Roxanne Vandermause

Philosophical Hermeneutic Interviewing

This article describes, exemplifies and discusses the use of the philosophical hermeneutic interview and its distinguishing characteristics. Excerpts of interviews from a philosophical hermeneutic study are used to show how this particular phenomenological tradition is applied to research inquiry. The purpose of the article is to lay out the foundational background for philosophical hermeneutics in a way that clarifies its unique approach to interviewing and its usefulness for advancing health care knowledge. Implications for health care research and practice are addressed.

First-time mothers preparing for birthing in an electronic world: internet and mobile phone technology

Background: As the twenty-first century moves forward, we are witnessing a surge of self-educating with electronic media (e.g. internet sites, mobile phone technology, television and/or videos). This phenomenon is deeply embedded in perinatal education and warrants an in-depth investigation to uncover the meaning of how mothers self-prepare with electronic media for birthing in hospitals. Methods: A sequential mix of two qualitative designs commenced. A preliminary descriptive design, involving three focus groups (childbirth educators, n = 5; obstetric providers, n = 6; and labour and delivery nurses, n = 1), was conducted to inform researchers of provider perceptions of childbearing women self-preparing with electronic media. Then, a primary hermeneutic (interpretive) design was used to conduct one-to-one in-depth interviews from a purposive sample (n = 7) of young first-time mothers (FTMs). Results: The preliminary descriptive findings suggested that interviewing young FTMs self-preparing for birthing in hospitals was warranted. A primary hermeneutic (interpretive) design revealed that FTMs were preparing with electronic media for what ifs based on what is known about birthing. At times, this educated the mothers and some became more knowledgeable or informed; however, there was also a debilitating effect, which increased the mothers’ level of anxiety and fear. Conclusions: Providing credible electronic linkages, mobile phone technology, videos and access to provider and hospital websites, guided by their care providers, is imperative for educating mothers. By addressing mothers’ needs, women may be better able to birth with confidence as they enter the electronic world of preparing for birthing in a hospital.

Being wholesome: The paradox of methamphetamine addiction and recovery – A hermeneutical phenomenological interpretation within an interdisciplinary, transmethodological study

This article presents a Heideggerian hermeneutic interpretation of findings from an interdisciplinary, transmethodological study addressing the questions, ‘What does it mean to experience methamphetamine addiction? What does it mean to recover?’ Study aims, to: (1) uncover the meaning of addiction and recovery via case intensive analysis, and (2) generate an interdisciplinary, transmethodology for understanding complex healthcare problems, were intended to stimulate a deeper understanding of the experience of addiction and recovery through an innovative methodological approach. Scholars from Nursing, English, Teaching and Learning, and Fine Arts contributed to the analysis. This article presents the hermeneutic interpretation of the transmethodological study.

Metaphors of Distress Photo-Elicitation Enhances a Discourse Analysis of Parents’ Accounts

In research on sensitive topics, photo-elicitation can be a profound aid to data collection and interpretation processes. Photo-elicitation methods were used in this manner in a discourse analysis of parents’ distress at least 6 months after preterm birth. After an initial interview, participants were asked to take digital photographs representing their distress and to return for a second interview to discuss the photographs. The elicited photo representations supported participants’ engagement with their current or past distress and generated new meanings from the reappraisal of old photographs. Photo-elicitation demonstrated the embodiment of parents’ distress in the child and the placement of distress in specific locations. Photographs of documents showed the power of the written word in generating and maintaining distress. Participants used existing photographs from their child’s photo history to generate rich metaphors for their distress as parents. These findings have implications for enhancing interpretive health research by incorporating photo-elicitation methods.

Goal Setting With Type 2 Diabetes A Hermeneutic Analysis of the Experiences of Diabetes Educators

Purpose The purpose of this study was to explicate and interpret common experiences of diabetes educators (DEs) with patient goal setting for patients with type 2 diabetes in diabetes education. Methods Transcripts (n = 10) from semi-structured interviews were analyzed using a hermeneutic phenomenological approach to more deeply explore the accounts of DEs’ goal setting with patients with type 2 diabetes. Results The overarching pattern that emerged was “Striking a Balance,” which subsumed 4 subthemes: Applying Theoretical-Practical Principles When Setting Goals, Identifying Idealistic-Realistic Expectations, Creating Patient-Educator–Centered Plans, and Readying-Living With Goal Setting. The pattern, “Striking a Balance,” revealed a common meaning of DEs as experiences requiring balance and nuance in goal setting with patients. Implications The results of this study combined with the tenets of the self-determination theory can provide the DEs with real-life exemplars and a theoretical framework to encourage their patients to self-manage, increase intrinsic motivation, and improve adherence related to their lifestyle changes and glycemic control. DEs, as facilitators of change, can implement these changes with flexible and reciprocal activities with their patients. The DEs owned these activities and they are: “building the bond,” “sharing the session,” “readying for change,” “sending them home,” and “bringing them back.”

See My Suffering: Women With Alcohol Use Disorders and Their Primary Care Experiences

Despite global initiatives to improve the primary care of 2.5 million US women meeting criteria for alcohol use disorders (AUD), many women with serious problems are unseen, misunderstood, misdiagnosed, or ignored. This interpretive phenomenological study explored the meaning of the primary care experience for a small group of women with self-identified AUD. Interviews uncovered suffering. Subsuming themes of Presenting My Damaged Self and Being Silenced/Being Heard revealed potential interventions for primary care practitioners. Analyzed alongside extant literature on suffering, these findings complement and enhance recent important research in the area of diagnosis of and intervention for AUD in primary care.

Assessing for Alcohol Use Disorders in Women: Experiences of Advanced Practice Nurses in Primary Care Settings

&NA; Alcohol use disorders (AUD) in women patients are frequently missed in primary care settings. This study explores common assessment practices by advanced practice nurses prescribers (APNPs) in one Midwestern state. Transcribed, in‐depth interviews with 23 APNPs were analyzed using Heideggerian hermeneutic research methods. Two patterns emerged from an overarching idea of Becoming Aware: 1) Recognizing Alcohol in Everyday Life and 2) Attending to HER Story. The first pattern revealed ways nurses approach and think about assessing for AUD in women. The second pattern revealed practices of listening and responding to womens unique and complex stories. Findings inform education and practice by raising new questions and suggesting possibilities for education and research.

Teaching thoughtful practice: Narrative pedagogy in addictions education

Preparing practitioners for this rapidly changing and demanding health care environment is challenging. A surge in knowledge development and scientific advancement has placed a priority on technical skill and a focus on content driven educational processes that prepare students for evidence-based practice. However, the most difficult health care scenarios require thinking-in-action and thoughtfulness as well as didactic knowledge. It is our contention that interpretive educational methods, like narrative pedagogy, will promote judgment-based practice that includes use of evidence and delivery of thoughtful care. In this article, we describe and interpret a narrative approach to addictions content and teaching thoughtful practice. We present our pedagogical process, including observations and field notes, to show how interpretive pedagogies can be introduced into nursing curricula. By presenting this process, the reader is invited to consider interpretive methods as a way to inspire and habituate thoughtful practice and judgment-based care.

Qualitative Methods in Patient-Centered Outcomes Research:

The Patient-Centered Outcomes Research Institute (PCORI), created to fund research guided by patients, caregivers, and the broader health care community, offers a new research venue. Many (41 of 50) first funded projects involved qualitative research methods. This study was completed to examine the current state of the science of qualitative methodologies used in PCORI-funded research. Principal investigators participated in phenomenological interviews to learn (a) how do researchers using qualitative methods experience seeking funding for, implementing and disseminating their work; and (b) how may qualitative methods advance the quality and relevance of evidence for patients? Results showed the experience of doing qualitative research in the current research climate as “Being a bona fide qualitative researcher: Staying true to research aims while negotiating challenges,” with overlapping patterns: (a) researching the elemental, (b) expecting surprise, and (c) pushing boundaries. The nature of qualitative work today was explicitly described and is rendered in this article.

Teen experiences following a suicide attempt

Teen suicide is the third leading cause of death for 15-24year olds. A clear understanding of what the experience of being suicidal means to adolescents living the phenomenon has not been clearly addressed in the literature. The aim of this research was to generate a comprehensive interpretation of the experiences of six adolescents who visited the ED following a suicide attempt, using hermeneutic phenomenological methodology. Participants ranged in age from 15 to 19years old, and all had been hospitalized for their attempt. Two patterns emerged: attempting as communicating and attempting as transforming. Underlying themes are described in detail. The findings have implications for nursing practice including how to assess and intervene with adolescent suicide attempters.