1. Phenomenology Qualitative Research Method
“Its Not Easy Being Green”
By Ronda Hildebrand, Chris Bikakis, Carol Lewallen,
Robin Koster & Rachel Wurth

2. Objectives At the end of this presentation, the learners will be able to...
State some of the key assumptions of phenomenology based research
Discuss the philosophical base of the method.
Indicate when this method is appropriate for research and identify appropriate research questions.
Discuss methods of data analysis and how results are presented
Analyze and critique published research done using this method.

3. Key Assumptions Humans coconstitute situations. (Parse 2001)
Coconstitution “refers to the coauthoring of relationships in which participants choose a way of being in a situation with each other. This way of being co-creates the emerging relationship as it continuously unfolds in the betweeness of the participants”.
Individuals are viewed as active participants interpreting their own experience and creating themselves through their own choices. The world we live in is constantly changing and evolving where all people have different histories, cultures and perceptions of the world.

4. Key Assumptions
Knowledge about human experience is expanded by allowing essences of phenomena to appear through descriptions without predictable prescriptions. (Parse 2001)
Truth is all in the interpretation of the phenomena, the more it is interpreted the more factual it becomes. It may only be specific to certain individuals and under varying conditions. The subjective experience of an individual or group is valued and described. Meanings can only come from the source and can not be presumed or assumed.

5. Key Assumptions
Knowledge about human experience is gained from retrospective descriptions of lived experiences. (Parse 2001)
Knowledge is gained from listening to the language, hearing what is being revealed while at the same time hearing what might be concealed.
2 different people may experience the same event and describe it using a different language, different verbage, but it may have the same meaning.

6. So What Does All This Mean?
Phenomenology represents a philosophic and human science research method that studies the lived experience of persons while remaining sensitive to the uniqueness of the person.
Instead of predicting and hypothesizing, phenomenology seeks to assign possible meaning and significance to a phenomena.
It opens possibilities and questions –what is the difference between “being” and “living”? Or “What is the meaning of being human?”

7. Philosophical Base
Phenomenology is both a research method and a philosophy
The phenomenological movement arose in Germany in the late 19th century.
Early philosophers were trained in religion, philosophy, mathematics, or physics.

8. Philosophical Base Edmund Husserl’s descriptive phenomenology
Martin Heidegger’s interpretive phenomenology (also called hermeneutics)
Many interpretations of phenomenological philosophy, we are focusing on the two most common used in nursing research

9. Philosophical Base Husserl Heideggar Three components to this approach
Essences
Intuiting
Phenomenological reduction (Bracketing) or setting aside all previous experience including the existence of other subjects.
Presuppositions and relationships are viewed as necessary to understanding and they should not be suspended.
Experiences can be understood in a new way by recognizing historical influences and meanings of past traditions.
Husserl believed the way to understand phenomena was through descriptions by those experiencing the phenomena. He limited his focus to individual personal experience and did not explore how others people might experience a phenomenon.
Essence – moving beyond individual cases allows for the development of ideal types of logical experience
Intuiting – allowed for deconstruction and reconstruction of previous ideas
Bracketing this is the primary difference between the two – Reduction brackets out personal prejudices, perceptions, commitments and biases transcends the subjectivity of the researcher. It is a an effort to maintain objectivity.

10. Philosophical Base
The French phase (during WWII) sought to intertwine objectivity and subjectivity.
Key figures were Gabriel Marcel, Jean-Paul Sartre and Maurice Merleau-Ponty.
Objectivity and subjectivity are united to form the human experience.
North American phenomenology will focus on describing the lived experiences within the context of a participants culture rather that searching for universal meaning.

11. Philosophical Base
While the assumptions of phenomenology are similar to the values of holistic nursing, interpretations of the many different forms of phenomenology have led to controversy.
“Nursing is a human science that focuses on individuality, is holistic in nature, and involves concern for human responses” (Dinkel 2005 p.8)
This is the one common belief among the nursing theorist

12. Why do nurses use phenomenology?
Nursing is a human science that focuses on providing individualized care.
Nursing is holistic in nature.
Nursing is concerned with human responses and experiences.

13. The concern of phenomenology
Phenomenology is concerned with the subjective experience, which is considered to be more real and more important in the understanding of human nature and human experience.
It focuses on the person’s lived experience within a phenomenon, including shared meanings and commonalities.

14. The phenomenological movement
Three main phases:
German phase with Husserl, the father of the movement (descriptive) and Heidegger (interpretative and hermeneutics)
French phase which influenced psychology and psychiatry.
Dutch phase (combining descriptive and interpretative methods
A new phase? The North American focus.

15. Phenomenology Main methods: Main types:
Interview (relaxed)- to explain experiences fully and deeply until nothing further to say
Group interviews
Diaries or journals
Audiotapes
Videotapes
Participant observations
Main types:
Descriptive
Interpretative
Hermeneutics

16. Phenomenological Research
Purposive sampling – participants have knowledge of a phenomenon
Small sample size – until saturation achieved
Usually relaxed interviews – from minutes.
Conducted in comfortable environment or natural environment of participants

17. Basic components of phenomenology
Intuiting
Bracketing
Identifying the essence
Describing
Examines lived experiences or phenomenon
Essences or the most essential meaning for
Participants are co-researchers and co-create meaning
No causal inference

18. Sample questions
What are the lived experiences of being clinical educators?
What are women’s expectations and experiences of childbirth?
What is the lived experience of pain during childbirth?
What is the lived experience of adolescents living with depression?

19. Sample questions
What is the lived experience of cardiac patients waiting for a heart transplant?
What is the lived experience of grieving the loss of a loved one?
What are the essential features of loneliness?
What is the lived experience of families with a child who has cancer?

21. Phenomenological Research Analysis
Remember- the intention is not to generate theory or determine causality- but rather to describe and possibly understand the essence of the concept by giving voice to the human experience just as it is.

22. Phenomenological Analysis- A few things to know
Phenomenologists are sometimes reluctant to focus or refer to steps (too scientific)
TIME CONSUMING
Only people who have lived the reality of the subject are legitimate sources of data- so always retrospective
Most usual data source is verbatim transcripts of interviews
Horizontalisation- All elements of data are initially deemed equal

23. Phenomenological Analysis- Becoming one with the data....Yes, Parse Terms
Intuiting
Analyzing
Describing

24. Phenomenological Analysis - Handout
Multiple “methods’ devised-some common features simplified regarding data:
The division of text into units
The transformation of units into meanings (also called phenomenological concepts)
The tying together of transformed meanings/concepts to general description of the experience

25. Presentation of Results
Themes/Essences/ Patterns/Common Concepts are identified.
Then a comprehensive description of the phenomena being considered is told- much like a story.
Often quotes are used. An understanding of a lived experience should occur for the reader.
“Informational needs and the experiences of women with abnormal Papanicolaou smears”- next two slides.

27. Dealing with stigma
Several participants indicated a burden of shame when
they learned that their abnormal Pap smear was a result of
an HPV infection:
Many years ago when my aunt had cervical cancer
people were very supportive but they had no idea that
it had anything to do with HPV. But now it’s different.
I feel like I won’t get that support because no one is
going to feel sorry for someone who got a sexually
transmitted disease and then later developed cervical
cancer because of it . it’s like it’s your fault . it’s
horribly embarrassing.
Social stigma was also characterized by an altered self-image
represented by feeling contaminated, feeling a sense
of anger and unfairness because they considered themselves
at low risk for acquiring a sexually transmitted
infection. The terms clean and dirty were used to describe
a physical self-concept associated with social stigma:
The first lady [healthcare provider] I went to made me
feel like I wanted to zip myself up in a Ziploc bag. All
the information I got was that it was super serious and
it’s a communicable disease like hepatitis or HIV.

28. Strategies to Ensure Rigor
Validity- to increase the trustworthiness of the interpretations of the date
Prolonged engagement with the data
Verification with the participants/source
Peer evaluations- regularly present for debriefing

29. Strategies to Ensure Rigor
Reliability – to increase consistency of procedures/data generated.
Disclose personal orientation/context.
Intensive engagement with material and iterations between data & interpretation
Technical accuracy with recording/transcribing

30. Phenomenon

31. Nurses’ Experiences of Drug Administration Errors
Qualitative Critique
Nurses’ Experiences of Drug Administration Errors

32. Why? Purpose of research? Kermit is an investigative reporter
Purpose well defined: Describe the experiences of nurses who had committed serious medication errors, the meanings these experiences carry, and what kind of help and support they received after committing their error.

33. Appropriate Qualitative Approach
Was exploring, interpreting or obtaining a deeper understanding of a clinical issue the objective?
Exploration of the meanings the medication errors experiences carried
Kermit as explorer

34. Settings & Participants
True Random Sample
Wide range of experiences within group
Sample: Having been the main person involved in a medication error event which a governing board defined as obligatory to report; an event that led to, or could have led to, substantial injury to the patient
Participants:
Wrong route, patient, drug or dose
Nurse for 6 months to 30 years
All female, some specialists
7 worked in hospital, 2 in community services & one in nursing home
Only one committed previous nursing error
All errors were reported with appropriate action taken to prevent harm to pts.
One pt. severely & permanently harmed
One nurse no longer practicing due to med error

35. Data Collection Methods
Enough information given about collection
Sensible & adequate way to address research question?
Interviews:
Tape recorded, consent obtained
Asked “Please tell me about your medication error”
Follow up questions open “How did it make you feel? & What happened then?”
Devised thematic guide for use in interviews
Addressed specific areas highlighted by lit review
Immediate reaction from nurse when realization of med error
Emotional response to error
Relations with pts. & family after error
Colleagues & managements reactions to the nurse after
Support & Coping
Impact on practice
Validity & Reliability
Ethical considerations

36. Data Analysis Method Systematic way of analyzing data?
Examples sought which contradict the majority?
Kermit recording responses
Data Analysis: Procedural approach to phenomenological interpretation & analysis
Inspired by Husserlian transcendental phenomenology
3 steps
Essences
bracketing

37. Credibility & Importance
Use common sense to determine if results are sensible & believable
Do results matter in practice?
Is actual data sited?
Are results independently & objectively verifiable & traceable?
Kermit in suit
Emotional responses
Relations with pts & families
Reactions from colleagues & management
Help, support, candour & coping
Impact on practice
Study limitations

38. Conclusions
How well does the analysis explain why people behave in the way they do?
How comprehensible would this explanation be to a thoughtful participant in the setting/
How well does the explanation cohere with what we already know?
Traumatic/devastating event seen as personal & professional threat
Need support from peers and managers
Systems approach to human error in nursing practice is essential

39. Critique of Phenomenology Study
Vulnerable and Strong

40. Critique What is the study purpose?
To describe the maternity care experiences of a sample of lesbian couples
Does the question lend itself to using phenomenology method?
Each participant lived the experience
Little is known
Sensitive topic 1
2 – to be phenom- the researchers belilefs have to be incorporated into the data
2 this method is used to study area where little is known or sensitive topics (donalek 516)

41. Why did the researcher believe there was value in this study?
To address the reported “lesbian baby boom”
All women feel powerful experiences of life, death, vulnerability and solitude during “maternity care”
Healthcare providers should see each woman as individuals, regardless of patient’s “culture”, be professional while providing empathy
Lesbian patients could benefit if providers had increased knowledge and ethical aspects of these specific encounters
1 paragraphs or
BUT ALL VERY STERILE AND NEVER RELATED BACK TO THE RESEARCHERS PERSONALL INTEREST
to be phenom- the researchers belilefs have to be incorporated into the data DONALEK
Maternity care later defined as getting pregnant alll the way through delivering and a few weeks after baby born

42. Method & Data Analysis
Did participants live the phenomenon in question and did the research incorporate his or her own beliefs?
Were the participants willing to describe their experiences? How?
What about the setting or researchers showed successful interviewing?
How did the researcher successfully interpret the data?
1 – to be credible documentation of this process must exist – from selection or topic to collection of data and analysis
In the background – the researcher quoted many studies regarding areas of concern (disclosure – options for conception – partner involvment – legal considerations but all OBJECTIVE
Why did the researcher choose this topic? – the very last page in ACK is where it becomes apparent
thanks to baby M who inspired the idea
Did the researcher respond to participants narrative?
What did the researcher focus on
This process makes it bcome phenom
2 – written or verbal?
Verbal
The participants were able to CHOOSE whether to be interviewed jointly or single
3 –Interview is sensitive and engaging –
Participants allowed to choose setting and were uninterupted and allowed to withdraw at any time
- participants are coresearchers – jointly explore – work together to create meaningful description –
SENSITIVE – the participants will able to choose the setting- (5 of 6 choose their homes)
It is not evident that the researcher is a integral part
4 – the researcher dwells/ spends time on the descriptions and narratives that were provided
Identifes and extracts themes and
Integrates all this into meaningful description

43. Method & Data Analysis Specific opening question provided in the study
Validity
Specific opening question provided in the study
Open narrative and only interrupted if clarification needed
3 phases of interpretation defined (Intuiting, Analyzing, Describing)
VALIDITY – is it supported by a presentation of the decision path in the process of the study
VALIDITY Did the final product allow the reader to follow the process of discovery
3 PHASES of interpretation –
1 - naïve reading…. The researcher gained an overall impressin of the meaning of the lived experience of lesbian maternity services
performed without any attempt at analysis?? NOT GOOD???to be phenom- researchers belifs have to be incorporated into the data DONALEK
2-structural analysis….divided reading into units of meaning… like sentence parts with related meaning… GOOD …
the meaning units were condensed and themes and subthemes identified GOOD –
3 – Comprehension developed – text read as a whole and transform meanings and concepts GOOD – This is where the author addresses preunderstanding being taken into consideration but never really defines what that preunderstanding was and if jived with reading BUT NOT GOOD
RELIABILITY – Can the reader see the accuracy – distinguish personal involvement – was there time and intesity between data and interp
3 – RIGOR – did the researcher return their conclusions to the participants for follow up and to get their response?
did the researcher share the conclusion with others that lived the same experience
Only 2 participants revisited – the participants checked for recognizability but did not give response but it does mention that in the interniew process that participants remarked that telling their story brought about new relections BUT IT WAS NOT AS A RESPONSE T THE STUDY FINDINGS

44. Method & Data Analysis Every participant was interviewed by researcher
Reliability
Every participant was interviewed by researcher
Every participant was a lesbian mother
Interviews recorded and transcribed verbatim by the researcher
Documented that there was discussion with study supervisor re design and data
VALIDITY – is it supported by a presentation of the decision path in the process of the study
VALIDITY Did the final product allow the reader to follow the process of discovery
3 PHASES of interpretation –
1 - naïve reading…. The researcher gained an overall impressin of the meaning of the lived experience of lesbian maternity services
performed without any attempt at analysis?? NOT GOOD???to be phenom- researchers belifs have to be incorporated into the data DONALEK
2-structural analysis….divided reading into units of meaning… like sentence parts with related meaning… GOOD …
the meaning units were condensed and themes and subthemes identified GOOD –
3 – Comprehension developed – text read as a whole and transform meanings and concepts GOOD – This is where the author addresses preunderstanding being taken into consideration but never really defines what that preunderstanding was and if jived with reading BUT NOT GOOD
RELIABILITY – Can the reader see the accuracy – distinguish personal involvement – was there time and intesity between data and interp
3 – RIGOR – did the researcher return their conclusions to the participants for follow up and to get their response?
did the researcher share the conclusion with others that lived the same experience
Only 2 participants revisited – the participants checked for recognizability but did not give response but it does mention that in the interniew process that participants remarked that telling their story brought about new relections BUT IT WAS NOT AS A RESPONSE T THE STUDY FINDINGS

45. Method & Data Analysis Rigour
Joint interviews provided shared and in- depth narrative
Focused on 3 phases as opposed to follow up
Only 2 participants revisited , no response recorded
VALIDITY – is it supported by a presentation of the decision path in the process of the study
VALIDITY Did the final product allow the reader to follow the process of discovery
3 PHASES of interpretation –
1 - naïve reading…. The researcher gained an overall impressin of the meaning of the lived experience of lesbian maternity services
performed without any attempt at analysis?? NOT GOOD???to be phenom- researchers belifs have to be incorporated into the data DONALEK
2-structural analysis….divided reading into units of meaning… like sentence parts with related meaning… GOOD …
the meaning units were condensed and themes and subthemes identified GOOD –
3 – Comprehension developed – text read as a whole and transform meanings and concepts GOOD – This is where the author addresses preunderstanding being taken into consideration but never really defines what that preunderstanding was and if jived with reading BUT NOT GOOD
RELIABILITY – Can the reader see the accuracy – distinguish personal involvement – was there time and intesity between data and interp
3 – RIGOR – did the researcher return their conclusions to the participants for follow up and to get their response?
did the researcher share the conclusion with others that lived the same experience
Only 2 participants revisited – the participants checked for recognizability but did not give response but it does mention that in the interniew process that participants remarked that telling their story brought about new relections BUT IT WAS NOT AS A RESPONSE T THE STUDY FINDINGS

46. Conclusion Is the description simple in identifying themes?
Is there an exhaustive essential description
Can the reader see the central theme or phenomeneon
Did the researcher express alternatives?
Again – did the researcher live with the data?
Did the researcher take ultimate responsibility for final description?
In the methodological considerations the acknowledgment is addressed that the reasearcher took an outsider perspective and may have affected willingness to be open and probably focused on different themes than an insider researcher would have

47. Conclusion Is the description simple in identifying themes?
YES, simply stated 3 main themes; being open, being exposed and being confirmed also presented in graph
Is there an exhaustive essential description
YES, then the author gives in-depth description of each theme
Can the reader see the central theme or phenomenon
YES in reading the excerpts and detailed description
Did the researcher express alternatives?
how provider contributes to lesbian maternity experience or caring by taking responsibility
Is the description simple in identifying themes? Findings and table 1
Is there an exhaustive essential description - pages 480 – 483 quotes provided
Can the reader see the central theme or phenomeneon – the acknowledgment that the participants had to check their confidence and if perceived “looks” or prejedices were true or if they were being overly sensitive
Often the particpants talked of bad encounters as “maybe it was us or maybe that is just them bieng who the are”
the couples positive attitude contributed to their experiences 484
Was anything removed from the description? Description felt complete bc of use of words like “bitch”
Did the researcher express alternatives?
The researcher addressed the obligations of the providers and how it fits with what the participants said in their interiviews
Also pointed out that feminist and political aspects appeared but were not addressed
Concludes that the caring moment betwee nurse and patient is opportunity to achieve dtranspersonal caring with authenticity and genuine presence
Again – did the researcher live with the data?
Did the researcher take ultimate responsibility for final description?
In the methodological considerations the acknowledgment is addressed that the reasearcher took an outsider perspective and may have affected willingness to be open and probably focused on different themes than an insider researcher would have

48. Closing Thought
“Doing phenomenological research is a challenging, exciting, and at times exhausting process. The researcher is forced into a sometimes uncomfortable self-awareness as she plums not only the meaning of the phenomenon for participants but her own responses. The final research product can provide a real sense of satisfaction for the researcher, an often expressed sense of meaningful contribution by the research participants, and insight and understanding for the reader.” Julie Donalek, 2004

49. The End
Phenomenon!
Doo dooo do do do
do doo do do

50. References
Dinkel, S. (2005). Phenomenology as a nursing research method. The Kansas Nurse, 80(5), 7-10.
Dowling, M. (2003). Hermeneutics: an exploration. Nurse Researcher, 11(4),
Jasper, M. (1994). Issues in phenomenology for researchers of nursing. Journal of Advanced Nursing, 19(2),
Leininger, M. (1988). Caring: An essential human need. Proceedings of the Three National Caring Conferences (pp ). Detroit, Michigan: Wayne State University Press.
Munhall, P.L. (2007). Nursing research: A qualitative perspective. (4th ed.). Sudbury, MA: Jones and Bartlett Publishers.
Parse, R. (2001). The phenomenological method. Qualitative inquiry: The path of sciencing. Boston, MA: National League for Nursing.
Priest, H. (2002). An approach to the phenomenological analysis of data. Nurse Researcher, 10(2),
Schelbred A. & Nord, R. (2007) Nurses’ experiences of drug administration errors. Journal of Advanced Nursing 60(3), 317–324.
Spidsberg, B.D. (2007) Vulnerable and strong – lesbian women encountering maternity care. Journal of Advanced Nursing 60(5), 478–486.
Van der Zalm, J.E. & Bergum, V. (2000). Hermeneutic-phenomenology: providing living knowledge for nursing practice. Journal of Advanced Nursing, 31(1),