Phenomenology Qualitative Research Method

1. Phenomenology Qualitative Research Method “Its Not Easy Being Green” By Ronda Hildebrand, Chris Bikakis, Carol Lewallen, Robin Koster & Rachel Wurth

2. Objectives At the end of this presentation, the learners will be able to... State some of the key assumptions of phenomenology based research Discuss the philosophical base of the method. Indicate when this method is appropriate for research and identify appropriate research questions. Discuss methods of data analysis and how results are presented Analyze and critique published research done using this method.

3. Key Assumptions Humans coconstitute situations.(Parse 2001)

4. Key Assumptions Knowledge about human experience is expanded by allowing essences of phenomena to appear through descriptions without predictable prescriptions.(Parse 2001)

5. Key Assumptions Knowledge about human experience is gained from retrospective descriptions of lived experiences. (Parse 2001)

6. So What Does All This Mean?

7. Philosophical Base • Phenomenology is both a research method and a philosophy • The phenomenological movement arose in Germany in the late 19th century. • Early philosophers were trained in religion, philosophy, mathematics, or physics.

8. Philosophical Base • Edmund Husserl’s descriptive phenomenology • Martin Heidegger’s interpretive phenomenology (also called hermeneutics)

9. Heideggar Philosophical Base Husserl • Three components to this approach • Essences • Intuiting • Phenomenological reduction (Bracketing) or setting aside all previous experience including the existence of other subjects. Presuppositions and relationships are viewed as necessary to understanding and they should not be suspended. Experiences can be understood in a new way by recognizing historical influences and meanings of past traditions.

10. Philosophical Base • The French phase (during WWII) sought to intertwine objectivity and subjectivity. • Key figures were Gabriel Marcel, Jean-Paul Sartre and Maurice Merleau-Ponty. • Objectivity and subjectivity are united to form the human experience. • North American phenomenology will focus on describing the lived experiences within the context of a participants culture rather that searching for universal meaning.

11. Philosophical Base • While the assumptions of phenomenology are similar to the values of holistic nursing, interpretations of the many different forms of phenomenology have led to controversy. • “Nursing is a human science that focuses on individuality, is holistic in nature, and involves concern for human responses” (Dinkel 2005 p.8)

12. Why do nurses use phenomenology? Nursing is a human science that focuses on providing individualized care. Nursing is holistic in nature. Nursing is concerned with human responses and experiences.

13. The concern of phenomenology Phenomenology is concerned with the subjective experience, which is considered to be more real and more important in the understanding of human nature and human experience. It focuses on the person’s lived experience within a phenomenon, including shared meanings and commonalities.

14. The phenomenological movement • Three main phases: • German phase with Husserl, the father of the movement (descriptive) and Heidegger (interpretative and hermeneutics) • French phase which influenced psychology and psychiatry. • Dutch phase (combining descriptive and interpretative methods • A new phase? The North American focus.

15. Phenomenology • Main types: • Descriptive • Interpretative • Hermeneutics • Main methods: • Interview (relaxed)- to explain experiences fully and deeply until nothing further to say • Group interviews • Diaries or journals • Audiotapes • Videotapes • Participant observations

16. Phenomenological Research Purposive sampling – participants have knowledge of a phenomenon Small sample size – until saturation achieved Usually relaxed interviews – from 30-120 minutes. Conducted in comfortable environment or natural environment of participants

17. Basic components of phenomenology • Intuiting • Bracketing • Identifying the essence • Describing • Examines lived experiences or phenomenon • Essences or the most essential meaning for • Participants are co-researchers and co-create meaning • No causal inference

18. Sample questions What are the lived experiences of being clinical educators? What are women’s expectations and experiences of childbirth? What is the lived experience of pain during childbirth? What is the lived experience of adolescents living with depression?

19. Sample questions What is the lived experience of cardiac patients waiting for a heart transplant? What is the lived experience of grieving the loss of a loved one? What are the essential features of loneliness? What is the lived experience of families with a child who has cancer?

21. Phenomenological Research Analysis Remember- the intention is not to generate theory or determine causality- but rather to describe and possibly understand the essence of the concept by giving voice to the human experience just as it is.

22. Phenomenological Analysis- A few things to know • Phenomenologists are sometimes reluctant to focus or refer to steps (too scientific) • TIME CONSUMING • Only people who have lived the reality of the subject are legitimate sources of data- so always retrospective • Most usual data source is verbatim transcripts of interviews • Horizontalisation- All elements of data are initially deemed equal

23. Phenomenological Analysis- Becoming one with the data....Yes, Parse Terms • Intuiting • Analyzing • Describing

24. Phenomenological Analysis - Handout Multiple “methods’ devised-some common features simplified regarding data: • The division of text into units • The transformation of units into meanings (also called phenomenological concepts) • The tying together of transformed meanings/concepts to general description of the experience

25. Presentation of Results • Themes/Essences/ Patterns/Common Concepts are identified. • Then a comprehensive description of the phenomena being considered is told- much like a story. • Often quotes are used. An understanding of a lived experience should occur for the reader. “Informational needs and the experiences of women with abnormal Papanicolaou smears”- next two slides.

27. Dealing with stigma Several participants indicated a burden of shame when they learned that their abnormal Pap smear was a result of an HPV infection: Many years ago when my aunt had cervical cancer people were very supportive but they had no idea that it had anything to do with HPV. But now it’s different. I feel like I won’t get that support because no one is going to feel sorry for someone who got a sexually transmitted disease and then later developed cervical cancer because of it . it’s like it’s your fault . it’s horribly embarrassing. Social stigma was also characterized by an altered self-image represented by feeling contaminated, feeling a sense of anger and unfairness because they considered themselves at low risk for acquiring a sexually transmitted infection. The terms clean and dirty were used to describe a physical self-concept associated with social stigma: The first lady [healthcare provider] I went to made me feel like I wanted to zip myself up in a Ziploc bag. All the information I got was that it was super serious and it’s a communicable disease like hepatitis or HIV.

28. Strategies to Ensure Rigor Validity- to increase the trustworthiness of the interpretations of the date • Prolonged engagement with the data • Verification with the participants/source • Peer evaluations- regularly present for debriefing

29. Strategies to Ensure Rigor Reliability – to increase consistency of procedures/data generated. • Disclose personal orientation/context. • Intensive engagement with material and iterations between data & interpretation • Technical accuracy with recording/transcribing

30. Phenomenon • http://www.youtube.com/watch?v=h5Mc55P1i9g

31. Qualitative Critique Nurses’ Experiences of Drug Administration Errors

32. Why? • Purpose of research?

33. Appropriate Qualitative Approach • Was exploring, interpreting or obtaining a deeper understanding of a clinical issue the objective?

34. Settings & Participants • True Random Sample • Wide range of experiences within group

35. Data Collection Methods • Enough information given about collection • Sensible & adequate way to address research question?

36. Data Analysis Method • Systematic way of analyzing data? • Examples sought which contradict the majority?

37. Credibility & Importance • Use common sense to determine if results are sensible & believable • Do results matter in practice? • Is actual data sited? • Are results independently & objectively verifiable & traceable?

38. Conclusions • How well does the analysis explain why people behave in the way they do? • How comprehensible would this explanation be to a thoughtful participant in the setting/ • How well does the explanation cohere with what we already know?

39. Critique of Phenomenology Study Vulnerable and Strong

40. Critique • What is the study purpose? To describe the maternity care experiences of a sample of lesbian couples • Does the question lend itself to using phenomenology method? Each participant lived the experience Little is known Sensitive topic

41. Whydid the researcher believe there was value in this study? • To address the reported “lesbian baby boom” • All women feel powerful experiences of life, death, vulnerability and solitude during “maternity care” • Healthcare providers should see each woman as individuals, regardless of patient’s “culture”, be professional while providing empathy • Lesbian patients could benefit if providers had increased knowledge and ethical aspects of these specific encounters

42. Method & Data Analysis • Did participants live the phenomenon in question and did the research incorporate his or her own beliefs? • Were the participants willing to describe their experiences? How? • What about the setting or researchers showed successful interviewing? • How did the researcher successfully interpret the data?

43. Method & Data Analysis • Validity • Specific opening question provided in the study • Open narrative and only interrupted if clarification needed • 3 phases of interpretation defined (Intuiting, Analyzing, Describing)

44. Method & Data Analysis • Reliability • Every participant was interviewed by researcher • Every participant was a lesbian mother • Interviews recorded and transcribed verbatim by the researcher • Documented that there was discussion with study supervisor re design and data

45. Method & Data Analysis • Rigour • Joint interviews provided shared and in-depth narrative • Focused on 3 phases as opposed to follow up • Only 2 participants revisited , no response recorded

46. Conclusion • Is the description simple in identifying themes? • Is there an exhaustive essential description • Can the reader see the central theme or phenomeneon • Did the researcher express alternatives?

47. Conclusion • Is the description simple in identifying themes? • YES, simply stated 3 main themes; being open, being exposed and being confirmed also presented in graph • Is there an exhaustive essential description • YES, then the author gives in-depth description of each theme • Can the reader see the central theme or phenomenon • YES in reading the excerpts and detailed description • Did the researcher express alternatives? • how provider contributes to lesbian maternity experience or caring by taking responsibility

48. Closing Thought “Doing phenomenological research is a challenging, exciting, and at times exhausting process. The researcher is forced into a sometimes uncomfortable self-awareness as she plums not only the meaning of the phenomenon for participants but her own responses. The final research product can provide a real sense of satisfaction for the researcher, an often expressed sense of meaningful contribution by the research participants, and insight and understanding for the reader.” Julie Donalek, 2004

49. The End Phenomenon! Doo dooo do dodo Phenomenon! do doo do do

50. References • Dinkel, S. (2005). Phenomenology as a nursing research method. The Kansas Nurse, 80(5), 7-10. • Dowling, M. (2003). Hermeneutics: an exploration. Nurse Researcher, 11(4), 30-39. • Jasper, M. (1994). Issues in phenomenology for researchers of nursing. Journal of Advanced Nursing, 19(2), 309-314. • Leininger, M. (1988). Caring: An essential human need. Proceedings of the Three National Caring Conferences (pp. 129-132). Detroit, Michigan: Wayne State University Press. • Munhall, P.L. (2007). Nursing research: A qualitative perspective. (4th ed.). Sudbury, MA: Jones and Bartlett Publishers. • Parse, R. (2001). The phenomenological method. Qualitative inquiry: The path of sciencing. Boston, MA: National League for Nursing. • Priest, H. (2002). An approach to the phenomenological analysis of data. Nurse Researcher, 10(2), 50-63. • Schelbred A. & Nord, R. (2007) Nurses’ experiences of drug administration errors. Journal of Advanced Nursing 60(3), 317–324. • Spidsberg, B.D. (2007) Vulnerable and strong – lesbian women encountering maternity care. Journal of Advanced Nursing 60(5), 478–486. • Van derZalm, J.E. & Bergum, V. (2000). Hermeneutic-phenomenology: providing living knowledge for nursing practice. Journal of Advanced Nursing, 31(1), 211-218.