Carolyn Emden

Conducting a narrative anlysis

This paper describes the process of narrative analysis as undertaken within a nursing study on scholars and scholarship. If follows an earlier paper titled: Theoretical perspectives on narrative inquiry that described the influencing ideas of Bruner (1987) and Roof (1994) upon the same study. Analysis procedures are described here in sufficient detail for other researchers wishing to implement a similar approach to do so. The process as described has two main components: (A) strategies of core story creation and employment; and (B) issues and dilemmas of narrative analysis, especially relating to rigour. The ideas of Polkinghorne (1988), Mishler (1986), and Labov (in Mishler 1986a) are introduced in so far as they impinge upon the analysis process. These relate especially to the development of key terms, and to the analysis strategies of core story creation and employment. Outcomes of the study in question are termed Signposting the lived-world of scholarship.

The good, the bad and the relative, part two: Goodness and the criterion problem in qualitative research

This (part two) paper finds the problem of the criterion at the heart of disputes about what constitutes goodness in qualitative research, an ancient philosophic conundrum as to how best represent reality. Ways around the problem are considered, including conceiving criteria as open-ended lists, and enabling conditions. Discussion principally concerns the impact of postmodernist thinking on the topic, and how qualitative researchers might usefully juxtapose the rationality of a modern world (in which notions such as reliability and validity are prized) with a mounting postmodern sensibility that acknowledges irrationality, fragmentation, and uncertainty. Part one of the paper traced efforts to define goodness in qualitative research within various fields, including nursing. Disputes were found to centre on how the traditional concepts of reliability and validity related to qualitative research. In reviewing various sets of criteria of goodness, these concepts were consequently conceived as being championed, translated, exiled, redeemed, and surpassed.

Theoretical perspectives on narrative inquiry

Narrative inquiry is gaining momentum in the field of nursing. As a research approach it does not have any single heritage of methodology and its practitioners draw upon diverse sources of influence. Central to all narrative inquiry however, is attention to the potential of stories to give meaning to peoples lives, and the treatment of data as stories. This is the first of two papers on the topic and addresses the theoretical influences upon a particular narrative inquiry into nursing scholars and scholarship. The second paper, Conducting a narrative analysis, describes the actual narrative analysis as it was conducted in this same study. Together, the papers provide sufficient detail for others wishing to pursue a similar approach to do so, or to develop the ideas and procedures according to their own way of thinking. Within this first theoretical paper, perspectives from Jerome Bruner (1987) and Wade Roof (1993) are outlined. These relate especially to the notion of stories as imaginative constructions and as cultural narratives and as such, highlight the profound importance of stories as being individually and culturally meaningful. As well, perspectives on narrative inquiry from nursing literature are highlighted. Narrative inquiry in this instance lies within the broader context of phenomenology.

A ‘partnership model’ for ethical Indigenous research

This paper describes the methodological challenges and innovative outcomes of a multi-site South Australian project investigating the use of medicines by Aboriginal people with mental health disorders (the full report of the research including outcomes of its various components appears elsewhere). Participatory action research using multiple methods and the epistimology of critical social science, enabled Indigenous research ethics to underpin the project-ensuring cultural relevance and respect throughout. Particular challenges encountered involved navigating mainstream and Indigenous bureaucratic structures, recruitment and training of Aboriginal research assistants from local communities, issues of confidentiality of individuals and families, time management that did not encroach on already stressed communities and workers, and leadership and internal research team issues. Meeting these challenges within the dynamics of a multi cultural project spanning urban, rural and remote Indigenous settings led to the development, implementation and articulation of a ‘partnership model for conducting Indigenous research. This model, together with its four key features-Respect, Collaboration, Active Participation, Meeting Needsis presented for consideration and potential use by other researchers and Aboriginal groups. As no previous research had investigated medication use by Aboriginal people to the depth and extent of this project, the model was necessarily innovative and developmental.

A web of intrigue: the search for quality in qualitative research

This paper reports an investigation about quality in qualitative research. For educatorsand students of nursing and midwifery, it serves as an exemplar for tackling vexing research questions, and as a model for creative research reporting. Practising qualitative researchers (post-doctoral nurses and midwives) from different countries were asked to identify the characteristics of what they considered to be a high quality published report of qualitative research. They then commented upon one anothers characteristics with a view to comparing and compiling ideas. Four themes were identified from the data, relatingto process, writing, outcome and excellence. The study highlights shifts in thinking about determinants of quality in qualitative research over time, and current challenges for researchers, consumers and others in the face of declining interest in quality criteria.A spiders web is used as a met aphor for the study to illustrate the enmeshment and intrigue that the research and its findings generated for the researchers, participantsand onlookers.

Better medication management for Indigenous Australians: findings from the field

This paper reports findings from interviews and focus groups conducted within a multidimensional action research project concerning medication management among Indigenous Australians. Participants were Aboriginal people with mental health problems, carers and family members, and health and social service workers from different regions in South Australia. A meta-analysis of findings from each regional project component was conducted, and major themes conceptualised and developed into a coherent summary. The findings revealed problems of a magnitude not previously realised—mental health problems (including alcohol and drug problems) and medication management among Aboriginal people clearly are major issues requiring immediate and sustained attention if the health and welfare of the Australian Indigenous population are to be improved. Findings concerned eight major areas: social and emotional wellbeing issues; stressors on Aboriginal health services and providers; training for the Aboriginal health workforce; mainstream health services for Aboriginal people; trust and confidentiality within Aboriginal health services; English language literacy and numeracy skills of Aboriginal clients; remote living arrangements for many Aboriginal people; problems with alcohol use; and institutionalised and individual racism in the community at large.

Improving coordination of care for Aboriginal people with mental health, alcohol and drug use problems: progress report on an ongoing collaborative action research project

This paper outlines the background and progress to date of a project to improve the coordination of care for Aboriginal people with mental health and/or alcohol and other drug problems living in the Eyre Peninsula region of South Australia. The project responds to recommendations from previous research by this team in this area, and has been running since 2004. Working with a wide range of health and human service providers, we explored issues that improve or hinder coordination of care and identified useful strategies. Some of these have already been implemented through the project: e.g. interagency cross-disciplinary training in response to shared needs, and lobbying for after-hours telephone help. Other strategies are still in progress: e.g. implementing a uniform triage and referral system and improving information sharing within Port Lincoln Aboriginal Health Service. The paper reflects on our experience of conducting Aboriginal health service research using a participatory action oriented approach, and discusses the challenges in providing effective and well coordinated rural and remote mental health/alcohol and other drug care in the context of complex health and social needs of Aboriginal people.

They were different and few: An Australian study of midwives' attitudes to research and computerised research findings

This study sought to determine factors influencing the utilisation of research findings by Australian midwives before and after exposure to an on-line research database within their practice setting. The setting was a large maternity hospital in South Australia and data were collected via pre and post intervention questionnaires. 14 midwives from the Delivery Suite and Birth Centre of this hospital participated in the study. Midwives showed an increased receptivity to the concept of computerised research findings after exposure to the database. They rated research as highly important to providing quality midwifery care and for the midwifery profession, and saw midwives as the key players in maternity care research. These findings are not in keeping with previous research--largely accounted for, we believe, by the particular, and small number of, midwives who volunteered to participate in the study (24% of those invited).

Nursing research programs gather strength in Australia

To shed light on programmatic research through direct experience is highly beneficial to nursing scholarship. Following a recent description of a successful Australian program of research centered around peoples chronic illness experience we are inspired to continue the commentary (Koch et al 2005). Koch et als (2005) case study reported on several core elements they believe have contributed to the growth and effectiveness of their program. In this paper we consider some of these in light of current literature and our own challenging experiences within several Australian universities. Koch et al (2005) also makes a not too subtle distinction between dedicated research units independent of universities and research programs emanating from academia, suggesting the former are more productive. While one of the authors in the above paper, a UK scholar and nursing academic, makes interesting observations about this assertion, we contend that his UK perspective fails to capture the urgency of establishing nursing research programs in Australian universities. Consequently, we have chosen to extend the discussion about nursing research programs from the perspective of Australian academe, including comment on building productive relationships, strengthening a track record, research and practice as symbiotic processes, competitive funding strategies, and the integral role of research students. The entire commentary is located in a celebratory context of 20 years of Australian nursing education in the university sector, a context not without controversy. We give consideration to the best way ahead for the future of nursing research programs and hope our ideas spark further sharing of experiences.

Improving Indigenous health through better medication management: an overview

This paper provides an overview of a major South Australian research project with implications for the health of all Indigenous Australians. The researchers set out to explore the medication needs of Aboriginal people with mental health problems and found that most Aboriginal people have to deal with profound challenges to social and emotional wellbeing with significant medication implications. No previous research had investigated the problem of medication use by Aboriginal people in metropolitan, rural and remote locations to the depth and extent of this project. The research therefore is of widespread relevance and holds interest for many Indigenous and non-Indigenous individuals and groups, consumers, service providers and policy-makers. As a research team comprising Indigenous and non-Indigenous members, we were committed to implementing strategies in the course of the project with immediate benefit to project participants as well as longer-term impact on improved use of medications. The design of the project enabled these strategic interventions and we are pleased to promote this model to other researchers. Recommendations from the project concern services, coordination of care, carers and family members, workforce education, and community development. Readers are advised where the project report and other published papers can be accessed. The project was funded by the Commonwealth Department of Health and Ageing.