In Search of Christian Theological Research Methodology

Abstract

The burgeoning methodological literature available for the guidance of researchers caters for a wide range of standpoints, but it ignores perhaps the commonest personal philosophies encountered in the nursing profession, those based on Christianity. Nursing’s historical and continuing relationship to Christian faith has been well-documented, and although this is reflected in literature stressing the importance of spiritual care, it has had no discernible impact on nurses’ formulations of research methodology. This article outlines the core features of Christian belief and draws out some of their methodological implications for nurse researchers, with a view to initiating a constructive debate from which Christian theological methodologies might be developed.

Keywords

theology research methodology Christianity faith nursing research

Introduction

The term “theological methodology” has long been used to describe the diverse methods adopted in the development and explication of Christian theologies (see, for example, Canale, 2001; Clinton, 1995; Erling, 1960; Guzie, 1965; Hai, 2006; Hefner, 1964; Lacugna, 1982; Porter, 2004; Rehnman, 2002; Schaab, 2001; Vahakangas, 1999; Weber, 1966). However, this is not an article about how to conduct research into theology; to avoid any confusion with this usage, therefore, the subject of this article is termed “theological research methodology.” The aim is to outline the foundations of a Christian theological methodology for use by researchers who wish to bring Christian beliefs to bear on their research endeavors. Although our focus here is specifically on Christian theology, general principles emerge, which may have salience in the context of other religious standpoints. Restricting the discussion in this way still presents a daunting task, but one eminently worth initiating, given the sustained silence on the matter in the research literature. It also reflects the cultural, personal, and professional identities of the authors as nurses, and is entirely consistent with the close and abiding association of nursing with the Christian religion specifically, and the spiritual elements of caring more broadly.

It is surprising that although a significant literature now exists regarding meeting the spiritual needs of patients, and the expression of Christian values through nursing practice, there has been no attempt to articulate how a Christian standpoint might form the basis of research methodology, either within nursing or from without. Such a silence also characterizes the vast general literature on methodology, which details approaches based on a wide array of worldviews and personal values (weltanschauung), but fails even to suggest the contours of a theological approach to methodology. As a result, Christians embarking upon a qualitative research project, for example, find themselves having to adopt one of the established methodologies such as phenomenology, ethnography, grounded theory, or feminist research and their associated methods and epistemological, ontological, and axiological perspectives, which may or may not be consistent with a Christian standpoint.

This results in confusing and potentially distressing attempts to identify which methodology is most readily reconciled with their beliefs, or the equally unsettling temporary adoption of a methodology solely for the purposes of the research. To obviate this oppressive situation, a literature articulating a Christian approach to methodology should be available, and we hope this article will be a first step in this direction. Our rationale for writing this article is founded on a desire to provide Christian researchers generally, and Christian nurses particularly, with tools for a more authentic, principled approach to research; indeed, the Christian religion, through its historical embeddedness in social institutions and cultural life as much as its present-day activities, continues to exert a powerful influence and must not be ignored in any effort to understand the world. Even commentators sympathetic to postmodernism, such as Bal (2005), concede that “present day culture in the West cannot be understood without theology . . .Christianity is a cultural structure that informs the cultural imaginary, whether one identifies with it in terms of belief and practice or not” (pp. 4-5).

Background

Christian theology has both constructed and responded to the social and intellectual landscapes in which it has evolved, variously rejecting, incorporating, and transforming ways of seeing the world. It is, therefore, always an evolving discourse, articulated from diverse standpoints and, yet, retaining claims of a shared mission, usually pursued from foundational beliefs held more-or-less in common. Kent (1995) notes that although some Christians accept the dynamic nature of theology, this is not taken as entailing “radical rejection of traditional doctrine, or more than minor doctrinal adjustment to changing historical conditions” (p. 875). The absolute authority of scripture, for example, is generally recognized and accepted by most mainstream Christians, however diverse its interpretation may be, “for the churches as institutions the identity of Christianity, supernaturally revealed and guaranteed, has not changed, whatever the appearances” (Kent, 1995, p. 875). Our attempt to articulate a theological standpoint for research, while acknowledging the multiformity of standpoints and opinions, seeks to identify those shared elements, which characterize contemporary Christian theology and which could be considered as providing a possible framework on which to explicate a personalized theological methodology.

As already indicated, a careful literature search, which began in relation to nursing research but then broadened to include research of any kind, drew attention to a complete absence of explicit theological influence, or even commentary, upon research methodology or methods. The relationship between Christian theology and the various theoretical streams, which shape contemporary approaches to research, thus, remains largely uncharted. One strategy to address this may be to infer the nature of such relationships from the debates between theology and, for example, philosophy, social theory (Milbank, 2006; Peukert, 1984), psychology, and the biological and physical sciences (Barbour, 2002; Birch, Eakin, & McDaniel, 1990; Deanne-Drummond, 2001; Dick, 2000; Hodgson, 2005; Newberg, 2010; Peters, 2003; Polkinghorne, 1996, 2007, 2008; Russell, Stoeger, & Ayala, 1998; Watts & Knight, 2012), and from theological standpoints, which draw upon those discourses. Although referring to such discourses wherever feasible, in this article we have mostly tried to develop the outlines of a Christian methodology inductively from first principles, that is from fundamental Christian beliefs, to provide a common foundation upon which more sophisticated and individualized standpoints might then be constructed.

Dogmatic Christian Theology

Although comprising many divisions—“historical,” “exegetical,” and so on, Christian theology has traditionally aspired to present a coherent, internally consistent, and ultimately comprehensive account of the substance of the Christian faith. The elaboration of a set of core beliefs, which identify mainstream Christianity regardless of denominational differences has been a continuing motif in the Christian tradition, and Hastings’ (1922) Encyclopedia of Religion and Ethics (Vol. XII) notes that it is correctly, albeit now unfashionably, called “dogmatic theology” or “Christian dogmatics.” Some authorities add that dogmatic theology expounds a set of beliefs which, because of their authoritative nature, are characteristically endorsed by the organized Christian churches. The Catholic Encyclopedia (Pohle, 1912), for example, defines dogmatic theology as the exposition of the dogmas of the church, and it has been described as “the crowning achievement of the whole theological enterprise” (Avis, 1995, p. 976). Dogmatic theology has traditionally tried to avoid the provisional nature of systematic theology, which must mutate as knowledge of the world changes, and has tried instead to articulate the timeless, universal, and immutable truths of Christian religion, an aspiration most notably championed in the 19th century by the German theologian and philosopher Ernst Troeltsch (1912-1992), and described in his seminal, two-volume work, The Social Teaching of the Christian Churches. Avis (1995) notes the problematic nature of a normative theology, however, and suggests that many theologians are liable to accept the less ambitious, ecumenically oriented goal of creating

consensus of scholarly conclusions concerning the fundamental truths of Christianity, limiting its assertions to what carries broad agreement, refraining from idiosyncratic interpretations, and curbing the apparently innate tendency of dogmatics to superfluous polemics . . . . and inflated rhetoric. (p. 998)

In this spirit, our aim here is to identify the core beliefs described by mainstream dogmatic theology, which appear to unite a majority of Christians and provide a foundation upon which more elaborate theologies may be developed. We will attempt to draw out the ontological, epistemological, and axiological standpoints, which core Christian beliefs seem to entail or imply, and which can subsequently form the basis for a Christian theological research methodology.

Using conventional theological terminology, the standpoints of mainstream dogmatic theology as articulated by the Catholic and Protestant traditions can be summarized as follows:

God

is perfect, omnipotent, omnipresent, omniscient, indestructible, and “supra-temporal,” with neither beginning nor end;

has revealed the divine will and character through Jesus Christ, believers, His Church (we follow the common and Biblical practice of employing “He” and “His” in respect of the Christian God), the Scriptures, and the physical World; and

is not disengaged from the World but is actively engaged in the affairs of mankind and can be known, albeit partially, by Man (the accepted term in theology for humankind).

The World (by which is meant the physical world)

is real and exists, and was created and is “upheld” by Divine will;

is orderly, and knowable through both reason and emotion;

exhibits signs of a Divine creator, while human affairs have a “progressive” history; and

has a future which is subject to God’s purpose.

Man (by which is meant each human being)

is made in God’s image;

has freewill, and therefore may be held accountable;

has the capacity for good and evil;

has the capacity for rational thought; and

comprises a spiritual as well as psychological and material component, which post cedes material death.

In addition, these characteristics are widely agreed to entail certain ethical demands, namely,

certain moral obligations to God, other Men, and the World, giving rise to various forms of personal, social and religious ethics reflecting care for self, Others and the World;

valuing truth; and

observing the demands of Christian religious life, such as worship and prayer.

The authority for claiming these to be foundational resides in their explicit or sometimes implicit expression in key statements emanating from mainstream Christian churches (see Appendix A).

Although attracting significant agreement from Christian Churches and Christian individuals worldwide, regardless of denomination, these foundational beliefs are nonetheless limited in that their precise meaning and import create much dispute and, at times, division among theologians, denominations, religious groups and lay people alike. Common points of dispute are acknowledged in Appendix B. The various positions taken in these and other disputes often differentiate or unite large sections of the Christian community, and we list them here only to acknowledge the diversity of belief, which can emerge from dogmatic theology. Focusing on what the literature suggests is the core of shared beliefs, which distinguish the Christian faith, we will now attempt to identify the ontological, epistemological, and axiological implications for a Christian approach to research.

Toward Christian Theological Methodology

The essential components of the foundation upon which research methodologies are generally constructed comprise explicit claims or, more often, unstated assumptions, relating to ontology, epistemology, and axiology; that is, concerning the nature of existence, ways of knowing, and values. With the exception of caveats regarding causal relationships, these are rarely acknowledged in experimental and quantitative methodology texts, but have been frequently discussed in the context of qualitative research (e.g., Hays & Singh, 2012; Schneider, Whitehead, LoBiondo-Wood, & Haber, 2014).

Ontological Issues

Researchers take a position, assumed or otherwise, about the nature of things: about order and chaos, certainty and uncertainty, about the material and immaterial worlds, and the status of sentient beings within that world; they also take a position as to the trajectory of human history and the possibilities and limitations that this might entail. In doing so, researchers make assumptions or develop working hypotheses as to the very nature of matter itself, including the material and extramaterial nature of human beings. The key belief underpinning Christian ontology is that all things owe their existence and persistence to God alone. This has been expressed in a variety of ways from the oft-cited cross-denominational phrase, “in whom all things live and move and have their being” (e.g., Calvin’s Commentaries on The Book of Acts; Church of England, 1852; Cranmer, 1562; Pope Paul VI, 1974), a phrase that captures a number of Biblical declarations, notably Romans 11.36, right across the spectrum to more recent, theological formulations in terms of “the ground of our being,” notably by the radical theologian Paul Tillich (McKelway, 1964).

So-called “mainstream” Christianity, however, teaches not only that God upholds all that exists, but that existence also serves God’s purpose, that the “Divine Plan” is realized through the joint efforts of God and man, and that everything that exists is beloved of God. In this respect, Christian theology posits human existence as unique, and distinct from that of the animal kingdom in terms of purpose, and in relation to God. It also characterizes human beings as distinctive in comprising body (soma), soul (psyche), and spirit (pneuma). The relationship between the soul and the spirit has long been disputed, but it is widely agreed that harmonious relationships between the three aspects contributes to a sense of individual well-being, a principle that finds expression through holistic nursing care (O’Brien, 2017).

Finally, an ontological position, which threads its way through articles of faith throughout the ages is that of the distinctively Christian way of “being-in-the-world.” The New Testament describes Christians as being in the world but not of the world; they are expected, in other words, to be engaged with worldly issues, but to allow their lives to be guided by the Divine will. At the heart of this is the belief in Christ, not only as a transcendent Savior, but also as a personal guide, mentor, and friend.

For the Christian researcher, these ontological positions suggest that

an holistic approach to understanding human behavior is required;

human research objectives should consider the person holistically, and spiritual considerations should ideally be taken into account;

although Christians acknowledge the relief of suffering to be important, human happiness alone is not a sufficient or ultimate objective in human affairs; and

all that the Christian does should be subjected to and consistent with the divine will, and glorify God.

For Christians, these principles will influence things such as the choice of research topics, the ethical way in which research is conducted, and the uses to which results are put. They dovetail with the epistemological and axiological standpoints of Christians to which we now turn.

Epistemological Issues

Researchers take a position, assumed or otherwise, about the relationship between knowing, understanding, and believing, about what may be known, and the means by which knowledge may be produced. For Christians, awareness of the reality of existence is a corollary of personal experience and belief, rather than a product of logical argument (see, for example, Romans 1 and 2). Although this highlights the tensions that arise in Christian theology as to the respective roles of subjectivity and reason, the outcome is a broadly realist standpoint located among conventional, mainstream epistemologies. Unlike those social theorists and postmodernists who cast doubt upon or entirely reject the claim that the material world is “real” in the sense of being “out there,” and can be directly examined and clearly understood, the Christian realist has no doubts that the world is both real and knowable. Quite apart from appeals to the authority of scripture, the most familiar theological argument supporting realism is perhaps associated with Berkeley and Descartes, who both argued that Man has a clear conviction, or impression, of the reality of both Man and the World and that this could be taken as authoritative as God would not deceive Man by creating a false and misleading impression. This realism can be qualified by linking it to other standpoints with which it is consistent. The many books by Polkinghorne (e.g., 2007, 2008, 2011a, 2011b), marrying his sophisticated knowledge of theoretical physics, scientific method, and mainstream Christianity, are written from an avowedly critical realist perspective. He writes

. . .I believe that critical realism is a concept that is fundamental to the entire human quest for truth and understanding and that theology can defend its belief in the unseen reality of God by a similar appeal to the intelligibility that this offers of the general nature of the world and of great swathes of well- testified spiritual experience. (Polkinghorne, 2011b, p. 11)

Although less concerned with attempting to reconcile science and religion, Barbour (1990) uses similar expertise to create his own sophisticated form of Christian critical realism. These are examples of the many points of contact, which have developed between Christian realist epistemology and contemporary scientific theories particularly, it has been noted (Byrne, 1995; Schaeffer, 1976), those theories concerning the nature of the universe, matter, creation, order, and temporality. There is also a substantial technical literature on the links between realist philosophy and Christian theology, but most of it (e.g., Insole, 2006; Moore & Scott, 2007) comprises extremely refined theological argument that divert us from mainstream theological perspectives.

There are, furthermore, many shades of realism. A positivist realist methodology asserts that there is only one reality, that it is directly amenable to investigation, and objective research can establish absolute truths about the world. The positivist realist regards theories, propositions, and terms as representations of reality. For the neorealist, on the contrary, although there is only one reality it allows for multiple interpretations, its apprehension is imperfect and knowledge is therefore probabilistic. Researchers see the world “through a glass darkly” as it were but, through an open-minded combination of approaches and careful mutual accommodation of interpretations a single, increasingly accurate account of reality can be formed. The aim of neorealist research is thus to discover contingent relationships and contextualized knowledge and insights, from which more generalized and precise accounts can be developed. Unlike positivist realism, neorealism recognizes the reflexive nature of research and the role played by participants and researchers in constructing and reconstructing the world, acknowledging the value-laden nature of attempts to understand and describe reality. It, therefore, entails thoughtful and open expression of ontological, epistemological, and axiological beliefs and viewpoints. As Marinósson (2007, p. 188) points out, the critical realist view is shared by Bhaskar, Harre, and others, and holds that “there is a world of events out there that is observable and independent of human consciousness [and that] knowledge of that world is socially constructed (Denzin & Lincoln, 2012, p. 13).” Thus, Bhaskar holds that “reality is ontologically stable but epistemologically unstable; although reality is in itself an intransitive phenomenon, our knowledge of it is subject to social and political influences and therefore transitive (Bhaskar, 1989)” (Marinósson, 2007, p. 188).

Whereas social constructionist epistemologies admit of an external reality, which must perforce be understood on the basis of such beliefs, antirealists and antifoundationalists, often associated with postmodernism, part company with realism altogether and conceive the world as unknowable in anything but symbolic, transient, and personalized ways. The realists standing against this revisionism include positivists and postpositivists, neo-Marxists and critical theorists such as Giddens and Habermas, and critical realists such as Bhaskar and Archer. It also includes those who undertake grounded theory research, case study, action research, ethnography, critical discourse analysis, and some types of historical research. Ethnography and action research, to the extent that they are participatory and reflexive, tend toward the constructionist middle ground. Further along the spectrum, we can count the pragmatists and neopragmatists, constructivists, Foucauldians, and poststructuralists; largely in the antirealist camp are those undertaking research using Foucauldian discourse analysis, ethnomethodology, existentialism, phenomenology, and deconstructionist and postmodernist strategies. Pragmatist research, associated with the so-called “mixed methodologies” championed by Creswell and his colleagues (Teddlie & Tashakkorie, 2009) side-step philosophical debate and rarely acknowledge their ontological, epistemological, or axiological assumptions. The superordinate position generally accorded to action by pragmatism, and its consequent reliance on instrumentalism, the view that what counts in our understanding of the world is the consequences of actions rather than any qualities ascribed to its contents, along with its explicit admission of defeat in resolving the long-standing disputes that surround these matters, distance it from conventional realism. In any case, we should acknowledge that research, as Schwandt (2000) reminds us, is never atheoretical and is always about more than just choosing a “method,” despite the declarations made by champions of deconstructionist, postmodernist, mixed methods or mixed methodology research.

The neopragmatist view that research should be exclusively devoted to problem solving, is consistent with the realist belief, fundamental to the zeitgeist of the Age of Reason, that all real-world problems are potentially solvable through human intervention. However, in contrast to pragmatist and humanistic philosophies, including Marxism, Christian beliefs entail the view that not all problems can be solved by human intervention, and that not all aspects of the world can be fully understood. From this point of view, human knowledge is always only partial, and the research endeavor is capable only of generating ever more accurate approximations, that is, there is only ever “probabilistic knowledge,” a view promoted by Karl Popper and the postpositivists. Man may “know” the world, but never in any complete sense, and the basic ethical or epistemological principles to which Christians subscribe are not sufficient to generate a single fixed solution; indeed they may even lead to polarized antithetical standpoints, as in the cases of responses to abortion and gay rights. There are many possible solutions to the problems with which we are confronted, and research can sometimes only suggest what the effects of each course of action might be; which is the “best” will depend on one’s objectives and values. The contrary view, that there is only one “right” answer to every problem, whether it is a physical, social, or ethical one, was once orthodoxy. It has figured particularly strongly in postwar nursing ethics, for example, with some American authors going so far as to argue that ethical questions should be treated as arithmetical ones, which simply need to be “solved,” using the “right” methods, to come up with the one and only “correct” answer.

Axiological Issues

Researchers take a position, assumed or otherwise, about their responsibilities in the world, and occupy a moral position, either as a result of conscious decisions or by virtue of their way of being in the world. As previously noted, commitment to Christian theology imposes specific and general ethical obligations, and these can be applied directly to research, in terms of aims and methods. First, the objects of research, what one investigates, should be chosen in a way that reflects these obligations. The potential argument that God’s Creation should be open to inspection and that no limits should be placed on research is clearly problematic because some types of knowledge appear to have potentially catastrophic consequences. The so-called “Armageddon virus,” for example, is a strain of bird flu genetically altered by Dutch scientists in a way that makes it potentially transmissible between human beings and therefore capable of a massive, uncontrolled and largely lethal pandemic, which could kill countless millions of people (National Institutes of Health, 2011). Scientists have generally argued in favor of reporting the results, whereas there was otherwise general support for suppressing the research and its reporting (“Armageddon Super Virus Recipe,” 2011).

This example also illustrates that “pure research,” detached from known applications and from any obvious pursuit of human interests, can have disastrous consequences. To argue that the researcher is simply a disinterested seeker after truth, and bears no moral responsibility for the potential consequences and applications of their research, would be anathema to most Christians. It is difficult to argue that the researcher has no responsibility for what is done with the fruits of their research, especially when these have no known application, but the harm of others. In other words, in respect of ethics, the objects of research cannot be divorced from the aims of research and for Christians, these should contribute to the relief of suffering and the improvement of human existence through increased understanding of the past and present. For Christians, human suffering has been linked theologically to the “Fall of Man” and the consequent presence of sin in the world, but reconciling it with belief in a good and omnipotent God remains, for many, a fundamental theological dilemma. Space does not permit further discussion, but thoughtful, eloquent, and influential analyses appeared in the classic books by Clive Staples (C.S.) Lewis, The Problem of Pain (Lewis, 1940) and A Grief Observed (Lewis, 1961).

With this in mind, the purpose of research for Christians can be summarized as follows:

to increase technical knowledge of the World, through reasoned accounts, and well-founded theories, thereby generating practical means for improving the life of Man (technology) without degrading the life of the planet, and increasing the appreciation of God’s Creation;

to increase self- and mutual understanding, through human research; and,

to reduce exploitation, marginalization, and other morally offensive circumstances.

The overriding aim is to glorify God and contribute to the outworking of His will on Earth.

The first three purposes roughly correspond to the knowledge constitutive of interests of Jürgen Habermas, and entail a rational, ethically and theologically defensible approach to the research agenda. Existing critiques of that agenda suggest that rather than reflecting Enlightenment ideals, it is a direct product of the technology–capitalism nexus, driving capitalist expansionism based on the profit motive through the exercise of an all-embracing stranglehold on everyday life and thought, constituting what some refer to as “technofascism.” Christians would find this corruption of the research agenda unacceptable; they would not be Luddites, however, who think technological research has gone far enough and that we ought to be devoting the time, expertise, and money to other pursuits. Rather, they would argue that consideration should be given to whether resources are being put to best use in the service of God and Man. Therefore, a Christian ethical standpoint demands careful articulation of the purposes of research, and entails valuing one research agenda over another.

The Christian researcher must obey the dictum “do unto others as you would have them do unto you,” which naturally follows from the fundamental injunction to “love thy neighbour as thyself.” For Christians, therefore, the conduct of research must be egalitarian in its aims, respect the rights of all people, and engage human participants with a caring do-no-harm attitude. There is consensus that research must not marginalize, exploit, or harm any participants, and should be reported honestly and openly subject to those considerations, and in nursing this is widely expressed in terms of the three key Kantian principles of nonmaleficence/beneficence, justice, and respect for persons.

Clearly, there is no way of knowing beforehand all the potential or actual outcomes of research, but the aspiration of the Christian researcher is that the fruits of research should glorify God by displaying the glory of Creation, and by relieving suffering, eliminating exploitation, and improving human well-being: For many, this aspiration extends to the animal and material world in its entirety. Research results, which contribute to this aim should be made readily available and brought to the attention of relevant decision makers. An obvious corollary is that Christian researchers should also be concerned about the application of research findings, and their translation into practice.

Implications for Practice

This article has outlined the contours of an approach to formal research that has the potential to provide Christian nurse researchers, be they clinicians, managers or a member of the academy, with a principled and legitimate research methodology. We acknowledge the significant pressure that may be brought to bear upon researchers to utilize one of the many commonly used, “mainstream” methodologies. However, our thesis is that Christian researchers, who wish to more overtly align their worldview with their research endeavors, should have a vehicle by which to do so. Christian research methodology thus offers a bridge that connects research with evidence-informed practice that resonates with nursing’s core values and aspirations.

Suggestions for Further Research

We acknowledge that what constitutes mainstream Christian belief is a matter of contention and that our decisions inevitably invite some disagreement; nevertheless, the field of socially situated research is often unashamedly characterized by diversity and conflict which, as Denzin and Lincoln (2017) contend, are “its most enduring traditions” (p. 24). It is our hope that the embryonic discussion presented here will initiate constructive debate from which mature Christian theological methodologies might be developed.

Conclusion

In this article, we have articulated what we feel can reasonably be regarded as the core features of mainstream Christian belief, clustering them under the commonly used elements, which inform the researcher’s methodological considerations, namely the ontological, epistemological, and axiological “positions” they assume, particularly, when undertaking qualitative research. Our intention was to provide Christian researchers with a methodological standpoint, which genuinely resonates with their beliefs about God, the world and man’s relationship with the two. This discussion was contextualized within nursing’s historical and continuing relationship to Christian faith which, though well-documented in literature stressing the importance of spiritual care, has to date had no discernible impact on nurses’ formulations of research methodology. We believe a Christian theological research methodology has the potential to complement existing critical and interpretive approaches, and thereby to assist Christian researchers to locate themselves politically, ethically, conceptually, and historically.

Footnotes

Appendix A

Appendix B

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

David Lindsay

Author Biographies

Colin Holmes has been the principal or co-investigator in competitively funded research, and has co-run national and international consultancies and other projects. He has successfully supervised and examined honours, masters, and doctoral theses for over 20 years, specializing in historical, interpretive, discursive, post-structural and critical approaches.

David Lindsay is an associate professor, a registered nurse and an experienced nurse academic and researcher within the School of Nursing, Midwifery & Nutrition at James Cook University, Townsville.

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