Minggu, 11 September 2011
Sabtu, 25 Juni 2011
action research
Qualitative approaches to research are based on a "world view" which is holistic and has the following beliefs:
Burns & Grove (1993) The Practice of Nursing Research: Conduct, Critique & Utilization 2nd Edition
Gestalt is a German word, which translates in to English as either figure or build when applied to a person, or shape or form when applied to objects (as in gestalt gewinnen which means "to take shape").
The concept of gestalt is closely related to the holistic approach and proposes that knowledge about a particular phenomenon be organized into a cluster of linked ideas, a gestalt.
A theory is a form of gestalt. If we are trying to understand something new and are offered a theory that explains it our reaction may be "Now that makes sense’’ or "Oh, I see."
Whatever the new thing was that we were trying to understand has "gelled" for us.
One disadvantage of this process is that, once we understand a phenomenon through the interpretation of a particular theory it is difficult for us to see the phenomenon outside of the meaning given to it by the theory.
Thus in addition to giving meaning, a theory can actually limit the meaning of a phenomenon.
The purpose of qualitative research is to form new gestalts and sometimes to generate new theories.
To accomplish this, the researcher has to "get outside of" any existing theories or gestalts that explain the phenomenon of interest. The mind must be open to, new gestalts emerging through the abstract thinking process of the researcher during the personal experiences of the qualitative research process.
One qualitative researcher Ihde (1977) in his book Experimental Phenomenology: An Introduction discussed this idea of gestalt formation in relation to human visual perception.
He found that one of the important strategies in switching from one view of a drawing to another was to change your focus.
As an example look at the drawing depicted here.
Most people initially see a cube. This is their sedimented view.
Now try focusing on a different point of the drawing or looking at it as two-dimensional rather than as three-dimensional.
If you concentrate and gaze for a long enough period, you can experience the change in gestalt.
If you look long enough you may see a reverse of the original cube you saw. You can imagine that it is a box made out of coloured glass with an opening at the top. Or the opening can be to one side or the other. Alternatively, you could see it as a peculiarly cut gemstone or a strange insect trapped in a hexagonal shaped box. Or you may just perceive it as a bunch of lines with some coloured shading.
Now try looking at a second drawing. Are you able to see more possibilities this time?
Ihde points out that a new reconstruction tends to be considered odd at first and unnatural, but attains stability and naturalness after a while.
The same can be true when we change our ideas about nursing practice.
By the term sedimented, we mean a long held belief that has become unshakeable although it may be mistaken.
Now, we are beginning to question many of these long held ideas, and the insights gained are changing nursing practice.
For example for many years nurses perceived the patient as being passive, dependent, and unable to take responsibility for his or her care.
This view was heavily influenced by the work done by Talcott Parsons in the 1950's through which he developed his theory of the sick role.
Parson's view was that the person who was sick had a responsibility to passively comply with doctors and nurses in order to become well again.
Now, patients are more often perceived as participating in their care and being responsible for their health.
Ascendance to the open context requires more than just switching from one sedimented view to another. The nurse functioning within an open context would be able to view the patient from a variety of perspectives.
Passive and dependent in some ways, participating with health care givers in other ways, and directing his or her care in some cases.
Qualitative research provides a process through which we can examine a phenomenon outside of sedimented views. The earliest and perhaps most dramatic demonstration of the influence qualitative research can have on nursing practice was the year study conducted by Glaser and Strauss (1965, 1968, 1971). They are credited with developing the qualitative approach referred to as grounded theory for health related topics.
This study was reported in three books entitled Awareness of Dying, Time for Dying, and Status Passage, which described the social environment of dying patients in hospitals. At that time, the gestalt commonly held was that people could not cope with knowing that they were dying. Therefore, they must be protected from that knowledge. The environment of care was designed to protect the patient from that knowledge. Glaser and Strauss examined the meanings that social environment had to the patient.
The study changed our gestalt. Instead of protecting, we saw the traditional care of the dying as creating loneliness and isolation. We began to see the patient in a new light, and our care began to change. Kubler-Ross (1969) perhaps influenced by the work of Glaser and Strauss then began her studies of the dying using an approach similar to that of phenomenology. From this new orientation of caring for the dying, hospice care began to develop, and now, nearly 30 years later, the environment of care for the dying is different.
Can you think of any other shifts in gestalt in nursing practice?
Scientific discipline or rigour is valued because it is associated with the worth of research outcomes and studies are critiqued as a means of judging rigour. Qualitative research methods have been criticized for lack of rigour. However, these criticisms have occurred because of attempts to judge the rigour of qualitative studies using rules developed to judge quantitative studies. Rigour needs to be defined differently for qualitative research since the desired outcome is different (Burns 1989; Dzurec 1989; Morse 1989; Sandelowski, 1986).
In quantitative research rigour is reflected in narrowness, conciseness and objectivity and leads to rigid adherence to research designs and precise statistical analyses. Rigour in qualitative research is associated with openness, scrupulous adherence to a philosophical perspective, thoroughness in collecting data, and consideration of all the data in the development of a theory.
In order to be rigorous in conducting qualitative research the researcher must ascend to an open context and be willing to continue to let go of sedimented views.
This process is known to qualitative researchers as deconstructing.
The researcher will be examining many dimensions of the area being studied and forming new ideas (reconstructing) while continuing to recognise that the present. Reconstructing is only one of many possible ways of organizing data. Lack of rigour in qualitative research can be due to problems such as inconsistency in adhering to the philosophy of the approach being used, failure to "get away from" older ideas poorly developed methods. Other problems include inadequate time spent collecting data, poor observations, failure to give careful consideration to all the data obtained, and inadequacy of theoretical development.
We will look at the three main approaches to qualitative research used in nursing research
There are some other approaches classed as qualitative research but they are less frequently encountered in nursing research. These include Historical Research, Philosophical Research, and Critical Social Theory. (see Burns & Grove [1993] ) or try linking to this excellent (although a little heavy in parts!) site devoted to qualitative research.
You will need to either bookmark this page or use the back button to return to it from the linked pages.
In some ways, the three main approaches are very different and in others very similar.
However, in each method, the purpose is to examine meaning. The unit of analysis is words rather than numerical values.
Although the data are gathered using an open context this does not mean that the interpretation is value free. Each approach is based on a philosophical orientation that influences the interpretation of the data. Thus, it is critical to understand the philosophy on which the method is based. Consequently, each approach is discussed in relation to the philosophical orientation as well as the research methodology.
- There is not a single reality.
- Reality based upon perceptions that are different for each person and change over time.
- What we know has meaning only within a given situation or context.
Burns & Grove (1993) The Practice of Nursing Research: Conduct, Critique & Utilization 2nd Edition
Gestalts
The reasoning process outlined above can be understood by exploring the formation of gestalts.Gestalt is a German word, which translates in to English as either figure or build when applied to a person, or shape or form when applied to objects (as in gestalt gewinnen which means "to take shape").
The concept of gestalt is closely related to the holistic approach and proposes that knowledge about a particular phenomenon be organized into a cluster of linked ideas, a gestalt.
A theory is a form of gestalt. If we are trying to understand something new and are offered a theory that explains it our reaction may be "Now that makes sense’’ or "Oh, I see."
Whatever the new thing was that we were trying to understand has "gelled" for us.
One disadvantage of this process is that, once we understand a phenomenon through the interpretation of a particular theory it is difficult for us to see the phenomenon outside of the meaning given to it by the theory.
Thus in addition to giving meaning, a theory can actually limit the meaning of a phenomenon.
The purpose of qualitative research is to form new gestalts and sometimes to generate new theories.
To accomplish this, the researcher has to "get outside of" any existing theories or gestalts that explain the phenomenon of interest. The mind must be open to, new gestalts emerging through the abstract thinking process of the researcher during the personal experiences of the qualitative research process.
One qualitative researcher Ihde (1977) in his book Experimental Phenomenology: An Introduction discussed this idea of gestalt formation in relation to human visual perception.
He found that one of the important strategies in switching from one view of a drawing to another was to change your focus.
As an example look at the drawing depicted here.
Most people initially see a cube. This is their sedimented view.
Now try focusing on a different point of the drawing or looking at it as two-dimensional rather than as three-dimensional.
If you concentrate and gaze for a long enough period, you can experience the change in gestalt.
If you look long enough you may see a reverse of the original cube you saw. You can imagine that it is a box made out of coloured glass with an opening at the top. Or the opening can be to one side or the other. Alternatively, you could see it as a peculiarly cut gemstone or a strange insect trapped in a hexagonal shaped box. Or you may just perceive it as a bunch of lines with some coloured shading.
Now try looking at a second drawing. Are you able to see more possibilities this time?
Ihde points out that a new reconstruction tends to be considered odd at first and unnatural, but attains stability and naturalness after a while.
The same can be true when we change our ideas about nursing practice.
Changing Gestalts in Nursing Practice
Nursing has a strong traditional base. With this tradition comes an historical view of such phenomena as patients, illness, health, and nursing care and its effects. We are introduced to these so called sedimented views very early in our nursing experiences.By the term sedimented, we mean a long held belief that has become unshakeable although it may be mistaken.
Now, we are beginning to question many of these long held ideas, and the insights gained are changing nursing practice.
For example for many years nurses perceived the patient as being passive, dependent, and unable to take responsibility for his or her care.
This view was heavily influenced by the work done by Talcott Parsons in the 1950's through which he developed his theory of the sick role.
Parson's view was that the person who was sick had a responsibility to passively comply with doctors and nurses in order to become well again.
Now, patients are more often perceived as participating in their care and being responsible for their health.
Ascendance to the open context requires more than just switching from one sedimented view to another. The nurse functioning within an open context would be able to view the patient from a variety of perspectives.
Passive and dependent in some ways, participating with health care givers in other ways, and directing his or her care in some cases.
Qualitative research provides a process through which we can examine a phenomenon outside of sedimented views. The earliest and perhaps most dramatic demonstration of the influence qualitative research can have on nursing practice was the year study conducted by Glaser and Strauss (1965, 1968, 1971). They are credited with developing the qualitative approach referred to as grounded theory for health related topics.
This study was reported in three books entitled Awareness of Dying, Time for Dying, and Status Passage, which described the social environment of dying patients in hospitals. At that time, the gestalt commonly held was that people could not cope with knowing that they were dying. Therefore, they must be protected from that knowledge. The environment of care was designed to protect the patient from that knowledge. Glaser and Strauss examined the meanings that social environment had to the patient.
The study changed our gestalt. Instead of protecting, we saw the traditional care of the dying as creating loneliness and isolation. We began to see the patient in a new light, and our care began to change. Kubler-Ross (1969) perhaps influenced by the work of Glaser and Strauss then began her studies of the dying using an approach similar to that of phenomenology. From this new orientation of caring for the dying, hospice care began to develop, and now, nearly 30 years later, the environment of care for the dying is different.
Can you think of any other shifts in gestalt in nursing practice?
Scientific discipline or rigour is valued because it is associated with the worth of research outcomes and studies are critiqued as a means of judging rigour. Qualitative research methods have been criticized for lack of rigour. However, these criticisms have occurred because of attempts to judge the rigour of qualitative studies using rules developed to judge quantitative studies. Rigour needs to be defined differently for qualitative research since the desired outcome is different (Burns 1989; Dzurec 1989; Morse 1989; Sandelowski, 1986).
In quantitative research rigour is reflected in narrowness, conciseness and objectivity and leads to rigid adherence to research designs and precise statistical analyses. Rigour in qualitative research is associated with openness, scrupulous adherence to a philosophical perspective, thoroughness in collecting data, and consideration of all the data in the development of a theory.
In order to be rigorous in conducting qualitative research the researcher must ascend to an open context and be willing to continue to let go of sedimented views.
This process is known to qualitative researchers as deconstructing.
The researcher will be examining many dimensions of the area being studied and forming new ideas (reconstructing) while continuing to recognise that the present. Reconstructing is only one of many possible ways of organizing data. Lack of rigour in qualitative research can be due to problems such as inconsistency in adhering to the philosophy of the approach being used, failure to "get away from" older ideas poorly developed methods. Other problems include inadequate time spent collecting data, poor observations, failure to give careful consideration to all the data obtained, and inadequacy of theoretical development.
We will look at the three main approaches to qualitative research used in nursing research
There are some other approaches classed as qualitative research but they are less frequently encountered in nursing research. These include Historical Research, Philosophical Research, and Critical Social Theory. (see Burns & Grove [1993] ) or try linking to this excellent (although a little heavy in parts!) site devoted to qualitative research.
The Qualitative Research Page
You will need to either bookmark this page or use the back button to return to it from the linked pages. In some ways, the three main approaches are very different and in others very similar.
However, in each method, the purpose is to examine meaning. The unit of analysis is words rather than numerical values.
Although the data are gathered using an open context this does not mean that the interpretation is value free. Each approach is based on a philosophical orientation that influences the interpretation of the data. Thus, it is critical to understand the philosophy on which the method is based. Consequently, each approach is discussed in relation to the philosophical orientation as well as the research methodology.
Senin, 16 Mei 2011
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