Nursing Research Portfolio - Assignment Example

Nursing Research Portfolio Reflexive Journal Week 5: Reflections on the Creation of Code Book Establishing the codebook was perhaps among the most difficult parts of the whole course. Indeed, although I had difficulties earlier in the interview and field observation, the hardship I experienced during the creation of the codebook was more difficult because it was much longer. I had to read the transcript over and over again in order to get a “feel” of the thoughts in the interview, and then I had to read them again in the coding of the transcript, and then again in the creation of the codebook. Looking at the steps, they can be almost considered as easy; however, what made them rather difficult was the fact that I grew tired of my transcript, to the point that I almost could not get new ideas in the succeeding times that I read it. Nevertheless, when I allowed myself some rest and then revisited the paper a few days after, I was able to appreciate the paper better. Somehow, the patterns and the recurrent concepts became more apparent and coding became a little easier. In addition, there were also some methodological/analytical insights that I realized from the coding process. One of these realizations is the fact that all the qualitative data are related to each other, although seemingly unconnected. Indeed, a response to one question could actually a supporting idea for another response in a later question. Another realization involves the fact that the researcher affects the way by which the coding is carried out, not only in the selection of methodology, but in the actual choice of concepts itself. From my experience in the coding of my interview transcript, I observed that the interpretive process is shaped by my own spiritual beliefs and orientation. An example of this would be my inclusion of the principal characters involved in the maintenance/observation of religion and spirituality. Some people may have overlooked this aspect of the transcript, but because I believed that religion and spirituality involves a collective effort, I included the said principal players. Furthermore, when I compared my codebook with those of my group mates, I observed some significant differences. For example, my group mates included the characteristics of a spiritual person, as well as the different perceptions on spirituality, but these were not included in my codebook. Also, my group mates did not include the principal characters involved in the maintenance/observation of religion and spirituality. I also noticed that the transcripts of my group mates did not really explore the role played or the influence of the work place in the maintenance of religion and spirituality, which was, ironically, supposed to be the main topic of the coding exercise. Perhaps, the most basic explanation for these differences lies in the fact that I am different and unique from my group mates, and that although we share the same religion, we may not have the same spirituality. Week 6: Reflections on the Thematic Analysis If I thought that the creation of the codebook was difficult, then I guess I was greatly mistaken because it would seem that the thematic analysis was much more difficult. I had two options in making the thematic analysis: I could either present the themes with written summaries and data excerpts illustrating the themes, or I could choose to present my thematic analysis with the use of a concept map and a narrative describing the said map. I chose to use the latter method because the use of a concept map would help me to better organize my ideas and analysis in a clearer manner. As I stated earlier, combining the results of the codebooks of my group mates was rather difficult. This was in light of the fact that we explored different aspects of spirituality, and they did not really focus on the effects of the workplace in religion and spirituality. However, in all the codebooks, one commonality I have observed is the central role played by the nurse in the promotion and maintenance of religion and spirituality. As the bridge between the grassroots and medical field, the nurse becomes a significant player in the maintenance of the person and the community’s spirituality. Still, coming up with this analysis was not an easy feat. First, we had to compare the different codebooks side by side. Then, some changes were made on our individual codebooks, so as to conform the ideas to one another, or to create a form of “fit” among the ideas. However, since the ideas were so diverse, adjustments were rather difficult to get at. Finally, my group mates and I decided to settle on the most important aspects of the comparison, as well as the contents that overlapped. From these overlapping concepts, the other connected ideas were then discussed. Actually, it was rather amazing that once we agreed upon a common denominator in all the codebooks, the other related concepts came easily into view. Indeed, once we acknowledged the central part played by the nurse in religion and spirituality, the nurse’s relationship with everyone concerned in the care of the patient immediately became clear. It was as if the pieces just fell into place, and all we had to do was overcome our differences and take the first step towards integration. Indeed, I guess this is what is most amazing in qualitative research because it looks at an experience that can somewhat represent the whole, which is something that cannot really be said about quantitative research. Week 7: Reflections on Scientific Quality Scientific quality of the research project was another significant matter of concern that we had to look at the end of the conduct of the whole study. I did not realize at first how much was to be considered in order to make the research “scientifically sound”. Indeed, I did not even realize that the biases I have observed earlier can shed doubts on the possible quality of the final product of the study. However, I can say with great confidence that the scientific quality of the study was ensued through the process of verification of the findings with the findings of other researchers and other existing literatures or secondary data. In fact, existing scientific data on religion and spirituality were consulted again and again to confirm the findings of the study. In addition, I also guaranteed that quality was ensured by comparing our transcripts with one another and then finding a common ground. Indeed, even though we had somewhat different codebook interpretations (despite the fact that we used similar interview guides), a unity can be seen in the innermost thoughts of the codebooks, if one would only look closely. Nonetheless, I am not exactly certain how my group mates and I were able to achieve triangulation, but I believe this was achieved through the open and multiple communications we had among our group. Certainly, even though the timeframe provided for us was rather limited, I believe our group maximized it. More importantly, to ensure the ethicality of the whole project, I ensured that the basic principles of ethics were observed religiously. In order to observe the said principles, I had to know them first. Thus, I looked into the ethics discussion of Richards and Schwartz (2002) and Speziale and Carpenter (2011), as well as other readings. From these literatures, I learned the necessary ethical principles that I had to observe. Primarily, I had to respect the patient’s identity as an individual, taking into consideration his autonomy and capacity to think as an independent human being. This principle was addressed by making the patient sign an informed consent form. Also, through the said form, I was able to address the other ethical principles in research: that of confidentiality, privacy, and anonymity. The said principles were indicated in the consent form as part of the agreement, wherein confidentiality involves the respondent’s right to remain anonymous, and for his/her profile to remain confidential and private. Thematic Analysis and One common theme I have observed in all three codebooks is the central role played by the nurse in the promotion and observation of religion and spirituality. In looking at the diagram, the nurse was placed in the middle. At an initial look, concept map would appear erroneous, since it goes against the principle of patient-centered care. However, the diagram is actually correct, since the focus of the ideas is NOT who receives the care, but rather, who gives spiritual and holistic care. Again, at the center of the diagram is the nurse. This is because the nurse serves as the bridge, or the connecting point between the recipient and the primary giver of the health care. This was most prominent in the combined codebooks, wherein he nurse was mentioned repeatedly as one of the most common factors that make the observation of religion and spirituality possible. In fact, in looking at the diagram, it can be seen that it is through the nurse that religiosity and spirituality is made possible. In the codebooks, this idea on the central role of the nurse was revealed in the theme that spirituality is a key feature of nursing. In other words, the nurse bridges the health team and the patient, as well as the community and the support system. This was demonstrated by the “setting” column of the diagram in the previous page, wherein through the nurse, religiosity in the community and in the practice environment is made possible. This fact was observed by the proponents of holistic nursing, wherein the nurse provides a care that address not only the physical aspect of the person, but also his entirety, including the person’s religion and spirituality[Bar09]. Still, a significant part of holistic nursing is that care is not only given to the patient, but to the community as a whole. Indeed, whoever can be included in the care is included, even the community when possible[Ame07]. In fact, holistic nursing encompasses Jean Watson’s Theory of Caring in Nursing, as well as Florence Nightingale’s Environmental theory[Bar081]. Under the latter theory, care should be focused not only on the person’s symptoms, but rather, the environment and surroundings, including the patient’s support system, should be maneuvered to help the patient recover. Moreover, this maneuvering involves the provision of holistic care, which is the focus of Watson’s theory[Maw05]. These principles were most exemplified by the concept map developed from the codebook and presented in the previous page of this paper. In following the arrows, one can see that the thickest line is that of the nurse, who bridges religion and spirituality, its several aspects, and the patient. Through this starting point in the relationship, the nurse can then influence and promote spirituality and religion in all other members of the health care system. By respecting and promoting the spirituality of the patient, the spirituality of the support system and community are also promoted. More importantly, through the example of respect and tolerance, the nurse can inspire the other members of the healthcare team to also respect and promote the spirituality of their patients, as well as their own. Indeed, it is through the nurse that the setting is laid out for religion and spirituality, and it is through the nurse that the core principles of religion and spirituality are promoted. Finally, the diagram shows that through the nurse, the elements or components of spirituality and religion are realized, and the interventions for quality care are made possible. References American Nurses Association (ANA). (2007). Holistic nursing: scope and standards of practice. Silver Spring, Md.: American Nurses Association. Dossey, B. M., & Keegan, L. (2009). Holistic nursing: a handbook for practice. Sudbury, Mass.: Jones and Bartlett Publishers. Kozier, B., Erb, G. L., Berman, A., Snyder, S., Lake, R., & Harvey, S. (2008). Fundamentals of nursing : concepts, process and practice. Harlow: Pearson Education. Mawdsley, S. (2005). Nursing Theories and Their Relevance to Contemporary Infection Control Practice. British Journal of Infection Control, 6, 26 - 29. Richards, H., & Schwartz, L. (2002). Ethics of qualitative research: Are there special issues for health services research? Family Practice, 19 (2), 135-139. Speziale, H. J., & Carpenter, D. R. (2011). Qualitative research in nursing : advancing the humanistic imperative. Philadelphia: Lippincott Williams & Wilkins. Read More