Introduction 1. Woman's Place in Man's Life Cycle 2. Images of Relationship 3. Concepts of Self and Morality 4. Crisis and Transition 5. Women's Rights and Women's Judgment 6. Visions of Maturity References Index of Study Participants General Index

In a Different Voice. Psychological Theory and Women’s Development. Cambridge, MA (Harvard University Press) 1982.

Process evaluation is an essential part of designing and testing complex interventions. New MRC guidance provides a framework for conducting and reporting process evaluation studies

https://www.bmj.com/content/bmj/350/bmj.h1258.full.pdf

Process evaluation of complex interventions: Medical Research Council guidance

The four Visegrad states — Poland, the Czech Republic, Slovakia (until 1993 Czechoslovakia) and Hungary — form a compact area between Germany and Austria in the west and the states of the former USSR in the east. They are bounded by the Baltic in the north and the Danube river in the south. They are cut by the Sudeten and Carpathian mountain ranges, which divide Poland off from the other states. Poland is an extension of the North European plain and like the latter is drained by rivers that flow from south to north west — the Oder, the Vlatava and the Elbe, the Vistula and the Bug. The Danube is the great exception, flowing from its source eastward, turning through two 90-degree turns to end up in the Black Sea, forming the barrier and often the political frontier between central Europe and the Balkans. Hungary to the east of the Danube is also an open plain. The region is historically and culturally part of western Europe, but its eastern Marches now represents a vital strategic zone between Germany and the core of the European Union to the west and the Russian zone to the east.

Economy and Society

Doing Qualitative Research

Truth and method

Title. Validity, trustworthiness and rigour: reasserting realism in qualitative research

Aim.  This paper challenges recent sceptical approaches to the possibility of validating qualitative research and underlines the benefits of adopting a realist approach to validity.

Background.  In recent discussion about the methodological bases for qualitative research it has been argued that, because different methodologies take different approaches to validity, attempts to develop a common set of validation criteria are futile. On the basis of this sceptical view, a number of strategies for judging qualitative research have been proposed. These include suggestions that: it should be judged according to aesthetic or rhetorical criteria, rather than epistemological validity; responsibility for appraisal should move from researchers to readers; each methodology should be assessed individually according to its own merits.

Discussion.  None of these suggestions provide a viable alternative to validity, defined as the extent to which research reflects accurately that to which it refers. Because the form of research does not determine its content, replacement of epistemology by aesthetics is unsustainable. Because research reports mediate between writer and reader, a one-sided approach to this relationship constitutes a false dichotomy. If we accept the criterion of practitioner confidence as a means of judging methodological approaches, this involves rejection of judgement according to a methodology’s own merits.

Conclusion.  If qualitative research is actually about something, and if it is required to provide beneficial information, then a realist approach to validity holds out greatest promise.

/pdf/validity-trustworthiness-and-rigour-reasserting-realism-in-4fwbzccm6u.pdf

Validity, trustworthiness and rigour: reasserting realism in qualitative research.

The problem addressed in this paper is how nurse-doctor power relations are manifested in a hospital setting. A review of the literature identified four major ideal types of interaction between nurses and doctors in decision-making processes. These were unproblematic subordination, informal covert decision making, informal overt decision making and formal overt decision making on the part of nurses. Each of these types was tested against empirical data gained from participant observation of interactions between the nurses and doctors working in an intensive care unit and a general medical ward. It was concluded that while both the unproblematic subordination and the informal covert decision-making types of interaction appeared superficially to be used frequently, closer examination revealed that, with the exception of nurse-consultant interactions, nurses were less dependent on these subordinate modes of interaction than much of the literature suggested. Formal overt decision making, despite official encouragement, was also infrequently utilized. However, it was noticed that senior nurses especially used informal overt strategies to involve themselves in decision-making sequences. Use of such strategies had the effect of reducing though not eliminating the power differential between doctors and nurses.

A participant observation study of power relations between nurses and doctors in a general hospital

The purpose of this paper is to identify a philosophy for ethnography which could overcome some of the epistemological criticisms to which it has recently been subjected, notably by Martin Hammersley (1990, 1992). It is argued that Roy Bhaskar's (1989a) theory of critical realism is capable of solving many of the problems raised in relation to representational claims, theoretical focus and explanatory status. A substantive example of how critical realist ethnography can be used is given in a participant observation study of how racism affects occupational relationships between nurses and doctors, and how its effects are mediated by professional ideology. It is argued that the universalist-achievement ethos of professionalism tends to counter the ascriptive nature of racism. Thus, as long as a functional-specific pretext is unavailable, the effects of structural racism will remain latent in social situations where professionalism has a powerful influence.

Critical Realist Ethnography: The Case of Racism and Professionalism in a Medical Setting

Background
Multidimensional rehabilitation programmes (MDRPs) have developed in response to the growing number of people living with and surviving cancer. MDRPs comprise a physical component and a psychosocial component. Studies of the effectiveness of these programmes have not been reviewed and synthesised.

Objectives
To conduct a systematic review of studies examining the effectiveness of MDRPs in terms of maintaining or improving the physical and psychosocial well-being of adult cancer survivors.

Search methods
We conducted electronic searches in the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL and PsychINFO up to February 2012.

Selection criteria
Selection criteria focused on randomised controlled trials (RCTs) of multidimensional interventions for adult cancer survivors. Interventions had to include a physical component and a psychosocial component and to have been carried out on two or more occasions following completion of primary cancer treatment. Outcomes had to be assessed using validated measures of physical health and psychosocial well-being. Non-English language papers were included.

Data collection and analysis
Pairs of review authors independently selected trials, rated their methodological quality and extracted relevant data. Although meta-analyses of primary and secondary endpoints were planned there was a high level of study heterogeneity and only one common outcome measure (SF-36) could be statistically synthesised. In addition, we conducted a narrative analysis of interventions, particularly in terms of inspecting and identifying intervention components, grouping or categorising interventions and examining potential common links and outcomes.

Main results
Twelve RCTs (comprising 1669 participants) met the eligibility criteria. We judged five studies to have a moderate risk of bias and assessed the remaining seven as having a high risk of bias. It was possible to include SF-36 physical health component scores from five studies in a meta-analysis. Participating in a MDRP was associated with an increase in SF-36 physical health component scores (mean difference (MD) 2.22, 95% confidence interval (CI) 0.12 to 4.31, P = 0.04). The findings from the narrative analysis suggested that MDRPs with a single domain or outcome focus appeared to be more successful than programmes with multiple aims. In addition, programmes that comprised participants with different types of cancer compared to cancer site-specific programmes were more likely to show positive improvements in physical outcomes. The most effective mode of service delivery appeared to be face-to-face contact supplemented with at least one follow-up telephone call. There was no evidence to indicate that MDRPs which lasted longer than six months improved outcomes beyond the level attained at six months. In addition, there was no evidence to suggest that services were more effective if they were delivered by a particular type of health professional.

Authors' conclusions
There is some evidence to support the effectiveness of brief, focused MDRPs for cancer survivors. Rigorous and methodologically sound clinical trials that include an economic analysis are required.

/pdf/multidimensional-rehabilitation-programmes-for-adult-cancer-4w5n5c6hkm.pdf

Multidimensional rehabilitation programmes for adult cancer survivors

This paper is a critique of naive realism, the philosophy which animates much nursing research, and which leads researchers to assume that the attainment of objective knowledge is possible The nature of naive realism, and its relationship to objectivity, is discussed Central to this outlook is the belief that the values and interests of the researcher can and should be divorced from the prosecution of research This is reflected in the literary convention of referring to the researcher in the third person Contrary to this position, I argue that the interpretations, values and interests of the researcher are central to the research process Moreover, nursing research may be affected by the interests of managers, educationalists, and those who wish to see nursing attain professional status Nursing researchers should accept that they are part of the social situations which they study They should therefore become reflexive in their outlook This entails recognizing and attempting to understand the effects of the researcher, rather than trying to eliminate or ignore them

Samuel Porter

Papers

Validity, trustworthiness and rigour: reasserting realism in qualitative research.

A participant observation study of power relations between nurses and doctors in a general hospital

Critical Realist Ethnography: The Case of Racism and Professionalism in a Medical Setting

Multidimensional rehabilitation programmes for adult cancer survivors

Nursing research conventions : objectivity or obfuscation ?