The use of focused ethnography in nursing research.
TL;DR: Focused ethnography has emerged as a relevant research methodology that can be used by nurse researchers to understand specific societal issues that affect different facets of nursing practice.
Abstract: Aim To provide an overview of the relevance and strengths of focused ethnography in nursing research. The paper provides descriptions of focused ethnography and discusses using exemplars to show how focused ethnographies can enhance and understand nursing practice.
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TL;DR: This paper defines focused ethnographies, locates them within the ethnographic genre, justifies their use in healthcare research, and outlines the methodological processes including those related to sampling, data collection and maintaining rigour.
Abstract: Focused ethnographies can have meaningful and useful application in primary care, community, or hospital healthcare practice, and are often used to determine ways to improve care and care processes. They can be pragmatic and efficient ways to capture data on a specific topic of importance to individual clinicians or clinical specialities. While many examples of focused ethnographies are available in the literature, there is a limited availability of guidance documents for conducting this research. This paper defines focused ethnographies, locates them within the ethnographic genre, justifies their use in healthcare research, and outlines the methodological processes including those related to sampling, data collection and maintaining rigour. It also identifies and provides a summary of some recent focused ethnographies conducted in healthcare research. While the emphasis is placed on healthcare research, focused ethnographies can be applicable to any discipline whenever there is a desire to explore specific cultural perspectives held by sub-groups of people within a context-specific and problem-focused framework. Keywords: Focused Ethnography, Healthcare Research, Qualitative Methodology, Guidance
335 citations
TL;DR: This paper used focused ethnography to study nurses' work experiences and demonstrated how particular research questions, the attributes of certain cultural groups, and the unique characteristics of specific researchers compel adaptations in ethnography that address the need for methodological evolution while still preserving the essential nature of the method.
Abstract: Ethnography is one of the oldest qualitative methods, yet increasingly, researchers from various disciplines are using and adapting ethnography beyond its original intents. In particular, a form of ethnography known as "focused ethnography" has emerged. However, focused ethnography remains underspecified methodologically, which has contributed to controversy about its essential nature and value. Nevertheless, an ever-evolving range of research settings, purposes, and questions require appropriate methodological innovation. Using the example of a focused ethnography conducted to study nurses' work experiences, this article will demonstrate how particular research questions, the attributes of certain cultural groups, and the unique characteristics of specific researchers compel adaptations in ethnography that address the need for methodological evolution while still preserving the essential nature of the method. URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs150111
161 citations
TL;DR: Nurses' roles within primary care setting appear to be focused mainly on case management, and minimal orientation and lack of preparation of nurses for their roles, vagueness of these roles among the interdisciplinary primary care team members and loss of communication appeared to be among the most important factors that influence teamwork and nurses' functioning within these teams.
Abstract: Aims and objectives
This study investigated nurses' roles and their perspectives on the factors that influence interdisciplinary teamwork within Canadian primary care setting
Background
Interdisciplinary teams have shown to lead to better system- and patient-level outcomes and, accordingly, have became important aspects of healthcare systems especially within primary care settings Nurses play a key role in these primary care teams, particularly with respect to chronic disease management
Design
A focused ethnography design using semi-structured individual interviews was conducted
Methods
Interviews were conducted with 20 primary care nurses between July 2010–May 2011 Interviews were recorded, transcribed, and content and thematic analysis was performed
Results
Nurses experienced increasing scope of practice and professional responsibility as they transitioned into the primary care setting Nine major roles of primary care nurses were identified Several factors that facilitate or hinder teamwork were identified and categorised under four theme areas: (1) organisation/leadership (eg having common goals and mandate, unclear descriptions of team members' roles); (2) team relationships (eg closed loop of communication, trust, respect); (3) process/support (eg unclear referral process and reporting structure, large patient panels); and (4) physical environment (eg decentralised model of care)
Conclusions
Nurses' roles within primary care setting appear to be focused mainly on case management Minimal orientation and lack of preparation of nurses for their roles, vagueness of these roles among the interdisciplinary primary care team members and lack of communication appeared to be among the most important factors that influence teamwork and nurses' functioning within these teams
Relevance to clinical practice
Given that nurses play a key role in interdisciplinary primary care teams, particularly in managing chronic disease patients, approaches to improve chronic disease management and care of these patients should incorporate strategies to ensure effective preparation of these nurses for their roles within these teams and settings
82 citations
Additional excerpts
...Additionally, the use of focused ethnography in nursing research for studying phenomenon related to nursing practice has been widely discussed and recommended (Cruz & Higginbottom 2013)....
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TL;DR: In today’s multicultural society there is a strong need to avert misunderstandings, and perhaps harm, through facilitating cultural awareness and competency of care rather than misinterpretations of resistance to care.
Abstract: Evidence suggests that immigrant women having different ethnocultural backgrounds than those dominant in the host country have difficulty during their access to and reception of maternity care services, but little knowledge exists on how factors such as ethnic group and cultural beliefs intersect and influence health care access and outcomes. Amongst immigrant populations in Canada, refugee women are one of the most vulnerable groups and pregnant women with immediate needs for health care services may be at higher risk of health problems. This paper describes findings from the qualitative dimension of a mixed-methodological study. A focused ethnographic approach was conducted in 2010 with Sudanese women living in an urban Canadian city. Focus group interviews were conducted to map out the experiences of these women in maternity care, particularly with respect to the challenges faced when attempting to use health care services. Twelve women (mean age 36.6 yrs) having experience using maternity services in Canada within the past two years participated. The findings revealed that there are many beliefs that impact upon behaviours and perceptions during the perinatal period. Traditionally, the women mostly avoid anything that they believe could harm themselves or their babies. Pregnancy and delivery were strongly believed to be natural events without need for special attention or intervention. Furthermore, the sub-Saharan culture supports the dominance of the family by males and the ideology of patriarchy. Pregnancy and birth are events reflecting a certain empowerment for women, and the women tend to exert control in ways that may or may not be respected by their husbands. Individual choices are often made to foster self and outward-perceptions of managing one’s affairs with strength. In today’s multicultural society there is a strong need to avert misunderstandings, and perhaps harm, through facilitating cultural awareness and competency of care rather than misinterpretations of resistance to care.
66 citations
TL;DR: Some of the underlying principles and practice of ethnography, and its potential for nursing and healthcare practice, are outlined.
Abstract: Ethnography is a methodology that is gaining popularity in nursing and healthcare research. It is concerned with studying people in their cultural context and how their behaviour, either as individuals or as part of a group, is influenced by this cultural context. Ethnography is a form of social research and has much in common with other forms of qualitative enquiry. While classical ethnography was characteristically concerned with describing 'other' cultures, contemporary ethnography has focused on settings nearer to home. This article outlines some of the underlying principles and practice of ethnography, and its potential for nursing and healthcare practice.
61 citations
Cites background from "The use of focused ethnography in n..."
...In essence, ethnography is concerned with ‘learning about people by learning from people’ (Cruz and Higginbottom 2013)....
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...Ethnography makes the influence of the researcher explicit, rather than trying to erase it (Cruz and Higginbottom 2013)....
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References
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Book•
01 Jan 1983TL;DR: Features include the selection and sampling of cases, the problems of access, observation and interviewing, recording and filing data, and the process of data analysis.
Abstract: Acknowledgements Preface 1. What is ethnography? 2. Research design: problems, cases, and samples 3. Access 4. Field relations 5. Insider Accounts: listening and asking questions 6. Documents 7. Recording and organizing data 8. The process of Analysis 9. Writing Ethnography 10. Ethics References Index
9,547 citations
Book•
01 Jan 1989TL;DR: The coming of age of evaluation What is fourth generation evaluation? Why should we choose to practice it? What Is this Constructivist Paradigm Anyway? Ethics and Politics The Twin Failures of Positivist Science Constructions and Reconstructions of Realities Paradigms and Methodologies The Methodology of Fourth Generation Evaluations Judging the Quality of 4G Evaluation Putting It All Together so that It Spells E-V-A-L-U-A -T-I-O-N
Abstract: The Coming of Age of Evaluation What Is Fourth Generation Evaluation? Why Should We Choose to Practice It? What Is this Constructivist Paradigm Anyway? Ethics and Politics The Twin Failures of Positivist Science Constructions and Reconstructions of Realities Paradigms and Methodologies The Methodology of Fourth Generation Evaluations Judging the Quality of Fourth Generation Evaluation Putting It All Together so that It Spells E-V-A-L-U-A-T-I-O-N
8,879 citations
01 Jan 2005
8,662 citations
Book•
01 Feb 2016
TL;DR: In this article, the authors introduce the concept of evidence-based research in the context of qualitative and quantitative research, and propose a methodology to generate evidence for nursing research in an Evidence-Based Practice Environment.
Abstract: Part I: FOUNDATIONS OF NURSING RESEARCH AND EVIDENCE-BASED PRACTICE 1: Introduction to Nursing Research in an Evidence-Based Practice Environment 2: Translating Research Evidence into Nursing Practice: Evidence-Based Nursing 3: Generating Evidence: Key Concepts and Steps in Qualitative and Quantitative Research Part II: CONCEPTUALIZING A STUDY TO GENERATE EVIDENCE FOR NURSING 4: Conceptualizing Research Problems, Research Questions, and Hypotheses 5: Finding and Critiquing Evidence: Research Literature Reviews 6: Developing a Theoretical or Conceptual Context 7: Generating Research Evidence Ethically Part III: DESIGNING A STUDY TO GENERATE EVIDENCE FOR NURSING 8: Planning a Nursing Study 9: Developing an Approach for a Qualitative Study 10: Designing Quantitative Studies 11: Enhancing Rigor in Quantitative Research 12: Undertaking Research for Specific Purposes 13: Developing a Sampling Plan Part IV: COLLECTING RESEARCH DATA 14: Designing and Implementing a Data Collection Plan 15: Collecting Unstructured Data 16: Collecting Structured Data 17: Assessing Measurement Quality in Quantitative Studies 18: Developing and Testing Self-Report Scales Part V: ANALYZING AND INTERPRETING RESEARCH DATA 19: Analyzing Qualitative Data 20: Enhancing Quality and Integrity in Qualitative Research 21: Describing Data through Statistics 22: Using Inferential Statistics to Test Hypotheses 23: Using Multivariate Statistics to Analyze Complex Relationships 24: Designing a Quantitative Analysis Strategy: From Data Collection to Interpretation Part VI: BUILDING AN EVIDENCE BASE FOR NURSING PRACTICE 25: Integrating Research Evidence: Meta-Analysis and Metasynthesis 26: Disseminating Evidence: Reporting Research Findings 27: Writing Proposals to Generate Evidence Methodologic References Glossary
5,800 citations
Book•
24 Oct 2012
TL;DR: In this article, Denzin and Denzin discuss the discipline and practice of qualitative research in the field of history, and present a set of guidelines for interpreting, evaluating, and evaluating qualitative evidence.
Abstract: Preface - Norman K. Denzin and Yvonna S. Lincoln About the Editors About the Contributors 1. Introduction: The Discipline and Practice of Qualitative Research - Norman K.Denzin and Yvonna S. Lincoln I. Methods of Collecting and Analyzing Empirical Materials 2. Narrative Inquiry: Still a Field in the Making - Susan E. Chase 3. Critical Arts-based Inquiry: The Pedagogy and Performance of a Radical Ethical Aesthetic - Susan Finley 4. Oral History - Linda Shopes 5. Observations on Observation: Continuities and Challenges - Michael Angrosino and Judith Rosenberg 6. Visual Methodology: Toward a More Seeing Research - Jon D. Prosser 7. Performative Autoethnography: Critical Embodiments and Possibilities - Tami Spry 8. The Methods, Politics, and Ethics of Representation in Online Ethnography - Sarah Gaston 9. Analyzing Talk and Text - Anssi Parakyla and Johanna Ruusuvuori 10. Focus Groups: Contingent Articulations of Pedagogy, Politics, and Inquiry - George Kamberelis and Greg Dimitriadis II. The Art and Practices of Interpretation, Evaluation, and Presentation 11. Qualitative Research, Science, and Government: Evidence, Criteria, Policy, and Politics - Harry Torrance 12. Reflections on Interpretive Adequacy in Qualitative Research - David L. Altheide and John M. Johnson 13. Analysis and Representation Across the Continuum - Laura L. Ellingson 14. Post Qualitative Research: The Critique and the Coming After - Elisabeth Adams St. Pierre 15. Qualitative Research and Technology: In the Midst of a Revolution - Judith Davidson and Silvana diGregorio 16. The Elephant in the Living Room, or Extending the Conversation About the Politics of Evidence - Norman K. Denzin 17. Writing into Position: Strategies for Composition and Evaluation - Ronald J. Pelias 18. Evaluation as a Relationally Responsible Practice - Tineke Abma and Guy A.M. Widdershoven, Norman K. Denzin and Yvonna S. Lincoln Author Index Subject Index
4,606 citations