Hermeneutic Phenomenological Research Research Articles

¿Qué sabemos sobre el duelo y el final de la vida las enfermeras? A propósito de un estudio mediante grupo focal en Santa Cruz de Tenerife

Introduction and purpose of the research: the authors, members of the End-of-Life Care group at the University of La Laguna (CUFINVIDA), seek to identify areas of improvement concerning end-of-life care, loss and grief in the professional context, from the premise that there is not enough training around this topic. Methodology: phenomenological hermeneutic research through a focus group of fifteen nurses from Ofra Delicias-Miramar primary healthcare centre in Santa Cruz de Tenerife (Spain), carried out in November 2019. Results: Four main categories are identified when delving into what mourning is: the physical space of mourning and death; meaning and context; mourning for deceased children and proposals for improvement. Conclusions: Nurses report not feeling prepared regarding grief and the process of dying. Training is scarce, and it is necessary to consider and reflect on how nurses carry out diagnoses and establish objectives and interventions for people at the end of life or in the mourning process.

From Description to Interpretive Leap: Using Philosophical Notions to Unpack and Surface Meaning in Hermeneutic Phenomenology Research

Hermeneutic phenomenology (HP) as research method is increasingly used in health and social science studies to collect and analyze lived experiential descriptions (LEDs) of a phenomenon. However, currently there is little guidance in how to apply philosophical notions to interpret LEDs in HP studies and this approach has faced critique in how meaning is attributed. In this paper, we offer clarity about what “we do” in HP studies. It does not present a comparative analysis of qualitative approaches or claim to present an inflexible “how to” menu. The purpose is to provide guidance to those new to this methodology or/and for less experienced supervisors of postgraduate research students using this approach for the first time. The focus is specifically on conducting HP research and how philosophical notions are used to inform methodological decisions. Drawing upon data from our empirical projects we illuminate how meaning is surfaced, demonstrating a key feature of HP studies in the use of philosophical notions to uncover ontological significance. Consideration is also offered on how trustworthiness in HP studies can be achieved. The key contention is how the philosophical underpinnings of HP thinking, and the constant call to be reflexive, draws forth hitherto unspoken meaning that can inform new thinking and practice.

Examining Internalized Homonegativity: Narratives of Same Sex Attracted Black Men

Research describes how Black cisgender queer men become limited in their sexual identity development when they internalize anti-gay messages disseminated from familial, religious, and social spaces. A hermeneutic phenomenological qualitative research study was conducted to explore nine Black cisgender same gender loving men's experiences with homonegativity. Results suggest that internalized homonegativity may reflect challenges that transcend same sex sexual and romantic engagement. Internalized homonegativity may arise due to fear of lost privilege that is contingent on masculine performance in various social contexts.

Teaching phenomenological research as a method of therapeutic art-making: A Covid-19 case study

This article is a case study about teaching undergraduate students to use hermeneutic phenomenological research methodology as a vehicle to make art which evokes the essence of lived experience. This study focuses on the phenomenon of living in a time of Coronavirus as human beings; 30 students were taught research steps to transform their experiences of living amidst a pandemic into phenomenological Covid-19 art. First, I taught students the craft of writing rich, descriptive, autobiographical anecdotes about lived experience, guided by Van Manen (1990) and Finlay’s (2012) approach to writing first-person phenomenological accounts. Second, I taught students to interpret and code their anecdotes to extract themes. Third, I guided students to transform the themes into phenomenological art, supported by Heidegger (1950), Merleau-Ponty (1945), and Van Manen’s (1990) affirmations of phenomenology as an aesthetic endeavour whereby art is the ideal language of phenomenology. A digital phenomenological art gallery was created to celebrate students’ work as a website which showcased Coronavirus paintings, songs, dance, video/film, photography, poetry and collages. This paper is methodological and pedagogical in nature, detailing step-by-step procedures in effort to inspire educators who teach qualitative methods to assign this arts-based phenomenological research project to students to foster healing through phenomenological art-making.

No time for reflection: Patient experiences with treatment-related decision-making in advanced prostate cancer.

The rationale of the study was the predominant understanding that patient involvement in treatment-related decision-making is essential and that communication with cancer patients can affect their quality of life, satisfaction with care, and psychosocial and medical outcomes positively. This study explored how patients with advanced prostate cancer experience the communication with health professionals and their experiences of how and by whom treatment-related decisions were made. A phenomenological-hermeneutic research design was applied, and data were collected using qualitative interviews supplemented with participant observations in a urological outpatient clinic at a regional hospital in Denmark. Thirteen patients participated. Data were analysed using Ricoeur's theory of interpretation. The patients experienced the course as being routine and that decisions related to treatment were made in advance. Three themes were identified: (1) Fast track diagnosing and treatment, (2) Off course I should have this treatment, and (3) They don't ask about existential issues. The study concluded that patients experienced communication primarily revolved around disease- and treatment-related issues and that it was characterised as efficient and straightforward, but insufficient. The patients experienced that the doctors made treatment-related decisions without involving them.

The meaning of leisure to children and young people with significant physical disabilities: Implications for optimising participation

Introduction The facilitation of meaningful leisure participation for children and young people requires an understanding of what leisure means to them. This study aimed to understand meaningful leisure from the perspective of children and young people with complex physical and communication disabilities. Method A hermeneutic phenomenological research design was used. Data was gathered through multiple interviews with six young people supported by photo elicitation, Talking Mats and direct observation. Individual case studies were analysed, together with six autobiographies of people with similar disabilities. Data analysis was iterative and multi-directional, alternating between segments and the whole throughout interpretation. Results Leisure experience meanings were uniquely constructed for each person, based on preferences, personality and circumstances. The tree of leisure emerged as a useful metaphor for three essential features (control, engrossing, enjoyment) and four key meanings (escape, exploration, exchange and expression) of leisure. Children and young people experienced five meaningful outcomes that lasted beyond the leisure activity (restoration, protection, construction, reflection and connection). Conclusion For children and young people with disabilities, a balanced array of diverse leisure experiences provides a powerful and accessible route to wellbeing. Implications for practice include understanding the individual, focusing on the social environment, supporting self-advocacy and promoting opportunities for free movement.

Nurses' experiences of delivering acute orthopaedic care to patients with dementia.

Nurses who care for acute patients with dementia in a hospital setting report a variety of challenges in regard to meeting the complex needs of their patients. In particular, known barriers to optimal care include a lack of knowledge about dementia, lack of dementia-friendly acute clinical environments, lack of time to care for the individual patient and a prioritised focus on the medical issues that triggered the hospitalisation. Research to date has not specifically focused on nurses' experiences of caring for people with dementia in orthopaedic wards. This study investigates nurses' experiences of caring for people with dementia, in an acute orthopaedic hospital ward setting. Qualitative interviews. This qualitative study employs hermeneutic phenomenological research methods. Eight Danish nurses were interviewed in an orthopaedic ward about their experiences in caring for orthopaedic patients with dementia. Nurses with various levels of expertise were selected for interview so that a full range of nursing experiences could inform the research study. The results of the study revealed two major themes: "Nurse communication and patient information" and "Care compromise", with three and four sub-themes, respectively. These findings are used to illustrate how, and why, nurses' experiences of caring for patients with dementia contribute a discontentment and negative preconceived perception by some nurses towards their acute care of patients with chronic dementia. The results are discussed in the context of Interactional Nursing Practice theory and describe the challenges experienced by acute care orthopaedic nurses who care for patients with dementia. Orthopaedic nurses find it challenging and professionally difficult to provide person-centred care for patients with dementia during an acute orthopaedic hospital admission. Orthopaedic nurses should work to adopt a positive attitude, and person-centred approach, towards dementia care. It is also recommended that the electronic patient record should be supplemented by oral dissemination to some extent, as information, plans of action and knowledge about the care situation for patients with dementia has a tendency to drown in chronological data presentation.

Caring for Children with Non-Accidental Head Injuries: A Case for a Child-Centered Approach

ABSTRACT Child abuse remains a significant issue. Non-accidental head injury (NAHI) is a major cause of mortality in young children with survivors often having to live a life with severe developmental and neurological dysfunction. The aim of this hermeneutic phenomenological research study was to examine the lived experiences of nurses who care for children and their families admitted to hospital with a non-accidental head injury. Semi-structured interviews were conducted with six nurses who had at least five years’ experience of nursing children with NAHI. Following the interpretive approach described by van Manen data was analyzed and two essential themes identified. Firstly, nursing children with NAHI is different from the care of children admitted with a similar neurological injury related to accidental injuries or medical conditions. Secondly, when nursing these children nurses adopt protective qualities, conceptualized in this study as a shield of protection. The findings of this study support the findings of other studies in regard to the emotional labor required of nurses caring for children who have been subject to child abuse and the importance for nurses of maintaining a professional demeanor. The study highlighted the tensions of sustaining a family-centered care approach when caring for a child with NAHI. It is argued that greater acknowledgment and emotional support for nurses is needed and that a child-centered approach offers a more compatible model of care than Family-Centered Care in the acute phase of caring for children with a NAHI.

Authenticity made visible in medical students' experiences of feeling like a doctor.

ObjectivesTo interpret the phenomenon of authenticity made visible in medical students’ experiences of feeling like a doctor, i.e., how authenticity took shape in narratives about feeling like a doctor in clinical situations where students were challenged to be independent and to a high degree make choices and clinical decisions.MethodsThe conducted research was positioned within phenomenological hermeneutic research tradition, interpreting participants’ experiences in a life-world perspective using narrative inquiry. Fifteen medical students in their fifth year were interviewed focusing on clinical situations. An abductive analysis approach was used to discover patterns and to interpret data following a phenomenological hermeneutic research method for textual interpretation. ResultsThe analysis resulted in a thematic structure of findings: Opportunity to experience authenticity through creating relationships; Opportunity to experience authenticity through responsibility; Opportunity to experience authenticity through independence, managing wholeness, and follow-up processes; Opportunity to experience authenticity through being able to reason and discern. Overarching the four themes was the perceived need for attachment, i.e. attachment to patients, to supervisors, to the workplace, to the situation and reasoning and knowledge. ConclusionsEssential for the experience of feeling like a doctor was authentic situations that resulted in the experienced members of a community of practice and the perceived development of a professional identity. These findings can advance the understanding of how clinical education should be organized to facilitate professional identity development.

Emotional Labour among Women Leaders within the South African Consulting Industry: A Hermeneutic Phenomenological Inquiry

The opinion that the workplace should be viewed as a rational environment is being swiftly dismantled by acknowledging and harnessing the power of emotions in favour of individual and organisational outcomes. This study explored the lived experiences of emotional labour among women leaders in the consulting industry in South Africa. A qualitative study was conducted and informed by the hermeneutic phenomenological perspective. Data were gathered through in-depth, unstructured interviews with eight women leaders resident in the Gauteng Province, South Africa. The data gathered were analysed by applying a hermeneutic phenomenological analysis, and interpreted from a work- and personally related emotional labour stance. The empirical findings suggest that these women leaders enjoy very little work-life balance, which is accepted as common practice in this industry. Role complexity and personal life obligations result in role conflict. Their emotional wellbeing is adversely affected, which manifests in guilt, loneliness, loss of identity, alienation, shame and the emotional exhaustion they experience. Furthermore, it seems that adequate organisational support is not experienced by women leaders in this volatile, highly pressured emotional context. This study contributes to the field of Industrial and Organisational Psychology, the literature on emotional labour, as well as human resource practices such as talent management, retention strategies and the career management of women leaders in the consulting industry by making suggestions for human resource practices and future research.

Learning in liminality. Student experiences of learning during a nursing study abroad journey: A hermeneutic phenomenological research study

BackgroundStudy abroad generates positive learning outcomes for students. However, experiences of learning, and processes of learning during unaccompanied-by-faculty nursing study abroad are unclear. This research therefore investigated student nurse experiences of learning during a study abroad journey in order to explore the phenomenon of learning and the processes of learning throughout this journey. Methods and participantsAn interpretivist hermeneutic phenomenological methodology was applied, and twenty student nurses, from the UK and Europe, participated; two individual semi-structured interviews were conducted per participant (post-return and follow-up). Findings and conclusionsThe ‘Phenomenological Hermeneutical Method’ of data analysis was employed and revealed the phenomenon of learning comprised four themes: ‘experiencing a different reality’; ‘active sense-making’; ‘being with others’ and ‘being changed and transformed’. When considered together, these themes identify that study abroad was experienced as the liminal space in which learning occurred. Students experienced liminality in this space and the process of learning was triggered by disjuncture. Students took responsibility for learning and undertook active sense-making activities to gain insight. Students struggled to make sense of troublesome experiences, and remained in a stuck place until resolution of troublesome-ness enabled students to cross a threshold into understanding. Learning was also influenced by others. Students experienced change and transformation as a result of the learning that had occurred, and a postliminal state was attained when troublesome-ness was resolved and students had re-integrated into their usual reality. These findings offer insight into student learning during unaccompanied study abroad journeys, and further development of nurse education and research is recommended.

Hope and Technology: Other-Oriented Hope Related to Eye Gaze Technology for Children with Severe Disabilities.

Introducing advanced assistive technology such as eye gaze controlled computers can improve a person’s quality of life and awaken hope for a child’s future inclusion and opportunities in society. This article explores the meanings of parents’ and teachers’ other-oriented hope related to eye gaze technology for children with severe disabilities. A secondary analysis of six parents’ and five teachers’ interview transcripts was conducted in accordance with a phenomenological-hermeneutic research method. The eye gaze controlled computer creates new imaginations of a brighter future for the child, but also becomes a source for motivation and action in the present. The other-oriented hope occurs not just in the future; it is already there in the present and opens up new alternatives and possibilities to overcome the difficulties the child is encountering today. Both the present situation and the hope for the future influence each other, and both affect the motivation for using the technology. This emphasises the importance of clinicians giving people opportunities to express how they see the future and how technology could realise this hope.

The experience of the nurse caring for families of patients at the end of life in the intensive care unit.

The patient who enters at the intensive care unit (ICU) usually does because of health conditions that are sometimes irreversible and lead to death, and the care at the end of life becomes the main factor of this situation; therefore, the aim of this article was to understand the meaning of the experience of giving care to families at the end of life in an ICU. For this reason, a qualitative, hermeneutic phenomenological research was carried out. For the data collection, a semi-structured interview was conducted to 18 participants, and the results were returned to each of the participants in order to validate each of the categories and interpretations. Among these results, two main categories were identified: emotional response of the nurse to the family and nursing care to the family of patients at the end of life. It was concluded that the nurses working at the ICU are facing aspects related to the end of life that generates emotional and psychological burden; additionally, they do not have specific training in this subject, especially in relation to the care of the families in this situation, for which they provide this care based on empiricism.

A Bourdieusian analysis of the educational field and professional identity of EFL teachers

PurposeInformed by the Bourdieusian construct of the social field, the purpose of this paper is to explore how different aspects of the educational field and the sub-field of English language teaching in Iran influence diverse components of the professional identity of high school EFL teachers. To this aim, the impact of the power hierarchization structure, distribution of capitals and field autonomy, as important aspects of the social field theory, is investigated in relation to Iranian EFL teachers’ professional identity construction.Design/methodology/approachVan Manen’s (1990) hermeneutic phenomenological research method was adopted to analyze the data obtained through the semi-structured interviews and reflexive journals from 15 Iranian EFL teachers at high schools.FindingsThe hermeneutic phenomenological analysis of the data yielded to the extraction of one global, three organizing and six basic themes. The global theme was the educational field and professional identity. The resulting organizing themes were: first, autonomous field and teachers’ commitment; second, asymmetric power relation and teachers’ autonomy; and, finally, cultural capital and teachers’ motivation. This study revealed how the complex and multi-dimensional nature of the power relations between the field of education and power influenced the professional identity of EFL teachers.Research limitations/implicationsThis dynamic representation of the inherent complexities of the educational context contributes to a more profound understanding of the role of the micro and macro contextual factors in formulating teachers’ professional identity. The implications of this study are further explained.Originality/valueHereby, the authors declare that all the procedures of data collection and analysis have been just done by the researchers.

Concept synthesis of dignity in care for elderly facility residents.

Protecting the dignity of elderly residents of facilities and providing dignified care can be difficult. Although attempts have been made from several aspects, dignity is considered an area in which less real impact has been made in both theory and practice. The objective of this study is to characterize the concept of dignity in care for elderly subjects in residential facilities from a practical perspective through concept synthesis. This study includes in-depth interviews with residents of elderly facilities and a literature review. A total of 12 residents of seven facilities in three prefectures in Japan were recruited via purposive sampling, and 27 interviews were conducted. Each digitally recorded interview was transcribed verbatim. The interview data were analyzed based on hermeneutic phenomenological research. The literature was searched using PubMed, CINAHL, and Web of Science with combinations of terms such as dignity, elderly, and residential facilities and then selected according to the predefined inclusion criteria. The descriptions about dignity in the included studies were divided into codes and compared with the results of the interviews. This study was approved by the institutional review board of Nagoya University's Graduate School of Medicine. There were 1728 data codes for the interviews from which four themes were generated. In the literature review, 3716 titles were searched, and 28 articles were selected. Combining these results, five following themes and a conceptual matrix were obtained: individual dignity not affected by others; dignified care in a narrow sense; elements of the staff side; dignity in relation to family members, friends, society, and other residents; and dignity in relation to nursing care facilities and the nursing care system. According to the established matrix, we must consider the role of the care system, facility, family, and society in providing care with dignity and the individual dignity to residents and dignity in daily care.

Clay handbuilding among children with spinal cord injuries: Towards educational protocol development

This study identifies and describes children with spinal cord injury with paraplegia and examines an intervention that can contribute to nursing education and practice. This qualitative Hermeneutic phenomenological research with multiple triangulations which include data, method, and investigator triangulation, with iterative approach in data analysis were utilized in data collection and analysis. A total of 8 children with their parents or guardians were purposively selected. A semi structured interview, storytelling and clay hand building was used to collect data. Analysis of molded clay figures was done by the child's personal interpretations and further interpreted by an expert in the field of psychology and art therapy. The experiences of children have revealed five themes and seven categories. The children's experiences are as follows; happy memories, representation of illness and hospital confinement, love for family, faith, and hope. Based on the results, an educational protocol for clay hand building was found effective.

Understanding Face and Shame: A Servant-Leadership and Face Management Model.

Clergy can have a negative impact on churches and other individuals when they knowingly or unknowingly attempt to save face, that is, try to protect their standing or reputation. The desire to gain face and the fear of losing face and feeling ashamed will likely permeate clergy's decision-making processes without even being noticed. This study explores the essence of face and face management and the relationship between face management and two characteristics of servant-leadership-awareness and healing-in both Chinese and American churches through the methodology of hermeneutic phenomenology. Prior to this study, to my knowledge, no hermeneutic phenomenological research of face management has been conducted in a church setting. Through a review of the literature, four areas are explored: face and shame, face management, servant-leadership, and face, shame, and face management within the church. This study obtained approval from the Institutional Review Board and informed consent from the participants. Three Chinese and three American Christian ministers were chosen to complete a question sheet and participate in two semi-structured interview sessions. A first cycle of open coding and second cycle of pattern coding were used during data analysis. Face experiences are discussed in light of eight major themes: body, triggers, becoming, face concepts, strategies, emotions, servant-leadership, and the church. Findings from the study help build a servant-leadership and face management model, which can offer an anchored approach for clergy and pastoral counselors to address face and shame and to develop therapeutic interventions.

Examining lived experiences in a professional development program for online teaching: A hermeneutic phenomenological approach

The increased number of courses taught in an online environment has led to more teachers in need of professional development for online or blended teaching. Although various professional development programs have been scrutinised, only a few studies integrate the feelings of teachers during their professional development process. Teachers’ feelings form an inherent part of their teacher-selves and are reflected in their everyday practice. Therefore, this study uses a hermeneutic phenomenological research method to examine the lived experiences – the feelings – of educational staff within a professional development program that targets online and blended teaching. The results indicate that teachers experience a large range of feelings and that these fluctuate throughout the program. These include positive feelings of connectivity, responsibility, and satisfaction, but also more negative feelings of chaos and frustration. The recognition and understanding of these feelings can illuminate particular aspects of professional development that are experienced more positively or negatively, which can guide further efforts for qualitative improvement.

Parents' experiences of videoconference as a tool for multidisciplinary information exchange for children with epilepsy and disability.

To explore the parents' experiences with the multidisciplinary information exchange between different levels of the health- social and school services using videoconference. Children with epilepsy and disability are in need of long-term multidisciplinary help and support. The information exchange between the child's providers of support is challenging. Scant attention has been paid to the parents' experiences of the information exchange. A qualitative study with a phenomenological-hermeneutical research approach. Children with epilepsy and disability had undergone a multidisciplinary assessment in a hospital in the tertiary health service followed by information exchange with each child's local support service using videoconference. Five parents were interviewed individually within a week after the videoconference. The COREQ checklist was used in the process of reporting on the empirical material. The increased local participation in the videoconference and the knowledge translation between the professionals made the parents save time, as they did not have to explain the written reports to each provider locally. The impact of technology created an emotional distance to the person on the screen and the information exchanged that some enjoyed while others disliked. The quality of the relationships to the professionals seemed to be crucial for the parents to feel safe talking about sensitive tasks. The parents prefer videoconference as a tool for information exchange to traditional face-to-face meetings as it enables discussions between professionals that might prevent treatment misunderstandings. They experience the method as time-saving and patient-centred. Professionals should be aware of the possible side effects of the impact of technology that might affect the interaction and the information exchange in a negative way. The findings are likely to be transferable beyond the current context.

Problematic and Damaged Image of a University among Iranian Students: The Lived Experience of Iranian Students at Universities

The current paper tried to explore the lived experience of Iranian students at universities in recent years after commercialization and commodification of higher education followed by limitations on the public and governmental resources of the universities. Thus, a university student is reduced to a customer position. The aim of this research is to study the lived experience of students in an old comprehensive university in the capital of Iran. Since the goal of the researchers was to go near the students themselves to reveal the lived and perceived experiences of them with the interpretive paradigm as a methodology. The hermeneutic phenomenological research method was chosen with deep exploratory interviews as a data gathering tool. Deep exploratory interviews were fulfilled with a purposive sample of 25 university students on the data saturation basis. 250 main propositions were found from these interviews. The most important propositions extracted with the thematic analysis method showed that just 30 percent of experiences were positive but 70 percent of them were negative.