and the participants, where the perspectives of the women are afforded primacy.
Dilemmas in Designing and Implementing Qualitative Research
Academic Enquiry Support Unit, Faculty of Health, University of Central England, Birmingham, UK, and Saxion Universities of Applied Science E-mail:
Qualitative research poses both theoretical and practical dilemmas, with the difficulty of trying to capture real thought and feelings well documented. Interviews are much more than the spoken word, providing insights into meaning through voice, gesture, eye contact and silence Recognition of such unspoken codes can, if the researcher is able to interpret them, increase reflexivity and deepen the focus of the study. Accepted explanations and justifications may be concealing as much as they are revealing, and it is only by seeing and using the signs given that the real essence, the most irreducible and unchanging elements can be uncovered.
However, researchers may avoid such recognition because unexpected elements of subjectivity can appear threatening to established theories and/or the researchers own perceptions. Then too, the researcher has an identity and persona developed from their past and current experiences. How they present and portray themselves will impact on the interviewee in a manner that cannot be ignored. Inevitably they will be seen as representatives of the aims of the study, as part of, not separate from issues under discussion. Just as public and private accounts differ, particularly regarding emotive and sensitive issues, so, the relationship that develops in an interview setting will lead to conscious or unconscious editing of what is shared. Even where the individual makes every effort to share what they believe to be the totality of the phenomena, descriptions inevitably include improvisation, change, contradiction (may be unconscious), ambiguity and hidden or overt vulnerability. Thus reports become, the product of multiple and possibly contradictory discourses, with an element of re-invention every time discourse occurs.
This paper uses examples from completed research to explore these issues and suggest ways in which potential problems can be avoided, minimised or translated into positive attributes.
“Case study”—the Weak Relation of Research?
Department of Nursing, University of Huddersfield, Huddersfield, UK E-mail:
This paper will discuss the use of case study as an approach to undertaking a piece of research exploring the socialisation of pre-registration student nurses in clinical placement areas. The case study approach was chosen as it most effectively represented the participants and the fieldwork areas that were used with the work being primarily focused upon the education and training of nursing students.
The study integrated the concepts of a social group study whereby the occupational groups of student nurses and qualified practitioners were observed and interviewed. The study of organisations and institutions was also used in the context that the information being collected related to the education and training of student nurses in the academic and clinical areas. Furthermore, events, roles and relationships were studied, as the focus was on boundaries student nurses have to overcome in their quest to socialise into their clinical roles and learn to be a real nurse.
Bromley (1986) maintained that the individual case study or situation analysis is the bedrock of scientific investigation with Valsiner (1986) arguing that the study of individual cases has always been the major (albeit often unrecognised) strategy in the advancement of knowledge about human beings. It would be reasonable to conclude that the work undertaken for this study was a form of enquiry that took place at a particular time, in a particular place with particular people. As such we can safely say that it was indeed a case study that used more than one method of data collection and did indeed present the views and personal experiences of the participants. It would be most difficult to replicate these findings, yet the premise and principles of the study could be used in further studies with different participants.
Glimpsing the Future of Acute Psychiatric/Mental Health Nursing Care through Critical Ethnographic Research?
University of South Australia, Adelaide, SA, Australia E-mail:
Despite increasing consumer activity and inclusion in planning mental health services, the evidence supports the view that acute inpatient psychiatric care is not meeting the needs of those consumers. What is responsible for psychiatric inpatient care being viewed in this way? Is this any different from what was happening in the past? What role does mental health nursing play? What factors have and continue to influence psychiatric inpatient nursing care today? And once these factors are revealed, is it possible to change psychiatric nursing practice into something that meets the needs of both nurses and people in care while simultaneously gaining the necessary social and political approval?
There is a tendency to hold nursing staff responsible for the felt inadequacies of acute psychiatric inpatient care. Is this because of something that nurses do or something that they don't do? Are these problems with acute inpatient care the burden of nurses alone? Indeed, are nurses responsible for these problems at all? Are greater forces at work that cause nurses to practice as they do? Or are nurses once again the convenient scapegoats because they are unable to defend themselves in an environment where they have less power than other players?
Many of the factors that influence our practice are so much a part of the fabric of our social world that they are essentially invisible to us. It is only once we become aware or conscious of those factors that we might be in a position to first challenge them, and eventually, to change the way we respond to them. Developing a conscious awareness is fundamental to changing the status quo. It is through social critique that the surface veneer of reality is peeled back and the underlying causes and conditions revealed. So why is acute mental health nursing custodial generally rather than therapeutically based on a recovery-oriented and caring approach?
A critical lens will be applied to data gathered through traditional ethnographic methods of data collection: participant observation, individual interview and documentation review. Critical theory takes as its starting point the assumption that oppression exists. This research aims to expose the injustices that persist and continue to shape acute mental health nursing practice in ways that are unsatisfying for both nurses and people in care.
More Than Local Colour: Using the World Café for Qualitative Participatory Evaluation
Division of Communication and Education, School of Education and Community Studies, University of Canberra, ACT, Australia E-mail:
Qualitative research has increasingly focused on research relationships and issues of voice, identity and power. However, there appears to have been little transfer of these lessons to evaluation praxis, which continues to privilege the evaluator. This paper will draw on a number of evaluation projects in developing countries and in Australia in which the researchers used the World Café technique to develop a participatory and facilitative model that places participants' knowledge and perspectives at the centre.
This model enabled the participants to name their issues, share and clarify their own perspectives and analyse the data together. The role of the researcher becomes that of facilitator as the participants engage in dialogue on the evaluation questions that hold the most meaning for them. The process addresses a number of “ethics of practice” issues including moving beyond the simplistic insider / outside dichotomy; imbalances between researcher and participants; practical and epistemological issues in cross-cultural settings and different languages as well as issues of reflexivity and interpretive authority. We will illustrate how this model enables evaluators to harness the power of participatory qualitative practice rather than extractive data collection or tokenistic use of qualitative data to add colour and/or credibility to their work.
Teaching Undergraduate and Postgraduate Research Methods
La Trobe University, Bendigo, Victoria, Australia E-mail:
In this paper we discuss teaching research methods within a developmental sequence. This paper commences with an exploration of ontology, epistemology and methodology of research methods and their relevance to undergraduate learning. We suggest it is important for students to understand the embedded assumptions within a diversity of research traditions. The developmental sequence of “philosophy then methods” is translated into student-centred learning that involves facilitating critical thinking in year 2 and implementing research design in year 3 within an undergraduate Bachelor of Social Work (BSW). We then discuss ways in which these philosophical underpinnings are translated into an experiential pedagogy. These learning techniques include practice relevant case studies, developing research proposals, and data analysis laboratories.
Both “pure” and “applied” methodology and methods is foundational for research education. We continue our developmental sequence with the discussion of becoming an independent postgraduate researcher, with a deeper/critical/analysis/synthesis/understanding of research philosophy, methods and application. We suggest that in applied fields, such as social work, nursing and public health it is both the “doing” (methods) and the understanding (methodology) of the research process that provides the possibility for enhancing professional practice.
Thereby, this paper presents an outline of our critically reflective teaching process as we move between implications for social work practice, teaching research methods and knowledge development.
Using Critical Action Research to Facilitate Collaborative Practice in Health Care
* Occupational Therapy Program, School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
** QUIPPED Project, Queen's University, Kingston, Ontario, Canada
*** School of Nursing, Queen's University, Kingston, Ontario, Canada
**** Departments of Oncology & Family Medicine, Queen's University, Kingston, Ontario, Canada
***** Postgraduate Medical Education, University of Toronto, Ontario, Canada E-mail:
The purpose of this oral presentation is to describe how a Canadian action research project is facilitating an inter-professional educational environment to promote collaborative patient-centred care. This action research is being carried out within the critical paradigm with funding of $1.2 million from the federal government. Action research involves the examination by agents of their own situations for better understanding and problem-solving (Patton, 2002). The critical paradigm “enlightens the change process by promoting understanding about how to transform current structures, relationships and conditions which constrain and reform” (Higgs, 2001, p. 49). Participants in this qualitative research project include university educators, patients and learners at the pre- and post- licensure levels from many disciplines including nursing, occupational therapy, medicine, physical therapy, X-ray technology, pharmacy and theology among others. The research approach includes: the establishment of an infrastructure to support inter-professional education, the delivery of educational sessions to educators to develop teaching of inter-professional collaborative practice, the development of clinical opportunities for learners where collaborative practice is modelled, the alignment of pre-licensure programs to mesh inter-professional learning opportunities throughout the curriculum, and the establishment of a network of patients as educators for health professionals. Examples will be provided of how we are developing an education program that is more integrated and patient/learner centred. The evaluation of the research project includes: a needs assessment of patient and learners, the effectiveness of existing initiatives, surveys, interviews, and focus groups for learners, educators, patients, clinical partners and administrators. Pre- and post-activity evaluation will assess the efficacy of activities, changes in knowledge, attitudes and beliefs, and determine educational advances. The expected outcome is the development of inter-professional models of education that enhance the ability of learners to practice patient-centred collaborative practice and the creation of a foundation for learning to practice in a socially accountable way.
A Good Mother: A Discursive Analysis of Breastfeeding and Health Promotion
Centre for Midwifery & Women's Health Research, Faculty of Health & Environmental Sciences, Auckland University of Technology, Auckland, New Zealand E-mail:
Increasingly mothers are returning to work within twelve months of giving birth. At the same time, the short term and long term benefits of breastfeeding are becoming more recognised. This is evident in the slogan “Breast is best” that is often seen in health media. The World Health Organisation has recommended that infants be exclusively breastfed for the first six months and then breastfed until two years of age. The subject of the paper is derived from a qualitative study which explored women's decisions regarding returning to work and feeding their infants. 30 women who had given birth within the last two years were interviewed and asked to identify and discuss the factors that had influenced their decision about returning to work and how best to feed their baby. In analysing the transcripts one theme that became evident was the discursive construction of breastfeeding as a health promotion practice. This paper identifies and explores the subjectivities, technologies of power and practices articulated by the women when positioning themselves in this discourse.
THE BODY AS FOCUS OF CARE IN NURSING: To Care for the Body of a Confused Elderly Person, A Means or A Goal?
Nursing College in Lisbon, Portugal E-mail:
This is a qualitative research study in the area of nursing knowledge, with the following guideline: to understand the procedures used by nurses when interacting with a confused elderly person during caring in hospital.
Specific goals:
To understand the way nurses approach the confused elderly person's restless bodies and explain their behaviour. To analyse the strategy that nurses use to respect the confused elderly person dignity during care. To emphasise the knowledge shown by nurses when they interact with the confused elderly person in caring.
I started from the assumption that caring the body of a confused elderly person with a good quality level, asks for a clarification of nursing care idea, for an understanding of the ideas of body, body control and for an understanding of the interference of the hospital environment in nursing care practices. As the quality level of given care is the result of all these factors, a question can be raised: which natures have the interactions between the nurse and the confused elderly person's body during care in a hospital environment?
I used the grounded theory method (Strauss and Corbin, 1998). For one and a half-year I used the participant observation technique in a trauma internment unit. I registered thirty observation moments of care to elderly persons who where classified by the nurses as confused. Further, I added to the sample fifteen formal interviews to nurses working in the same hospital. These nurses are seen as experts in this area of knowledge and belong to the staff of medicine, surgery and neurosurgery units. To complete the sample I conducted a formal interview with a nurse from a different hospital who has a vast experience of working with adults, children and young people suffering from serious cognitive impairment.
For data analysis I used the constant comparison method technique that is recommended by the authors mentioned above.
Main findings: nurses succeed in changing the confused elderly person from an unwanted client into an appreciated person. Delirium situations are the most demanding ones.
I identified the following key concepts:
Approaching/(nearing) must be a special way of coming up to the confused person. It should always be seen as if it was the first time and thus, be carefully prepared. The nurse's body can be used as a therapeutic agent. His self-control, his personal qualities and his knowledge merge into a very personal way of acting. Caring the confused elderly person's body is the mediator to the wholeness of the self. To mobilise the elderly person body's habitus, to personalise care, to protect from threat lead to an ingenious and complex interaction.
As a result of care the patient becomes restful and, at the same time he turns into a skilful actor. To be recognised by the patient is a very important success for the nurse. But failure is a common result, although the investment is very big.
I discuss the findings emphasising the relevance of spending time as a structuring component of caring, as far as the care to the body of the confused elderly person as a way to make easy to restore the wholeness of the self of the person.
Grounded Theory: An Act of Faith? Experience of a “Minus Mentor” Researcher
International Centre for Management and Organizational Effectiveness, School of Management, University of South Australia, Adelaide, SA, Australia E-mail:
The erosion of grounded theory through misuse, misinterpretation and issues that confront novice researchers has attracted attention in the recent literature. Experienced mentoring has been suggested as a possible resolution to these issues. However sourcing such a mentor is difficult, especially in certain disciplines i.e. business and management.
This paper shows that grounded theory attracts a “distinctive” kind of researcher and argues for the need to establish the congruency of the researcher's world view, research objectives, temperament and skills with grounded theory in “minus mentor” situations. It proposes a process of self reflection early in the research journey. A study in the hospitality industry is used to illustrate the process.
The paper argues that establishing congruency of researcher's world view and grounded theory requires abandoning the search for “correct” grounded theory and confidently exploiting its ability to enrich several theoretical perspectives. It details how this congruency guides the researcher through the quagmire of several versions/interpretations and abundant “how to do” literature. It then illustrates that researchers who are congruent with the methodology leave aside “get it right anxiety” and review functionalist literature for methods that serve generation of grounded theory aligned to research objectives.
The paper posits that the methodology's ability to marry almost dichotomous matters is its attraction to practitioner/researchers and emphasises the need to establish congruency of the researcher's temperament and skills with dialectic components of grounded theory i.e. induction/deduction, creativity/systematic procedures, theory/practice among others.
Finally, it illustrates the delayed and experiential learning curve of grounded theory as creating confusion and frustration against a backdrop of speedy completions. It shows how establishing congruency boosts researcher confidence, prompting researchers to redesign conventional research calendars and “just do it.” An act of faith!
The paper concludes that early establishment of congruency with grounded theory assists novice researchers in “minus mentor” situations.
Researching Sex: Getting our Hands Dirty
* School of Social Work and Human Services, University of Canterbury, Christchurch, New Zealand
** School of Community Studies, Christchurch Polytechnic Institute of Technology, Christchurch, New Zealand E-mail:
Research is a powerful and strategic device that social workers can use to advocate for clients, and this significantly contributes to the profession's social change agenda. However, though research is deemed to be a core social work activity, function and role (NZASW., 1993), it remains an activity that is given little priority by practitioners. This paper is our response to the limited qualitative research experiences available in Aotearoa/New Zealand of two “hard to reach” groups of social work clients: HIV positive sexually active men, and female adult sex workers. As researchers, we entered the “worlds” of our research participants, and this article makes available our experiences of qualitative and ethnographic research. Further, avoiding the standard “clipboard” and tape recorder “sitting across the table,” we entered the fields of research to consider the particular meanings held by the people we talked to. We didn't quite “get into bed” with our participants, yet unlike the studies we had reviewed and methodological pathways available to us, we entered the homes, bedrooms, and private sex spaces of the participants we spent time with. It was this “entering” and “following” particular stories about condoms, lubricant, medication bottles, prescriptions, towels, and sex toys that facilitated rich and meaningful qualitative data. Importantly, these personal “things” become social tools, and the associated meanings held by participants were crucial to the research findings we both concluded. Our methodological pathways are presented in this paper to argue that the private spaces of sexual action, and the various “things” found within these environments, can be accessed ethically, to assist social work understandings about the particular sets of sexual and social issues confronting these “hard to reach” populations.
Developing Teacher Education in German Universities: New Ways for the Practical Study Courses in Schools
Didaktik of Physics, Fakultät Physics, University Duisburg-Essen, Germany E-mail:
Starting with a brief description of the present teacher Education in Germany, I would like to present my plan for a further development of the practical study courses..
In Germany, Teacher education is merely divided in 3 phases.
Phase one contains lectures, seminars and practical study courses at Universities. The focus lies on facts and theories of the given domain, e.g. physics, pedagogic or chemistry. The duration is varying between 3 and 5 years, depending on the aimed level (e.g. K-9, K-12…). Phase two is the “Referendariat” (comparable to the “Temporary” in US Schooling System) where the Students work as trainees in school service. Supervision of the trainee is shared between mentors of the School and Teacher Trainer of a government agency, called “Studienseminar.” The “Studienseminar” is responsible for the Certification of the teacher. The duration is 1 1/2 - 2 years. With certain certifications of teacher experience, a half year may be credited. Phase 3: Special teacher training centers provide certified teachers with on-the-job training and additional courses. A special focus is on the 2 years following up the certification.
Up to now, these 3 phases are not interconnected. Nearly no crossovers exist, and the staff of the different teacher education institutions are qualified in very distinctive ways. Cooperations, if existing, are initiated by personal contacts, bound to the persons and have temporary character.
That's where the concept of our study sets in:
In a pilot project, starting 2006, the duration of the practical study courses at Universities are extended from currently 6 towards 10 weeks. In the nearer future, even an extension towards the duration of an entire semester is under consideration, where students work for the most part of their time at schools and are cooperatively supervised by university lecturers and the experienced teachers.
The students work as assistant teachers and are assigned to class and accompany the pupils during all school activities.
The study is focused on science education in elementary school, where a lack of expertise in the staff was detected by former studies (Peschel 2006).
Our main goal is:
Fostering the exchange between students, Teachers, university lecturers and Teacher trainers. This includes lots of other sub gains and outcomes e.g. training the experienced teachers by students in science and—the other way round—students in field experience.
We present drafts of the planned study design and the aim of a network of cooperation partners throughout the EU. Lived-Experience of Aggression by Educators and Learners in a Secondary School in an Informal Settlement
University of Johannesburg, South Africa E-mail:
Research worldwide indicates that educators and learners experience aggression in the secondary school setting. Newspapers report, that in the past two years in South Africa, numerous incidences of aggression were identified. It became clear that this is a serious problem that needs to researched and addressed. Secondary schools in informal settlements are especially exposed to possible aggression because of the poverty, violence and crime stricken environment. The research questions that arose for this research were: “What are the lived-experience of educators and learners of aggression in a secondary school in an informal settlement?”; and “what could be done to facilitate their mental health?” The objectives of this research project were to explore and describe the experience of educators and learners of aggression in a secondary school in an informal settlement in South Africa and to describe guidelines to facilitate the mental health of involved educators and learners. The research design was qualitative, explorative and descriptive and contextual. Measures to ensure trustworthiness through utilization of the strategies of credibility, transferability, dependability and confirmability were applied. Ethical principles were applied in the research. A purposive sample was taken from secondary school educators and learners in an informal settlement. Data was collected using in depth phenomenological interviews, diaries, naïve sketches, observations and field notes. The central question was “How do you experience aggression in this school?” Tesch's method was used to analyze the data. A consensus discussion was held with an independent coder. Thereafter, the results were recontextualized in the literature. The identified themes from the educators' experiences were: disrespect experienced by educators as aggression; irritation experienced by educators; and reflection of educators experiencing aggression. The identified themes from learners' experience of aggression were: Disrespect experienced by learners from other learners; disrespect experienced by learners to educators; and disrespect from educators experienced by learners. Based on these results guidelines were described to facilitate the mental health of educators and learners.
Kaupapa Mäori Research, Supervision and Uncertainty: “What's a Pakeha Fella To Do?”
Department of Sport and Leisure Studies, University of Waikato, Hamilton, New Zealand E-mail
Over recent years appropriate ways to conduct research with Mäori and within Mäori communities have evolved. In Aotearoa New Zealand we have seen a welcome burgeoning of researchers and graduate students adopting Kaupapa Mäori as a preferred methodology. Grant (2005) has recently described the act of supervision as an uncertain practice marked by a plethora of contradictory and competing discourses. Between such discourses are spaces that Linda Tuhiwai Smith has termed tricky ground. Such a term is pertinent as because it highlights the complexity, uncertainty and shifting nature of not only the ground upon which researchers work, but also the individuals and communities who perform the research, the epistemologies and understandings they hold, the practices they indulge in and the effects such research can have on the participants. As a supervisor working within a institution where Kaupapa Mäori has established a high profile, I have found myself in the role of supervisor to several Mäori students. Furthermore, As a pakeha New Zealander I have in recent years, discovered myself standing on tricky ground, learning and appreciating this methodology and its associated worldview. How can a white, male, middle-class supervisor contribute to the conduct of Kaupapa Mäori and the growth of Mäori graduate students? Such an experience has revealed a different way of knowing, far removed from the ‘colonial gaze’ that has marked much of my own research. Russell Bishop (1996) has argued that story telling is a culturally appropriate way of empowering participants and I will employ this strategy to share my experiences as a supervisor working on tricky ground.
Working as a Qualitative Research Team: Facing the Challenges Presented in Exploring Australian Families' Experiences Caring for Children with Life Limiting Conditions
* Oncology Department, The Children's Hospital at Westmead, Sydney, NSW, Australia
** The Life Limiting Conditions Project & Oncology Department, The Children's Hospital at Westmead, Sydney, NSW, Australia
*** Nursing & Health Services Research Consortium, University of Technology Sydney, Sydney, NSW, Australia
**** Ambulatory & Emergency; The Children's Hospital at Westmead, Sydney, NSW, Australia E-mail:
Undertaking qualitative research within vulnerable populations presents challenges and opportunities for exploring how to gather crucial information ethically, effectively and responsibly, in order to inform and guide the health care management of such populations. Choosing to do research as a team introduces a level of added complexity, as the ideas, experience and research strategies of team members are balanced and negotiated throughout the research process.
An overview is presented of one multi-disciplinary research team's journey in undertaking a qualitative research project exploring families' experiences of caring for a child with a life-limiting condition. Twenty eight families with one or more ill children participated in home based in-depth open ended, audio-taped interviews exploring all aspects of family life. Approximately 100 persons, [mothers, fathers, ill children, well siblings and extended family members], spoke about how the ill child's condition affects family life, at the level of the individual; the nuclear and extended family units.
Information is provided about how the research team decided to address important methodological issues associated with gaining access to, approaching, engaging and interviewing vulnerable families. Issues reviewed include recruitment of family members; managing initial contact; negotiating space/time and preparing for interviews; establishing rapport; informed consent; collecting the stories; care of both the participants and the research interviewer. Data analytical challenges faced by the research team such as managing a “mountain” of data; coding and processing as a research team; negotiating differences within the team, and using qualitative software as a team [NVivo] are also addressed.
While researching as a team can present challenges not faced when researching as an individual, it affords valuable opportunities to review and consider the data gathered from a number of perspectives, potentially offering a level of richness and depth of interpretation of both relevant literature and of the project's data.
What's in the Papers? The Role of the Newsprint Media in the Construction of Medicines Information
Prescribing Research Group, Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool, UK E-mail:
There is a high prevalence of health issues represented in the newsprint media. It is generally assumed that the media are a powerful mediator of information to the public and that it can shape individual values and expectations and impact on health-related behaviour and patient action. It has also been suggested that media coverage of health challenges medical practice and authority. At the same time, with changes in UK health care policy, there has been a reported wider shift in the conceptualisation of doctor-patient relationships, from a “paternalistic” approach to one in which there is now a strong premium on shared decision-making and patient participation in healthcare.
The aims of this paper are to: a) discuss the representation of prescription medicines in the British newsprint media; b) explore the extent to which the media offer a more challenging view of medicine; c) explore the extent to which the newsprint media contributes to readers' knowledge of medicine and shapes their perceptions of its expectations, benefits and risks. The paper discusses how mixed methods can contribute to a better understanding of the newsprint media's role in the production of medical knowledge.
For six months all articles relating to prescription medicines in a range of widely distributed UK newspapers were collated. Content analysis determined the types and frequency of medicines reported, the evidence cited and the nature of reports. Secondly, discourse analysis explored the use of language, underlying imagery and meanings used to construct representations of prescription medicines. Drawing on interviews with newspaper readers, reception analysis explored individuals' use and views of media health coverage, and their overall perceptions, expectations and experiences of medicine. Discussion focuses on the media's role in providing adequate medicine information, how it frames medicines and its relative power in structuring individuals' approach towards medicine and treatment decision-making.
The Ethics and Politics of Researching HIV/AIDS within the School Context
University of KwaZulu-Natal, Durban, South Africa E-mail:
My experience thus far as a researcher and a supervisor of research within the context of HIV and AIDS presented a range of concerns around ethical considerations. Does initial informed consent make a difference in revealing the life stories of individuals affected by AIDS? What does a researcher do when certain information presented by the individual cannot be revealed, or that one cannot pursue a line of thought or that the individual withdraws from further participation? Can one theorise an incomplete story, draw insights and conclusions based on partial information, or continue with a project after withdrawal of participation even though initial consent had been obtained? How would we break the bond created with the HIV/AIDS affected individual, when that individual has built a trust around you and hope for some comfort from you when all that you can do as a researcher is tell the story of that individual? These are the cold face realities of situational ethics researchers find themselves woven into. There are no easy answers to these ethical issues, especially when there are multiple issues complicated by a life-threatening disease affecting participants.
This paper explores the politics and ethics of researching HIV/AIDS within schools in South Africa by drawing on researchers' experiences as they engaged with their research projects through review of their study reports. Some emerging themes that are theorized are confidentiality and anonymity, activism and advocacy, politics and ethics, participation and agency and alternatives.
Understanding Depression in Women of Tall Stature: Generating Theory Using Qualitative Methods
Mother and Child Health Research, La Trobe University, Melbourne, Vic, Australia
Onemda VicHealth Koori Health Unit, Centre for Health and Society, University of Melbourne, Vic, Australia
Menzies Research Institute, University of Tasmania, Hobart, Tas, Australia
School of Psychology, Victoria University, Melbourne, Vic, Australia
E-mail:
Although now rare, treatment with synthetic oestrogens to reduce adult height has been available for tall girls in Australia since the 1950s and was primarily initiated for psychosocial reasons. A retrospective cohort study of girls assessed and/or treated for tall stature in adolescence (between 1959 and 1993), included quantitative measurement of lifetime prevalence of major affective disorder and major depression. The prevalence of major depression among this cohort was significantly raised when compared with the general female population, although there was no significant difference by treatment status or height. Previously reported associations with depression did not explain the significantly raised prevalence compared to population-based studies. It was thought experiences of this group may predispose women to depression.
Therefore a qualitative study was undertaken, focusing on the meanings tall women give to their experiences and their feelings about interactions they had with people and events. Two in-depth interviews with 35 women (25 assessed and/or treated as adolescents for tall stature; 10 tall women never assessed) have been undertaken. The first interview explored the experience of being tall through memories of childhood and adolescence, and feelings about their height now. Transcripts were returned to women for comment and the second interview involved discussion to validate possible themes. The analytical strategy is characterised by a feminist and social constructionist viewpoint which acknowledges that women's view of themselves is shaped by socio-cultural discourses and ideologies.
It is important to consider what is missing or taken for granted when trying to understand depression in women. Gender as a sex category alone does not explain high rates of depression. However, examining the meanings of gender including symbolic beliefs about femininity and women's material bodies, by listening to women's experiences of the social world they live in, may provide some insight.
Examining the Evolution and Interpretation of Health, Primary Health Care and Health Promotion Discourses, Policies and Practices in Britain During the 1990s
School of Nursing and Midwifery, City University, London, United Kingdom E-mail:
Health promotion and primary health care development and implementation involve a complex web of relationships operating within, and between multiple domains. Analysis of these relationships includes the examination of numerous texts, structures, practices, and media designed to maintain and regulate the health of society. This paper will discuss how I drew upon Foucauldian theoretical propositions and merged these with qualitative research approaches in order to explore the connections and interconnections between macro-level level discourses, policy and professional discourses, and “micro-level” interpretations and practices operating in the field of health promotion and primary health care in Britain during the 1990s.
I will discuss how my research, which began as a diachronic sociological study of the incorporation of health policies into changing professional discourse and organisational arrangements, evolved into a synchronic qualitative ethnographic approach in order to account for how these policies were played out in the micro-organisational contexts of everyday professional life.
The focus of my research was on health promotion and primary health care discourses, policies, and practices associated with the themes of agency, knowledge and organisation. However, I will argue that Foucauldian theories, propositions, and studies offer a way of examining many aspects of social and political discourse and policies by providing a model for inspecting how seemingly diverse social functions, such as economics, technology, politics and sociology, interrelate to create the conditions for, and models of, social policy organisational systems, professional agency and practices. 1 They also create new epistemological spaces for an examination of how discourse is played out in everyday life, and in relation to my research findings, how individuals “constantly escape, evade, and subvert the functioning of discipline.” 2
Researching From the Inside: Re-Defining the “Self” Through Reflexive Ethnography
Occupational Therapy, School of Healthcare Studies, Cardiff University, United Kingdom E-mail:
An ethnographer brings to the field different aspects of his or her self, shaped by an unique personal, professional, educational and socio-cultural background. In addition, Reinharz (1997: 5) categorises selves in the field as “research-based” and “situationally created.” How these selves change and develop as a result of fieldwork will depend on the ethnographer's initial status within the sub-culture, relationship and familiarity with its members. Where the ethnographer is an insider, a “complete member” (Adler and Adler 1987: 34), a further category of known selves could be identifiable, such as being a friend and a trusted group member, which are familiar to other members and constant in the setting.
Drawing on an ethnography in progress exploring creative textile-making in the context of a British guild of weavers, spinners and dyers, a guild where I, as the researcher, am a long-standing member; this paper examines the issues and ethical dilemmas arising from insider research as the brought researcher-self (Reinharz 1997) gradually inter-weaves with known selves in the field. The issues include negotiating access; the impact on relationships; trust and reciprocity; familiarity; giving voice to participants; informed consent; and maintaining confidentiality.
Through reflexive ethnography I aspire to “authentic understandings” and interpretations (Atkinson et al 2003: 42) of textile-making from the participants' perspectives, whilst accounting for my personal background, knowledge and continuing participation. Through a process of active reflexivity and on-going negotiation, there is a constant re-definition of known selves in relation to both the ethnographic process and the product (Stacey 1988, Coffey 1999). In this way, I aim is to achieve a balance between the self and the other in portraying the nature and meanings of textile-making.
The Spaces In-Between: Narratives Surrounding Quantitative Data Collection
Centre for Postgraduate Nursing Studies, Christchurch School of Medicine and Health Sciences, University of Otago, Christchurch, New Zealand E-mail:
Standardised Geriatric Assessment Tools such as the InterRAI suite of tools are becoming internationally accepted as a valid and rigorous method of assessing older people. While this method gathers data which is indeed thorough and which contributes towards care-planning, collection of statistics and measurement of quality; it leaves a gap in terms of the older person's voice. This paper will explore the “spaces in-between” the coded answers which a primarily quantitative instrument demands of its respondents. In these spaces, a narrative emerges: an expression of context, meaning and explanation—not about how much medication an older person is taking, but how they feel about this, and why—in their own words. Listening to this narrative version of events enhances and enriches the quantitative data. More importantly, in terms of assessment, the stories proffer clues and hints as to how the older person copes and intends to continue coping—the true stuff of comprehensive assessment. This paper introduces the notion of symbiosis in the quantitative/qualitative relationship—how the one is less without its partner. Examples will be drawn from interviews with older people regarding their medication usage and beliefs—what medication means for them, as well as how they understand the purpose and dosage of their medications.
Doing Fieldwork with Old People: Methodological Challenges
University of Guadalajara, Mexico E-mail:
Several recommendations have been made to do fieldwork in different cultures and with various informants, such as indigenous people, workers, or urban citizens. Doing fieldwork with sick and old people, however, faces several challenges for health and social researchers. In this paper I argue that fieldwork with elderly and chronically sick people face new dilemmas. My reflections are based on my experience doing ethnographic fieldwork among sick elderly people in urban and rural areas in Mexico. My analysis will focus on three methodological issues: a) the bias in the selection of elderly informants; b) the construction of the “other” in the relationships between researchers and older people; c) the use of new technologies to improve data gathering. Finally, I introduce the term decolonizing methodologies as a mean to analyze theoretically these issues.
Professional Socialisation in the Workplace: A Phenomenological Study
* Research and Evaluation, Workplace Strategy and Capability, Department of Labour, Wellington, New Zealand
** University of Sydney, NSW, Australia E-mail:
This paper illuminates the professional socialisation process in a variety of physiotherapy workplaces in New Zealand through engagement with a range of facilities and participants (including new graduates, physiotherapy managers, and more experienced physiotherapists). It explores the experience of being and becoming a physiotherapist in New Zealand, and gives recognition to the importance of the workplace in the professional socialisation process. It examines the impact of positive workplace experiences for recent graduates, and identifies links between these experiences, professional career structures, and the attrition rate from the profession. What is it like to be a physiotherapist in New Zealand?
Exploring Epistemic Communities: The Making of Attachment Theory
Centre for Work and Community Studies, Athabasca University, Athabasca, Alberta, Canada E-mail:
Attachment theory has played a prominent role in shaping understandings about the course and consequence of intimate human relations across the life span. Dr. John Bowlby, a child analyst first articulated attachment theory and drew attention to the acute distress of young children resulting from periods of separation from their mothers. From these observations, Bowlby defined a theoretical framework that sought to explain how specific aspects of relationship functioning are organized across the life span. Early attachment theorists formed a particularly tight-knit community, controlling the research agenda through their participation in professional organizations, in supporting a range of psychology and psychiatry journals, and by their presence in the popular media. This paper charts the ways in which early attachment theorists created an epistemic community that ultimately resulted in the theory's global reach (Haas, 1992). Epistemic communities are based on notions of “thought collectives” that describe groups sharing common styles of thinking. Social scientists have recently been attracted to the idea of epistemic communities as a framework for understanding the structure and organization of knowledge. In an era where the high volume of published articles in specific research areas, like the attachment literature for example, it is difficult, if not impossible, to keep track of the evolution of theory. This framework offers a particularly salient approach to organizing and understanding knowledge and its community (Roth & Bourgine, 2005). In the past, strategies used to understand epistemic communities either focussed on the social links between researchers or on the semantic links between topics being researched. Taking into account both the researchers and their shared interests, this paper will discuss a methodology, and the results of an exploratory study, that allows a comprehensive pictorial representation of the structural features underlying attachment theory.
The Reflective Interviewer: Key Considerations in Using Interviews in Social Sciences Research
Department of Lifelong Education, Administration, and Policy, The University of Georgia, Athens, Georgia, USA E-mail
Our daily exposure to the “interview” as a format for gaining information, debating viewpoints, and providing entertainment obscures the complexity of conducting interviews for research purposes (Atkinson & Silverman, 1997). This paper reviews key considerations for qualitative researchers who use interviews for the purposes of research. Since qualitative interviews are a taken-for-granted aspect of qualitative research, the complexity of generating and interpreting qualitative data is sometimes overlooked by qualitative researchers, and simplistic analyses and interpretations of interview data have been critiqued both within in and outside the field of qualitative research methodology (Rapley, 2001; Roulston, 2001). Yet, there is still relatively little literature that demonstrates ways instructors might effectively work with beginning researchers to develop their interview practice (Roulston, deMarrais & Lewis, 2003). This paper aims to provide students and instructors of qualitative research methodology with a theoretically-informed guide to interview practice that will assist novice researchers to develop as reflexive researchers and design high quality research projects using interviews. I begin by reviewing different theoretical perspectives of the research interview and how these inform the design of interview questions and analysis of data (Alvesson, 2003). I then discuss practical approaches that instructors of qualitative methodology might use to assist beginning researchers to learn (1) about themselves as researchers and interviewers; (2) how to identify and analyze salient features of their interview practice; (3) how to design, conduct, analyze, evaluate, and represent qualitative interview data in ways that meet the criteria for quality research. This paper will be useful for teachers of courses in qualitative research methodology in multiple disciplines whose task it is to introduce students to qualitative methods; students of qualitative methods; and qualitative researchers who would like to enhance their understanding of their own interview practice.
The Role and Impact of Stakeholders in Elite Sport—Comparing England with Australia and France
The Institute for Health Research, Staffordshire University, Stafford, England E-mail:
The paper investigates the role and impact of stakeholders in policy networks and communities concerned with elite sport. Whilst the research does not seek actively to compare the whole research field, it examines cross—national characteristics and data, in order to develop models that can be used in wider comparative research. The stakeholders were identified from extant literature, government documents, and discussions with a consultative group drawn from the sports industry. The stakeholders included government ministers responsible for sport; the Director of the United Kingdom Sports Institute (UKSI); heads of the Australian Institute for Sport (AIS) and its associated regional groups; and France's INSEP (Institute Nacionale Superior D'Education Physique). The high performance managers, performance directors, and technical directors, of the 4 focus sports (athletics, hockey, squash and rowing) were also identified, as were the performance athletes and coaches from the four sports. Each of these groups of stakeholders were part of the policy community for elite sport within each case study country and had been shown to have significant interest in the management of elite sport.
The recent literature and governmental reports indicate that in England extensive resources have gone into the facilities and services that support elite sport. This investment has accompanied the development of the English Institute, (EIS), and the United Kingdom Sports Institute (UKSI). However, it is not clear as to how the Government's strategy, “Raising the Game” (Department of National Heritage, 1995), and subsequent strategies, (for example Game Plan, 2000, DCMS), can deliver their objectives without government understanding of how stakeholder groupings impact on policy communities and how programmes, funding, and national policy, contribute to the elite sport process (Cunningham, 2001).
This research has utilised an analytical framework which both conceptually and methodologically views different policy contexts locating the development of elite sport policy within the wider discussion of public policy. The research offers for the first time the opportunity to investigate how stakeholders interact with government and other actors within their policy community.
The findings from the research indicate that there is evidence of policy communities in elite sport within each of the case studies. Evidence supports the view that there is policy convergence across the case studies on elite sports policy, and that there are similarities in the role, impact and interaction of stakeholders groups within policy communities. The research identifies the role the athletes have in the development of the policy communities, and the importance of the different approaches taken in the funding of their elite sports programmes.
The Emancipatory Vision in Critical Ethnography—Dream or Reality?
National Institute of Education, Nanyang Technological University, Singapore E-mail:
As an enthusiast of critical theory, I found the critical ethnography espoused by Phil Carspecken highly attractive as a methodology for a research study of a group of Singapore primary school teachers who participated in an action research platform called “Learning Circles.” The central task of the study was to do a cultural description and interpretation of power relations in the social interactions of a group of teachers as they learn, work and relate to each other during Learning Circles' professional learning discussions. As the study was situated within a critical social science paradigm, the pursuit of promoting emancipation and therefore power symmetry, along with resisting domination in the relationship between the researcher and research participants became central in the reflexivity aspect of the study. This value orientation or bias is however not without problems when translated into actual practice especially within a society that values hierarchical social relations. In this paper I seek to surface dilemmas that I faced pertaining to power covering matters of access, fieldwork, methods of data analysis, ontological and epistemological claims to truth, and presentation of findings, and how I had made attempts to resolve them. Attempts at resolving these dilemmas had not only revealed the practical limits of embracing a critical stance in social science research, but also expanded the imaginative possibilities of emancipation for research participants.
Exploring Doctoral Supervision from Above, Amidst and Below: A Collaborative Autoethnography
School of Nursing, Midwifery and Health Studies, University of Wales Bangor, UK E-mail:
The process of earning a doctorate is complex (Phillips & Pugh 1994), and a critical success factor is the supervisory relationship. The supervisor's task is to provide technical and emotional support (Easterby-Smith et al 2002:14). Undertaking a PhD is a personal process, with highs and lows—for both supervisor and supervisee. Wisker (2001) identifies three stages: the beginning; ongoing; and final stages; in which the supervisor's role changes to adapt to emerging students' needs.
The aim of this autoethnography is to share experiences from three researchers at different stages of their career, involved in one doctoral supervision process. Sally provides a view from above, having successfully supervised other doctorates, and is now mentoring Fiona. Fiona provides a view from amidst, supervising Caroline, her first doctoral student. Caroline provides the view from below, at the beginning stage of her doctorate.
There are many models of doctoral supervision (Price & Money 2002, Enders 2004). However, whatever the model, Wisker (2001:29) notes, “Managing your supervisor(s) well and developing and maintaining a supportive, positive, constructively critical relationship over time is essential to help you produce a good quality thesis.”
To explore and analyse our experiences, we employ autoethnography, a relatively recent qualitative approach to research whereby the researchers themselves are the “subjects” of study. Denzin's (1989:2) term autoethnography is described by Ellis and Bochner (2003:209) as an “autobiographical genre of writing and research that displays multiple layers of consciousness, connecting the personal to the cultural.” Autoethnography links the researcher's self to the study, attempting to understand the experiences of the individual (auto) and the group she is studying (ethno). Here, this involves the researchers, considering their observations and experiences of the process of doctoral supervision as participants. The aim is to explore their interactions within the culture of academia, and sub-culture of doctoral supervision.
Critical Theory and Case Study: The Logical Links
* Cairns Health Service District and School of Nursing Sciences, James Cook University, Cairns, Queensland, Australia
** School of Nursing Sciences, James Cook University, Townsville, Queensland, Australia
*** James Cook University, Cairns Campus, Queensland, Australia E-mail:
Critical theorists believe that reality is shaped by social, political, cultural, economic, ethnic and gender values, enabling researchers to explore marginalised groups within society. Critical theory challenges the status quo by revealing the hidden relations of domination and power inherent in society's structures. It is also emancipatory and seeks to bring about change for the marginalised groups.
Case study enables a detailed examination of a unit within real life and contemporary context to be undertaken using multiple data sources. Through the use of multiple perspectives, the richness of obtained data is one of the strengths of this method, despite being labelled “soft” research. Case study is very versatile and has been described as a “bridge across the paradigms.”
While critical theory has frequently been used as a theoretical framework for action research, the link between critical theory and case study have not been explicitly identified. In this paper, we will describe both critical theory and case study, and then will argue that case study, as a research methodology is compatible with critical theory. The specific aspects of case study such as exploration of real life, in particular contexts and the integration of guidelines into practice are consistent with the tenets of critical theory.
Teaching Qualitative Methods at a Postgraduate Level: Some Reflections from a model of “Scholarship of Teaching”
Postgraduate Programme Division, Universidad de La Salle, Bogotá, Colombia E-mail:
As a teacher in charge of some seminars on qualitative research methods (critical ethnography and action research) in the MA in Teaching Programme of the Universidad de La Salle, I have found myself reflecting on my teaching. One model that has been especially relevant and useful to do it is the one proposed by Kreber and Cranton (2000), who understand scholarship of teaching “as both learning and knowing about teaching and mak(ing) suggestions for how it can be demonstrated and assessed” (p. 1). They combine Mezirow's theory of transformative learning with Habermas's theory of knowledge-constitutive interests (technical, practical and emancipatory). As a result they suggest a model composed of three levels of reflection (premises, processes and contents) on three different types of learning and knowledge of the teacher (pedagogical, curricular and instructional). This paper presents some reflections derived from my answering to the questions posed in this model. One of the main conclusions of this exercise is referred to the fact that various pressures coming from the now so called “society of knowledge” have been making the original principles orienting qualitative research and those guiding the educational process disappear or be distorted. Likewise, social changes are at risk if we consider that both research and teaching have been reproducing the problems we ourselves are committed to fight against.
Interpreting Professional Service Quality: A Study of General Practice Medicine
Department of Marketing, Griffith Business School, Griffith University, Queensland, Australia E-mail:
This interpretive study investigates consumer understanding of professional service quality. The research focus is the consumer's experience of professional service quality and the research goal is to identify and describe the varying ways that consumers experience professional service quality. The primary aim of this interpretive, specifically phenomenographic, study is a detailed description of the qualitatively different ways that consumers understand professional service quality. Importantly, such a description aims to include all variations in understanding and it is therefore a priority not to dismiss inefficient or seemingly unbefitting ways of understanding professional service quality.
The context-dependency of experience requires the specification of one service context to situate the study prior to any potential informant selection. Assuming that the general population has at one time or another visited their doctor, for this initial reason, the context of General Practice (GP) medicine was selected as the specific profession to contextualise this work.
The design of this phenomenographic study of professional (GP) service quality is a two-phase approach, deliberately taken to allow for initial exploration and preliminary analysis, followed by a second phase of data collection and final analysis. In terms of data collection methods, the two phases of this study entailed observation of the doctor-patient consultation and patient interviews post-consultation. Observation was achieved unobtrusively via a wall-mounted camera. Patient interviews were conducted as soon as possible following the patient's consultation with their doctor.
Given the value we attribute to our health, the quality of health care services is a priority in our society, as it is within the medical profession. Hence, research that aims to further our understanding of GP service quality seems worthwhile.
“They're All Nuts You Know …”—Constructs and Characterisations of Mental Illness and the Mentally Ill in the Discourse of Paramedics
Research Centre for Clinical Practice Innovation, School of Nursing and Midwifery, Griffith University (Logan Campus), Brisbane, Queensland E-mail:
Stigmatisation and stereotyping of the mentally ill is pandemic. The literature is dominated with research into how stigmatisation by individuals, communities, cultures, populations and professions, including health care workers has profound negative impacts on care and service provision for this vulnerable group. The decentralisation of mental heath services has resulted in increased attendance at emergency departments and to emergency medical services by patients with mental health problems. This is well documented in Australia and around the world, with some health facilities reporting a 10-fold increase of the number of patients presenting with mental health problems in 10 years.
Although well-documented in many other professions, little is known about if or how mental illness is stigmatised in the paramedic profession, or how language and discourse is used by paramedics to characterise the mentally ill. Further, little is know on how stigmatisation and stereotyping of the mentally ill (and representations of mental illness paramedics construct) influences care given by paramedics, particularly in emergency situations.
This paper will report results from a study that examines the language of paramedics about the mentally ill and how paramedics discourse has major influences for the care of vulnerable people suffering from a mental illness. This paper presents the results of a study that undertook a discourse and case study analysis of paramedic professional work relating to the mentally ill. It employed interpretive ethnographic and ethnomethodological research methods to allow the explication of paramedic discourses characterising the mentally ill.
To Investigate the Social Construction of Learning/Intellectual Disability by Lecturers in the “Real” Stories They Tell to Their Students within Teaching Narratives
School of Human and Health Sciences, University of Huddersfield, West Yorkshire, UK. E-mail:
This study draws heavily upon the view that discourse interacts with and effects the ways in which LD constructions are formed and utilised by lecturers in their classroom interactions with students.
This study is concerned with dominant discourses which act upon and influence the construction of LD by teachers and is manifested in the stories they tell. It is therefore important to identify the discourses their origins and the discursive practices which appear to contribute to the LD constructions in lecturers' stories (Willig, 2003). Although separated into four main discourses in this study it is acknowledged that many of the wider discourses influence and corresponds to each other in the social world and as such do not form discrete categories acting in isolation (Potter and Wetherell, 2004). However the four discourses identified do have individual characteristics which can usefully assist the interpretations and analyses of the LD constructions in this study. The four discourses which arise from my literature review are what I analyse to be the most commonly used when LD is constructed in the stories told by teachers in this study. These discourses will be presented and discussed.
The four discourses The medicalising discourse. The professional discourse. The political discourse and The inclusion/exclusion discourse
As these four discourses figure strongly in the analysis of the stories and the interpretation of the LD constructions I consider it appropriate to locate them as a dominant feature and to refer to their location and influence to meet my research aims and objectives. As Willig (2004) reminds;
“from a Foucauldian point of view, discourses facilitate and limit, enable and constrain what can be said, by whom, where and when” (Willig, 2004,p. 107).
Capturing Commonalities and Differences in Research: Towards a Unitary Framework for Action
Department of Social Work, Liverpool John Moores University, Liverpool, UK E-mail:
This paper attempts to identify and explore significant themes, which arise in facing the challenge of developing a qualitative research method grounded in the centrality of the respondent/participant. In the diversity of several projects, undertaken by the authors, salient commonalities and differences arise which provide a route to establishing a unifying frame of thinking for qualitative research practice. These projects span the inclusion of an urban Black and Ethnic Minority Community's evaluation of a public service, Social Work Students' experiences of the newly launched Social Work Degree in England and Social Service Users Voices in the development of professional values. They have projected to the forefront of our thinking new dimensions in addressing issues of power, identity, knowledge and status.
Making explicit the complexity of “if and how” power is equalised, transferred or seized in relation to the participants and what factors, including technology, influence the course and nature of this process is essential in achieving an honest and transparent insight into the relationships involved in the research process. The ways in which the participants own senses of identity, located in an increasingly globalised world, affect their relationship to the research topic, and their understanding of the “common” agenda underpinning a collaborative effort can steer the direction of the venture in specific ways, knowingly or unknowingly. The different “knowledges” of those involved and perceived relative status in an increasingly fragmented social context, if not exposed and explored can operate at different levels in supporting or subverting the announced aims of any one project.
This paper attempts to capture these human factors, drawing material from the particularities of the authors' research, and deploying them in a frame for action, which will provide a common core of thinking and planning for qualitative approaches. A framework, which aims to further empower the participants and enrich the outcomes in which relevance to human experience is maximised.
Mixed Methodology in the Middle
School of Health Sciences, University of South Australia, Adelaide, SA, Australia E-mail:
Mixed methodological approaches offer considerable benefits by answering both qualitative and quantitative research questions while providing the opportunity to further triangulate data. Equal emphasis on quantitative and qualitative in a research project is possible, rather than creating an artificial divide between quantitative and qualitative approaches. Traditionally both qualitative and quantitative approaches have been used when piloting data, undertaking exploratory work, responding to shortcomings of one method to the research question or triangulating data.
A research problem may seek information that is not amenable to one type of method only, it is then appropriate to use both approaches with equal emphasis. This can arise when there is a need to understand context of a problem from many aspects. For example the use of document review, observations data and interviews.
The strengths of using a mixed methodology can be compromised when considering the process of peer review. The conventions of each paradigm and therefore of those assessing mixed methodology research have expectations of the researcher's work. For example, the convention of writing in the first or third person, which should apply? More difficult is when adaptations or applications of qualitative theories are used within a mixed methodological framework. A qualitative purist seeing adaptations of a theory could find the approach unsound, and dismiss the research as not trustworthy.
This raises questions as to the suitability of research student projects which require peer review examination using mixed methodologies. Within the scope of a student project, even a PhD, is it not feasible to do a mixed method, where concise finite project outlines are more valued as research training? Alternatively can three students do one topic from three different methodological views? which one author triangulates or compiles?
This paper will explore the use of mixed methodologies, their applications and propose processes for acceptance using peer review.
Family Caregivers and People with Learning Disabilities Experiences of Support Received from Community Teams: Questions on Proxy Data Collection and Collective Phenomenology
Institute of Nursing Research, University of Ulster, Northern Ireland E-mail:
Most people with learning disabilities are now cared for in community settings by family caregivers rather than in institutions. Some of these people require support in the community and multidisciplinary groups called community learning disability teams (CLDTs) provide this. A survey of all CLDT members (N=145, 58% response rate) in Northern Ireland was undertaken to determine the perceived effectiveness of the CLDTs. Nine focus groups were then undertaken with service users (21 people with learning disabilities and 27 family caregivers) with two main aims:
To identify the experiences of the service users who have contact with CLDTs To verify (or not) the perceived effectiveness expressed by the CLDTs.
To compare perceived CLDT effectiveness and expressed service user satisfaction a short rating scale was completed and analysed for all participants. This paper focuses mainly on the qualitative findings, data for this were analysed following a phenomenological method (Collaizzi, 1978).
Findings of the study are used in this presentation to emphasize various methodological issues. First, is the need for caution regarding proxy data, which here related to the perceptions of CLDTs about satisfaction of service users. The life experiences of these service users and how they rated the services provided suggest that CLDTs may over estimate their ability to meet service user needs. Only family caregivers know the loneliness and as some stated “day-in and day-out toil of caring.” Second, is a methodological question on whether or not collective phenomenological experiences can be obtained in group interviews when phenomenology typically involves one-to-one interviews? It will be argued that the focus groups in this study did allow the detection of collective phenomenological life experiences. Finely, it is asserted that collection of data from multiple groups (using various methods) has high value in determining verification of research findings.
Learners Play, Teachers Pray… Ethnographic Narratives of Teacher Identity
University of Johannesburg, South Africa E-mail:
This ethnographic inquiry portrays teacher identity as lived experience and as narrative of educational change in the context of a South African school. I conducted the study as part of a larger inquiry into ten schools in urban South Africa. A decade of democracy begs some attention to educational progress and future reform, from the viewpoint of teachers and with the culture of their schools as the inquiry's landscape. I will present ethnographic portraitures, crafted of a specific “township” school, and with two teachers as main social actors. In addition to participatory observation, interviews and journal data, our project also uses photo data from teachers' photographing activities. These field texts are analysed for content, discourse and narrative, and presented in three acts: “learners play, teachers pray,” the “absent principal” and “towards departure”—all indicating culture and identity in flux. Data “themes” are then theorised from a symbolic interactionist framework, using constructs such as situational, social and personal identity.
Carspecken's Critical Methodology in Practice
* Townsville Health Service District, Townsville, Queensland, Australia
** School of Nursing Sciences, James Cook University, Townsville, Queensland, Australia E-mail:
This paper builds on articles by the presenters, published and in press, which describe Carspecken's highly theorized “critical qualitative research” methodology, also referred to as “critical ethnography” (Carspecken 1996). It takes the next step and explains how his methodology translates into research practice, drawing on the experience of using it as a basis for a doctoral study of the research ethos in a hospital unit. The presentation begins by briefly reviewing the diverse theoretical foundations of Carspecken's approach, including Habermas, Derrida, pragmatism and phenomenology. We then focus on the main issue, which is how this sophisticated methodology can be used as a framework for a practical and productive research project. We review the sequence of research events, the role of theory, and especially critical theory, in the conduct of the research, noting areas of strength and weakness, and a few glitches and points of disagreement encountered along the way. We have found Carspecken's writings to be theoretically challenging, and not for the fainthearted! We argue that his methodology is, nonetheless, underwritten by theory in such a way that it constitutes a rigorous, powerful and practical approach to critical ethnographic research.
Phenomenology: From Data Collection to the Publication of an Article
Division of Health Care Practice, Auckland University of Technology, Auckland, New Zealand E-mail:
The philosopher, Gadamer, argues that a preoccupation with method is antithetical to the spirit of human scholarship (van Manen, 1990) and Gadamer, himself, suggests that “there has been too much talk about phenomenology and not enough phenomenological work” (Gadamer, 2001, p. 113).
Responding to the challenge to teach phenomenology phenomenologically, we embarked upon a project that would enable workshop participants to work “descriptively, creatively, intuitively and in a concretising manner” (Gadamer, ibid.) towards the publication of an article. This paper tells how the participants began to write and interpret stories that would reveal the essence of being a nurse. These texts were then worked and reworked using the reflexive processes of reading, thinking, questioning and re-writing to more fully articulate and extend previous understandings of this phenomenon. The purpose of proceeding to publication was to enable the workshop participants to see how their data could become phenomenological text.
Home is Where You Are: Developing a Living Community within Residential and Nursing Homes
Department of Academic Nursing, Saxion Universities of Applied Science, Enschede, The Netherlands E-mail:
Across Europe as a whole, the ageing population is placing increasing strain on both established healthcare services and on families. In the Netherlands alone, it is projected that in the next 25 years the percentage of the population over 65 will rise from 13% to 22%. This changing demography with its increased survival levels from serious disease and illness, results in increasing numbers of older people with complex pathologies that result in the need for nursing and/or residential care. Those providing care have become increasingly aware of the need to move service provision away from traditional forms of institutional care, to settings where individuality can be expressed, and where the individual is able to retain a sense of self and belonging.
This paper presents the first results from a project using co-operative inquiry to work with clients and healthcare professionals to develop a “living community” providing culturally safe care, within two different institutionalised settings. The project has been developed from a unique and innovative partnership between education and service providers. The advantage of this participatory approach is that with education providing the facilitators, both clients and healthcare professionals have been involved in the identification of key issues factors in service provision and their resulting impact on quality of life for patients, staff morale and job satisfaction. The outcomes from this initial analysis are being used to develop an evidence based model for care that incorporates recognition of the individual needs of clients, their rights to a “home environment” and to multidisciplinary seamless care.
The paper also reviews the processes and procedures used within cooperative enquiry to facilitate change and to support staff as they move from traditional patterns of practice to innovation and change.
Methodological and Ethical Challenges and Dilemmas of Participant Observation: Reflections on Method
Department of Health Sciences, University of York, York, UK E-mail:
The study of work is essentially a study of social action and the complex processes surrounding this action.1 Participant observation is a vital tool in the armoury of research methods for examining social action. The method focuses data collection on interactions within groups, illustrates the whole picture rather than snapshots, and captures context, processes and the influence of the physical environment on behaviour.2 The method produces data which often contrasts with that generated by other techniques (such as interviews) because it goes beyond what people say and explores what people do.3
Whilst many publications offer descriptions of the method, few provide reflective accounts of using participant observation. This paper presents the reflections of one researcher's engagement with participant observation method in the context of an in-depth case study using multi-methods to explore the work of non-registered nurses (health care assistants) in a UK NHS Acute Hospital. Ten health care assistants (purposively sampled for maximum variation within the case site) were “shadowed” by the researcher during 220 hours of participant observation.
The researcher as a registered nurse, adopting a participant observer role with non-registered nurses, raised methodological and ethical challenges and dilemmas. Reflections on method, with researchers external to the study, will consider: the processes of negotiation at a number of levels within the organisation; gaining the trust of study participants and achieving access to areas where care is delivered by “looking and being the part”; balancing the roles of researcher and participant (as a registered nurse with clinical skills); and managing the researcher-participant relationship with study participants. By sharing an experience of deploying the method, others will be able to appreciate the complexity and potential pitfalls of using participant observation, the ethical considerations associated with use, as well as its strengths for generating quality data.
Ethical Considerations when Researching with Participants with Serious Mental Health Problems
Consultant Social Work Researcher & Educator, Melbourne, Victoria, Australia E-mail:
The presenter will explore the meaning of ethical research practice particularly in relation to working with research participants with a serious mental health problem. She will use her PhD research to illustrate how one might engage with, interview and involve this population in research sensitively and ethically. She will use her PhD research Gender and Psychosocial Rehabilitation: A Study of the Different Perspectives of Service Users, Service Providers and Policy Makers to illustrate her arguments. She will also explore the meaning and implications of payment of participants. She will present a framework for gauging the influence the researcher may have in the interview process in this context. She will argue that this may be a useful tool to use in conjunction with trustworthy criteria in qualitative research.
Teaching Qualitative Research On-line
School of Health Sciences, University of South Australia, Adelaide, SA, Australia E-mail:
As universities look to the future, the push to use on-line technologies for teaching and learning poses a challenge for all educators. This paper will describe one approach to teaching qualitative research on-line. Students in the under-graduate occupational therapy degree at UniSA study a fully on-line research course in 3rd year. The course is divided into 10 modules that represent the research process, and students are stepped through each module in order to develop a research plan by the end of the course. The substantive area of driving and older people is used as the research scenario for students to choose a particular angle to develop. The modules cover developing a research problem statement and research question; selecting an appropriate research design, data gathering and analysis approach; as well as considering steps to ensure rigour; and, the ethical issues. Within each module students contribute drafts of their developing work to a web-based asynchronous discussion, where they also give and receive feedback from their peers. Emphasis is placed on students providing a rationale for each of their research decisions and on congruency of the approach.
Reflections written by students on completion of the course have been analysed and demonstrate a great depth of learning about one particular qualitative research approach. The responses to the course experience questionnaire are more concerning which seem to reflect the student's distaste for a “disembodied” experience. The on-line environment of the course will be demonstrated and presented together with qualitative and quantitative evaluation data. This paper will inform other educators as they face the opportunities and challenges in the future of teaching qualitative research in an on-line environment.
Using Autoethnographic Perspectives to Inform Workplace Learning
College of Education, Zayed University, Dubai, United Arab Emirates E-mail:
Autoethnography is a form of self-narrative that places the self within a social context (Reed-Danahay, 1997) and enables individuals to learn about themselves and others by reflecting on the self, in social action with others. Thus, using an autoethnographic approach a person learns how they are defined by the world, and how to redefine themselves and their relationships with others through reflection on what people do with and to each other.
This paper discusses a project that aimed to investigate individual learning at different organizational levels within a developing university in the in the United Arab Emirates (UAE) over a three year period. I will define autoethnography, outline the research aims of the project and provide examples of the autoethnographic genres used to promote the reader's empathetic participation in the lived experiences shared within it (Saks, 1996). I will also discuss strengths and challenges when using autoethnographic perspectives and suggest future directions for this type of research.
My research demonstrates that an autoethnographic approach is an appropriate way to understand, analyze and interpret how individuals learn in organizations; in particular how organizational cultural agents can either hinder or enable this to happen. This approach is appropriate for the exploration of the nature of individual learning in a university because it captures longitudinally the multi dimensional, integrated web of complexities grounded within the social context of a University setting. It enables the study of the development of identities of self as an individual negotiates an organisation.
Furthermore, it enables the study of informal and implicit learning at different organisational levels and the impact of organisational cultural agents on that learning. Although the strengths as indicated are evident, I will also raise some of the challenges linked with such an approach.
Overcoming Challenges in Teaching Qualitative Methods—An Attempt to Make Human Science Research More Digestible
Malmö University, School of Health and Society, Malmö, Sweden E-mail:
As regards qualitative methods, facilitating the teaching-learning process remains a vital challenge for educators today, thereby making human science research accessible for students at all university levels. In paving the way towards a deepened understanding of the human science paradigm, its boundaries, sensitivity, potentials and “spirit” students may experience themselves at a loss by the complexity of understanding, or doing, a project underpinned by qualitative methods. These challenges may be due to the predominance of the natural science perspective from early school years and onwards. Moreover, research methods derived from the human science paradigm are well anchored in western philosophy, hence basic knowledge in western philosophy is inevitable but an uphill climb for some students. Learning about qualitative methods does not seldom involve a change in students' ways of thinking about research. A fundamental understanding of the human science paradigm, is a prerequisite that may have potential to seriously influence qualitative research production as well as research utilization improvements. At all events, it is not without relevance for qualitative methods that educators are able to arm students with no less than a common denominator of what they at least should know in order to fruitfully read results from, or better yet, be able to design a project where qualitative methods are involved. This presentation report on scholarly work combined with experience based knowledge from research, teaching-learning processes as well as didactic examples of ways for paving the way towards a deepened understanding of the human science paradigm. A phenomenological hermeneutic research method based on the philosophy of Paul Ricoeur is used as the case in point.
History of the Present of the Research Quality Framework (RQF)—Methodological Considerations
Division of Health Sciences, University of South Australia, Adelaide, SA, Australia E-mail:
As an analytic research approach, a history of the present, drawing on the work of French social philosopher Michel Foucault (1926–1984), can be described as essentially problem centred and present-orientated. Within this paper methodological considerations related to carrying out a history of the present will be presented. Interrelated concepts of Archaeology, Genealogy and Governmentality will also be examined with particular regard to how they might be used to shape the practice of research.
Examples from research currently underway in Adelaide, South Australia, will be used to articulate the methodological decision making process informed by the work of Foucault. The aim of this research is to problematise federal government reforms to the ways in which research and research education is funded and administered within higher education institutions. A particular focus of the research is the development of the federal governments Research Quality Framework (RQF).
This paper will provide researchers with an example of how the theoretical work of Foucault, specifically in relation to undertaking a history of the present, can be used in research.
Pushing Open the Door—Advancing the Case for Systematic Review and Meta-Analysis of Qualitative Studies
Institute of Primary Care and Public Health, London South Bank University, London, UK E-mail:
In relation to research on interventions to improve health and health services, the traditional hierarchies of evidence all too often dominant, and the potential contribution made by qualitative research to understanding what happens, why and to whom is frequently simply ignored by restricting systematic reviews to quantitative studies. There is a small and rapidly growing body of systematic reviews that are beginning to change this picture (for example: Britten et al 2002, Campbell et al 2003, Feder et al 2005, Smith et al 2005), and an increased recognition that the health and social policy require more inclusive approaches to the synthesis of research evidence and the scope of systematic reviews (see for example debates in the special issue of the Journal of Health Service Research and Policy (volume 10, supplement 1, July 2005).
Drawing on their recent meta-analysis of qualitative studies of expectations and experiences of women experiencing intimate partner violence when they encounter health care professionals (Feder et al 2005), as well as an ongoing systematic reviews of screening for domestic violence we will:
present an approach to conducting systematic reviews of qualitative studies, and contextualise this in terms of previous work; present an approach to conducting qualitative meta-analysis and contextualise this in terms of previous work; identify theoretical and methodological issues that make problematic the use of reviews of qualitative studies in health and social policy formulation, including:
the juxtaposition and comparative weighting of different types of evidence; ensuring methodological robustness; the weight accorded to the patient/community perspective in policy formulation and in clinical guidance.
Aboriginal Women's Experiences of Breast Cancer: A Phenomenological Exploration with Photography
Department of Sociology, University of Saskatchewan, Saskatoon, Canada E-mail:
There is a paucity of sociological research surrounding breast cancer survivorship, particularly with respect to Aboriginal women's quality of life post-treatment. Two of the objectives of our project are: 1) To develop an understanding of the meaning of breast cancer for Aboriginal women; and 2) To evaluate the use of a visual method (photography) in connection with more established methods of qualitative data gathering (interviews and group discussions). Orientation sessions were held with Aboriginal women in Saskatchewan, Canada in order to introduce the participants to the use of digital cameras and the research project. These sessions were followed by photographic data collection and in-depth interviews. Data were interpreted using a phenomenological approach and feminist, decolonizing lenses. While key themes will be presented using selected photos and quotations, this paper also evaluates the use of photography and its implications for future research. Key outcomes of this project are the potential empowerment of women through the sharing of experiences and the possible development of support networks.
Students Look at Present Practices to “See” Future Challenges: The Ethics and Cost Effectiveness of Using Qualitative Methodologies within Nurse Education
School of Nursing Sciences, James Cook University, Townsville, Queensland E-mail:
“a way of seeing the world is given by tradition, but since traditions change it must be possible to see the world in different ways … what we see depends, quite literally, on the way we have been taught to see” (Langford 1985, pp.8).
This paper focuses on the specific opportunities and challenges for qualitative research within a Queensland university nurse education program. It outlines the ethical and financial considerations of analysing student nurses' lived reality during clinical placement, especially in a regional or rural area.
The opportunities and challenges of this research are two fold: those of research design for the students and investigators, and those of the topic for students.
Conducting this research provides an opportunity to publicly acknowledge the validity and worth of students' lived experience, with no extra-curricula commitment from them, and for Faculty to “see” the impact of their ethics teaching. Challenges for the investigators include developing a research design that retains the authenticity, language, and richness of the student experience whilst at the same time protects the welfare of students, individuals and institutions. The role of electronic technology is discussed.
The research topic looks at present practices within a particular health region of Queensland in order for students to “see” future opportunities and challenges they might face as beginning practitioners. Thematic analysis of written essays explores how student nurses experience ethics within the practice of Nursing by the time they reach year two of a three-year Bachelor degree program, and whether or not the theoretical content on ethics is reflected in their reasoning.
The proposal is that (i) qualitative methodologies not only provide insight into the lived experiences of students, but also offer cost-effective data gathering; and (ii) student nurses can contribute to the future of Nursing through narrative and “insider” critique; that is, providing criticism from within the practice. The innovation of the individual nurse, therefore, can and does move the practice forward, and qualitative methodologies allow these voices to be heard.
Researching the Clinically Personal: When the Investigator is an Insider
Faculty of Nursing & Midwifery, The University of Sydney, New South Wales, Australia E-mail:
There is a tradition within the qualitative paradigm for insider research, that is, investigation of a population in which the researcher is a member. This “researching of the personal” has frequently involved clinical populations and been a particular focus within health care research. This paper addresses ethical and methodological issues associated with a qualitative project investigating a clinical population in which the first author was an insider. Ethical and methodological issues encountered in the journey of the project are tracked from the initial design through to implementation, and include factors and effects related to the participants, the researcher, the data, and the communication of findings. The evolution of methods associated with these effects and the emerging nature of the project's design are examined. In particular, discussion of the project draws upon wider qualitative theories and findings, and is framed around articulating the ontological and epistemological nature of insider research from a qualitative perspective.
Collaborative Action Research: Facilitating Change in Acute Dementia Care
School of Nursing, University of Nottingham, UK
University of Nottingham, UK
Nottinghamshire Health Care NHS Trust, UK
Nottingham City Hospital NHS Trust, UK
University of Nottingham, UK
University of Bradford, UK
E-mail:
Aim of presentation: To illustrate how a collaborative action research approach can be achieved by working in partnership with practitioners to facilitate the implementation of person centred dementia care in acute health care facilities.
Setting and participants: A one-year project was undertaken with health care staff, patients with a dementia, and carers, from two acute wards (i) medical and (ii) aged mental health care.
Methods: A collaborative action research project was undertaken using an insider/outsider partnership approach. A scoping exercise provided an overview of current practice: (i) observations (20 hours) (ii) patient and carer interviews (8) and (iii) staff focus groups (2). Content analysis was used to generate themes to explain an acute care experience for patients with a dementia and their carers. Staff workshops were used to challenge current practice and develop action plans for new ways of working.
Findings: The collaboration was achieved by seconding one registered nurse from each participating ward. Regular two-way communication between the seconded nurses and the researchers were used to inform the content of the workshops. Five themes were generated from the data analysis and feedback from workshops around which action plans were developed: (i) maintaining identity (ii) essence of dementia care (iii) communicating with the person (iv) environmental and organisational issues and (v) aftercare. The seconded nurses worked with staff from each ward area to implement action plans.
Conclusions: Adopting a collaborative action research approach requires partnership working. Partnership working was established by seconding nurses from the two participating wards. The seconded nurses had knowledge about the ward areas which ensured the researchers could sensitively approach staff to challenge current practice and achieve change. The seconded nurses also provided the day-to-day momentum to implement the action plans and facilitate change in practice for person centred dementia care in acute settings.
Confinement Practices amongst Afghan Immigrant Women in Melbourne
School of Public Health, La Trobe University, Bundoora, Victoria, Australia E-mail:
This paper discusses our research that explored the question: What is the lived experience of confinement, as described by first generation Afghan immigrant women? Women's experiences of confinement in both Afghanistan and Australia were explored. Twenty five first generation Afghan immigrant women from diverse ethnic and linguistic groups, and geographic regions within Afghanistan participated in the study. Data were collected by in-depth interviewing and participant observation. Confinement was viewed by all women as a significant tradition which has implications for their health and the health of their baby. Traditionally confinement entailed engaging in specific practices over a 40-day period: avoiding strenuous work and resting; keeping warm indoors; eating “hot” foods; and using traditional medicines. A number of ritual Islamic practices were identified as ways of ensuring the baby's health and wellbeing. Practices were aimed at gaining protection during visits; protection from the “evil eye”; and seeking spiritual protection. Throughout the women's accounts are references to differences between the practice of confinement in Afghanistan and in Australia. Lifestyle differences were related by the women to the observance of a shorter period of confinement. The need and/or desirability of conforming to hospital protocol were also attributed to the inability to observe some confinement practices. However, regardless of the form in which the women observed the tradition of confinement, they continued to observe it. It remained an important event in their life as an Afghan woman—as a woman who has given birth. Confinement essentially meant a time of “recovery and affirmation.” The findings indicate that the experience of childbearing for the Afghan women is multifaceted and complex. The diversity of women's experience has important implications for health care providers. Health providers need to acknowledge these complexities so that they can provide culturally sensitive maternal and child care services.
An Ethnographic Study of Patient Care on a Trauma Unit
Kadoorie Centre, John Radcliffe Hospital, and the Royal College of Nursing Institute, Oxford, UK E-mail:
Background: This paper demonstrates how ethnography can be used within an interdisciplinary research strategy in a trauma unit to develop a deeper understanding of the cultural norms that support patient centred care. The use of qualitative methodologies within a strategy orientated towards clinical trials provides a balance of evidence that supports practice and theory development. The study focuses on the patients' experience of a traumatic injury, subsequent hospitalisation and the staff experience of working in this speciality.
Aims: This study extends existing knowledge of patient centred care by exploring the experience of patients and staff on a trauma unit.
Methods: The study took place on a trauma unit in the United Kingdom. Ethnography was the methodology. Qualitative interviews with 40 patients and 20 staff, 16 sessions of observation and two focus groups were undertaken. Data were analysed line-by-line and coded using QSR N6 as a means of managing the data.
Results: Two themes emerging from the study are closeness and therapeutic care. Closeness encompasses: i) the emotional work patients undertake in relation to their injury, hospitalisation and impact of close proximity with others, and ii) the emotional labour staff undertake through being in close contact with the suffering of others. Therapeutic care identifies i) the importance of the social environment, and ii) the impact of the proactive, dynamic approach to care.
Discussion: These themes will be used to illustrate how the cultural norms of the unit aimed to maximise opportunities for therapeutic interventions. The impact this has for practice and theory development will be considered, in light of the existing interdisciplinary research strategy.
Conclusion: The study suggests that key elements, such as a proactive approach to care, do facilitate patient centred practice but how this is maintained and sustained over time within large organisations with competing agendas is a critical issue.
“Hello My Name is April and I Will Be Your Researcher”: Decolonizing the Interview
Cultural Anthropology, University of Wales, Lampeter, UK E-mail
Decolonization of academic research with marginalized, oppressed, and indigenous populations, especially with regards to fourth world cultures, is a very important trend in contemporary qualitative inquiry. This presentation will examine the process of performing the interview in life history, life story and narrative research. I will focus on a collaborative interview with a research participant with whom I have been working in order to gather her life stories and I will discuss how we have reflected together on the interviewing process in particular and the research process in general. The ultimate goal of this presentation is to examine the process of “story sharing” as a way to democratize interviewing.
Social Semiotics and Fieldwork: Method and Analytics
School of Communication and Culture, Royal Roads University, Victoria, BC, Canada E-mail:
Drawing from recent analytical developments in semiotics and postmodern ethnography, this paper exposes and assesses the combination of social semiotics and fieldwork as a form of qualitative inquiry. Approaches to semiotics and fieldwork are not new; both structural ethnographers in cultural anthropology and structural interactionists in sociology and communication studies have previously laid the foundations for the integration of formal methods of analysis and inductive approaches to data collection, yet, as this paper argues, structuralism's limitations have hampered the growth of semiotics within qualitative inquiry. By presenting social semiotics as a viable alternative to structural semiotics, by describing in clear pedagogical fashion how social semiotics can be used as a research strategy, and by exposing its potential for applicability, this paper attempts to bring socio-semiotic ethnography to the forefront of contemporary qualitative inquiry.
A Merger and Acquisition Team Coaching Programme Facilitating the Mental Health of Managers for Sustainable Performance
University of Johannesburg, South Africa E-mail:
Merger and Acquisition (M&A) change impacts on performance levels in companies worldwide. It is a well-documented fact that about 75% of change initiatives fail with potential detrimental consequences to the mental health of those involved. Globally business's tract records indicate that sustainability of M&A change is often an evasive dream despite vast financial and human capital investments. The core premise of the study is that change demands are difficult to meet if businesses do not honour the philosophy of lifelong learning and growth. Coaching is seen in the New World of business as a process that enables learning and development to occur, thereby unleashing team performance even under stretching circumstances like M&A change. Literature currently indicates inadequately described M&A team coaching interventions and models in the hospitality industry that presents the context for the research. This paper describes the generation process of a pragmatically sound M&A team coaching programme that aims to facilitate the mental health of managers for sustainable performance in a Multi-National Hotel and Property owning company. To this end a qualitative evaluating programme design, combined with a theory validating design was conducted. A single case study and auto-ethnography strategy guided the research process. The design is unique because it creatively incorporates programme evaluation with theory validation in a rigorous way. Prolonged engagement with the participant team for more than three years, as well as multiple interconnected data collection methods (focus group interviews, naïve sketches, documentation and field notes) enhanced the trustworthiness of findings. In the search for meaning, data analysis was done as suggested by Tech's descriptive method of open coding. A literature control assisted with re-contextualisation of data throughout the research process. The team-coaching programme, embedded in appreciative inquiry adds new theoretical knowledge to the practice area of mental health, coaching and the hospitality industry.
A Model for Combining Idiographic and Nomothetic Strategies
Occupational Therapy Department, University of New Hampshire, Durham, USA E-mail:
Many researchers consider idiographic and nomothetic methodologies as mutually exclusive. However, proponents of each domain acknowledge a value in connecting these research methodologies more closely, and who advocate combining these approaches in a mixed methodological model. Idiographically-derived indices in nomothetic analysis are attractive when examining individual differences in the structure or patterns of human responses. For example, in health-related research, it is important to understand individuals' perceptions of illness and the meanings they assign their illness, but it is equally desirable to aggregate information across individuals to examine patterns of similarity and differences among people in response to a particular illness. The study presented in this paper used personal action construct methodology (personal projects3), an idiographic-nomothetic hybrid model, to examine individuals' personal goals and purposeful actions in an attempt to understand their response to low back pain and disparate recovery patterns. The intention was to ensure the constructs used in nomothetic procedures were an accurate reflection of the experiences and characteristics of individuals with low back pain. The methodology, data, and results of this study of low back pain are used in this presentation to discuss a model and the issues of combining strategies from both qualitative and quantitative approaches.
New Approaches to the Challenges of Researching Organizational Gossip
@AU =Kathryn Waddington* and Grant Michelson**
* Department of Applied Psychosocial Sciences, School of Nursing and Midwifery, City University, London, UK
** Work and Organisational Studies, School of Business, Faculty of Economics and Business, University of Sydney, New South Wales, Australia E-mail:
In this paper we will examine the methodological, ethical and practical challenges associated with researching organizational gossip, and propose new approaches to meet these challenges. We will bring together a number of different perspectives from our experiences as researchers and practitioners in health and business settings in the United Kingdom and Australia. Gossip is currently undergoing a revival of interest as a topic worthy of academic debate and scholarship, but researchers interested in this phenomenon are faced with a number of theoretical, epistemological and empirical difficulties. These relate to its association with similar concepts and the problem of definition, the elusive and often hidden nature of gossip, the politics of gossip including its negative and pejorative reputation as “women's talk,” and the rights and responsibilities of participants and researchers. In particular, there are issues relating to the third parties of gossip who may be unaware that they are the subjects of other people's gossip and/or research, trust, confidentiality, accuracy of recall and reflexivity. The paper draws upon findings from multimethod research into gossip in nursing and health care organizations, as well as ethnographic research in the higher education sector. Gossip is highly resistant to “paradigmatic summing up,” and a variety of methods of data collection and analysis are necessary to capture its apparently ubiquitous yet ephemeral character. These can include diary methods and participant observation. In the paper we will argue that “reflexive gossip,” defined here as mindful attention to informal conversation, is one way that researchers can help identify, record, and analyze organizational gossip.
Sustained Encounters, Transparency, Interrogated Subjectivities: A Personal Reflection of the Qualitative Data Analysis Process
Office of Minority Health, New York State Department of Health, Albany, NY, USA E-mail:
Qualitative data analysis occurs at the intersection of three relationships—researcher-participant, researcher-data, and researcher-“self”—that are seldom explored holistically in the literature. The author, a healthcare practitioner-qualitative researcher, presents a firsthand account of her use of the Listening Guide, an interpretive, voice-centered, relational method of narrative data analysis, in illuminating this intersection. First, she describes the Listening Guide methodology. Then she provides an overview of her use of the Listening Guide in her dissertation research that explored Community Coalitions as Sites of Transformative Learning, followed by an examination of the emotional investment, constrained tensions and merged biographies that this analytical process and exposed. Use of the Listening Guide revealed the ways in voice, being heard, responding, and relationship are cornerstones of the qualitative data analysis process and the importance of understanding and making explicit its relational dynamics. The paper concludes with a discussion of opportunities and challenges of a transparent qualitative data analysis process its implications for qualitative inquiry and the practice of health promotion and prevention.
Clinical Supervision in Prison Health Care: Conducting Action Research Within Secure Environments
IHCS, Bournemouth University, UK E-mail:
Following the publication of Nursing in Secure Environments (UKCC & University of Central Lancashire, 1999) and the UK policy document The Future Organisation of Prison Health Care (NHS Executive/HM Prison Service, 1999) a nationally funded clinical supervision project was commissioned. The project, using an action research methodology, was designed in three phases. Phase one aimed to develop, implement and evaluate clinical supervision appropriate to the needs of prison health care staff. Phase two involved the training of prison staff in clinical supervision incorporating the findings from phase one. Currently, phase three involves the use of regional action learning sets to facilitate a national roll out of clinical supervision.
The project, in keeping with the philosophy of action research, has been developmental, dynamic and iterative in its unfolding. Phase one of the project examined the efficacy of different models of supervision and their implementation in the prison setting. Three cohorts of staff from five prisons undertook clinical supervisor training. Clinical supervision was then implemented in these prisons using a variety of models. This phase was formally evaluated and supervisor training modified and adapted as appropriate. Phase two of the study involved providing clinical supervision training to 71 members of prison staff via six national training opportunities. The revised training addressed the issues raised in the action strategy utilised in phase one. Phase three of the study has recently commenced, and drawing upon lessons learnt from the previous action involves the use of regional action learning sets to facilitate the cascading of training and development of clinical supervision at regional level.
The aims of this paper are two fold, firstly to disseminate information regarding the emergent findings of the study into clinical supervision within prison health settings. Secondly, the authors aim to discuss the specific challenges and opportunities facing the researcher/practitioner when undertaking action research for management of change within secure environments.
How Does the Researcher See the World as Preschool Children Do?
Christchurch Polytechnic Institute of Technology, New Zealand, and The University of Newcastle Australia E-mail:
Conducting qualitative research with preschool children has particular challenges. Those challenges include but are not limited to finding an ethical way of accessing the life world of the preschool child and seeing and interpreting that world as the child does. Phenomenological ethnography and Merleau-Ponty's theories on intersubjectivity and corporeality create opportunities for addressing the methodological challenges of conducting qualitative research with preschool children. In this paper I will discuss the way in which I developed and applied a methodology incorporating phenomenology and ethnography to access the life world of preschool children in order to investigate what it is like for them to be ill. In addition, I will critically analyse the opportunities presented by Merleau-Ponty's theories of intersubjectivity and corporeality for overcoming adult conventionality and interpreting the world as children do. Looking to the future I will question orthodox traditions for presenting the findings of research that seeks to understand the life world of children.
Mixed Methods Studies in Health Research: Passing Quirk or Here to Stay?
* CIHR Strategic Training Initiative in Health Research (the EQUIPP Program), International Institute for Qualitative Methodology, University of Alberta, Edmonton, Canada
** International Institute for Qualitative Methodology, University of Alberta, Edmonton, Canada E-mail:
The mixed-method design is increasingly described as the “holy grail” of research, a solution to the limitation of conducting individual studies in separate incommensurable paradigms. Based on the philosophy of pragmatism, the goal of mixed-method research is not to replace either qualitative or quantitative approaches but to draw from the strengths and overcome the limitations of both. Researchers adopting a mixed-method design take an eclectic approach to thinking about research and method selection that offers the best chance to obtain useful answers to research questions. The health literature abounds with published mixed-method research that purportedly offers advantage over single method studies. Is this trend a passing quirk or here to stay?
In this presentation, we share our observations and reflections from examination of the research and theoretical literature and of information from the major North American funding agencies supporting mixed-method health research. We describe the various mixed-method designs implemented in completed studies in nursing and medical contexts, outlining the typology, setting, sample, major findings, and justification for the design. Researchers tend to treat mixing methods as inherently beneficial without fully describing study purpose, rationale, and the costs of increased resources including time, funding, and personnel. Therefore, we identify areas of confusion and disagreement about what counts as a mixed-method design and the challenges for showcasing the qualitative component within the larger design. In particular, we discuss scientific rigour, philosophical and methodological issues, priority given to qualitative and quantitative components during integration, semantic concerns, and the role of multidisciplinarity. A balanced perspective of the costs, trade-offs, and decisions involved in conducting mixed-method studies is needed in published studies. This critique contributes to an understanding of the ramifications of mixed-method research on knowledge development, practice, and further research within nursing and health care.
Strategies for Recruiting Participants from Vulnerable Populations
School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada E-mail:
This paper focuses on the recruitment of women with HIV/AIDS into a study of community participation. The purpose of the study was to understand the ways in which women with HIV/AIDS manage this chronic, episodic illness in order to continue their day-to-day participation in their communities. Participation included activities such as self-care, household management, paid/unpaid work, social and leisure activities. While having Research Ethics Board approval for a broad recruitment strategy, we began our recruitment by posting information at AIDS service agencies and hospital clinics. As we started interviewing, we tried to use snowball sampling but found that many participants were very isolated. It soon became apparent that these strategies were not working. Change was needed if we wished to enrol enough women within a reasonable time frame. Recognizing the ongoing stigma of HIV and issues of confidentiality and disclosure, our research team explored possible problems with our original recruitment strategy. In follow-up we found that, rather than allowing women to make their own decisions about participation, some gatekeepers had not posted our advertisements. While others, often women with HIV who worked as advocates for services for women, eagerly volunteered to make our advertisements available within their groups. In addition, a suggestion from these advocates was to post our advertisement on targeted web sites to allow for wider participation. Internet postings led to an increased number of women willing to participate as well as women from remote areas volunteering. Traditionally in health research we have depended on other health providers to help us with recruitment. But with the increasing focus on community based research we need to use diverse recruitment approaches when recruiting vulnerable community based groups. Consumer groups may provide an additional resource but we must remain mindful of the ethical implications of involving these groups.
The Benefits and Technical, Ethical and Acceptability Problems of Establishing a Longitudinal Qualitative Dataset of Routinely Recorded Primary Care Consultations: The Scottish Clinical Interactions Project (SCIP)
Division of Community Health Sciences, University of Dundee, Dundee, UK
Bute Medical School, University of St Andrews, Edinburgh, UK
Division of Applied Computing, University of Dundee, UK
E-mail:
The Scottish Clinical Interactions Project (SCIP) is seeking to use recent developments in information technology to establish a unique longitudinal dataset of routine digitally audio-recorded consultations within primary care. This would provide one of the largest and most detailed insights into real world medical consultations in the world. Furthermore, by linking the data to a range of available and internationally recognised clinical datasets both the precursors and consequences of consultations could be examined. This will be a novel resource, capable of addressing many previously unfeasible questions, and supporting a large number of projects for researchers from around the world. A cohort of individuals, who agree to have all subsequent consultations with general practitioners digitally recorded, will be recruited. Data will then be indexed, linked through a unique patient identifier to other routine health data, anonymised and stored for subsequent use. The recordings and linkages will enable researchers to track changing health care use over time, and may help identify events within consultations that result in problems such as delayed diagnosis and non-adherence to prescribed regimens. It may also enable us to identify clinician behaviours that are associated with successful events such as patient lifestyle change, disease detection and shared-decision making.
While there are potential benefits from such a dataset there are also a range of potential problems. This paper discusses the ongoing findings from a nationally funded feasibility study. It will focus on the various ethical, technical and practical issues stemming from consultation with the public, primary care staff and research ethics committees along with reviews of the relevant technical and methodology literature.
Understanding Children's Illness and Treatment Experience with the Aid of Drawings: The Case of Physiotherapy and Cystic Fibrosis
Division of Community Health Sciences, University of Dundee, Dundee, Dundee, UK
Division of Maternal and Child Health, Ninewells Hospital, University of Dundee, Dundee, UK
E-mail:
Objective: To explore the experience and problems of implementing non-drug treatment regimes among children, using chest physiotherapy for cystic fibrosis (CF) as an example.
Methods: In-depth interviews and drawings with 32 children with cystic fibrosis, aged from 7 to 17 years, and 31 parents.
Results: Reasons for (non)adherence were substantially different to those that have been typically identified in the literature on drug adherence. Content, duration, frequency and visibility of the intervention influenced adherence. These characteristics resulted in a sense of “difference,” giving rise to feelings of unfairness, inequality, and social stigma. Lay physiology and anatomy were important with some parents and children having a graphic conceptualisation and visualisation of the pathophysiology of CF as evident in some children's drawings. Perceived effectiveness of treatment was problematic and based on either trust or the association of indicators such as sputum production with clinical improvement. Adherence involved both children and parents. However, strategies to improve the experience of physiotherapy were hindered by infection control policies that prevented parents and children sharing ideas and practices.
Conclusion: Attempts to improve children's illness experience must address both children's subjective experience of treatment, parents' beliefs about its positive and negative impact on the illness and their child's life and identity, and lay conceptualisations of the underlying pathophysiology. Illness perceptions may be more easily accessed through the use of drawings. Health professionals should recognise some families' success in developing strategies to improve adherence and establish ways of communicating these with others.
Working With Community from The Inside Out
University of Canberra, ACT, Australia E-mail:
This paper is as much about finding the means for dialogue about the intangibles embedded in the relationships between people and their environment as it is about illustrating a methodology for recognising and working with these intangibles. Many approaches privilege information gained from intellectual processes over that obtained from other levels of consciousness. Investigations underpinned by scientific rationality leave intangible aspects inadequately handled or just simply ignored. Recognition of and working with the intangibles is “to make visible that there is something that can be conceived and which can neither be seen nor made visible” (Lyotard). Something that is conceived, something that someone is conscious of, is personal to them. Their perception is not directly observable and is therefore outside the language and scope of empirical science. No one person has the same perception, simply because they are living different relationships and experiences of their environment.
The language for dialogue about the intangibles deals with personal perceptions. The means for dialogue is an issue of language and definition. People have their own experiences of time and space, which are personal to them. So reference to the intangibles involves a reference to things not subject to the ordinary rules of space and time. Dialogue about such an experience should avoid getting distracted by pedantic definitions. This paper illustrates a methodology that recognises and works with the meanings and associations that form an experience. Meanings and associations have social, cultural and environmental bases that influence peoples' perception of their environment. By combining languages of the human and environmental sciences and the creative arts all the social, cultural and environmental aspects of an experience can be articulated. The means of expression of the experience needs to be as variable as the personal perceptions being expressed.
A Contemporary Tale of Participatory Action Research from Aotearoa / New Zealand
Prairie Region Health Promotion Research Centre, University of Saskatchewan, Canada E-mail:
Much ambiguity continues to surround the term Participatory Action Research (PAR), which simply distilled represents the synthesis of two traditions: action research, which largely emanates from White, Northern countries, and participatory research, whose roots mainly lie in the liberatory aims of participatory research from Latin America, Asia and Africa. To date, much of the literature available to researchers on PAR remains grounded in Western assumptions and cultural values. However, the internationalization of development work and increasing migration patterns of people's from to less economically developed countries to largely Western, wealthier countries, means the practice of PAR must become increasingly context specific.
The intent of this paper is to illuminate PAR as an evolving practice, whose ongoing development must be informed by the entirety of contexts and participants that, in reality make up any one PAR project. It tells the story of an 18 month PAR project in Aotearoa New Zealand with migrant Tongan and Samoan women living on low-incomes in the Auckland suburb of Glen Innes. The author, Lewis Williams undertook this work as part of her PhD research. This project evolved through several phases of development which culminated in these women, who were all mothers and state-owned housing tenants, undertaking a child health and safety survey of State-owned houses in their neighbor hood and engaging in public policy advocacy. Throughout each phase, the author and the other research participants had to successfully negotiate a number of cultural-power dynamics and associated tensions located in the cultural assumptions of PAR, working cross-culturally and the challenges of attempting PAR within the context of a university—community partnership. It draws on several key examples to illustrate these dynamics and invites the audience to reflect on PAR as a diverse and changing practice.
Cries and Whispers: The Narrative Pathos of Expressive Research
* Adult and Vocational Education, Centre for Research in Education, Equity and Work, Hawke Research Institute for Social Sustainability, School of Education, University of South Australia, Mawson Lakes Campus, SA, Australia
** School of Nursing and Midwifery, Griffith University, Logan Campus, Meadowbrook, Queensland, Australia E-mail:
This paper explores the narrative power and pathos of expressive forms of research into purposive interpersonal activities like education, nursing, community development and the like. It is offered as a significant complement to the more common explanatory forms of research. Examples of expressive social research have appeared in artistic and literary artefacts such as paintings, novels, poetry, cinema and drama and have generated considerable questioning from the side of social science (how can this be social science?) and from the side of aesthetics, (how can it be artistic?).
This paper begins with an introduction to the expressive approach to so-called naturalistic social science inquiry. The argument for this approach is that it enriches social inquiry with its careful exploration of episodes of actual education practice as lived experiences. Expressive inquiry is inspired by interpretative and especially phenomenological methodology.
The phenomenological approach seeks to uncover and represent as accurately and completely as possible what a specific educating episode was actually like as a lived experience for the educator in terms of its immediate impact and the raw meanings it had for them. Such holistic representation seeks to communicate imagistically through the language of image and metaphor to the human imagination and heart—the source of so much choice, desire and action.
Finally this paper looks at a way of integrating the expressive method into a professional training curriculum using cinema as expressive and phenomenological resources. It concludes by providing a brief example of the use of a short extract from a commercial film which briefly portrays the lived experience of being an educator. The value and power of this contribution, its cries and whispers is what is argued for in this paper.
Basic Social Process to Strategic Organisational Process: Grounded Theory Development
Griffith Business School, Department of Marketing, Griffith University, Nathan Campus, Brisbane, Queensland, Australia E-mail:
Grounded theory analysis should ultimately derive a core category that explains the phenomenon under investigation (Glaser, 1992; Glaser & Strauss, 1967; Goulding, 2002). Historically these core categories are a single expression of a social process, representing a specific change of behaviour of an individual occurring over time.
While grounded theory has traditionally been used by sociologists to investigate social processes, contemporary exceptions are apparent. These exceptions have re-focussed grounded theory into areas such as management, marketing, strategic alliances and consumer behaviour (Goulding, 2002). The connecting similarity between these studies and traditional grounded theory is the focus on interaction between individuals, which underlies the notion of a social process. Grounded theory analysis progressively integrates and saturates these interactive processes. The categories are then scrutinised and tested for any linkages so that higher levels of abstraction emerge until one overarching social process emerges which can explain variation in all lower level concepts. This final category is known as a basic social process (Parry, 2004).
While grounded theory has traditionally focussed on the interaction and social influence between individuals, the notion of applying the same method to inter-organisational behaviour appears to be possible when logic is applied. An analogy is drawn between a basic social process and a superordinate organisational process; both being representations of influence producing change over time. This argument therefore posits that many individuals, working in conjunction, directly influence an organisation to interact with other organisations at a macro level. Hence, if the “mind” of an organisation could be derived in a similar fashion to that of an individual, grounded theory appears to be applicable.
To further support this approach the following observations are made. “Process” can be defined as a systematic series of actions directed to some end; or a continuous action, operation, or series of changes taking place in a defined direction. This function could then translate to strategic actions influencing an organisation's direction. “Social,” pertaining to the life and relation of individuals in a community, where ultimately the sense of community could be expressed in an organisational context or a body of persons organised for some end of work. These definitions can be linked and appear to support an argument that an organisation's behaviour could be observed from a combination of individuals' actions and that subsequently action/interaction between organisations could take place. It is important to note that this concept of social process does not exclude the incorporation of psychological, structural or cultural constructs.
Therefore, this paper is concerned with inter-organisational relationships and the subsequent incorporation of this strategy into grounded theory analysis.