The concept of despair in nursing practice - a research critique
Authors: Wolfensberger, P.
Publisher: Cardiff University, School of Nursing and Midwifery Studies
Place of Publication: Cardiff UniversityAbstract:
This essay has been submitted in partial fulfilment of the requirements of the Masters Degree in Nursing Studies - Module: Research as Evidence for Practice
What is good or sound nursing research? It is this question which stands at the beginning of this critical reflection of two research articles dealing with the concept of despair in nursing practice. Both studies in this assignment use qualitative research methodologies. One of them is using a grounded theory design, a method which is mentioned and described in most nursing research books. However, grounded theory originates in sociology: is it still nursing research if the methodology does not originate in nursing theory? Research methods have been developed in different sciences and may be used in a variety of disciplines. It is rather the research question, the field in which research takes place and the researcher who carries out the research than the chosen method which makes it nursing research or something else. The second study shows an approach which is based on a nursing theory, Rogers’ Science of Unitary Human Beings (Rogers 1990, 1992), using a unique, nursing discipline-specific research method called Unitary Appreciative Inquiry, UAI (Cowling, 2001). UAI, as well as other nursing discipline-specific research methodologies, cannot be found in any nursing research books so far. Does it mean that these methods are not good enough? How come nursing research relates almost exclusively on methods which are not nursing discipline-specific? What does it take for the discipline of nursing to focus more on its own theories, concepts and models in research? A special focus on these questions will be included in the conclusion of the assignment.
There seems to be consensus that nursing research should contribute to the development of advanced nursing practice (ANP), help building the foundation for nursing practice in general and evidence based nursing (EBN) specifically. In that context it is important though to discuss the interpretation and definition of evidence. From a nursing perspective it needs to be questioned to simply accept the hierarchy of the levels of evidence as they are used and originated in natural sciences including medicine (meta-analysis of randomized controlled trials on top of the hierarchy and qualitative studies almost on the lowest level).
Considering that the medical model is primarily problem-oriented and mainly reflects a linear, causal and reductionist approach and nursing instead is supposed to have an integrative, more holistic approach with a focus on simultaneity or totality, one cannot compare these two different worldviews or paradigms with the same interpretation of evidence. Therefore it depends on the research question, the aim of a study, which level of evidence can be achieved and that does not make one level of evidence automatically better or higher in hierarchy than another.
To focus on nursing research it is important to realize that many questions of importance to nurses need rich qualitative data to be best answered (Polit & Beck, 2006). The field of themes and issues of relevance to nurses and the profession of nursing are extremely broad and difficult to limit. Parahoo (2006) argues that all research into nursing practice and issues, including educational and organizational issues, are nursing research. Nursing research is seen as a systematic inquiry into issues of importance to nurses to develop knowledge (Polit & Beck, 2006).
The following critique of the two articles may help to answer some of the questions raised above and lead to a continuing discussion about some of these issues raised through the following exploration of the concept of despair in nursing practice.
Preferred by: Peter Wolfensberger