This chapter provides a guide to conducting a life history from conceptualization to dissemination. Life history is used to explain an individual’s understanding of social events, movements, and political causes, that is, how individual members of groups or institutions see certain events and how they experience and interpret those events. As it is unlikely that nurses will be conducting traditional fieldwork to gather life histories because of the extensive periods of time involved, the chapter describes the process for collecting focused life histories by researchers whose only purpose is to document the story of the participant and not to frame this life history within a broader ethnography. It considers life history as a sociocultural methodology and leave oral history on historical research and life review to the one on clinical literature.
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Grounded theory is a systematic qualitative research method of data collection and analysis, ultimately leading to a theoretical explanation (a “grounded theory”) that is grounded in those data and that explains a phenomenon of interest. Widely used in nursing, grounded theory enables researchers to apply what they learn from interviewees to a wider client population. This book describes traditional and focused grounded theory, phases of research, and methodology from sample and setting to dissemination and follow-up. The grounded theory method was developed by Glaser and Strauss, in response to Blumer’s call for a method founded on concepts of symbolic interactionism, the social psychological theoretical framework that provides the guiding tenets of grounded theory methodology. Over the years, grounded theory has undergone an evolution of sorts. An alternate method of grounding data in qualitative research is dimensional analysis. Other scholars have developed variants of grounded theory, such as constructivist grounded theory and situational analysis. The book describes the extent to which nurse researchers have published grounded theory and presents an overview of the process of conducting a qualitative study using grounded theory as the method. Varied case studies range from promoting health for an overweight child to psychological adjustment of Chinese women with breast cancer to a study of nursing students’ experiences in the off-campus clinical setting, among many others. The book also discusses techniques whereby researchers can ensure high standards of rigor. Examples from published nursing research, with author commentary, help support new and experienced researchers in making decisions and facing challenges.
This book delivers everything nurses and other health researchers need to know about designing, testing, selecting, and evaluating instruments and methods for measurement in nursing. It features the most current content, strategies, and procedures available with direct applicability to nurses and health researchers engaging in interprofessional research, collaboration, education, and evidence-based practice. Chapters focus on challenges in using big data, evaluation, and measurement in interpersonal practice and education; metrics and benchmarking in health education and practice; and measurement issues in translational science. The book gives particular attention to measurement issues resulting from changes in nursing, health research, and the increased emphasis on and undertaking of interprofessional research and evaluation. Presenting the material in step-by-step format, the book is designed for readers with little or no experience in measurement, statistics, or interprofessional issues. It focuses on increasing the reader’s ability to use measures that are operationalized within the context of theories and conceptual frameworks, derived from sound measurement principles and practices and adequately tested for reliability and validity. Additionally, the text provides a pragmatic account of the processes involved in several aspects of measurement such as content analysis, interviews, and questionnaires. In nursing and health research, the Delphi technique is used for obtaining judgments from an expert panel about an issue of concern that is designed to structure group opinion and discussion. Visual analog scale (VAS) can be used even in high-stress, high-volume clinical settings, such as emergency departments.
The health professions have taken very seriously the importance of ethical considerations in research and practice. Most of the ethical issues regarding measurement of human subjects have been addressed in connection with biomedical and social research. Three basic, comprehensive ethical principles provide the foundation for the guidelines, recommendations, and standards that provide for the rights and well-being of human subjects in measurement and research: respect for persons, beneficence, and justice. In accordance with these ethical principles, researchers are obliged to recognize and protect the basic rights of subjects in measurement activities. The Health Insurance Portability and Accountability Act (HIPAA) privacy regulations took effect on April 14, 2003. These provisions, which require health care organizations and providers to protect the privacy of patient information, underscore the importance of privacy in the measurement context, and limit communication and use of individual patient health information in both practice and research.
This chapter addresses selected measurement issues that threaten the reliability and validity of the measurement effort. Topics include social desirability, process and outcome measurement, measuring state and trait characteristics, cross-cultural measurement, and triangulation. During the selection and/or development phase of instrumentation, the investigator should consider how the respondent is likely to think about each item when responding to the measure of interest. Outcome measures help health care and social welfare agencies establish indicators against which to evaluate the success of changes made to bring about improvement, and to identify areas in processes, programs, or interventions in which improvements are still needed. The specific process that is the focus of measurement should be clearly defined in a manner that captures the essence of its characteristics. Within nursing, specific nursing interventions or programs are common processes that are the focus of measurement.
The purpose of the life histories is to introduce doctoral students to a methodology that is not usually covered in qualitative texts but that has applicability to the study of nursing phenomena. Three doctoral students conducted abbreviated life history interviews as a class assignment for their course on qualitative methods. Their interviews were part of a larger study by de Chesnay on successfully overcoming adversity, for which she obtained institutional review board (IRB) approval from the university. The first publication was a set of life histories with successful African American adults. The second publication was a series of life histories conducted by master’s degree students on clinical topics related to their interests. These topics were surviving colostomy surgery, multiple sclerosis, and bereavement. The third publication involved undergraduate nursing students who interviewed affluent adolescents about their experiences of substance abuse.
This chapter presents an overview of the state of the art ethnographies conducted by nurses and highlights a few works by the early generation. An extensive search of the literature was conducted to identify ethnographies completed by nurses. Nursing knowledge was a common thread throughout the literature reviewed. The literature review revealed the progress nursing is making in recognizing this gap and attempting to close it. Nursing knowledge is essential in patient care. Using the ethnographic method of inquiry, nurses have been able to identify areas of need both in knowledge and practice and make recommendations for enhanced practice. Caring and patient advocacy were other common themes in the literature. Caring is the essence of nursing and consequently should be incorporated in nursing research. The common purpose of the ethnographic studies reviewed was to explain or understand a phenomenon to increase nursing knowledge.
This chapter provides a brief overview of the research followed by a discussion of what issues the author considered in preparing a qualitative design, the challenges faced while conducting the study, and lessons learned from the process. Comparative politics and public policy are the two areas the researcher chose to focus on health policy. The process of seeking government assistance for a problem and obtaining a response is called the policy process. This process is composed of agenda setting, government response, program/policy implementation, and evaluation. Facilitators and barriers for implementing needle exchanges (NEXs) were identified and were available to policy makers to consider in planning and implementing NEX programs. The value of a shared philosophy about drug use, drug users, and implementation strategies was clearly important as an implementation strategy to the policy community.
Teaching Cultural Competence in Nursing and Health Care, 3rd Edition:Inquiry, Action, and Innovation
Preparing nurses and other health professionals to provide quality health care in the increasingly multicultural and global society of the 21st century requires a comprehensive approach that emphasizes cultural competence education throughout professional education and professional life. The ideas and suggestions presented in this book are offered to stimulate new ideas and invite health professionals to explore new paths on the journey to developing cultural competence in themselves and in others. The book is divided into five parts. Part I is composed of three chapters filled with resources to help educators begin teaching cultural competence. Essential background information about the multidimensional process of teaching cultural competence offers a valuable guide for educators at all levels who are planning, implementing, and evaluating cultural competence education. Educators and researchers are continually challenged to measure outcomes following educational interventions. Part II addresses this challenge by introducing several quantitative questionnaires and assessment tools and discussing implementation and data interpretation strategies in a detailed, user-friendly approach that can be easily adapted by novice and advanced researchers. The tools include Transcultural Self-Efficacy Tool (TSET) and Clinical Setting Assessment Tool-Diversity and Disparity (CSAT-DD). Parts III, IV, and V offer a wide selection of educational activities that can easily be applied by educators everywhere. Three chapters provide a general overview and a menu of activities for use in three areas: the academic setting, the health care institution, and professional associations. Five chapters creatively link strategies via detailed case exemplars that spotlight various populations and settings. The book’s final chapter presents important implications for educators everywhere.
In a method-limited research program, the researchers keep choosing the trodden path, the beaten path that keeps that path a sacred groove. The current state of knowledge on the research topic and the findings from the researcher’s most recently completed project help determine whether the next step in the program of research will lead down a quantitative path, a qualitative path, or perhaps a mixed methods path. Once that is decided, the specific type of quantitative, qualitative, or mixed methods research design is the next decision to be made. The ideal point of entry for a program of research is during doctoral studies. This chapter shows some types of minds a successful researcher needs to achieve one’s goals. The synthesizing mind is also needed for nurse researchers throughout a trajectory of research. With a creative mind, a person can break new ground and consider new ideas and ways of thinking.