From individual to group: use of narratives in a participatory research process

From individual to group: use of narratives in a participatory research process Aims. This paper provides a theoretical understanding of narrative research and its use in research. It aims to expose the ways narrative research, when taken beyond the researcher’s lone analysis of text, can contribute to the development of clinical knowledge. Background. Methodological approaches involving the construction of narratives are increasingly apparent in the nursing and allied health literature. Narratives, constructed from stories of nursing practice, become texts available for analysis. This is undertaken predominantly by a researcher engaged in a lone activity with little involvement of those contributing the stories. Methods. This paper is drawn from a critical praxis study of nurse–patient friendship utilizing participatory research processes. The nurses involved in the study were co‐researchers in an indepth study of their relationships with patients. Findings. The paper traces the movement from naïve story, through individual narratives during interviews with each nursing and demonstrates the changes in understanding about the narrative accounts that occurred during the participatory group process. Conclusion. The nurses involved in this study were able, through the use of narrative stories reexamined in a group context, to develop new insights and understandings about their practice. Knowledge generated in these ways remains grounded in the real life world of clinical nursing and gives voice to the complexity of those aspects of nursing practice that are taken for granted.     

Narrative methods and children: theoretical explanations and practice issues.

TOPIC: The Narrative approach is an innovative way of working with children and adolescents experiencing mental health problems. This approach can be effectively integrated with the expressive arts and other nonverbal ways of accessing the life world of children. In addition, the approach promotes respect for and collaboration with the child in working towards healing and growth. PURPOSE: In this paper core features of the narrative approach are described; the theoretical and philosophical and evidence base for this approach as well as its congruence with the special nature and needs of children will be explored. Finally, the benefits and challenges of this approach in relation to a specific clinical situation will be highlighted. SOURCES USED: Published literature and the author's clinical experiences. CONCLUSION: Narrative methods are ideally suited for addressing needs of children experiencing mental health problems and can enhance therapeutic effectiveness. Some of the challenges associated with its use include: finding creative ways to apply specific narrative concepts and methods with diverse clinical issues/problems; learning to collaborate with children and respect them as experts in their own lives; and shifting the nursing focus from a problem-focused orientation to a strength-oriented and child-centered approach.     

Narrative inquiry: Locating Aboriginal epistemology in a relational methodology

BACKGROUND: This methodology utilizes narrative analysis and the elicitation of life stories as understood through dimensions of interaction, continuity, and situation. It is congruent with Aboriginal epistemology formulated by oral narratives through representation, connection, storytelling and art. Needed for culturally competent scholarship is an experience of research whereby inquiry into epiphanies, ritual, routines, metaphors and everyday experience creates a process of reflexive thinking for multiple ways of knowing. Based on the sharing of perspectives, narrative inquiry allows for experimentation into creating new forms of knowledge by contextualizing diabetes from the experience of a researcher overlapped with experiences of participants--a reflective practice in itself. AIM: The aim of this paper is to present narrative inquiry as a relational methodology and to analyse critically its appropriateness as an innovative research approach for exploring Aboriginal people's experience living with diabetes. NURSING APPLICATION: Narrative inquiry represents an alternative culture of research for nursing science to generate understanding and explanation of Aboriginal people's 'diabetic self' stories, and to coax open a window for co-constructing a narrative about diabetes as a chronic illness. The ability to adapt a methodology for use in a cultural context, preserve the perspectives of Aboriginal peoples, maintain the holistic nature of social problems, and value co-participation in respectful ways are strengths of an inquiry partial to a responsive and embodied scholarship.     

Working with stories in nursing research: procedures used in narrative analysis

This paper describes the procedures undertaken in a qualitative study that used nurses' stories to examine the influence of Gestalt therapy training on the professional practice of psychiatric nurses. The paper places narrative research methodologies within a nursing context before introducing narrative inquiry, specifically narrative analysis methodology. Procedures used in the study are subsequently described in sufficient detail to serve as a guide for novice researchers interested in undertaking a narrative analysis study. An exemplar of a storied outcome is provided to evidence the product of the narrative analysis research process. The paper concludes with reflections on the importance of articulating the process of narrative analysis as a means of developing interest and competence in narrative research, and using nurses' stories as a means of exploring, understanding, and communicating nursing practice.     

Rituals,ghosts and glorified babysitters: A narrative analysis of stories nurses shared about working the night shift

Working the night shift can be fraught and experienced as demanding and, yet, is often dismissed as babysitting. Few researchers have explored the social and cultural meanings of night nursing, including storytelling rituals. In 2019, a narrative study was undertaken. The aim was to explore the stories recalled by nurses about working night shifts. Thirteen Australian nurses participated. Data were gathered using the Biographical Narrative Interview Method, and narrative analysis produced forty stories and three themes: strange and challenging experiences; colleagues can be mentors (or not); and textbook knowledge is only part of what is needed on night shift. Nursing students who engage with these stories may come to understand the challenges of the night shift, and the valuable work that nurses engage in throughout a 24‐hr period, work that involves adept psychosocial and interpersonal skills alongside technical and physical competence.     

422名新入职护士医学叙事能力现状及影响因素分析

目的 了解新入职护士医学叙事能力现状,并分析其影响因素。方法 采用便利抽样法,于2021年12月—2022年1月选取南昌市某三级甲等医院的422名新入职护士作为研究对象。采用一般资料调查表、医学叙事能力量表、家庭关怀度量表、护士职场适应度量表对其进行调查。采用多重线性回归分析新护士医学叙事能力的影响因素。结果 本组新入职护士医学叙事能力总分为（139.06±20.79）分。多重线性回归分析显示,家庭关怀度、护士职场适应度和叙事护理开展观点进入回归方程（P<0.01）,共解释新入职护士医学叙事能力总变异的43.5%。结论 本组新入职护士医学叙事能力处于中等偏上水平,家庭关怀度、护士职场适应度和叙事护理开展观点是其叙事能力的主要影响因素。护理管理者应实施针对性培训,以提高其叙事能力水平,助力专业成长。     

407名规范化培训护士叙事护理的知信行调查分析

目的 了解规范化培训护士的叙事护理知识、态度、行为现状,并分析叙事护理知识、态度、行为的相关性,为提高规范化培训护士叙事护理知识和技能提供依据。方法 采用一般情况调查表、临床护士叙事护理知识、态度、行为问卷,对广东省3所三级甲等医院的407名规范化培训护士进行调查。结果 407名规范化培训护士叙事护理知识、态度、行为得分分别为(26.83±3.18)分、(33.49±3.70)分、(30.86±4.35)分。不同科室的规范化培训护士的叙事护理态度和叙事护理行为得分比较,差异有统计学意义(P<0.05)。规范化培训护士叙事护理知识与态度之间(r=0.281,P<0.001)、知识与行为之间(r=0.139,P=0.005)、态度与行为之间(r=0.552,P<0.001)均呈正相关关系。结论 规范化培训护士叙事护理知识掌握情况较好,叙事护理态度较为积极,但叙事护理行为不足,需进一步推动规范化培训护士叙事护理教学,提高规范化培训护士对叙事护理的积极性,促使其将叙事护理理论知识外化为叙事护理行为。     

Narrative inquiry as a research methodology exploring person centred care in nursing

Background

Although, person centred care has for a long time been an important approach to nursing care, it is often not a reality in the clinical environment. The focus of health research has, until recently, been on the physical aspects of a persons’ illness and this has influenced how care is delivered. There is a need to broaden the focus from the illness to the person who is ill. A holistic approach to the persons’ social and cultural experience of their illness will aid health care professions to provide person centred care.This paper will make the argument that narrative inquiry is a well suited to health care research in general and nursing research in particular as it focuses its inquiry on the individual person's experience of their illness – ‘what matters’ from the person's point of view. Narrative inquiry explores the narrative from a temporal, social and spatial view.

Reconciling voices

There is a lack of nursing research in relation to how people with mental health problems make sense of their experiences of mental distress. Furthermore, few nursing related studies have conveyed service user's understandings and meanings for their experiences of mental 'disorder'. Narrative psychology claims that people make sense of the world and their lives by using narrative structures to organize diverse experiences. By sharing these stories with others, interpretations are negotiated and personal and cultural meanings are formed. This study used a tried and tested approach to narrative analysis to analyse the transcribed narrative of one man, Gary, who was experiencing mental health problems. The study explores Gary's process of meaning making as it appears in his narrative; the frameworks and metaphors that he uses to help him make sense of his experiences. The tensions between Gary's internal voices and beliefs and the external voices of surrounding culture and psychiatry are highlighted. Emphasis is placed on the importance of attending and responding to personal meanings embedded in narratives as a means of developing sensitive nursing care and enriching nursing research.     

Using narrative pedagogy: learning and practising interpretive thinking

AIM: This paper reports a hermeneutic study undertaken to explicate students' experiences in educational courses in which teachers enact Narrative Pedagogy. BACKGROUND: International interest in developing and implementing discipline-specific pedagogies is becoming commonplace as teachers respond to the challenges of preparing students for contemporary practice. Lifeworld Pedagogy, developed in Scandinavia, and Narrative Pedagogy, developed in the United States of America, Canada and New Zealand, are two approaches developed from nursing research for nursing education that provide teachers with research-based alternatives to conventional pedagogy. Further research is needed, however, that addresses how new pedagogies are experienced in schools of nursing. METHOD: Teachers and students from 22 schools of nursing in the United States of America were interviewed over a 4-year period between 2002 and 2005. Using interpretive phenomenology as the philosophical background and Heideggerian hermeneutics as the method, accounts from 52 participants were analysed by a research team. FINDINGS: The theme Learning and Practising Interpretive Thinking reveals how reform is occurring in schools of nursing that use Narrative Pedagogy. It documents how Narrative Pedagogy helps students challenge their assumptions and think through and interpret situations they encounter from multiple perspectives. Findings suggest that by focusing teachers' and students' attention on thinking and interpreting as communal experiences, interpretive pedagogies such as Narrative Pedagogy engage teachers and students in pooling their wisdom, challenging their preconceptions, envisioning new possibilities for providing care and engaging with others to ensure patient-centred care and safety. CONCLUSION: By documenting students' experiences in courses in which Narrative Pedagogy is used, this study provides teachers with research-based evidence to guide their pedagogical decisions. It extends international efforts to develop discipline-specific pedagogies and offers a practical, student-centred approach teachers can use to enhance students' thinking.     

Narrative and exploration: toward a poetics of knowledge in nursing

Narrative and exploration: toward a poetics of knowledge in nursing
The dualism of subject and object has been a traditional model for nursing knowledge. That model is portrayed here as an epistemological exile. Our self-imposed exile from the lived world of nursing can be remedied by inquiry based on engagement rather than distance. One model for engaged inquiry is explorers'journeys in remote regions. Knowledge of a region can be local or colonial, according to the explorer's stake in the region as homeland or territory. Nursing is an existential region where people live. In the exploration of nursing as homeland, knowledge takes the form of local narrative, the story of a place told by its inhabitants. Narrative inquiry offers nursing an epistemology that is both ethically and aesthetically congruent with its practice of engagement.     

Are nurses prepared to respond to a bioterrorist attack: a narrative synthesis

Aim. To report a review and narrative synthesis conducted to analyse and evaluate nurses’ preparedness to respond to a bioterrorist event. Background. The anthrax attack on the USA in 2001 resulted in the development of global response strategies for future bioterrorist events. However, despite these actions, it remains unclear whether nurses are prepared to respond to such events. Data sources. A search for relevant research articles was conducted using the MEDLINE, CINAHL, BNI, and EMBASE databases to locate articles published in the period 1996–March 2010. Design. Narrative Synthesis Review methods. A narrative synthesis of qualitative and quantitative studies was undertaken and the articles reviewed using Greenhalgh’s critical appraisal criteria. The review was conducted with inclusion and exclusion criteria applied to ensure the studies examined focussed on the hospital nurse’s role in responding to a bioterrorist event. Results. Seven original research studies were included in the review. Four themes were identified as affecting nurses’ preparedness for a bioterrorist attack. These were perceptions of bioterrorism, the role of formal knowledge, the role of institutional plans and policies, and personal factors. The overarching theme centred on nurses’ willingness to respond to a bioterrorist event. It was clear that, although nurses were willing to respond to a bioterrorist attack, they felt unprepared to do so. Conclusions. Existing nurse education in areas such as infection control can incorporate bioterrorism training to improve preparedness, yet nurses must also prepare themselves personally for a bioterrorist attack.     

The potential benefits of applying a narrative analytic approach for understanding the experience of fibromyalgia: a review

Purpose: People with fibromyalgia (FM), a medically unexplained illness, habitually experience widespread pain and fatigue. While some qualitative research has aimed to understand the experiences of people with FM, studies from a specific narrative perspective are particularly lacking. This review argues that future research could be significantly enhanced by studies which analyse the narratives of people with FM. Method: This argument is made through reference to an examination of the extant qualitative literature on the experience of FM and theories and narrative studies on chronic illnesses and identity. Results: The empirical literature is reviewed from a narrative perspective; this assumes that the stories people tell reveal much about their identities and social worlds. As such, it is proposed that narrative analysis is particularly well suited for exploring issues of self and culture and for appreciating how meanings evolve over time. Further, it is also argued that consideration of these issues is particularly relevant for understanding the experience of FM given the enigmatic nature of the syndrome and its chronic course. Conclusions: The review concludes by emphasizing that narrative analysis is a valuable method which offers the potential for uncovering novel insights about the illness experience for these individuals.

Implications for Rehabilitation

• Fibromyalgia is a chronic syndrome characterised by pain and fatigue.

• Previous research has neglected the social context within which experience of fibromyalgia develops.

• Narrative studies have the potential to reveal how people make sense of illness.

• It is important for health professionals to acknowledge and validate the uncertainly of the illness experience in fibromyalgia.

     

Searching for collaboration in international nursing partnerships: a literature review

GEORGE E.K. & MEADOWS‐OLIVER M. (2013) Searching for collaboration in international nursing partnerships: a literature review. International Nursing Review 60 , 31–36 Background: Nurses from low‐income countries (LICs) face extreme nursing shortages, faculty shortages and a lack of professional development opportunities. Nurses from high‐income countries (HICs) can leverage their wealth of resources to collaborate with nursing colleagues in LICs to expand clinical, education and research capacity. In turn, nurses from HICs gain stronger competency in the care they provide, improved communication skills and an increased understanding of global health issues. Aim: The purpose of this literature review is to identify international nursing clinical, education and research partnerships among nurses from LICs and HICs and to analyse the degree of collaboration involved in each partnership using DeSantis' counterpart concept. Methods: We conducted a systematic review of international nursing partnerships in the scientific literature from January 2001 to July 2012. A total of nine articles met inclusion criteria for analysis. Findings: All of the articles discuss lessons learnt in building international nursing partnerships among nurses from HICs and LICs. However, the articles failed to meet the criteria set forth by DeSantis' counterpart concept to achieve fully collaborative nursing partnerships. Conclusions: International nursing partnerships require more foresight and planning to create partnerships in which the benefits derived by nurses from LICs equal those of their colleagues from HICs. By striving for such collaboration, international nursing partnerships can help build nursing clinical, education and research capacity in LICs.     

Understanding personal narratives: an approach to practice

AIM: This paper explores the need for and nature of personal narratives and their relevance to nursing practice. It proposes that the co-creative aesthetic process can be used to understand and co-create personal narratives through an emphasis on self-defining memories and metaphor. BACKGROUND: Many authors in nursing and other human sciences have recognized the need for and importance of personal narrative, its relationship to aesthetic knowing and its value in qualitative research and in practice. The role of memory and metaphor in the creation of meaning in personal narratives, however, has not been sufficiently explored in nursing literature. DISCUSSION: The nature of personal narrative is explored, focusing on the way meaning is created from self-defining memories using metaphor. Then, the importance of personal narratives in nursing practice is considered, followed by discussion about how meaning in personal narratives may be co-created between clients and nurses using an aesthetic process developed by the author. CONCLUSION: The co-creative aesthetic process is an example of nursing as art and can be used to co-create personal narratives in practice. The experience of co-creating a self story with a nurse can be healing, as the self story is heard by a caring person, memories are understood in new ways, and the self story is both confirmed and recreated.     

以提升叙事护理能力为主导的临床护士人文关怀培训模式的构建与应用效果

目的:构建以提升叙事护理能力为主导的临床护士人文关怀培训模式,并探讨其在临床培训中的应用效果。方法:选择62名叙事护理执行水平相近的临床科室护士作为研究对象,采用基础理论课程与叙事故事共情理论教学相结合,结合嵌入临床实践体验、总结反思写作以及参与人文素材开发创作的沉浸体验式培训方式。比较培训前后护士在叙事能力、共情能力、人文关怀能力等方面的表现。结果:培训后护士的叙事能力明显提高(P＜0.05);共情能力量表总分及各维度均显著提升(P＜0.05),护士的人文关怀能力也明显增强(P＜0.05)。有95.1%的学员认为培训方案科学合理、易于接受,并具有实用性。结论:以提升叙事护理能力为主导的人文关怀培训模式能有效提高临床护士的叙事护理能力,提升其人文关怀素养。     

Accessing Self-development through Narrative Approaches in Child and Adolescent Psychotherapy

TOPIC: Narrative psychotherapy with children and adolescents. PURPOSE: To demonstrate the integration of developmental theory with narrative approaches to psychotherapy as a means of accessing self-development during childhood and adolescence. SOURCES: Published literature and the author's experience in using narrative therapy with an 8-year-old and his foster mother. CONCLUSIONS: When informed by developmental theory, narrative approaches can be used effectively with children and adolescents to assist them in constructing positive life stories that can influence their identity formation.     

Storytelling and the interpretation of meaning in qualitative research

AIM: This paper reviews literature on narrative analysis and illustrates the meaning-making function of stories of chronic illness through analysis and discussion of two case studies from a study of acute episodes of chronic obstructive pulmonary disease (COPD). BACKGROUND: Individuals living with COPD experience acute exacerbations characterized by extreme dyspnea, but there has been little research to provide understanding of these events from the perspectives of individuals with COPD, family caregivers, and nurses. Narrative analysis -- considered in the context of the aims of qualitative research -- illuminates how these people make sense of acute exacerbation events by telling stories. DESIGN AND METHODS: In an ethnographic study, 10 patient-family nurse units in two Canadian general hospitals participated in interviews concerning acute episodes of COPD. Narrative analysis enabled identification of several story forms and their functions. RESULTS: Examples were found of a story told twice with different meanings, and of a patient's 'death story' used to communicate distrust of the nurse's ability to recognize the seriousness of distress and implications for its potential course. These examples are presented, and interpreted with respect to issues of meaning. CONCLUSIONS: The analysis indicates that stories told by patients in the context of nurse-client interactions inform understanding of the individual's acute exacerbation events beyond the biophysical.