Journal of Research in Nursing

Abstract

Drawing on the philosophy of Michel Foucault and Gilles Deleuze, this paper interrogates the constitution of ‘evidence’ that defines the evidence-based movement in the health sciences. What are the current social and political conditions under which scientific knowledge appears to be ‘true’? Foucault describes these conditions as state ‘science’, a regime that privileges economic modes of governance and efficiency. Today, the Cochrane taxonomy and research database is increasingly endorsed by government and public health policy makers. Although this ‘evidence-based’ paradigm ostensibly promotes the noble ideal of ‘true knowledge’ free from political bias, in reality, this apparent neutrality is dangerous because it masks the methods by which power silently operates to inscribe rigid norms and to ensure political dominance. Through the practice of critique, this paper begins to expose and to politicise the workings of this power, ultimately suggesting that scholars are in a privileged position to oppose such regimes and foremost have the duty to politicise what hides behind the distortion and misrepresentation of ‘evidence’.

Abstract

The systematic review is an important research method that allows for the critical analysis of the results from a range of existing studies to answer research questions. The findings can be used to inform clinical decisions, as well as the development of protocols and guidelines. The aim of this paper is to explore the steps involved in undertaking a Cochrane systematic review and to encourage more nurses to participate in this world wide collaboration to answer questions that are relevant to nursing practice. The first stage of a review involves initiating a focussed clinical question in which the patient group or problem is identified as are the intervention, comparison and outcome, which will become the focus of study. Each review is guided by a protocol that is subject to peer review and followed by a structured search of the worldwide literature on the subject. Quality assessment and data extraction are done systematically and subject to cross-checking. The results are analysed using statistical methods, including meta-analysis. Publication is electronic in the Cochrane Library and many will also be published in other journals. As with all research, findings should be presented in a way that enables the reader to assess whether the review can be applied to their patient.

The CIT is a practical and efficient methodology that encourages participants to tell their story; with happenings that are memorable events in participants' lives. It is a form of story-telling, as participants share their singular experience as a story to the researcher. It is a qualitative, systematic, open-ended technique for educing descriptive data from participants as well as being an effective naturalistic tool for focusing participants' on a specific event. The CIT is a user-friendly instrument that can foster reflection and promote personal expression. The development of the CIT to generate indicators of specific happenings relative to research questions demonstrates the technique's suppleness and emphasises the capability of this methodology in nursing research. As nurses learn more about this methodology and its application to the study of nurses and nursing care, they will begin to comprehend how simple and effortless this technique is to use. The CIT can be developed to conform to any area of nursing and provide a more comprehensive awareness of what nurses do and the needs of our clients.

Abstract

This paper examines the use of a qualitative research methodology, ethnomethodological ethnography that has had little application within nursing, whether in the United Kingdom or elsewhere. This methodology is concerned with describing how members of a social group perceive, define and classify the ways that they perform their daily activities and what meanings they assign to these activities. Ethnomethodological ethnography analyses the everyday methods people use to construct and sustain the typical activities in their cultural world, that is, their ‘sense assembly equipment’. This enables them to act in ways that are congruent with their culturally learnt attitudes. Although this paper focuses on describing ethnomethodological ethnography, examples of its use in a study of nursing practice are provided from a doctoral study that explored the everyday methods military nurses used to rationalise their post-operative pain assessment decisions. From the experiences of this study, it is argued that ethnomethodological ethnography is a valuable methodology for investigating how nurses rationalise their decisions within nursing practice.

Abstract

Fieldnotes and their processes tend to be implicit endeavours in the nursing and midwifery literature. The opportunity, therefore, to build an understanding of the social practice of this part of the research process is lost. This paper explores fieldnote generation in an ethnographic doctoral study examining the building of research capacity. Ethnographers claim that data is generated collaboratively. In this study, data was collected from two fields of ‘peers’. First data set contained 50 h of observation with doctoral research fellows, and the second data set contained 2 years diary recording of a nurse working in a national research funding agency. The paper shows that the levels of collaboration in constructing the ethnographic data can depend on the field itself, the stance of the researcher and the willingness of peer participants.

Abstract

This paper gives an example of the autoethnographic approach to research by examining the life of the author. The account considers her creative identity as a female nurse and life long learner from a white, middle class Northern Irish background. Autoethnography is a relatively new, and controversial, area of research. This paper evaluates the validity of the method with reference to nursing and nurse education. It concludes that autoethnography is a useful research tool, which provides personal insights, which can provide meaning to others. This is particularly true when creative methods of expression are harnessed.

Abstract

During an ethnographic study of an Acute Medical Admissions Unit, informed consent was not obtained from some patient informants despite research proposals to various research committees stating that it would. The ethical judgement was made that not to seek informed consent was in the best interests of patients who were very ill or distressed and that to insist on informed consent would have been potentially harmful to these patients. Drawing on my experiences of collecting data whilst holding the dual roles of researcher and nurse, I argue that contextual moral judgements can enhance ethical decisions in the field and further that rigid adherence to formal bio-medical ethical guidance can lead to inappropriate ethical actions. Importantly, the ethnographer must be able to articulate arguments that reflect the contextual nature of ethical decision-making to powerful gatekeepers, such as research committees. If this does not happen then challenges to the dominance of deontological-rationalist ethics will not occur and researchers may be drawn to the use of less ethically demanding data collection methods. Drawing on insights from literature that considers feminist ethics, and in particular the concept of an ethic of care, justification for my ethical conduct whilst in the field is presented.