2Philosophy of Caring Inquiry Grounded in care/caring philosophy (Ray, 1981a, b, 1991, 1989,1990, 1994, 2011, 2012)Grounded in phenomenological-hermeneutics (descriptive-interpretive reflection and analysis)Influenced by van Manen, Husserl, Heidegger, Gadamer, Ricoeur, Buber, the philosophy of care/caring, and aestheticsFocuses on the caring relationship in nursing and human experience
3Caring Inquiry Research method that: Seeks to describe the meaning of experience of peopleSeeks to understand a person’s reality and experiencesHonors the human-environment integral relationshipValues individual human beingsValues the nurse/researcher-patient relationshipEmbraces a holistic approach (body, mind, spirit)Approaches the research experience and the participants from a compassionate, loving, and spiritual-ethical view
4Caring Inquiry The Philosophy of Caring Inquiry Caring and love are synonymous. Inquiring about caring touches the heart and translates through the soul, the ‘speaking together’ between the one caring and the one cared for…. the shifting of consciousness from a focus on ‘they’ or ‘I’ to a compassionate ‘we.’(Ray,1991/2012)
5Caring Inquiry Compassion is defined as the following: a wounding of the heart where the other enters into us and makes us other. It is an immersion into the human encounter that also reveals the human, environmental and spiritual [and ethical] contexts that are nursing. In the compassionate way of being, the forms of ‘other’ in consciousness communicate a depth of felt realness or authenticity which is intuitive and depends on the granting to the other to whom one communicates, a share in one’s being.(Ray, 1991/2012)
6Caring Inquiry Caring inquiry as an aesthetic/artistic process: in research (creativity, sensitivity, quality of presencing) attends to both the immanence—communion with and transcendence— reflective intuition and spiritual creativity.Caring inquiry engagement:the compassionate ‘we’ is enacted for caring inquiry-descriptive phenomenology, and interpretation (phenomenological-hermeneutics), and the aesthetic knowing of the experience of caring are the means by which questions about the meaning of caring are illuminated. (Ray, 1991/2012)
7Caring Inquiry: Husserl’s Phenomenology Husserlian Phenomenology: Theory of knowledge, an epistemologyBeing of the worldScience of the mindHow do human beings know?Capture human beings in life world (Lebenswelt)Captures meaningModes of reflection at heart of philosophic and human science thought
8Caring Inquiry: Intentionality Inseparable connectedness of the human being to the worldConsciousing the world: Fundamental structure of consciousness is intentionalAll thinking (imagining, perceiving, remembering, anticipating), thinking about something—Intentionality—Integral evidence: The knower and known are integral through reflectionRetentions (past)Portentions (anticipation of the future),in the NOW, the present
9Caring Inquiry: Essences The ideal or true meaning of somethingUltimate structures (essences) of consciousnessSystematic view of mental content, brought into internal consciousness by cognitive processesObject of experience—the body as a container for the mind (Cartesian—mind-body split)Returning to the things themselves—whatness of a thingThose concepts that give essential meaning to the phenomenon under investigationEmerge in isolation or in relation to each other
10Caring Inquiry: Intuition A technical term relating to the mode of awareness in which the object is not only “meant” but originally givenOne sees what is meantMake lived experience evident to clear intuition (insight)
11Caring Inquiry: Phenomenological Reduction Transcendental Reduction: Eidectic reduction (Ideal form)-Structured ReflectionBracketing presuppositions (suspension)--Outer world not denied but bracketedUniversal essences—Reduction from particular facts to general essencesTo intuit meanings as they are [direction apperception of the whole] in the description of experience
12Caring Inquiry: Heidegger’s Phenomenology Ontology—a study of the modes of ‘being in the world Phenomenology is hermeneutical or interpretive Presuppositions constitute the possibility of intelligibility or meaning Being is being present in the world (German, Dasein—being there)
13Caring Inquiry: Heidegger’s Phenomenology Dasein—human being but also, openness in which entities are revealed in light of beingWorld is revelatoryWorld and person co-constitute each otherThings show up as significant and significance is background for Reflective Understanding
14Caring Inquiry: Heidegger’s Phenomenological Hermeneutics Understanding a persons in context—what a person values and finds significantHermeneutics—interpretationGoes beyond description to discover meaning, uncover hidden phenomena and their meaningsInterpretations based on horizons of meaning we already haveThe ontological path—we can effectively attend to epistemological concerns after we first understand ourselves and what it means to be human
15Caring Inquiry: Hermeneutics: Gadamer Articulated an interpreted within the context of temporality and historicity of human existenceOntologicalTradition is preunderstanding—the total background of prejudices, practices, vocabulary, concepts, hypothesesHuman understanding does not occur through a silent act of self reflection but a dialogical process of linguistic experiences
16Caring Inquiry: Ricouer’s Hermeneutic-Phenomenology RicoeurAll phenomenological description is text interpretation or hermeneuticsWidened the notion of textuality to any human action or situationTo interpret a social situation is to treat the situation as text and then to look for the metaphor that may be seen to govern the textReturns hermeneutics from ontology (understanding as a mode of being) to the question of epistemology (understanding as human science method)—Explanation and understanding in terms of distanciation (keeping a distance emotionally or intellectually and participation)Human science is descriptive and interpretive—no such thing as uninterpreted phenomena
17Human ScienceName that reflects a number of approaches to research e. g., phenomenology, hermeneutics, semiotics, critical social theoryThe study of meaningDescriptive-interpretive studies of patterns, themes, structures, levels of experiential or textual meanings
18Hermeneutic-Phenomenology: van Manen A general concern for examining human values that would restore a sense of meaningfulness, personal relationship—an at “homeness” in the worldIntegrates phenomenology description, hermeneutics (interpretation) and semiotics (signs)Writing the story—textual reflection is where insight occurs“We can only understand something or someone for whom we care.”
19Caring Inquiry Evolution Caring as the essence of nursing as the basis for the research methodologyIntegrates philosophies from Husserlian and Heideggerian, Gadamerian, Ricoeurian, van Manen Phenomenological traditionsMethod seeks integrity—” the thought, word and love/caring” are a synthesisHuman choice to share in the life of anotherCall to a deeper life, integrated wholeness, coming to understand meaning of life world experiences and relationships more fully (the I-Thou relationship (Buber))
20Phases of the Process of Caring Inquiry A. The Intentionality of the Inner Being of the ResearcherResearcher focuses on the meaning of caring in nursing--past, future within the presentFocuses on her/his inner being to reflect on the self and the life of a caring researcher to come to appreciate the “vision” withinRecognizes the research relationship as co-presencing with the other, andFocuses on identifying one’s presuppositions of care and caring in nursingPracticing bracketing to hold in abeyance one’s preshistory and presuppositions about caring in nursing
21Phases of the Process of Caring Inquiry B. The Process of Dialogic ExperiencingSelecting participants for the study grounded within the imaged visionEngaging with the participants to discuss the roles of interviewer and interviewee, and securing informed consent signaturesCo-presencing/sensing the other by recognizing the immediate impact of each other’s being on each other—the compassionate “we”Conversing with participants in tape/digitally recorded, intensive interviews lasting about one hour, about the meaning of caring by asking the phenomenological question, “What is the meaning of care/caring to you in your experience? What is it like to experience caring?
22Phases of the Process of Caring Inquiry B. The Process of Dialogic (Communicative) Experiencing (continued)Engaging in a cue-taking, talk-turning, researcher-bracketed, dialogical-dialectical interactive process based on participants’ experience to penetrate the meaning of and experience how caring is constructed for or understood by the otherResearcher at this time of dialogic interviewing holds in abeyance or temporarily sets aside, his/her knowledge of caring that is a part of his/her embodied consciousnessFlow of interviewing from the lead question of the meaning of the caring experience follows a cue-taking, talk-turning interaction whereby the researcher learns more deeply about the phenomenon of concern or interest from the participant as meaning is probed
23Phases of the Process of Caring Inquiry C. The Process of Phenomenological-Hermeneutical Reflecting and Transforming: The Flow of Analysis occurs through:Reflecting and feeling the presencing of the participants’ beings in one’s consciousnessTranscribing the phenomenological data of the meaning of the art of nursing/caring as texts through an analytic system of computer-assisted programFirst Encounter with Data Analysis:Bracketed reflection (bracketing one’s interpretive tendencies: Pure descriptive phenomenology or receptive knowing in consciousness of the researcher
24Phases of the Process of Caring Inquiry Attending to the speaking of language in the texts. If a transcriber, other than the researcher transcribing the data, the researcher should listen to the digital recordings or tapes at the time of encountering the texts for the first timeDescriptive phenomenology: Highlighting the descriptive experiences (the art of caring in nursing) by using a highlighter pen or device or computer-assisted program to illuminate the participants’ language of experience
25Phases of the Process of Caring Inquiry Interpretive reflecting (hermeneutical thinking or “unbracketed” reflection to reveal the immanent themes (linguistic dimensions) emerging in the text--“Unbracketed reflecting” is the foundation for phenomenological-hermeneutical interpretation—the horizon of meaning of the researcher is brought into being in the dialectic of consciousing the textMoving back and forth in understanding the meaning of the textual data (copresencing and dialoguing with data)
26Phases of the Process of Caring Inquiry Writing and transforming the themes in the transcribed text to cocreate metathemes—linguistic abstractions of the descriptive themesPattern can be identified and is that which persists throughout the dialogic process and is retrievable
27Phases of the Process of Caring Inquiry Phenomenological Reducing and IntuitingTurning to the nature of the transcendental meaning of the phenomenon by grasping the unity of meaning as a direct, unmediated apprehension of the whole of the experience—a universal-a transcendent experience of knowing wherein the researcher as knower makes a connecting leap of insight and the separateness of the phenomenon melds into a whole. The universal is reached by a “coming together” of the variations. Thus, variations or similarities of the experience are intuitively and authentically grasped and constituted in consciousness, the primordial material of sensation out of which arises the knowing of the meaning of experience (insight or new awareness). A new way of thinking and theorizing is opened up for the researcher—this experience may occur at any time; a metaphor may be grasped as the unity of meaning as well.
28Phases of the Process of Caring Inquiry Composing linguistic transformation of the data to themes, metathemes, patterns or metaphor (metatheme and metaphor may be the transcendent experience)
29Phases of the Process of Caring Inquiry D. The Movement of Phenomenological-Hermeneutical Theorizing to a Theory of MeaningPutting together a theory of meaning, which, when constituted by the descriptions, themes, metathemes, and/or metaphor/s, and transcendent unity of meaning becomes the form or structure of the phenomenological meaning of caringThe theory as form may be represented as a visual model showing all the dimensions of the experience
30Phases of the Process of Caring Inquiry A theory in phenomenological philosophy and method may seem contradictory given the fundamental notion of the continuous experiencing process of the living world. However, the idea of theory in this sense is a way of giving form to the intentional acts of the research itself—where the knower and the known are one, are integral (Reeder, 1984), and where the researcher communicates to the world the integrality of understanding of the esthetic act itself (the transformation by the “artist” to bring to speech (in writing or speaking) reflective understanding of a phenomenon—a caring act).Theorizing (and subsequently theory) in this sense aims at making explicit the universal meaning of the whole of the experience—a full description of human actions, behaviors, intentions, and experiences in the lifeworld (van Manen, 2003, p. 20).
31Phases of the Process of Caring Inquiry E. Dialoguing with Written Texts: Examining Similarities and DifferencesRelating the theory of meaning to literary writings in nursing, art, and other literature to enhance the epistemic development of nursing theory—information is expressed by illustrating and illuminating similarities and differences, and differences from phenomenological analytic data and theory or theories previously advanced. The form or structure of the meanings, i.e., the phenomenological theory gives rise to its value in relation to the existing theories or literary works.Recommendations are made for nursing education, administration, leadership, research and practice
32Phases of the Process of Caring Inquiry F. Credibility and Significance of the Process of the Phenomenology of the Esthetic Act of Caring in NursingRecognizingBelievingAcknowledgingMeaning convince, and the meanings of the experience enlarge human awareness directly or expand the range of human perception with new ways of experiencing. Deepening and expanding the possibilities of being—the quality of making humans more human, humane, moral and spiritual.
33Phases of the Process of Caring Inquiry Affirming and ConfirmingThe dynamics of the significance of the research are expressed and understood not as agreement, conformity or generalization, but moving toward the universal which is paradoxical. The universal is deep. It is a sympathetic relationship through which the researcher is transposed into the interior lives of others. It is undifferentiated wholeness or caring wisdom, a reflective symmetry, which brings together into a unity the reflective interiority of the researcher with the possibilities or traditional contradictions of historical-cultural horizons of meaning. The transformations or possibilities in experiencing (the epistemological) are open or available to all readers in the reflective symmetry or the synthesis encapsulated in the theory of meaning (the phenomenological nod –recognizing it as an experience we have had or could have (Buytendijk, 2003, p. 27).
34ReferencesBuber, M. (1958). I-Thou (Trans. R/ Smith)(2nd ed.). New York: Collier Books, Macmillan Publishing Company.Leininger, M. (2012). Caring-an essential human need: Proceedings of three national caring conferences. In M. Smith, M. Turkel, & Z. Wolf (Eds.), Caring in nursing classics: An essential resource. (pp ). New York: Springer Publishing Company.Ray, M. (1985). A philosophical method to study nursing phenomena. In M. Leininger (Ed.), Qualitative research methods in nursing (pp ). Orlando: Grune & Stratton, Inc.Ray, M. (1990). Phenomenological method for nursing research. In N. Chaska (Ed.), The nursing profession: Turning points (pp ). St. Louis: Mosby.
35ReferencesRay, M. (1991). Caring inquiry: The esthetic process in the way of compassion. In D. Gaut & M. Leininger (Eds.), Caring: The compassionate healer (pp ). New York: National League for Nursing Press.Ray, M. (1994). The richness of phenomenology: Philosophic, theoretic, and methodological concerns (pp ). In J. Morse (Ed.), Critical issues in qualitative research. Thousand Oaks, CA: Sage Publications.Ray, M. (2011). Complex caring dynamics: A unifying model of nursing inquiry. In A. Davidson, M. Ray & M. Turkel (Eds.), Nursing, caring, and complexity science: For human- environment well-being. New York: Springer Publishing Company.
36ReferencesRay, M. (2012). Caring inquiry: The esthetic process in the way of compassion . In M. Smith, Z. Wolf & M. Turkel (Eds.), Caring classics in nursing. New York: Springer Publishing Company.Reeder, F. (1984). Philosophical issues in the Rogerian science of unitary human beings. Advances in Nursing Science, 8(1),Reeder, F. (1988). Hermeneutics. In B. Sarter (Ed.), Paths to knowledge: Innovative research methods for nursing (pp ). New York: National League for Nursing Press.Smith, M., Turkel, M. & Wolf, Z. (Eds.)(2012). Caring in nursing classics: An essential resource. New York: Springer Publishing Company.