While the richness of Heideggerian philosophy is attractive as a healthcare research framework, its density means authors rarely utilise its fullest possibilities as an hermeneutic analytic structure. This article aims to clarify Heideggerian hermeneutic analysis by taking one discrete element of Heideggerian philosophy (Being-towards-death), and using it’s clearly defined structure to conduct a meta-synthesis of Heideggerian phenomenological studies on the experience of living with a potentially life-limiting illness. The findings richly illustrate Heidegger’s philosophy that there is either an inauthentic positioning (...) towards death, or an authentic positioning towards death with a proposition that (1) death is certain; (2) death is indefinite; (3) death is non-relational; and (4) death is not-to-be-outstripped. None of the 29 included studies on the experience of a confrontation with death fully utilised this framework, despite claiming a grounding in Heideggerian thought. This demonstrates the value in modelling how Heideggerian existential structures can be used proactively as analytical ‘hooks’ for data in research claiming a basis in this philosophy and/or method. By modelling the potential application of an important Heideggerian philosophical construct to published qualitative data, this meta-synthesis has revealed new domains and more nuanced understandings of the temporal structure of Being-towards-death. Such an approach helps to more fully unveil the existential concerns of people at the core of interpretative phenomenological enquiry and may provide a blueprint to map either primary or synthesised data to other key ontological existentials. (shrink)

In this article, an attempt is made to analyse important implications of the hermeneutic approach in qualitative studies. The article discusses the hermeneutic circle with regard to reasoning contexts, on which the researcher's interpretation is based. Problems in connection with achievement of ‘proper’ understanding in an interpretative process are discussed in light of Gadamer's hermeneutic philosophy. Some features of qualitative studies are addressed. This is concerned with arguments in the presentation of findings in qualitative studies using the hermeneutic approach. The (...) essence of the article is there are grounds for reasonable understanding, even though it cannot be absolute in the hermeneutic. (shrink)

The quality of phenomenological research in nursing has been a subject of long‐standing debate and critique, but conversation took a particularly contentious turn following publication of John Paley's 2017 Phenomenology as Qualitative Research (Routledge), which elicited strong reactions. Faculty in nursing doctoral programs now face a challenge: in light of current controversies, what can we teach that is appropriately labeled phenomenological, and is there a way to present philosophical concepts that might equip students to avoid the most egregious mistakes of (...) the past? In this article, I suggest that ordinary clinical nursing practice is an inherently phenomenological enterprise, and creative bedside insights belong at the center of our teaching, as they embody an everyday phenomenology which exemplifies core elements of the phenomenological method. Instead of following ever‐more‐precisely elaborated instructional manuals, I propose, our students should begin their studies of phenomenology by returning attention to the way creative insight emerges during routine care. Bedside insights have been rendered invisible by our discipline's valuing of technical proceduralism over artistry in research and by the turn to evidence‐based practice in clinical work, but they are a valuable pathway to learning and should be part of our response to the current crisis. (shrink)

In this article, the authors use the context of childbirth to consider the power that is endemic in certain forms of evidence within maternity care research. First, there is consideration of how the current evidence hierarchy and experimental‐based studies are the gold standard to determine and direct women's maternity experiences, although this can be at the detriment of care and irrespective of women's needs. This is followed by a critique of how the predominant means to assess women's experiences via satisfaction (...) surveys is of limited utility, offering impartial and restricted insights to assess the quality of care provision. A counter position of hermeneutic phenomenology as research method is then described. This approach offers an alternative perspective by penetrating the taken‐for‐granted ordinariness of an event (such as childbirth) to elicit rich emic meanings. Whilst all approaches to understanding maternity care have a place, depending on the question(s) being asked, the contribution of phenomenology is how it can uncover a depth of contextual understanding into what matters to women and to inform and transform care delivery. (shrink)

O objetivo deste artigo é, primeiro, apresentar e considerar as críticas de Paley com mais detalhes e, em seguida, discutir algumas das aplicações significativas da fenomenologia que muitas vezes foram negligenciadas pelos pesquisadores qualitativos. Como foi amplamente demonstrado ao longo dos anos, a fenomenologia pode não apenas fazer a diferença no manuseio, análise e interpretação dos dados disponíveis, mas também em como os dados são obtidos em primeiro lugar, por exemplo, através de técnicas especiais de entrevista. Consideraremos algumas figuras centrais (...) da psicologia fenomenológica clássica e da psiquiatria fenomenológica e apresentaremos alguns dos desenvolvimentos mais recentes na ciência cognitiva. Em seguida, discutiremos três casos concretos que demonstram como a fenomenologia foi aplicada no trabalho clínico com pacientes com esquizofrenia, paralisia cerebral e negligência hemispatial. (shrink)

Recently, a book was published, the sole purpose of which was to discourage researchers from using the scientific phenomenological method. The author had previously been critical of nurses who had used the scientific phenomenological method but in the new book he goes after the originators of different methods of scientific phenomenological research and attempts to criticize them severely. In this review I defend only the scientific phenomenological method that is strictly based upon the thought of Edmund Husserl. Given the entirely (...) negative project of only critiquing phenomenologically grounded scientific research, one would expect the author to be sensitive to the cautions historians and philosophers of science speak about when one attempts to criticize concepts and procedures that belong to a different research community. Paley, an empiricist, uses empirical criteria to criticize phenomenological work.Moreover, given the entirely negative project of critiquing phenomenologically grounded scientific research one would expect the author to be knowledgeable about phenomenology and the innovative research practices used by a new research community. However, the author has only a thin, superficial understanding of phenomenology. One gets the impression that he only reads phenomenology in order to critique it. He displays an outsider’s understanding of it which means that his criticisms of it are faulty because he does not know how to think and dwell within the phenomenological framework; he does not understand “discovery-oriented” research and he keeps judging such research according to criteria from the “context of verification” perspective which are the wrong criteria for “discovery-oriented” research; he denigrates and reduces nursing research strategies because he interprets them to be based on pragmatic motivations only. He does not even grant that nurses can have authentic scientific motivations for seeking phenomenologically based methods; he uses unfair rhetorical strategies in the sense that he uses strategies himself that he criticizes when others use them. The review below documents what has been summarized here. (shrink)

In recent years there has been a notable increase in the use of phenomenology as a research method, particularly in educational research. With the rise of phenomenology as a research method, confusion has also arisen concerning what counts as phenomenology, and how best to practice phenomenological research in non-philosophical contexts. Consequently, this article will be concerned with three issues: firstly, to contextualise the debate, I provide a brief overview of three popular and influential approaches to phenomenology as a research method: (...) (1) Giorgi’s descriptive phenomenological method; (2) van Manen’s hermeneutic phenomenology; and, (3) Smith’s interpretative phenomenological analysis; secondly, for the sake of conceptual clarity, I then turn my attention to a critical discussion of these approaches and argue that these approaches tend to converge phenomenology into either a descriptive or interpretative focus that essentially transforms phenomenology into a kind of solipsist subjectivism; and, lastly, to progress the debate forward, I argue that it makes sense to look beyond the qualitative or educational research literature to successful applications of phenomenology in non-philosophical contexts because there are plenty of relevant resources that can offer significant theoretical and methodological support to researchers. (shrink)

At the bedside, nurses are expected to be precise when they read indications on screens and on the bodies of patients and decide on the meaning of words framed by the context of acute care. In academia, although there is no incident report to fill when we misread or misrepresent complex philosophical ideas, the consequences of inaccurate reading include misplaced epistemological claims and poor scholarship. A long and broad convention of nursing phenomenological research, in its various forms, claims a philosophical (...) grounding in the ideas of Husserl, Heidegger, and other thinkers. But for nearly two decades, nurse phenomenologists' knowledge claims have been challenged by well‐informed criticisms, most notably by John Paley. At the heart of criticism lies an observation that Continental phenomenological thought is misrepresented in many nursing sources and that nursing phenomenology, both descriptive and interpretive, cannot appeal to the authority of either Husserl or Heidegger. Taking these criticisms seriously, I am asking, Is phenomenology after Paley possible? If misreading seems to be an issue, how can – or should – we read rigorously? My thinking through these questions is influenced by the ideas of Jacques Derrida. Under a condition of a play of language, of Derridian différance, when meaning is never self‐identical and never fully arrives, I suggest that one has to negotiate meanings through reading for differences. I develop this idea in relation to the methodological conventions of phenomenological nursing research and argue for a careful rereading of the whole field of phenomenological nursing research. Such rereading presupposes and necessitates interdisciplinary engagement between nursing and the humanities and interpretive social sciences. Greater familiarity with research practices of those disciplines that stress theoretical and writing rigour might make visible the limits of nursing research approaches and their quality criteria. An understanding of philosophical and theoretical works – a condition of quality scholarship – depends on our reading of both originary texts and contemporary literature from the humanities and the social sciences. This understanding, far from obliging researchers to always trace (often erroneously) their work to its philosophical roots, opens other, often more sound, methodological possibilities. (shrink)

This paper analyses the question what other healthcare professions should learn from nursing ethics, e.g. what should medical ethics learn from nursing ethics. I first analyse and reject all strong versions of the claim that nursing ethics is unique, because nursing is a unique practice. I then move to the question of whether the link between nursing ethics and nursing theory can be a model for other areas of healthcare ethics. I provide an analysis of the possibility of creating a (...) theory of medicine and find that there cannot be a theory of medicine, and I argue briefly that this finding is also applicable to nursing. If there cannot be a theory of nursing, this entails that nursing ethics cannot be justifiably based on such a theory. In the final section, I then analyse the success of nursing ethics in resisting certain of the vices of Anglo‐American analytic ethics, in particular the reductionism and individualism that characterizes much of healthcare ethics. I conclude that other healthcare ethics could usefully learn from this aspect of nursing ethics. (shrink)

Research Question: What are patients’ experiences of technology in adult intensive care? Research Objectives: -To explore patients’ perceptions of receiving care in a technological environment -To explore patients’ perceptions of how technology has influenced their experience of care Background: Technology is fundamental to the physical recovery of critically ill patients in intensive care (ICU), however, there is a suggestion in the literature that its presence may dehumanise patient care and distract the nurse from attending to patients’ psychosocial needs. Little attention (...) has been paid to patients’ perceptions of receiving care in a technological environment. The purpose of this research, therefore, was to explore patients’ experiences of technology and care within ICU. Methods: This study was informed by Heideggerian phenomenology. The research took place in a university hospital in England. Nineteen participants who had been a patient in ICU were interviewed using a semi-structured approach. Interviews were transcribed verbatim and analysed utilising Van Manen’s framework. Findings: Resulting themes were ‘My Useless Body’ which describes how participants experienced their body as dysfunctional, disconnected and invaded by technology, ‘Making Sense of It’, which describes how participants rationalised their experiences by constructing a story, and ‘Technology and Care’, which describes how and why participants endured technologies in ICU. Conclusions: The disintegrated body is central to the critically ill’s experiences in ICU. Families play an important role in helping patients make sense of their experiences by filling in gaps in memory and helping them to sort the real from unreal memories. Families therefore require support and information resources in fulfilling this role. Patients experience technology and care as a series of paradoxical relationships: alienating yet reassuring, uncomfortable yet comforting, impersonal yet personal. Nurses maintaining a close and supportive presence and providing personal comfort and care may minimise the invasive and isolating potential of technology. (shrink)