Uncovering the common ground in qualitative inquiry Combining quality improvement and phenomenology in clinical nursing research

摘要

Purpose - The purpose of this paper is to describe the use of a common qualitative data set analysed with both a quality improvement tool to facilitate service improvement, and a rigorous research methodology to engage beginning nurse researchers in a mentored project. Design/methodology/approach - A qualitative cohort study of the experience of hospitalisation across six diagnostic groups interrogated data from 104 patient and carer interviews using the Picker Dimensions of Experience and Heideggerian Phenomenology. Findings - The paper reveals that well-conducted qualitative interviews can provide common ground for service improvement initiatives and rigorous research analysis. Research limitations/implications - The Picker Dimensions use simple coding methods that push findings towards utility, but at times are overly reductionist and exile any data not related to hospital services. Heideggerian phenomenology is training and resource intensive, but its exploration of the meaning of the illness experience provides a profound backdrop for the subsequent understanding of hospitalisation. Practical implications - The access that qualitative data provides to the patient and family's perspective is becoming increasingly valued in processes of ongoing quality improvement, clinical redesign and evaluation for hospital accreditation. Social implications - The intrinsic rewards of deep qualitative analysis for the staff involved are extraordinary. Clinicians were humbled by new understandings, which surprised them despite their long clinical experience. Originality/value - While quality improvement processes require training, ethics applications and data collection, the same framework can support rigorous qualitative research through use of the data as "common ground". The researchers experienced a tension, but eventually, a balance between the strengths and limitations of these combined modes of qualitative inquiry.