Ethnography Study Design In Health Care and Nursing

Nursing Research and Ethnography Research

Ethnography,Historical Overview,Ethnography and Nursing Research,Traditions In Ethnography ,Field Work In Ethnography,Strategies in Ethnography,Methods of Data Collection.

Ethnography

    The term ethnography translates as "the written description of the folk (people/nation)." However, the term is currently used to refer to both a specific naturalistic research method and the written product of that method. 

    As a research process ethnography is a comparative method for investigating human behavior and patterns of cognition through observations in the natural setting. As a written product, ethnography is a descriptive analysis of the beliefs, behaviors, norms, and patterns of a culture. 

    The focus on culture and cultural processes is central to ethnography and is one of the ways in which ethnography differs from other naturalistic methods, such as grounded theory (the study of basic social processes) and phenomenology (the study of the individual's lived experience).

Historical Overview

    Ethnography was developed primarily by anthropologists as they sought to understand other cultures and traditions. Although ethnography remains the primary research method in anthropology, it is employed by several other disciplines, most notably sociology, psychology, education, and nursing. 

    As the method was adopted outside anthropology, the focus of study shifted from small-scale or tribal societies to areas more closely linked with the discipline adopting the method. 

    For example, the study of small urban social communities was undertaken by sociologists from the Chicago School, investigations of schools as microcosms of society were addressed by educators, and the health beliefs and law systems of ethnic groups were targeted by nurse anthropologists.

Ethnography and Nursing Research

    In the discipline of nursing, ethnography was introduced into the literature primarily by nurse anthropologists beginning in the late 1960s. Two seminal articles appearing in Nursing Research by Elizabeth Byerly (1969) 1990) and Antoinette Ragucci (1972/1990) laid the foundation for future nurse ethnographers. 

    As doctoral education came to be sponsored through the nurse scientist program, several nurses chose anthropology as a focus of doctoral study. This first generation of nurse anthropologists who conducted ethnographies included pioneers such as Madeleine Leininger, Agnes Aamodt , Pamela Brink, Margarita Kay, Elizabeth Byerly, and Oliver Osborne. 

    A second generation of nurse anthropologists included Juliene Lipson, Evelyn Barbee, JoAnn Glittenberg , Marjorie Muecke , Janice Morse, and Toni Tripp-Reimer. Later, as schools of nursing developed their own doctoral programs, some nurse ethnographers began to be trained within schools of nursing.

Traditions In Ethnography 

     There are several different traditions subsumed under the term ethnography. Each of these has emerged with its own particular historical context, and each address some- what different elements of culture. 

    However, each of these approaches may be used fruitfully in nursing research, given the appropriate research question. Although there are over a dozen distinct ethnographic traditions, examples of four will be provided to demonstrate the diversity of approaches within ethnography.

    An early ethnographic approach developed by Boas around the turn of the century is termed historical particularism. The central tenets of this approach are that each culture has its own long and unique history and that all elements of a culture are worthy of documentation. 

    A typical product of historical particularism is the creation of cultural lists or inventories. This approach has been used in nursing research to identify specific folk treatments used in ethnic groups and to generate items to be used later in the construction of structured instruments.

    Functionalism is a second ethnographic tradition. Here, however, the task of ethnography is to describe the structural elements and their interrelated functioning in a culture. This approach historically has been the most widely used in nursing research. A prominent example is that of Leininger's sunrise model. 

    The goal of ethnoscience, a third ethnographic tradition, is to discover folk systems of classification to determine the ways people perceive and structure their thinking about their world and to identify the rules that guide decision making. The taxonomy known as the Nursing Interventions Classification (NIC) was derived by using the ethnoscience approach.

    Symbolic ethnography is a fourth approach, which is rapidly growing in application in nursing research. Here, investigators view culture as a system of shared meanings and symbols. 

    They further believe that cultural knowledge is embedded in "thick descriptions" provided by cultural members. Most nursing research that deals with informants' explanatory models use this ethnographic tradition.

Field Work In Ethnography

    Fieldwork is the hallmark of ethnographic research. Fieldwork involves the investigator's immersion in the target community for long periods of time in order to gain understanding for contextualizing the ethnographic data. Stages of fieldwork include.

(a) field entry

(b) development of relationships

(c) data collection

(d) data manipulation

(e) data analysis

(f) termination. 

Many of these stages, particularly (b)-(e), overlap in time.

Strategies in Ethnography

    In conducting fieldwork an investigator may employ several strategies for data collection, including participant observation, informal interviews, structured interviews, pictures and videotapes, census and other statistical data, historical documents, projective tests, and psychosocial surveys. 

    The variety of research strategies that are appropriately employed is another way in which ethnography differs from most other naturalistic methods. Furthermore, ethnographers may use quantitative data to augment qualitative data. 

    However, the mainstay strategies of ethnography rest in participant observation and informant interviews. If the focus of the ethnography concerns the cognitive realm (attitudes, beliefs, schemata) of the members of the culture, then interviewing is the primary strategy. 

    On the other hand, if the focus of the ethnography involves structural features or patterns of behavior, then observations are the primary strategy. The majority of ethnographies, however, use a combination of strategies.

Methods of Data Collection

    Methods used for data manipulation include strategies for taking notes and making memos, coding strategies, and indexing systems. More recently, computerized software programs such as ETHNOGRAPH and NUDIST have been fruitfully employed to aid in the management of data. Methods used in data analysis include matrix, thematic, and domain analysis.

Conclusion

    In summary, ethnography is a method designed to describe a culture. The ethnographer seeks to understand another way of life from the perspective of a person inside the culture (emic view). 

    Participant observation and informant interviewing are the major strategies used during fieldwork. The specific ethnographic tradition used by the investigator determines the form of the ethnographic product.