Nurses,formerly incarcerated adults,and Gadamer: phronesis and the Socratic dialectic

This paper describes the first phase of an ongoing education and research project guided by three main intentions: (1) to create opportunities for phronesis in the classroom; (2) to develop new understandings about phronesis as it relates to nursing care generally and to caring for specific groups, like formerly incarcerated adults; and (3) to provide an opportunity for formerly incarcerated adults and graduate nursing students to participate in a dialectical conversation about ethical knowing. Gadamer's writings on practical philosophy, phronesis, and the Socratic dialectic provide the philosophical foundation and framework for the project. The first phase in the project was a 4‐h class within a graduate‐level health promotion course during which 30 nursing students and three formerly incarcerated panelists engaged in a dialectic conversation about what it means to care for formerly incarcerated adults in a meaningful way. After the class, two focus groups were conducted, one with the students and one with the formerly incarcerated panelists. Findings articulated participants' prejudices and assumptions prior to the class, expanded sense of phronesis, and ability to consider nursing practice within a larger ethical framework. Panelists and students left the class with a deeper understanding of one another and expressed an openness towards continued dialectic conversations together. Use of the Socratic dialectic within nursing curricula reflects a current and critical trend in nursing education to bring non‐epistemologic forms of knowledge into the classroom.     

Laypersons' views of material incentives for enhancing colorectal cancer screening

Background

Colorectal cancer (CRC) early detection improves health outcomes; screening programmes invest efforts in initiating invitations to target populations to be tested. Enhanced adherence is essential for reduction of morbidity and mortality. Participation rates in Israel are still relatively low.

Objective

To explore lay views regarding the concept of receiving material incentives in exchange for enhanced adherence to CRC screening.

Research design

Qualitative study. Between November 2009 and February 2010 six focus group discussions were carried out in two urban, middle and low socio‐economic status primary care clinics in a Northern city in Israel. Participants were eligible individuals for CRC screening, aged 50–68 (N = 24). Data analysis followed the principles of grounded theory, supported by qualitative software.

Results

Participants found administering incentives in exchange for CRC screening inappropriate on rational and moral grounds. They valued their relations with the medical team and the health system more than the potential gain expected. Individuals eligible for CRC screening perceived themselves as responsible for their health, admitting difficulties in realizing this responsibility. Incentives were reported unsuitable for solving reported screening difficulties and a potential harm to the doctor–patient relationship.

Conclusions

Focus group participants expressed an unconventional voice towards the use of material incentives. They pointed to the need for focused support of health behaviour change and valued their autonomy. While a proportion of the invitees in the target population see the importance of screening and appreciate the HMO''s initiative to invite them for testing, they also expressed their need for support from the HMO in realizing the recommended health behaviour.