DEFORGE R and SHAW J. Nursing Inquiry 2012; 19: 83–95 Back‐ and fore‐grounding ontology: exploring the linkages between critical realism, pragmatism, and methodologies in health & rehabilitation sciencesAs two doctoral candidates in a health and rehabilitation sciences program, we describe in this paper our respective paradigmatic locations along a quite nonlinear ontological‐epistemological‐axiological‐methodological chain. In a turn‐taking fashion, we unpack the tenets of critical realism and pragmatism, and then trace the linkages from these paradigmatic locations through to the methodological choices that (...) address a community‐based research problem. Beyond serving as an answer to calls for academics in training to demonstrate philosophical‐theoretical‐methodological integrity and coherence in their scholarship, this paper represents critical realism and its fore‐grounding of a deeply stratified ontology in reflexive relation to pragmatism and its back‐grounding of ontology. We conclude by considering the merits and challenges of conducting research from within singular versus proliferate paradigmatic perspectives. (shrink)

PARLOUR R and MCCORMACK B. Nursing Inquiry 2012; 19: 308–321 Blending critical realist and emancipatory practice development methodologies: making critical realism work in nursing researchThis paper examines the efficacy of facilitation as a practice development intervention in changing practice within an Older Person setting and in implementing evidence into practice. It outlines the influences exerted by the critical realist paradigm in guiding emancipatory practice development activities and, in particular, how the former may be employed within an emancipatory practice development study (...) to elucidate and increase understanding pertinent to causation and outcomes. The methodology is based upon an emancipatory practice development approach set within a realistic evaluation framework. This allows for systematic analysis of the social and contextual elements that influence the explication of outcomes associated with facilitation. The study is concentrated upon five practice development cycles, within which a sequence of iterative processes is integrated. The authors assert that combining critical realist and emancipatory processes offers a robust and practical method for translating evidence and implementing changes in practice, as the former affirms or falsifies the influence that emancipatory processes exert on attaining culture shift, and enabling transformation towards effective clinical practice. A new framework for practice development is proposed that establishes methodological coherency between emancipatory practice development and realistic evaluation. This augments the existing theoretical bases for both these approaches by contributing new theoretical and methodological understandings of causation. (shrink)

Pragmatism emphasizes practical consequences and empirical explanations rather than introspective contemplations. However, the arguments of pragmatists are not uniform, as shown by the four prominent pragmatists presented in this article. The major difference between them is that Peirce and Haack acknowledge an objective truth, whereas James and Rorty do not. Thus, for a fuller understanding of the pragmatist view of our knowledge, both camps must be consulted. In the nursing field, pragmatism is occasionally referred to as a guiding philosophy. However, (...) the influence of James and Rorty has been greater than that of Peirce and Haack on pragmatists, which may risk leading to a skewed understanding of pragmatism by nursing scholars. Still, the four pragmatists share naturalism, which rejects a metaphysics that defines the nature of knowledge before our enquiry and emphasizes experience and practice. Pragmatic naturalism can help ensure that nursing theory does not deviate from clinical practice. This article also explores the broad adaptability of the ideas of all four pragmatists to philosophical issues in nursing, such as mixed‐methods research, epistemic relativism and realism. By showing that pragmatism can be relevant and stimulating to each of these topics, the article demonstrates that the different approaches to pragmatism can provide more inspiration for nurses and nursing researchers in the future. (shrink)

ABSTRACTIt is well acknowledged that the categorization of people with specific political, social and economic characteristics as ‘migrants’ – migrantization – is facilitated by mainstream, positivist versions of science and is associated with the production and/or reproduction of power relations. To date, this important critique has been advanced by academics influenced by interpretivism/poststructuralism who tend to relativize the discussion, and who are unable to provide a space for quantitative research. The main objective of this paper is to offer an alternative (...) approach to avoiding positivism and relativism in ‘migration studies’, based on critical realism, which I term ‘migrantization research’. Critical realist migrantization research is multi-methodological and provides an interdisciplinary framework for conducting mixed-method social research on ‘migration’. It aims to discover, uncover or indicate how various causal powers – of structural, discursive/cultural and agential character – interact and produce certain outcomes. It presupposes that both measurable and non-measurable dimensions of the social world are relevant. (shrink)

Abstract This paper explores gender and mental health with particular reference to the emerging philosophical field of critical realism. This philosophy suggests a shared ontology and epistemology for the natural and social sciences. Until recently, most of the debate surrounding gender and mental health has been guided either implicitly or explicitly within a positivist or constructivist philosophy. With this in mind, key areas of critical realism are explored in relation to gender and mental health, and contrasted with the positions of (...) positivism and constructivism. It is argued that critical realism offers an alternative philosophical framework for the exploration of gender issues within mental health care. (shrink)

HARWOOD L and CLARK AM. Nursing Inquiry 2012; 19: 29–38 Understanding health decisions using critical realism: home‐dialysis decision‐making during chronic kidney diseaseThis paper examines home‐dialysis decision making in people with Chronic Kidney Disease (CKD) from the perspective of critical realism. CKD programmes focus on patient education for self‐management to delay the progression of kidney disease and the preparation and support for renal replacement therapy e.g.) dialysis and transplantation. Home‐dialysis has clear health, societal and economic benefits yet service usage is low (...) despite efforts to realign resources and educate individuals. Current research on the determinants of modality selection is superficial and insufficient to capture the complexities embedded in the process of dialysis modality selection. Predictors of home‐dialysis selection and the effect of chronic kidney disease educational programmes provide a limited explanation of this experience. A re‐conceptualization of the problem is required in order to fully understand this process. The epistemology and ontology of critical realism guides our knowledge and methodology particularly suited for examination of these complexities. This approach examines the deeper mechanisms and wider determinants associated with modality decision making, specifically who chooses home dialysis and under what circumstances. Until more is known regarding dialysis modality decision making service usage of home dialysis will remain low as interventions will be based on inadequate epistemology. (shrink)

Critical realism, a philosophical framework originally developed by Roy Bhaskar in the 1970s, represents a relatively new approach to research generally and to nursing research in particular. This article explores the ontological and epistemological tenets of critical realism and examines the application of critical realist principles to nursing research and practice through a review of the literature. It is evident that few published nursing research studies have, as of yet, utilized critical realism as their paradigm of choice. Both the strengths (...) and limitations of the presentation and use of critical realism in these studies are discussed in this article. Given the varying degrees of success of the authors in explicating critical realism as a philosophical framework, the value of critical realism to the research study, and the ways in which usage of the critical realist framework influenced development of the study and interpretation of findings, it is evident that the quality of future publications espousing the use of critical realism must continue to be strengthened significantly. (shrink)