El análisis de los escenarios futuros

In Summary

When just the phantom, the body-less nature of this work existed only perhaps somewhere deeply cocooned in my subconsciousness, wonder was there, stirring what could be. It has become the tonic note upon which, not only this methodology, but also the entire thesis is built. As the work began to assume its living reality in me, I took hold of its creation in my hands, taking on the awesome responsibility of re-creating the primal sounds of lived experiences, through the methodology, using the clef and stave of existential hermeneutic phenomenology on which to form the music you hear. The tempo is unhurried, played in a reflective mood with notes having been appointed to their creative places on the stave. At times in its playing, it has seemed as though the sound has diminished to the barely audible and then crescendos again as silence and sound have taken their places.

Essentially, music touches our hearts and souls and minds, entwined together in our embodied being. It is a living experience. But before it can be played and heard it has to be written down. This is our access to the music. What you hear though is not the soundtrack, the original playing in the composer’s head. Instead the manuscript has entrapped, restrained and contained the music by its written form. Likewise this research exists to be shared, to bring new life, new understanding and knowledge to the reader, but it cannot say it all. Communicating will always, to some extent, be confined by the limits of an artist’s skill or palette or manuscript, or by language and words, or by the reader’s interpretation. And so, in a sense, the mourning begins for me as the darkness overshadows it to some extent. But I am not in full, black mourning. This research can live on in its words and for its time: ‘all is not said and done’.

So, from wonder, all the components of this chord have taken their place and will continue to be doing their work. While not all of these will be explicit in its reading, what will be evident throughout, giving its very distinctive style, will be the following five components, linking its philosophical roots, its

methodology, its method and data analysis. Throughout this research you will be aware of,

1. It being explicitly existential, describing personal lived experiences and making no reference to recurring themes, grouped data, n= numbers, charts or graphs. It will articulate ‘unique variations of experience’. (Galvin and Todres, 2013 p. 31)

2. Its movement from natural science with its search for theory to explain and control the world, towards the humanities, to bring plausible insights and offering direct contact with the world. There will be no ‘final and conclusive law-like absolutes’ (Ibid.).

3. Its interpretation of the texts.

4. Its use of reflexive engagement of self throughout.

5. Its use of the artistic component of poetry and of metaphor.

These components together have provided a methodology (Diagram 2) that has been both an extraordinarily helpful guide for every aspect of this project and has added colour to my original sketch map (Finlay and Evans, 2009 p. 13). They have assisted this traveller on her journey from ‘Philosophy’ to structuring a ‘Method’ and for the onward journey to its ‘Eventual Destination’ the place of haunting echoes, whispers and song.

Chapter 6

Chapter Six: Method

Creating a Pathway

‘Everything here is the path of a responding that examines as it listens. Any path always risks going astray, leading astray. To follow such paths takes practice in going. Practice needs craft. Stay on the path, in genuine need, and learn the craft of thinking, unswerving, yet erring.’ (Heidegger, 1971/1975 p. 186)

Previous chapters have been dedicated to presenting my personal ontological stance, reviewing my research field and outlining the philosophical tenets underpinning this research with its related methodology. These have provided a way for me of looking at the world that is authentically grounded and has provided a congruent epistemology. In this chapter I am now turning my attention to the method. While method in research may be described by some as the ‘techniques’ and ‘procedures used to gather and analyse data’ (Crotty, 1998 p. 3) I see this more like a path or a backbone: the central, supporting structure for this research, which has grown within its body and which carries its central nervous system to generate data from the encounters, dialogue and reflection (Finlay, 2011 p. 197). This method therefore prioritises the sharing of individuals’ experiences through the embodied being-together of researcher and participants in interviews with the continuation of these relationships through the transcripts and of further intertwining in co-created interpretations of participants’ experiences.

Introduction

The word method, first used in the 16th _{century for the study of natural} sciences, and from the 19th _{century in social sciences, is now often thought} of as a set of procedures designed by specialists, to ensure the objectivity of results, to limit researcher biases and to allow other researchers to check the accuracy of the results by following the same procedures (Romanyshyn, 2013 p. 205, 209). As I have discussed my research with others there has been some presumption that this was the type of research I was doing

although there are of course many different methods that researchers use to discover new knowledge and understanding. Within phenomenological research different methods are employed with some, like Gadamer, believing that scientific methods cannot lead to ‘true’ understanding (Gadamer, 1975/2013) with his hermeneutic phenomenological method bearing very little resemblance to this. Romanyshyn is in agreement, saying that it is necessary ‘to erase the erasure of the presence of the researcher in research’ (Romanyshyn, 2013 p. 209) and argues for the inclusion of the ‘unconscious depths of the researcher’ along the path ‘from the place of not knowing one’s topic to the place of coming to know it’ (Ibid. p. 215). Because the researcher’s subjective, creative presence is very much at the heart of such research, researchers must remain open to the possibility of being struck by the wonder of something new, or of hearing and experiencing an older, more familiar song being sung with a new voice or to a new tune. This must be so in every stage of the process including the creation of its method with the outcome that methods can never therefore be replicable, predetermined or prescribed, but always guided by the researcher’s openness to the new and perhaps the unexpected.

Van Manen continues this theme by saying that,

‘Phenomenological method is always a matter of attempts, bids, and hopeful risks. Within a phenomenological context, method is never just an engine that will unerringly produce insightful outcomes.’ (2014, p. 29)

To achieve this he highlights the need for the researcher to be guided by ‘interpretive sensitivity, inventive thoughtfulness, scholarly tact and writing talent’ (van Manen, 1990 p. 34). I certainly questioned whether I had these skills at the required standard and for some time believed this may be too much to take on. However, it also seemed I was being goaded or enticed by another voice calling me into this, with the offer of an adventure into the unknown, which I found I could throw myself into when it seemed to meet up

with my growing passion to go beyond these voices to ‘hear the voice of matter itself’ (Hansen, 2010 p. 163).

The Development of the Research Method

This chapter describes in detail the methods for this research, which, true to van Manen and Romanyshyn’s statements above, involved not simply the application of a given process or a fixed set of procedures. I remained open to changes and amendments along its way and it was therefore an emergent, creative process with very few directional or distance signposts, and with no programmed satnav system set for the journey. Instead I often had the sense of being something of a lone traveller, a wondering wanderer and pioneer, having to find my own pathways. This also felt, at least initially, as though I was setting off into the night with only the pale moonlight of my research questions illuminating the vocative, whispering landscape of the methodology. It did feel risky, but less so as I gradually became aware that the moonlight and the landscape had merged together which seemed to deepen my confidence and invigorate my passion for this project. Pathways became clearer and the project took on some tangible form.

Following on from van Manen and Romanyshyn’s introduction to phenomenological research method above, Finlay (2011) extends this and describes in very clear detail the nature and purpose of such method in hermeneutic phenomenological research projects.

‘Hermeneutic phenomenologists seek methods that allow the concrete, mooded, sensed, imaginative, aesthetic, embodied and relational nature of experience to be revealed.’ (Finlay, 2011 p. 111)

I found this list as demanding and as daunting as van Manen’s researcher credentials above but equally challenging and exciting. I had come to hope that my thesis might not only reveal these in participants’ experiences, but that I could approach the whole project in a mooded, sensed, imaginative, aesthetic, embodied and relational way. While I needed to consider whether each of the above was breathing through my method, I also had the sense

that I needed to experience this holistically, like a baptism into a new way of being. I came to understand this better for myself by considering acting as something of a comparison. An actor does not become the character she is representing simply by putting on her costume. Instead to become a really convincing character, she must of course put on the appropriate clothing, but more importantly she becomes that character by her research and through immersion into the person’s life. The new character can then be played effortlessly and authentically. The actor has become the character and could even ad lib in character. By spending time reading and researching a congruent philosophy and methodology for this research and by being so immersed into this, I felt able to design this unique, appropriate research method. However, along its course there have certainly been places where I felt the need to retrace my steps and to re-orientate myself, but fortunately, like Heidegger, always with renewed hope of finding my way to the clearing (Heidegger, 1971/1975 p.186). These occasions have not been debilitating but neither have they been very welcome at the time; sometimes more like the feelings I imagine an explorer might have when, having taken a wrong turn, she nevertheless finds some new treasure. At other times the ‘clearings’ themselves have seemed rather ‘wild’ and not at all the ‘domesticated’ (Todres, 2007 p. 19) places I expected them to be, where I hoped I might relax a little in the sunlight and fresh air. I did nevertheless find them to be places of reorientation and places from which I felt able to proceed.

The rest of this chapter is an explanation and description of my path-clearing journey: the methods used in this research. I have structured this in four main sections, the first concerning the preparation for this research, the second section is focused on the data gathering process, the third expands the methods I have used for generating further layers of data, and the focus of the forth is the method for the presentation of the data which will be evident in Chapter 7.

Part 1

Preparation for the Research

While phenomenology promotes a sense of openness to phenomena for new understanding to be gained and from new perspectives with creative methods, van Manen (1990, 2002, 2014) Hansen (2010) and Finlay (2011) champion the use of the word wonder to encapsulate this notion. Because I have incorporated this as an essential component of this research and not wanting to lose what I see as its naïve beauty anywhere in the process, I made a conscious plea to myself to hold onto this before I began to craft its methods. To ensure this, I pinned a note above my desk with the word

wonder on it, with the intention of checking regularly that I maintained the

sense of ‘being swept up in a spell of wonder’ (van Manen, 2014 p. 26). Part of my reason for doing this was because I was aware that I could not completely bracket off what ‘was rooted in a metaphorical vision of (my) subject matter’ the design of my methods revealing, to an extent, what I already imagined about my subject (Romanyshyn, 2013 p. 211) and the research questions I wanted to answer. Working with this tension demanded that I trusted the process and believed that I had sufficient of the qualities highlighted by van Manen (van Manen, 1990 p. 34) and in sufficient quantities. I also balanced this with Crotty’s encouragement that, while with such research there is no prescribed method, researchers can ‘knock’ ‘glean’, ‘learn’ and ‘engage’ with other thinkers (Crotty, 1998 p. 216). By doing this I felt that I lessened the darkness and the isolation of the journey.

The Research Questions and an Emergent Methods

The next step for me was, in fact, to take a step back and review my research questions. I needed to craft methods which could reveal how nurses experienced their person-centred dementia care work, and which could then lead to the discovery of the essences and the meanings of it. From this I wanted to consider how such an enhanced understanding could be used to make a positive contribution to such care in Jersey.

One of the first decisions I needed to make was how I would gather examples of lived experiences. I therefore needed to decide very early on whether or not this would include observation as this would impact upon every other aspect of the fieldwork and the way I would generate the data. Because of the complexities of this, including the practical arrangements of timing, of positioning myself discretely in busy care environments and of working with added layers of complexity associated with my interpretations of the situations I would be observing, I relatively quickly decided to focus only on the participants’ spoken accounts of their lived experiences. This also meant that I would not have to work through what would have been the much more complicated ethical considerations of observing people with dementia while observing nurses at work. This however did not altogether deal with the situation. My professional work takes me into care homes and hospital wards where I find I cannot but have my eyes, ears and heart open. Inevitably what I experience in this becomes an interpretation, which I store, and which then informs my opinions. Two solutions initially presented themselves to me in response to this, the first was to extract myself from such work for the course of this research and the second was to acknowledge this and to work reflexively with what might come from it. As it was impossible to set a time frame on the data collection process and because I also came to realise that I already carried a weight of historical observations already in-forming me, the first option was impossible which meant the second became necessary. This meant that I had a further layer of reflection and reflexivity to engage with throughout the data gathering and analysis process, which I also saw as something of a benefit, because while I was not part of any clinical team, I was, quite literally, in the midst of my research field. Keeping field notes of my experiences from this early stage helped later as I worked reflexively with the participants’ transcripts in the data analysis.

Participant Interviews

Early in this research process it had become clear to me that EHP fitted well with my epistemological position and that this therefore would become my

honouring of the relational nature of research, often using recorded, transcribed, semi-structured interviews, producing texts to be used for analysis following the interviews. I knew from my counselling work that empathic, non judgemental presence, the promotion of an equal power base, time, and a real interest in others’ lives (Rogers, 1980/1995; Kirschenbaum and Henderson, 1990) could give people freedom to share at immense depth and that this could therefore lead to rich descriptions of participants’ experiences of person-centred care. Because of the potential depth to this work and because EHP does not require a representative range (Finlay, 2011 p. 191) or attention to recurring themes or patterns, but aims rather to find what is unique in a lived experience (van Manen, 2014 p. 352-353) I was aware that there would not be as many participants involved as there could be with other methods.

Recruiting Participants

How I would recruit the participants in a way that would encourage people from various working contexts to take part had to be considered. I was sure there were many who would agree to take part if I approached them personally, but considered that by so doing there could be an element of coercion or of doing me a favour, neither of which I wanted and neither did I want others to feel any guilt if they declined to take part. My first course of action therefore was to arrange meetings with care home and ward managers to gain their permission to place recruitment literature on staff notice boards. During these meetings I showed them both the notices I wished to display and the other supporting literature (Appendix D) including the letter of ethical approval from the university (Appendix F). This literature made it clear that staff would not be required to inform their managers of their participation and should contact me directly. Without exception, all were happy to permit this. I also planned to make use of an intranet system accessible to employees of the States of Jersey (SoJ) and to make use of the local media, but this proved unnecessary as the initial notices generated sufficient interest.

The ease with which I was able to recruit participants was encouraging and probably related to the size of Jersey, and that I may have been known through my work with Jersey Alzheimer’s Association, which is a generally respected local charity. The fact that I was not a colleague of any of the participants, that I was not a HCP, but an allied professional, and that neither was I an employee of the SoJ, meant there was a healthy detachment, though close connection to the participants’ person-centred dementia care. There was therefore no sense of the participants being researched by a