자연주의적 탐구조사(Naturalistic Inquiry)

Background.  Observation is used in research in two ways – structured and unstructured. Which of these methods to choose depends on the research question but will be defined predominantly by the paradigm underlying each study. Positivistic research generally uses structured observation and interpretist/naturalistic paradigms use unstructured observation. This paper is concerned with unstructured observation.

Aim.  To discuss the importance of unstructured observation as a research method and to examine critically the problems associated with both access and field notes.

Application to nursing.  Although unstructured observation has been used in nursing research, it is less favoured than the interview. Furthermore, although some of the dilemmas concerned with observation such as the role of the researcher, covert research and informed consent have received attention in the nursing literature, other aspects remain relatively unexplored. In particular little has been written concerning access to the field and field notes. Both of these aspects have practical and theoretical considerations that require the attention of the researcher. This omission may partly explain nurses' apparent reluctance to use unstructured observation in their studies. This paper seeks to redress this situation.

In the field: notes on observation in qualitative research

Good medical practice

BackgroundPurposive sampling has a long developmental history and there are as many views that it is simple and straightforward as there are about its complexity. The reason for purposive sampling ...

Purposive sampling: complex or simple? Research case examples.

The Asia-Pacific Clinical Practice Guidelines for the Management of Frailty

http://palcare.streamliners.co.nz/DIGNITY.pdf

Patient dignity in an acute hospital setting: a case study.

This article explores perspectives on qualitative research and the variety of views concerning rigour in the research process. Evaluating and ensuring the quality of research are essential considerations for practitioners who are appraising evidence to inform their practice or research. Several criteria and principles for evaluating quality in qualitative research are presented, recognising that their application in practice is influenced by the qualitative methodology used. The article examines a range of techniques that a qualitative researcher can use to promote rigour and apply it to practice.

Promoting and evaluating scientific rigour in qualitative research.

Students' and facilitators' perceptions of simulation in practice learning.

Introduction: Frail older people experience frequent care transitions and an integrated healthcare system could reduce barriers to transitions between different settings. The study aimed to investigate care transitions of frail older people from acute hospital wards to community healthcare or community hospital wards, within a system that had vertically integrated acute hospital and community healthcare services. Theory and methods: The research design was a multimethod, qualitative case study of one healthcare system in England; four acute hospital wards and two community hospital wards were studied in depth. The data were collected through: interviews with key staff (n =17); focus groups (n = 9) with ward staff (n = 36); interviews with frail older people (n = 4). The data were analysed using the framework approach. Findings: Three themes are presented: Care transitions within a vertically integrated healthcare system, Interprofessional communication and relationships; Patient and family involvement in care transitions. Discussion and conclusions: A vertically integrated healthcare system supported care transitions from acute hospital wards through removal of organisational boundaries. However, boundaries between staff in different settings remained a barrier to transitions, as did capacity issues in community healthcare and social care. Staff in acute and community settings need opportunities to gain better understanding of each other’s roles and build relationships and trust.

/pdf/care-transitions-for-frail-older-people-from-acute-hospital-jpqtk5o1bg.pdf

Care transitions for frail, older people from acute hospital wards within an integrated healthcare system in England: a qualitative case study

Aim The aim of the RCN dignity survey was to gain the perspectives of nurses, healthcare assistants and nursing students regarding the maintenance and promotion of dignity in everyday practice. This article presents survey respondents' experiences of providing dignified care for older people. Method A survey questionnaire was developed including fixed response and free text questions. A survey link was emailed to RCN members. Of the 2,048 respondents, 1,110 (54 per cent) worked with older people. These responses were analysed using an Excel spreadsheet for the quantitative data and the free text data were analysed thematically. Results The respondents perceived that the physical environment and organisation influenced the provision of dignified care. Respondents described how they endeavoured to promote dignity during care activities which might threaten dignity through thoughtful planning, sensitive communication, preserving privacy and promoting choice. Conclusion A conducive physical care environment, a supportive organisation and individual nurses' actions can do much to promote the dignity of older people while they are undergoing health care.

Lesley Baillie

Papers

Patient dignity in an acute hospital setting: a case study.

Promoting and evaluating scientific rigour in qualitative research.

Students' and facilitators' perceptions of simulation in practice learning.

Care transitions for frail, older people from acute hospital wards within an integrated healthcare system in England: a qualitative case study

Nurses' views on dignity in care