Nursing as Discipline - Essay Example

Running head: Qualitative Research – Nursing Qualitative Research – Nursing [Writer’s Name] [Institution’s Name] Qualitative research - Nursing Introduction to Nursing and Qualitative research Nursing is a profession regarding heath care of individuals, young or adult, ill or socially maladjusted. Research in health care is done to find out quantitative as well as qualitative aspects of an issue. The research methods developed for the health research include the three perspectives interpretive, critical social sciences and post modern paradigms (Taylor, Roberts, & Kermode, 2006). These paradigms are used according to the focus of research topic being worked by the researcher. As nursing is an important research discipline of health studies, it uses mostly, the paradigms of phenomenology, grounded theory, ethnography and some modern and critical social science methods to explore, analyze and describe the social situations of delivering and receiving of nursing care. The qualitative research in nursing investigates the traits and immeasurable aspects of nursing care. The focus of such a researcher can be goodness, efficiency, satisfaction or personality effectiveness etc. All such research issues cannot be measured without using qualitative research methods. The goodness of a person can only be categorized in levels, intensity and grades. The quantity of goodness is immeasurable as it is an imaginative concept and lies in the minds of people. Such things make the significance of qualitative research evident before the research professionals. In addition, different hypothesis of every research require diverse kinds of research methodologies. This is because of the fact that some researches aim at discovering only the quantity of a quality existing in the nursing profession. This kind of research will adopt an interpretive approach and will quantify the qualitative aspects to arrive at the acceptance or rejection of research question previously developed. The research methods that can be used by the interpretive researchers include Focused group discussion, interviews, survey, questionnaire, and field research. All these methods excluding field research can be used to get quantitative outcomes. Similarly, if the nursing research focuses on the description of a specific culture let’s suppose, the study of group work in a nursing home. It will not have to draw a conclusion from the research rather it will just describe and explain the culture prevailing as it is. From such ethnographic studies, grounded theory researchers can develop theories. When the approach of research is to find out what wrong is happening in the society and criticizing the knowledge after extracting a pattern out of social structures being observed, researcher uses action-based research methodologies. Several other techniques like discourse analysis, mixed methods are also used according to the researched theme. Interpretive paradigm Interpretive paradigm, as its name suggests attempts to interpret data. It aims to work out individuals’ experiences, thoughts, opinions and attitudes towards certain issue. It involves research techniques: phenomenology, ethnography and grounded theory (Barker, 2008). Phenomenological Research The branch of knowledge that relates different phenomenon to each other on the basis of empirical evidence is called phenomenological research (Munhall, 2006). In this regard, it uses data collection methodologies like: Focused group discussion, interview, questionnaire, survey etc. these methodologies are qualitative in nature but can be converted to quantitative methods to make the findings of a research more reliable and authentic. Phenomenology, according to Neill (2006) is basically an explanation of structures of experiences which are perceived by the individual himself. It does not take into account the theories, scientific deduction, or assumptions from other disciplines. Research Question The good quality of nursing reduces the intensity of psychological illness and increases patient’s satisfaction. Research Variables Good quality of nursing - Qualitative variable that requires indicators Psychological illness - That cannot be measured directly unless coding is done of qualitative categorical variables. Satisfaction - Qualitative variable measurable by phenomenology techniques like interview. The variables that are put to test in above research question are purely qualitative in nature. Two of the variables psychological illness and satisfaction of patient are dependent upon good quality of nursing. Good quality of nursing has a negative correlation with dependant variable psychological illness. It means that the research question supposes that good quality of nursing helps reduce psychological illness of a patient where as at the same time quality nursing will increase patient’s satisfaction. As all the three selected variables are qualitative, they must be defined clearly before proceeding toward qualitative research methods. Good quality nursing can be defined as proper medication along with care for the patient under treatment by hospital staff, families or community as a whole. Care by nursing staff can be indicated by friendly relationship between patient and nurses, visits, timely check up, counselling, civilized and tender treatment in all manners. Material facilities can be another indicator in this regard. The indicators identified are qualitative in nature and can be measured in terms of nominal categories. After data collection by questionnaire of selected sample of patients (psychologically upset), coding will be done of answer categories. The questions in the questionnaire will aim at asking for patients’ opinion about his illness that is being cured or reduced by quality nursing or not. Or does the quality nursing have increased satisfaction level of the patient. The sample selected can be of a well reputed hospital or nursing home. Other data collection methods like Focus Group Discussion can also be used to carry out the empirical study. The phenomenological method is the most reliable (Valente, 2002) but yet not perfect, for interpreting and relating phenomenon to each other. The phenomenology is best suited to this research question because the opinions and experiences of people are the basic interest of phenomenology along with the data collection to arrive at one result that either nullifies the hypothesis or accepts it. Literature review To judge the quality of nursing institutions and their effectiveness, a comparative study can be done. A study by Fortune et al. aimed at the analysis of the nursing type that increases the patient’s satisfaction level and rate of recovery by it. The abstract of this study states that by the comparison of a hospital-based and a primary care-based CBT service providing institutions, the assumption that the setting of treatment affected participants' pace of improvement and levels of satisfaction was tested. In this attempt, the researchers analysed that both groups showed an improving trend over the period of the study but the participants from the primary care group recovered at faster rate than that of hospital based participants. The primary care participants also reported considerably higher levels of satisfaction from the care and treatment they are receiving. So in short this study revealed that the setting of treatment might impact on patients' recovery and satisfaction. Moreover, the primary care patients recover more rapidly than those seen in secondary care. Research limitations of phenomenology It simply interprets the issues and is not meant to criticize social situations but yet it is more reliable as it helps in quantifying qualitative aspects of humanity. The individuals selected for the study must be willing to participate in the research and express their opinions, attitudes, feelings before the researcher on the issue being studied. It can also happen that the individuals do not express true opinions because of personal biases or any social pressure. Ethnography Ethnography aims at the analysis of socio cultural themes and patterns. By conducting ethnographic study one attempts to learn about a culture (Johnston, 2000). Data collection involves field work most of the times. It is a kind of case study of a group of people for some length of time. Researcher selects a group to be studied and formulates a rough research question. In field research the researcher himself adapts to the culture of that group and observes by interacting with the group. Notes and report is made on the basis of daily observations and finally a culture is explained to reveal the trends. This type of study may involve usage of interviews, observation, maps, photographs and reading of local newspapers techniques for data collection. The steps of ethnographic research include: (1) Selecting a site or culture to be explored (2) Identifying the significant variables within the culture, (3) Literature review of previous work done in the selected area (4) Gaining entry, (5) Cultural concentration, (6) Acquiring informants, (7) Gathering data, (8) Analysis of data gathered, (9) Description of the culture Research question The study of nurse and doctors relationships at work place The above mentioned statement is a loosely formulated statement for research. In other to achieve the objective of analyzing nurse and doctor professional relationships, the researcher has to adopt the environment of hospital site selected for research. The daily interaction with the hospital staff will be noted and in the end, on the basis of observation and opinion of people and social interaction a final report is made. Focus of analysis in this study of nurse doctors professional relationships can be to find out the effectiveness of their mutual relationship while working in the hospital. For this the domain analysis method can be adopted which will work on the major cultural aspects of the hospital. The norms and values along with structures in the nurse doctor relationship with in the overall culture can also be a focus of the study. Componential analysis focuses on the attributes that signal differences among symbols in a domain. Here the domain will be the interaction in hospital staff with in which the attributes like cooperation and gender biasness perhaps, will show the symbols of groups formed in the hospital of different gender people. Similarly the researcher can do the domain analysis but that will make specific traits of the culture evident hiding many other important aspects of that specific culture. Related Literature Demir. Bayram. Kasapoğlu. and Aytül. (2008) conducted a case study on the same issue. In such a qualitative study, there an investigation conducted of the physician-nurse relationships in view of the current literature that is available. This is done through concentrating on the arguments plus also the solutions at the workplace. Actually these authors conducted the study for understanding and interpreting the social relationships in a certain hospital in Turkey. They write that in accordance with the focus group discussions, gender-based arguments are present not just between the physicians and nurses but there are arguments also owing to inequities in the society which exist in the area of personal, professional, economic and gender-based issues. In view of this there is a very vital role played by the psychological, cultural and structural elements. Other than this, the organisational as well as professional elements also have a role to play in the procedure of physician-nurse relationships. In the study that these writers conducted it was seen that the female physician-female nurse conflict were not in accordance with the current results. However, even the results of the nurses’ interventions in regard to the physicians’ treatments plus also the capability of controlling power distribution, are said to be challenging. Criticism on ethnography One flaw of this research is the biasness of researcher that may get into the connotation of the report. Even in the pure sciences the biasness and human element cannot be completely eradicated. Also the social situations are always changing. Social interaction highly depends upon the behaviour of people. May be the social situations prevailing at the time of research may reflect such a culture that may not be the actual one. All the attributes of the culture may not be evident or can come in the perception of researcher as every individual receives stimuli that clicks his mind and matches to what his mind accepts or rejects (about which one has attitudes) Critical paradigm of qualitative research The critical paradigm mainly explores the issues of power, oppression, equality and freedom for criticizing what is happening in the structures of a society. These approaches are majorly used for explaining criticizing social conditions, norms prevailing in the societies fundamentally like gender violence, social classes, power etc. It questions the validity of socially held beliefs. They use critical approach that challenges the conventional ways of lives with in society. Critical science enables people to understand how society functions and methods by which unsatisfactory aspects can be changed.  In short, critical social science paradigm extorts out certain structures in the social world which must be questioned on their validity. It criticizes the problems and raises voices against them to empower the suffering individuals in that particular society. Action based research Action-based research is done to work on the sensitive issues and where it is necessary to ensure participation of researched population (sample). It can involve quantitative research methods as well. Action Research is not altogether a quantitative research or a qualitative one but it makes use of research methodologies that are involved in both of these research types. However, no matter what technique, or combination of techniques, is used the actual process of action based research is as follows: First of all the researcher identifies a problem Discussion and negotiation between researcher and practitioners Literature Review of previous research Selection of the research and assessment methods Implementation of change, data collection and feedback. This often involves the revisiting and inspection of the earlier steps in a cyclical process of research and change The last step is to review of the study as a whole, give recommendations and then finally pass the research onto the masses. Research question of action based methods Nurses on duty in hospitals have more authority over patients than the patients themselves have on their treatment. The control and power in nursing care should be allocated to one channel only rather it should be divided between the nursing staff and patients so the patients may not suffer from learned helplessness. By this study the disadvantaged group perhaps of the patients will become evident and the state if interested will employ researchers and planners to eradicate power and control differences between the patient and staff on care. The total power in the hand of nurses will weaken the self of the patient making him a will-less robot acting on the indication of nursing staff. This research may have different results if carried out in different hospitals because of different organizational cultures. Some will come out to show that the nurses and patients both have authority where as some will demonstrate opposite trend. So to generalize findings of such analysis, research is needed on larger sample. The researcher makes sure that he is treating the researched ones with non discriminatory manner. Criticizing Action based approach Researcher attempts to work on participatory basis with the research group to ensure equality. But equality can never be achieved as perfection exist nowhere. Generalization on the basis of action based research as well as on other qualitative research is impossible. This can be due to standard error mean that is the one representative sample. In the research question taken above to check the authority by rules and by culture of hospitals in the hands of two groups (patients and nursing staff) the sample of hospitals selected may reveal that the nurses do not have more authority over patients treatment where as in general the other hospitals may perhaps be having trends at odd. Benefits and Criticism of qualitative research Aspects like quality and nature of nursing can only be investigated if qualitative research methods are available to the researchers. These are the only means that make the qualitative information measurable. But at the same time the findings of a qualitative research cannot be generalized on the population of the specific and selected sample. One of its major strength lies in the fact that it enables the researcher to explore and describe issues in depth. By qualitative results and details, the complex phenomenon is made clear to the greatest possible extent.   References Barker, A. M. (2008). Advanced practice nursing: Essential knowledge for the profession. Sudbury, MA: Jones & Bartlett Publishers. Dahms, H. F. (2008). No Social Science without Critical Theory. JAI Press. Demir, B., Kasapoğlu, & Aytül. (2008). ‘Nurse Physician Relations: A Qualitative Case Study in the Emergency Department of a Hospital in Ankara, Turkey’. European Journal of Turkish Studies. URL: http://www.ejts.org/document1783.html Fortune, L., Gracey, D., Miriam, B., & Don, R. (2005). The effect of service setting on treatment outcome: A comparison between cognitive behavioral approaches within primary and secondary care. Journal of Mental Health, 14 (5), 483 – 498. International Labour Organisation. ‘Work-Related Stress in Nursing: Controlling the Risk to Health’. Retrieved September 10, 2009, from http://www.ilo.org/public/english/protection/safework/stress/nursing.htm Johnston, R. J. (2000). The dictionary of human geography. 4th ed. Malden, MA: Wiley-Blackwell. Munhall, P. L. (2008). Nursing research: a qualitative perspective. Sudbury, MA: Jones & Bartlett Publishers. Neill, J. (2006). Analysis of Professional Literature. Retrieved September 10, 2009, from http://wilderdom.com/OEcourses/PROFLIT/Class6Qualitative1.htm Taylor, B. J., Roberts, K., & Kermode, S. (2006). Research in nursing and health care: evidence for practice. Scarborough, ON: Thomson Learning Nelson. Valente, T. W. (2002). Evaluating health promotion programs. New York: Oxford University Press US. Read More