This paper develops a framework for establishing rigour for a discourse analysis of professional transition in midwifery, theorised as a ‘female professional project’. Discourse analysis has gained recognition as a useful approach in nursing and midwifery research. It provides an alternative to those qualitative approaches that propose to reveal a ‘reality’ from the perspective of the individual experience, and that this lived experience can be directly represented in language. There are multiple discourse analytic approaches, and often researchers are not explicit (...) about what type they are employing. Furthermore, to date there are few clear guidelines for what constitutes rigour in a discourse analytic study. Rigour in qualitative research broadly falls into two categories: the replication perspective that argues for the maintenance of criteria of validity and reliability, usually with an underpinning assumption (often unquestioned) that a ‘truth’ can be revealed. The second is the parallel perspective that questions the ontological and epistemological assumptions of the replication perspective and argues for the development of criteria that reflect the assumed questionable nature of truth and reality. Transferring these criteria to a discourse analytic study revealed some problems. A common challenge identified in achieving rigour in discourse analysis is the maintenance of congruity between the epistemological and ontological basis of a piece of research and the actual analysis conducted or reported. A framework is proposed to address these incongruities and includes six elements. As nurses and midwives increasingly employ discourse analysis in their research, attempts to clarify how rigour will be determined are important if the outcomes of such research are to be seriously considered for their implications for theory, policy and practice. (shrink)

Psychiatrists' accounts of clinical significance in depression Clinical significance is a crucial element in the diagnosis of mental illness, yet, it is practically untheorised and significantly under-researched. This article takes up the question of how the criterion of clinical significance is translated into psychiatric practice. More particularly, it examines how psychiatrists account for the threshold between health and depression. The paper is anchored in the constructionist view of discourse underpinned by the assumptions of critically oriented discourse analysis. It is based (...) upon a convenience sample of 39 semi-structured interviews with specialist-psychiatrists in south-western Poland. There is no discursive space for clinical significance in psychiatrists' accounts. There is no boundary, no decision to be taken as to whether the symptoms are clinically significant. Depression, invariably constructed in terms of diagnostic criteria, is always represented as fully developed, appearing out of thin air, with no period of falling ill. The article raises the issue of the validity and usefulness of psychiatric diagnosis. (shrink)

The recent process of deinstitutionalization of the psychiatric treatment system, in both Denmark and other European countries, has relied heavily on the involvement in treatment and recovery of cohabitant relatives of diagnosed people. However, political objectives regarding depression and involvement rely on a limited body of knowledge about people’s ways of managing illness-related problems in everyday life. Drawing on a discursive notion of gender laid out by Raewyn Connell, the aim of the article is to elucidate how the involvement of (...) relatives is guided by an extra- individual rationale about gender and caregiving, and how this gendered discourse might frame different challenges and burdens, depending on the gender of the diagnosed person and the cohabitant relative. Drawn from a larger, multisited field study on involvement processes in Danish psychiatry, t he article is based on field notes and 21 interviews with seven heterosexual couples. The analysis shows that gender works as a decisive premise for the division of caregiving labour among the couples, and clarifies how the couples’ gendered institution is disrupted after the onset of depression. The article argues that gender-blind involvement strategies could produce divergent treatment outcomes and varying social effects in relation to couples’ everyday family lives. (shrink)