Janice M. Morse
6
THE BATTLEFIELD OF KNOWLEDGE: DIFFERENT PURPOSES, DIFFERENT APPROACHES
“It’s a bird.” “It’s a plane.” “It’s Superman!”
—Maxwell and Duchovny (1939)
As our perception of something changes, and we see the “thing” more clearly, so our understanding of whatever the thing is, also changes. The “thing” itself does not change, of course, just our understanding, or perception of it.
Our perceptions are manipulated by various mechanisms. The one you experienced when you read Bohannan’s “Shakespeare in the Bush” (Chapter 3) was a cultural frame. Our culture indoctrinates us from the earliest age, providing us with sets of values and beliefs, and sets of ways to view the world. Our own culture connects us by groups but also divides us by race, nationality, gender, occupational group, religion, age, politics, and economic status. You can name any of these demographic divides by characteristics that sort us as “like me” and “not like me.” But it is also true that culture separates us from others. As we learned from the Tiv, culture gives us all the confidence of believing that we alone are right.
Research has an equal set of such frames—frames that provide us with different approaches of seeing the phenomenon we are researching. And with the equal force of a belief, some regard these frames as correct and incorrect, right and wrong, and worthy or not worthy of teaching, funding, publishing, and using the results.
But we hope we are wiser than our colleagues who divide. We see these frames, these alternative ways of seeing and doing research, as alternative tools with different purposes, different goals, and different outcomes. Considering the selections, the onus is on you to recognize the difference, and to select the correct “frame” for your task in hand.
For decades, debates have argued over the objectivity of science, but for the purposes of this book we will assume that no research is value-free. Even the selection of your topic is something that has come to your attention as “being interesting,” “being in need of research,” or even “important to understand.” But, the trick when doing research is to be able to recognize one’s values, beliefs, culture, background, and interests that have led to your present position. Whether one approaches research objectively and supposedly without bias, or subjectively, with the need to access the phenomenon subjectively overriding objective technique, one may come to understand one’s own lens with which one views reality.
A lens is the broad perspective that one overlays a problem, providing a paradigmatic perspective on the way you see the world.1 For example, the perspective of feminism may adjust your gaze to give your research a particular agenda: you may passionately believe that your research will improve the status of women, will bring the plight of women to the attention of others, and so forth, so that your research, either objectively or subjectively conducted, will allow you to view the world from the perspective of a feminist, and to ask research questions that will explore the plight of women.
Another such lens may be adherence to culture as a framework, so that all of your research explores cultural beliefs and practices, differences in behaviors, health and illnesses, and so forth. One may write as an ecologist, considering environmental concerns; or as a humanist, focusing on the plight of the poor. One may adhere to the writings of a particular theorist (and, for instance, be considered a Marxist), or have a perspective, such as feminism, or a theoretical stance, such as the social determinants of health.2
These perspectives often follow disciplines, and as a result are closely tied to the set of concepts of interest. For instance, if you are a nurse physiologist, you will be interested in the physiological concepts and theories that address physiological processes such as homeostasis. If you are interested in gerontological nursing, you may be interested in concepts concerned with aging. Someone who is interested in the nurse–patient interaction may have a list of concepts that includes:
• Concepts important for the nurse and the patient: trust, respect, privacy, and dignity
• Concepts important for the nurse: acknowledgment, empathy, sympathy, commiserations, condolence, compassion, reflective listening, being with, and presence
• Concepts important for the patient: hope, dignity, suffering, sorrow, grief, and despair
Concepts that are associated with a single topic are usually called “concept families.” They may be separate, addressing different aspects of your topic, overlapping, addressing related areas of your concept as allied concepts, or competing concepts addressing the same phenomena.
TO DO 6.1. CONCEPT FAMILIES
1. Make a table of concept families in your area of interest (practice or research topic).
2. Indicate which of these are lay concepts and which of these are scientific concepts.
INDUCTIVE APPROACHES TO CONCEPT DEVELOPMENT
Induction
Induction is usually, but not always, associated with qualitative research. Induction is the cognitive process of working, thinking “up” from the data through processes of categorization, synthesis, and abstraction. It begins with seeking and identifying commonalities in pieces of data, and forming categories of common data. The researcher then looks for characteristics within each category and differences between categories, and from this develops concepts, identifies the relationships between categories, and thus develops theory. As such, induction is the primary mode of thinking in developing qualitative theory.
Role in Inquiry
Is induction value-free? Do researchers who use inductive inference work from a “blank slate?” The answer is, “no.” Qualitative research is usually conducted within a particular paradigm or even a frame that gives the research perspective. Ideally, with an inductive approach, the researcher puts aside all presumptions and commences inquiry from these data allowing the categories to be developed and be incrementally built, rather than using preconceived categories. The categories are built by looking for patterns as provided in the data by participant’s interviews and observations, rather than the investigator’s—or the literature’s—a priori notions and conceptualizations.
If the researcher has a preconceived framework, assumptions of paradigmatic view, this creates the agenda for conducting research or may rise even to affecting the question being asked. For instance, a researcher may have a social justice lens for his or her research program. However, the research should then attempt to bracket all assumptions, and approach the researcher with a neutral stance. If the researcher retains the underlying perspective and uses it in the data collection and analysis, this should be done consciously, to prevent untoward bias in the research. An example of using a preconceived notion is shown in the cartoon (Figure 6.1) in which Colleen Burke considered the executive approach as one of “greed and cruelty.” In this case, not only is her perspective forming her questions and presupposing her findings, she will also find it difficult to recruit executives into her study, for being “greedy and cruel” are not desirable states, especially for successful executives.
FIGURE 6.1
The value of induction.
Reprinted by permission of Daniel Piraro.
Using Frameworks in Qualitative Inquiry
Although valuing induction, qualitative inquiry does not take place in a vacuum, or from a “blank slate.” However, to begin qualitative research from a theoretical perspective may be dangerous, for one may use the theoretical frame to either consciously or unconsciously prove a certain point or position. For this reason, phenomenologists document all that they know about the topic before starting, and then try to begin their study by putting these assumptions aside, a process called bracketing in phenomenology (van Manen, 1990, 2014).
Even when researching relatively harmless, or value-free, topics, the consent process itself may interfere with induction. The consent form contains a description of the study (or even the title), which informs the participants about the study, and the interviews are therefore slanted toward this topic (or concept), rather than emerging more or less spontaneously (Morse, 2008).
Do qualitative studies use theoretical frameworks? This is rather a contentious issue, as the framework itself may circumscribe investigation, prematurely restricting the boundaries and becoming a source of invalidity. Consider if from the framework you developed a checklist. This means you were working deductively. In this case, does the researcher discover anything new? No—at worst, the data collection form restricts inquiry to checking frequencies in each preidentified item. The answer is to keep such frameworks removed from the data and to use them with care. For this reason, qualitative inquiry does not use forced choice questionnaires. Frequently, with semistructured questionnaires, the researcher identifies all questions that should be asked within a certain domain, but does not know enough about the responses to make the questionnaire fixed choice. So, even semistructured questionnaires may constrict the inquiry by limiting and overly guiding the participant’s responses.3 Nevertheless, because the domain is restricted by the questions asked, the researcher must be careful to obtain an adequately large sample—or again validity is threatened.
Theoretical Contexts
Contextual frameworks are different from theoretical frameworks, as they encompass the proposed study making an argument for its significance, placing it in context. They are used to justify the research questions or to establish a context for the study—usually one that is larger than the actual study. Once, I wanted to study gift giving in hospitals (I also discuss the results of this study in Chapter 15). I wrote a straightforward proposal, but it was denied by the funding agency. I was informed that the topic was trivial and insignificant. I am not certain that was the whole story, for gifts given to nurses seem to cause embarrassment to the administration, believing that nurses are in a position to inappropriately solicit such gifts, and nursing organizations and hospitals have rules prohibiting nurses from accepting gifts. Despite this, gifts still come. Why?
In the resubmission, I created a contextual framework, trying to show the significance of the study. I argued:
Caring for patients frequently requires intensely personal and intimate tasks to be performed by nurses. In their professional role, nurses are relative strangers to the patients, yet are responsible for providing support for patients in their most distressing moments, such as when they are in pain or facing the fear of death. Nurses also provide patients with such care or treatment as assisting with bedpans, bathing or catheterization, that would in other circumstances be considered “shameful” and private to the patients. Although these procedures are expected and routine nursing tasks, they rarely become expected and accepted by the patients themselves. Patients frequently apologize and express shame at the “work” being created by the loss of bodily control.
Nurses work for the hospital, yet they give care to the patient. I argue that this situation creates an imbalance in the nurse–patient relationship. It creates a loss of power, dependency and passivity within the patient, and a feeling of being obligated to reciprocate for the care given. Chapman (1976, 1980), Dowd (1975) and Kayser-Jones (1979, 1981) note that reciprocity is an essential part of the therapeutic process, although, ironically, the practice is discouraged in health care. As the nurse’s employer considers that the nurse has already been reimbursed adequately in the form of salary, and recognizes the more powerful position of the nurse and the potential for exploitation, administrative policy frequently is such as to prohibit gift giving. I suggest that such a policy inhibits patient recovery and that the constant refusal results in a double-bind situation for nurses. The nurses are placed in a situation whereby they must choose between accepting or refusing the gift. The former involves breaking hospital rules with the subsequent feeling of guilt and the possibility of reprimand; the latter violates social norms (i.e., it is considered rude) and may be construed as rejecting the patient. Finally, although this must be investigated further, the lack of a direct patient-nurse reward system may foster burnout in nurses. (Morse, 1989, pp. 33–34)
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