Ethical Dilemmas associated with small samples.

7/29/2019 Ethical Dilemmas associated with small samples.

1/10

Jourml


2/10

The author's mterest m this area stemmed from a feelmgis mevitable that nurses encounter difiicult

ssful than they need be If it was possible to identify

ize these factors m nursmg Conversely, factorslt sahsfied with, may be able to be capitahzed on

This paper addresses methodological issues that emergedthe study The study was a qualitahve analysis of cnhcal

adents associated with difibcult, chailengmg and sahsfyir^m nursmg The issues captured the author's atten-

y surprised her when they began to emerge,sheunderstood as convenhonal

or the qualitahve researcher Also theyto the focus of the study

nt and researcher The volunteer, not takmg part inike to have coped better with As she descnbed

t encounter with death, on her first ward, prepared to deal with either her own feelmgs or those ofd the emohon surrounding the event, and the author

ized strongly with herThe second situahon descnbed by the volunteer was

dy and human sufenng that she descnbed made itm the researcher role, who

The author reflected to herself that this was not areseardi mterview, and that of course she would be less

flection on the researcher's role

am trf t p>ject had been to obtain detailed desp-of mffs' expensKes of three types of sitmhons, a

difficult situation m which they coped well, a dif&cult situ-ahon m which they would like to have coped better, and asatisfying or rewarding expenence Individual informalmterviews were conducted with 10 nurses who wereundertakmg post-registrahon psychiatnc nurse trainmg,utilizmg the cnhcal madent technique, onginally outlinedby Flanagan (1954) and utilized m mdividual interviewswith nurses by Benner (1984)

There are some differences m the ways that Bennerand Flanagan mterpret and utilize the concept of cnhcalmadent analysis Flanagan obtamed a large number ofwntten descnptions of situations encountered by pilots,and analysed the information quantitatively, usmg theprocess of content analysis

A number of other researchers usmg the cntical madenttechnique have followed similar lmes, where the dataobtained by the qualitahve tool are then analysed quanh-tatively (see Jacobs d al 1973, Fox 1976, and Cormack1983,1984) Benner's (1984) approach differs from this, mthat synthesis rather than analysis is used, foUowmg theprmaples of hermeneuhc phenomenology by Heidegger

Heideggerian henneneutic phenomenologyHermeneutics is an anaent disapline, ongmally mvolvmgthe lnterpretahon of religious texts It was mitiaUy amethod for fmdmg out the correct interpretation fromseveral difenng versions of the same text Benner (1984)ates Heidegger (1962) and Gadamer (1975) as modemproponents of hermeneutics Rowan & Reason (1987)define hermeneutics as sn mterpretive method inherent mthe everyday processes through which people make senseof their world

All understanding is hermeneuhcal, taking place, and to avery large extent determined by, our &rute existence in tune,history and culture we are histoncal bemgs, and ourunderstanding is an histoncal process

(Rowan & Reason 1987)Central to the concept of hermeneutic mterpretation is

the concept of foreknowledge, influenced by one's history,culture, and place within it The hermeneutic task is toexanune the foreknowledge of the world and its phenom-ena m order to amve at a deeper understandmg of thesephenomena Benner (1984) applies these pnnaples todiscover nursmg knowledge embedded m experhse Shedevelops Heidegger's concept of expenence, where pre-conceived ideas and expedahons are diallenged, refaned ordisconfirmed by the actual situahoa Sl% has obtained richdescnphons of paradigm or exemplar situati(ts (her \se


3/10

V Wtldeof the term cnhcal inadent) and synthesized rather thananalysed the results She states that this model of studyresembles the mterpretahon of a text

A sentence, for example, cannot be understood by analysingthe words alone Rather, one und nstan ds a sentence as part erfa larger whole, and interprets its meaning from the con text mwhich it IS found Similarly, behaviour can be seen as havingpotentially multiple rather than single meanings To under-stand behaviour, therefore, one must lode at it m its largercontext Practical knowledge, particularly a t the expert level,must be studied hohsticaUy

(Benner 1984)Benner states that her mterprehve approach fi ts thedescnp hon of the constant comparahve approach out lmedby Glaser & Shau ss (1967) (see Benner 1984), but that herapproach differs from that of Glaser & Strauss m that hermtent was to identify meanmgs and content, rather than toproduce theoretical termsAfter much consideration the author deaded to use thecnhcal m aden t technique m information mverviews and toanalyse the transcnpts using grounded theory p nn aple s

Grounded theoryThe interviews were tape recorded and transcnbed ver-bahm Constant comparahve analysis was camed out asoutlmed by Glaser & Strauss ( 196 7) and utilized by a numberof nurse researchers (Meha 1981) The transcnpts werecompared repeatedly, data were coded, compansons weremade between codes, clusters were formed, and arrangedmto categones

Most of the analysis focused on codmg and clustermginformation relatmg to the difficult, challengmg and sahs-fymg situahons descnbed, and use was made of theprmaple of concept mappmg to assist hypothesis gener-ahon regardmg the links between categones However,emerging coinadentally, ideas began to formulate m theauthor's mmd on the relahonship between p artiapant andresearcher m quahtahve research. It is on this issue that thispaper will focus

T H E Q U A L I T A T I V E I N T E R V I E WThe pn nap les of symbolic lnterachon are central to mostqualitahve mterviews Symbolic mterion focuses cm themeaning of events to people m everyday settmgs (Chemtz& Swanson 1986) and ts concemed with the mner aspectsof htnnan behaviour, how people define events or reality,a d how ttiey react w th regard to tha r beliefs For human

behaviour to be understood, it must be examined machon Chemtz & Swanson pom t out that tie resneeds to understand behaviour as the parhapantsstand it, and must take the role of the other, and undthe worldfi-om he perspective of the parh apan tField & Morse (1985) descnbe the ethnoapproach as an attempt to discovCT the ways m wh

hcipants achvely construct their soa al world The study uhlized such an approach Raguca (1972) dethe major instrument for data collechon m ethnoresearch as the interviewer herself Field & Morseoutlme the progression m the mterrview from a relahvely shallow relahonship, where the informanup the mterviewer and deades whether or not theviewer can be trusted, to a more mtimate mtergenerahng m ore valid and meanmgful mformahonChemtz (1986) descnbes the mfonnal mterview

use of everyday conversahons for the purpose of cmg and validahng data, and that it is characterinatural speech and m terachon between the researchrespondent Chemtz a te s Becker and GeerIn this kind of interview the interviewer explores manof his interviewees' concem s, creating subjects as theup in conversation, pursuing interesting leads, allowlmaginahon and ingenuity full run as he tnes to develtest them in the cou rse of the intervie

Hypothesis generationAs her ideas on the research er/parhapant relationshshape, the author retumed to the literature on quamethodology to compare her hypotheses with rtielmes advocated by others These hypotheses arosthe constant com parative analysis of the data andfi-process of memo wntmg The author kept vanous tmemo The ones relevant to this discussion develoherfielddiary, where she wrote down any ob servahreflechons on the methodo logy being used She incomments on her mterviewmg style, observahonsthe transo ibmg and analysis processes, and other wnotes They served as memos on her behaviour research process, and provided mvaluable shmub formulahon of her ideas on the mterachon beresearcher and par hapan t m the informal mterviewdbary, the author reflected on her style of m to-adioefect on the p ar ha pa its ' disclosures As she lookedat the literature on the relahonship between researchparhapants, she found some authors va) supportemei^ing hunches u t the vahie crfsaiess and self-disclosure, an d others who en^hazl a nec


4/10

Qualitative research

Benoliel (1975) recognized that the mteraction betweener an d interview ee is subjective m itself

the meanmg of any data collected by man interacting withman must take account of the reality that the investigatorrelies on a common sense knowledge and everyday languagewhen he selectively notices certain events and makes certainchoices abou t their relevance the process of interviewinginvolves human beings with all their ideosyncratic situationaland cultural vanations coming into play, so that bias andselective interpretation are built in features

(Benohel 1975)

sus the nursing roleother m ethodological issue to emerge which seemed to

r was related to the ad optio n of the role ofSwa nson (1986) emph asizes that it can be prob-

r's hat Che nitz (1986) states that, while it isntage ous to have a dmical background, the nurse con-

e, to mamtam versatil i ty and manoeu verability' How -

Swanson (1986) mentions a major problem for nursesduc tmg qualitative research as bem g the desire to inter-

ocates tha t 'unless the health of the respondentthreate ned the bes t way to deal with the need to m ake

dent 's response' (Swansonuct research in pn va te areas of md ividuals' lives, 'it is

in discussing ethical considerations to be m ade,

researchers often seem to ignore the fact that active partici-pation in a researdi project, even on a purely verbal level, mayarouse feelings, stir moones, or force perceptions whichotierwise would no t have occurred When there is some nskof tbs , the researdier should be wiUmg to establish whateverccHiditions are needed to remedy the situation

This pom t IS i llustrated b y N olan (1989) wh o conductedsemi-structured interviews with 12 retired male psychiatncnurses, the enten a for inclusion in the stud y bem g that the yhad been servicemen m W orld W ard II, had bee n c apturedand taken pnsoner, and had spent their post-war workinglives as psychiatnc nurses

Although all said they wanted to tell their stones and foundthe interviews therapeutic there were som e for whom recall-ing aspects of the past was a very disturbing exjjenence On eman became so distressed that it was necessary to visit himfour times to complete his interview

(Nolan 1989)

Cou nselling and researchThis dilemma over being supportive and dealing withrespondents' feelmgs and memones evoked dunng theinterview, while trying to avoid influencing th e res pon den tor revealmg one's ow n perspective, is a difficult o ne M os tauthors adopt the same stance that although nurseresearchers may be skilled at informal mterviewmg andcounsellmg, in their clmical role, the function of theresearch infonnal mterview is quite different, be ing earne dout to collect research data, and not used for the purposesof intervention

Therefore, although Swanson (1986), Chenitz (1986)and Field & M orse (1985) ackno wledg e the role confusionthat can exist for the nurse researcher soaalized m thenursmg role to deliver service and intervention, they allemphasize the aim of the research mterview as being thecollection of research data, and c aution ag ainst fallmg m toa teachmg or counsellmg role

Role conflictBenoliel (1975) wntes of the role conflict facmg the nurseresearcher m participant observation and states that 'thedecision to limit activity as a nurse may be easier to statethan to put mto action, because the nurse who is also anobserv er eventually com es face to face with con crete pr ob -lems that demand a choice between bemg a nurse andbemg an observer

Benoliel (1975), rather than em phasizing the nee d for thenurse researcher to k eep all othe r roles m check apart fromthe researcher role, descnbes the m terview as neg otiation,'as a contmu ous flow of negotiation lnvolvmg b oth pa rtia-pants m a bargainmg process the bargam mg processwhereby mformation exchanged was heavily dependenton the mvestigator's flexibility, both m creatmg an atmos-phere conduave to open discussion and shiftmg easily


5/10

V Wilde

horn role to role, as the occasion demanded' (Benoliel1975)

To intervene or not to intervene?As has already been discussed, the general advice to theresearcher engaged m informal mterviews is that sheshould delay answering questions raised by the pa rtiap an tuntil the mterview is over, that she should avoid the tem p-tation to intervene, and that she should avoid being drawninto the teacher, preache r or counsellor role Sw anson(1986) and Field & M orse (1985) view all these as having anundesirable influence on the informant changing theirknowledge base, or mfluenang how subsequent questionsmay be answered Field & M orse wa m against presentingone's own perspective, smce m their view this is likely toinfluence how the informants present their views

fiowever, as the mterviews progressed the author de-veloped hunches that seemed to challenge some of theseguidelines Sometimes the hunches emerged dunng themterview itself when she found herself bemg drawn m, forexample, to respond to the funny aspects of traumaticsituations being descnb ed At oth er t imes, her shp ups werediscovered only when the transcripts were reviewed, andshe saw her disclosure m all its glory' Ho wev er, the autho rnoted the effect this seemed to have on the participantsand, as a result her, ideas chaUenging traditional guidelinesto the qualitative mterviewer began to take shape (seediscussion)

Davis (1986), m discussing partiap ant observation, con-siders the dilemma over a role that might mvolve theresearcher m a dmical intervention The tactic she sugge stsfocuses on increased self-awareness on the part of theresearcher

If you d ea de to intervene, be aware that you are intervening,why you are, as well as no ting w hat occurs as a result of you rbehaviour I have found at tunes that these 'problematic' situ-ations can also be the serendipitous event which opens up anew way of thinking about a situation and provides data notobtained heretofore

(Davis 1986)Most authors advocate that the researcher resists the

temptation to make mteventions during the interview,and that they postpone answering questions or makingcom ments until the end of the interview

Davis (1986) offers a number of examples, however, ofthe researcher becoming involved and partiapating in theresearch interaction For example, wh en she was conduc t-ing a research project involving mtervjewu^ multiple

sclerosis sufferers at home, she found that many patients were unaware of the community-based seavailable Once the interview was over, she woulthe patient the relevant information and was surpnthe comm ents that the subjects made as a result responses revealed valuable msights into the interand mfomiation exchange between the patients andphysiciansThese o bservations made by Davis (1986), as a reher contributions at the end of the interview, led develop mg hun ches and hypothe ses which she later by interviewing physicians She made the pomt thavenu e of enquiry w ould n ot hav e been followed if snot offered information at the end of the interview, she had not followed up information emerging from'post interview' mteractions

Self-disclosure by the researcherM an y of the participants had clearly spent considerab lpnor to the interview reflecting on the madenrequested , and this resulted in them giving very nch detions On occasions the author found hereelf being mto sha nng and disclosing her view of the situation, dsucceedmg the majonty of t imes m refrainingfi-omdoiThese shp ups and the effect on the interview relatioled the author to ponder on the function of self-discm the research interview, and to look back at the liteavailable on this subject

Field & Morse (1985), Swanson (1986) and C(1986) all emphasize that the researcher should against revealing any opinions or values, as in theirthis will influence what the mformant reveals tresearcher However, Swanson (1986) repeatedly mreference to the importance of the researcher's use oFor example, 'the researcher consciously and selfsaously uses self to conduct informal mterviewConsaous use of self and one's interpersonal sfaUs tate eng aging with informants' (Swanson 1986) Ho wshe states earlier . The mterviewer is not a therRespondents must be referred to other resources if fup IS necessary'

I t would seem that there is another dilemma here,how one t ies this in with Fox's (1976) recommendathat whe n sensit ive feelings and me mo nes are generathe respondent the researcher should be will ing to l ish whatever conditions are needed to remedy theation Referral to anoth er pe rson could well lnfiinge osubject's entitlenient to confidentiality in the ressettmg. I t was with this ddemma in mmd, desinng detract from the mam atm of the mterviews (the o bta


6/10

Qtutlitative research

on w as condu cted

rgent h ypo theses that challenge tradit ional guidelinesqua btative nurse researcher Thes e will be presented

Rather than attempting to maintain a purely research role, thenurse researcher benefits from utilizing other roles acquiredthrou gho ut her career These roles may include clinician,counsellor, therapist and teacher

hypo thesis em erged to contradict the advice given byld & M ors e (1985), Che nitz (1986) and Sw anson (1986),

should attemp t to ign ore the other roles acquiredng a nurse The autho r was aware, m proceeding

As a nurse therapist , the auth or has been used to helpingts with p roblems of stress and coping, and has focusedcreasing their self-esteem, self-confidence and copm g

lls As a counsellor, the auth or has used a wide range ofexp ene nce As a teacher, the focus has

n m creasing the studen ts' self-awareness, engagingh their expene nces Again the aim in

their expen ence s, to giv e positive feedback w hereer cons tructive su ppo rt As a clmical

t ioner, wo rkmg in a team the author has been used to

These roles are part of the ' luggage' that the author

ly but still accessible It occurred to the autho r durm gg the present project, that i t would

on tha t she had develope d m her dmical and teach-

e had mtemabzed so many aspects of the occupationales outhned abo ve that, m a sense, they had 'become' her

To quote Dreyfus & Dreyfus (1977, cited by Bermer1984) m their discussion of skill acquisition.

As long as the beginner pilot, language learner, chess playeror dnver is following rules, his performance is halting, andmediocre But with mastery of the activity comes the trans-formation of a skill, which is like the transformation thatoccurs w hen a blind person learns to use a cane The beginnerfeels pressure in the palm of the hand, which can be used todetect the p resence of distant objects, such as kerbs But withmastery, the blind person no longer feels pressure in the palmof his hand, but simply feels the curb The cane has become anextension of the body

Expenenced pe r f o r m erIn descnbing the expenenced performer, Dreyfus &Dreyfus (1977, oted in Benner 1984) continue.

The performer is no longer aware of features and mies, andhis/her performance becomes fluid and flexible and highlyproficient The chess player develops a feel for the game, thelanguage leamer becomes fluent, the p ilot stops feeling thathe/she is flying the plane, and simply feels that he/she isflying

Therefore, when practitioners and teachers have inter-nalized a style of interaction thro ugh the execu tion of theirroles, an attem pt radically to a lter their style of mterac tionin the research setting can result in an unnatural style ofmteraction that co mes across as false to th e informant

Field & M orse (1985) caution against the use of counsell-mg techniques m the research interview, seemg them as ahindrance The y cite the effects of prem ature reflection andsummanzing, stating that these inhibit the interview, itbeing easier for the informant t o agree with the mterv iewerthan explain how it really is The author would argue thatthese comments relate as much to the clmical or thera-peutic interview as to the research interview, and thatprema ture or excessive use of counselling strategies such assummanzing or hypothesizmg tire ineffective in any typeof mterview It is her observation (which seems to besupported by Dreyfus & Dreyfus (1977, cited by Benner1984, and discussed earlier) that while the novice inter-viewer finds help fi-om the structure of counsellmg tech-niques, with mcreased skill acquisition comes a naturalconversational style, which mcorporates a vanety ofmteraction techniques

On reviewing the transcnpts of the mterviews numer-ous examp les of interaction techruques were found th at areas pertment to the research mterview as they are to thedmical mterview There were examples of the author 's use


7/10

V WtUe

of a vanety of questioning techniques, clarification, lowerorder and higher order questions (see Barker 1985) andopen and closed questions There were examples ofempathizing with the subject, over both bad and happyexpenences, and of shanng the humour in both sad andhap py expen ences There were occasional exam ples of theauthor shanng her views, and although she felt guil tyabo ut this on first reviewmg the trans cnpts, she later sawthe value of this There were other examples of the use ofparaphrasmg, reflection, summanzing, accommodatmg,and self-disclosmg, all of which seemed to function asfacilitating techniquesH y p o t h e s i s t w o

Intervention by the researcher dunng data collection does no thave an undesirable influence on the informant Rather it canopen up new avenues of enquiry previously unexplored

In conducting the research mterviews the author didattempt to 'keep to the rules' regardmg mtervention butexpenenced a pull to respond m a way that was perhapsmore akm to a colleague givmg support , or a teacher orsupervisor helping the partiapant to make sense of a badexpen ence It is mterestm g that the autho r felt rather guiltylmtially as she discovered her little lapses out of theresearcher role She now thinks that perhaps th e guidelinesand expectations regardmg non-partiapation and inter-ven tion are too ng id Certainly, if, as it app ears m thebterature, the majonty of nurses expenence the conflictbetw een con duch ng pure research and respond ing to a pullto intervene, then further mve stigaho n is mdicated It maybe that rather than resisting at all costs the temptation torespond to the role of nurse, teacher or therapist, andattem phn g to m amtam a pure research role, i t may be mo reappropnate to respond as a person, encompassmg theman y roles on e has amassed

H y p o t l s i s threeThe research process can be used effectively for the benefitof both researcher and partiapant and not purely to collectresearch data

The l i terature contams a number of references to thecounsellmg skills and m terview mg skills that nurses acqu ireand be com e exp ert at, m the co urse of their education (Field& M orse 19 85, Chem tz 1986) H owe ver, these authors arekeen to pomt out that the cruaal difference betweenresearch mterviews and dmical woric (and presumablystudent supervision) is that the research mterview is per-fonned purely to collect researdt data, and shcmld not beused for the purposes of m tervention

In other words , they see the research m terview away process, the researcher merely probmg, pickleads from the informant, and encouragmg them abou t their expe nenc es Th e auHior felt rather uncable with this, since it goes a gainst her basic philosomteraction, either in the the rapis t/dien t relationshipteacher/student relationship She sees any healthyaction as having benefits for both parties, and bemon negotiation and shanng, without these facexemphfies supenonty, power, pnvilege and statuspart of the teacher, therapist or researcher

The author felt dunng the course of this projethere could be benefits for bo th researcher and subjefrom the collection of data, and that these benefits nmvalidate the research process It seemed that thetw o proce sses o[>erating side by side, and th at m o ba nch descnpt ion of the par t iapan ts ' expenence, angathermg research data for later analysis, she wenablmg them to analyse or to reanalyse the behand mteractions of sigruficant people m the mMany subjects spontaneously volimteered how they had foimd the exerase, and how surpnsed theat the degree of detail they could recall In helpsubjects make sense of an incident the author mat tempt to interpret what she thought might bebutmg factors, but merely offered a safe environmwhich they could make their ow n conn ections at thepace

Other benef i t sAlthough the pnmary aim of quahtative researchcollection of data, it is possible for other benefits tand even be consciously built m Indeed, no oneargue that the majonty of research has additional bfor the researcher apart from the advancement of edge (e g the obtammg of MSc or PhD degrees ansequent advancement of careers) Why then shoulno t be benefits for the subjects takm g part? I would that m the present project there were tw o possible bavailable to the participants first, the opportunity fjects to make sense of a traumatic expenen ce, and the opportunity for subjects to leam more aboubecom e mterested m research, by th e act of par ttap

Hypothesis fourIt IS difficult and disadvantageous for the nurse reseamaintain a detached relatiOTiship with the informant tative research Self-disdosure by the researcher enhancing effect on information exdiange and resunK>re honest an d meaningful sha nng b y tte informan


8/10

Qfialttative research

escnb ed (see "Breaking the rules') Hav ingsuppo rt, give positive feedback, and ldenhfy with the

ar m tenh on of avoiding being drawn m to revealing heropinion s on the topic under discussion Ho wev er,r found th at m the process of interacting naturally

ve even ts, she unw ittmg ly let slip someher values and opinions O ne particular transcnp t

ormant It's strange that you can go through 6 years ofhaming, or nursing, and never feel as thoughthat was it' But I sort of self-actuabsed [shelaughs] I just sort of hit the top I really feltthat day that it was fantastic'Which makes sense, because it was you makingthe decisions [revealing m y opinion that auton-om y can lead to increased self-esteem in nursing]

ormant Mnun, rather than a joint decision with otherpeople but I don't think that it was the actualnursing decisions that made me feel the way I did[disconfinning the interviewer's hypothesis] Itwas the fact that I had heard that patientpraise w hat 1 had done, to someone else [whichstrengthened another hypothesis regardingthe importance of positive feedback m jobsatisfaction]S significant th at this particular mte rview wa s the last

s (Or was she just becom-meth odically n go rou s with th e end of this stage of

s m sight?')Field & Morse (1985) encourage the nurse researcher to

r or not to con hnue The lmphcation fi-om this isbiasmg the mterviewThe wh ole topic of mterviewer bias is an mterestmg one,

With regard to the issue of self-disdosure, the authoro wo nde r wh at would be the effect of the researcher

pped out by ac ade nt m her project

Jourard (1971), a shong advocate of self-disclosure mclinical settm gs, found m his studies on self-disdosure thatthere was a strong correlation between what people werewilling to disclose to other people and what these otherpeople had disclosed to them He looked at the topic ofself-disclosure by researchers and hypothesized that'eighty years of saentific research m psy cho logy maynot em bod y an authentic imag e of man In fact it ma y be amuseum of lies told by suspiaous subjects to expen-menters they do not trust ' ourard I97I) He advocatesself-disclosure o n the p art of the researcher, and rath er thanavoiding self-disclosure for fear of biasing the results, theresearcher is encouraged by Jourard to self-disclose as ameans of mcreasmg trust and disclosure on the part of thesubject

Essence of lifeJourard (1971) sees the essence of life as a person, apsychotherapist, a nurse or a researcher as being oneselfHe states

Overly technical psychotherapists (and we can perhapsinclude researchers here) probably fall down on the ability togive an authentic, self revealmg response, t o the disclosures oftheir patients, and block thereby, the ongoing process of thetherapeutic dialogue In Buber's terms they hav e the capacityfor distance, but not for entenng into relation ourard 1971)In a similar vein, McHaffie (1988) draws a compansonbetween the wounded healer and the wou nded researcher

The concept of the wounded healer was descnbed byRippere & Wilbams (1985) who drew together accountsfrom a number of mental health workers who had them-selves expenenced mental illness Many of these pro-fessionals acknowledged that their personal expenencehad given them addihonal msight and empathy and that b yshanng their own vulnerability the y helped to break do wnthe distinction between professionals and pahents

McHaffie (1988) raises the pomt that perhapsresearchers are fnghtened by the ideas of showing awound, and asks, 'Must they hide behmd a detached p ro-fessional armour?' She conducted a study of mothers ofvery low birthweight babies, may of wh om were cnticallyill Capitalizing on the concept that common suffenng canreduce the distance between professional and patient, shestates that she wished to be identified more as a motherthan as a researcher, particularly because of the sensihvenature of the investigation She confided m her letter ofmtroduchon to the partiapants her own expenence ofhaving a very ill baby w ho was expected to die All exceptone of the 21 respondents spontaneously asked for more


9/10

V Wildeinformation about the expenence, and said that knowingabout the researcher's personal expenence had faalitatedthe shanng of very deep personal fears, anxieties andemotions

Shanng part of one's personal life would seem to have anefiFect on the subject's view of the researcher, who becomes,m the subject's eyes, less of a professional and more of ahuman bemg

CONCLUSION

A number of observations arose dunng the project whichprompted the author to explore the relahonship betweenresearcher and partiapant In a way they are more exiatmgthan the results from the mam body of the project, set up toexplore nurses' perceptions of difficult, challenging andsatisfying events encountered at work

The methodological issues which the author was stimu-lated to explore centred on the themes of the researcher'srole, the effect of her past expenence on the researchsettmg, the value of researcher mtervention, the mutualbenefits to both researcher and informant, the use ofcounselling strategies and the pnnaple of self-disclosureThe author was surpnsed and exated by the issues thatarose, mcidental to her onginal focus of study, and thatraised a whole new senes of questions to explore

The author can identify to a certam extent with theanonymous author quoted by Field & Morse (1985) whowrote

I have not succeeded in answenng my problem The answers Ifound only serve to raise a whole new set of questions Insome ways I am as confused as ever, but I believe I amconfused at a higher level, and about more important things

AcknowiedgementsThis paper is adapted from one ongmally presented at theRCN Research Soaety annual conference m Apnl 1989The author was greatly encouraged by the positive feed-back received and, as a result, plans to follow up heremerging hypotheses at doctorate level

The author would also like to express her gratitudeto Baroness McFarlane of Llandaff who supervised theproject, and who throughout the author's nursmg careerhas encouraged creative, chailengmg enquiry

ReferencesBark-PJ (1985) Patient Assessment in I^chmtnc Nursmg CrocanHelm, Beckenham, Kent

Benner P (1984) From Novice to Expert Excellence anClimcal Nurstng Practice Addison-Wesley, LcmdonBenoliel I Q (1975) Research related to death and thpahent In Nursing Research I (Verhomdc, PJ ed)Brown, BostonChenitz W C (1986) The informed interview InFrom PGrounded Theory Qualitative Research m Nursing (W C & Swanson J M eds), Addison-Wesley, WokBerkshireChenitz w e & Swanson JM (1986) Qualitative researcgrounded theory InFrom Practice toGrounded Thetative Research mNurstng (Chenitz W C & Swanson IAddison-Wesley, Wokmgham, Berkshire

Cormack D (1983) Psychtatnc Nursing Descnbed CLivingstone, EdinburghCormack D (1984) Flanagan's cntical incident techniTh e Research Process in Nursmg (Cormack D ed).Saentific, OxfordDavis M Z (1986) Observation m natural settings IPracttce to Grounded Theory Qualitative Research i(Chenitz WC & Swanson JM eds), Addison-Wokingham, Berkshire

Field PA & Morse J M (9S5) Nursing Research The of Qualitative Approaches Croom Helm, LondonFlanagan JC (1954) The cntical m ad en t techruque PsycBulletin Sl{4), 327-356

Fox DL (1976) Fundamentals ofResearch inNursingCentury-Crofts, New YorkGlaser BG & Strauss AL (1967) TheDtscovery of GTheory Strategies for Qualitative Research Aldine, ChHmgley P & Coop>er C L (1986) Stress and the Nurse MJohn Wiley, ChichesterJourard S M (1971) Th e Transparent Self Van Nostrand RLondonMcHa&e H (1988) Wounded researchers Senior Nurse19Melia K M (1981) Student nurses' accounts of their wtraining a qualitative analysis Unpublished PhDUniversity of EdinburghNolan P (1989) Attendant dangers Nurstng Times5 6 - 5 9Ragucci AT (1972) The ethnographic approach andresearch Nursing Research 21(6) , 485-49 0RippereV & Williams R {19S5) Wounded Healers MenWorkers' Expenence of Depression John Wiley, ChichRowan J & Reason P (1987) On making sense InEnquiry A Sourcehook of New Paradigm Research (RRowan J eds), John Wiley, ChichesterSwanson JM (1986) The formal qualitative intervi

grounded theory InFrom Prachce toGrounded Thetattve Research mNursing (Chenitz W C & Swanson JAddison-Wesley, Wokingham, BerkshireWilde V (1988) A qualitative analysis of cntical ina de ntsated with difficult, challaiging and satisfying expenenursing Unpublished MS c thesis, Uiuversity of Mand


10/10

Ethical Dilemmas associated with small samples.

Documents

Transcript of Ethical Dilemmas associated with small samples.