Abstract
Phenomenology is a ritual of Qualitative research methodology. Interviews in healthcare enables researchers to recognise and understand data from lived experiences of the participants by using Phenomenological approach.
The purpose of this article is to review the various face to face in depth interviews conducted using Husserl’s descriptive, Heidegger’s interpretive phenomenology or Hermeneutic phenomenological approach in healthcare. The in-depth interview will help to understand the health issues and ethical issues faced by participants.
Methodology
Four articles were selected based on phenomenological approach.
Article.1 was based on Hermeneutic Phenomenology approach. In this study thirteen women were taken as sample. Sampling was done by snowball method. The women were asked to share their rural maternity experience. Data was analyzed without any influence of the researcher.
Article.2 was based on Transcendental phenomenology. There were 15 students from 4 different cultural background belonging to different health professional programmes like nursing, medicine, pharmacy, dentistry, and physical therapy. Triangulation methods were used and semi structured interviews were conducted, recorded and transcribed. Health professional students shared their lived experience with patients.
Article.3 was based on a study conducted using both Transcendental phenomenology for patients interviews and Hermeneutic phenomenology for healthcare professionals’ interviews.
The semi structured interview of patient was taken to understand and record their lived experience with the medication without any bias or interpretation and data received was bracketed. The healthcare professionals’ interviews were conducted on Hermeneutic strategy regarding the medications they prescribe for life threatening illnesses.
Article 4 was based on Hermeneutic phenomenological approach. There were nine patients selected and in depth semi-structured interviews were conducted. The patients shared their experience of living with a life limiting illness.
Author Contributions
Academic Editor: Sasho Stoleski, Institute of Occupational Health of R. Macedonia, WHO CC and Ga2len CC.
Checked for plagiarism: Yes
Review by: Single-blind
Copyright © 2021 Farzeen Tanwir, et al.
This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Competing interests
The authors have declared that no competing interests exist.
Citation:
Introduction
Qualitative research is an unquantifiable knowledge about human life world. It is the way to give words and meanings to symbolic interactionism. It seeks the perspectives of the research participants and interprets their understanding of their life experiences and events.
There are different qualitative research strategies used in Healthcare research. The purpose of this report is to briefly review the various face to face in depth interviews using phenomenological approach in healthcare. The in-depth interview will help to understand the health issues and ethical issues faced by participants.7
Qualitative research has been a part of the field of Healthcare since the 70s and 80s. Interview is the most common way of collecting qualitative data. The purpose of the qualitative research interviews in healthcare is to understand and gain information from lived experiences of the participants by using Phenomenological approach. They give conceptual and theoretical knowledge about life experiences of the participants 4. The preferred Phenomenological approach in healthcare interviews provides in-depth, contextualised, open-ended responses from research participants about their views, opinions, feelings, knowledge, and experiences 9
Interview is the most versatile method used in qualitative research. It is the means to gain insight to participants’ views and opinions. The methods of Interviews used can be structured, semi-structured and unstructured. It consists of organized predetermined open-ended questions. These questions are flexible and may be modified according to the situation and response. It ensures that the participants are replying to the questions related to the topic of research. It also must let the participants express their agreement and disagreement along with their opinions. Interviews can be conducted with an individual or in groups 13. The in-depth interview is a subjective and detailed direct verbal method used to draw detail narratives from the participants. The foundation for a good interview is based on the Ten commandments of interviewing that focuses on respect for the participants and being understanding and sensitive to the issue being interviewed along with assurance of safety and confidentiality. Semi-structured in-depth interviews with Phenomenology approach are most commonly used in healthcare.
Phenomenology is the study of phenomena as they appear in our experience, the way we understand and perceive the phenomena of subjective lived experience 12. Phenomenology is the study about phenomena as they appear in our lifeworld. It is about exploring the life experience and how we perceive, understand and deduce the meaning of the phenomena in the subjective experience 14.
The Phenomenological strategy in Qualitative research originates from 20th century. The philosophical traditions of Edmund Husserl, a German mathematician and the founder of philosophical movement of transcendental (descriptive) phenomenologyand Martin Heidegger who brought forward Hermeneutic (interpretive) phenomenology showed new dimensions of the approach. It is a philosophical approach that concentrates on phenomena and the way we perceive it instead of actual reality of life world. It explores the confrontation between consciousness and the world 8.
Edmund Husserl defines Transcendental phenomenology as a lived experience of a person. This approach is less interpretive, and the rich data is very descriptive. The lived experience phenomenon goes beyond sensory perception and the researcher keeps their own perception, bias or previous beliefs away during data analysis10.
Hermeneutic phenomenology is an interpretive phenomenology, that was based on the philosophy of Martin Heidegger. It is based on the interpretations of experiences of participants in their life world. Heidegger considered individuals as actors and therefore he concentrated on the relation of individual and their life world. He explained that the individual’s experiences were influenced by the world around them. Historical background is implied in order to understand the concept under research. Researchers perception biases and belief system influences the data analysis 6.
Literature Review
Article 1
A qualitative research was conducted using Hermeneutic Phenomenology approach. The article published was’’ Open, trusting relationships underpin safety in rural maternity a Hermeneutic phenomenology study’’3.
In this study thirteen women were taken as sample. Sampling was done by snowball method. The women were asked to share their rural maternity experience. The research was conducted with in-depth unstructured interview. The interview was recorded and transcribed and data was interpretively analysed.
The interviews conducted by Hermeneutic approach gave the opportunity to analyse the data without any influence of the researcher. The women disclosed the maternity experience in the rural health care. The focus of this approach is to understand the meaning from lived experience descriptions bringing knowledge and unbiased interpretation of data. This would help healthcare providers to better their treatment and services.
Article 2
A Transcendental phenomenology research was conducted, and the article was published as ”International service learning (ISL) and interprofessional education in Ecuador: Findings from a phenomenology study with students from four professions” 1.
The main objective of study was to understand the lived experience and explain the shared experience of health professional students participating in an ISL trip to a small community in Ecuador. There were 15 students from 4 different health professional programmes. They belonged to nursing, medicine, pharmacy, dentistry and physical therapy. The participants came from a different profession and different country having no knowledge of the patients in Ecuador. The differences of culture fulfilled the requirement of Transcendental phenomenological study. Triangulation methods were used. There were semi structured interviews conducted, recorded, and transcribed. The results showed limitation of knowledge and some bias when writing descriptive result6.
Article 3
‘I don’t think I’d be frightened if the statins went’: a phenomenological qualitative study exploring medicines use in palliative care patients, carers and healthcare professionals 15. A study was conducted using both transcendental phenomenology for patients interview and Hermeneutic phenomenology for healthcare professionals’ interviews
The semi structured interview of patient were taken to understand and record their lived experience with the medication according to their experience without any bias or interpretation and the knowledge received was bracketed. This type of Hermeneutic and transcendental approach led to different response of patients and based on that healthcare providers can understand the patients perspective better. Transcendental approach gave patients the opportunity to share their lived experience and to be able to express their agreement and disagreement. Such approach is helpful in designing better options for patients.
The healthcare professionals’ interviews were conducted on Hermeneutic strategy regarding the medications they prescribe for life threatening illnesses. There was previous knowledge and interpretations and discussions took place before recording and analyzing data.
Article 4
A qualitative research was conducted using Hermeneutic phenomenological approach. The article published was “Experiences of time: A qualitative inquiry into experiences of time as described by palliative care inpatients” 11.
There were nine patients selected and in depth semi-structured interviews were conducted. The patients shared their experience of living with a life limiting illness. The interviews were conducted using Hermeneutic approach. It gave the researcher an opportunity to analyse the palliative patients and to explore their lived experience and interpret it and get meaning out of it. The interpretations are done by the researcher were based on previous knowledge about the life limiting illnesses and their life worlds.
Ethical Consideration
All ethical requirements were fulfilled. Consent forms were signed. Ethical approval for interviews is taken form the Ethical board.
Benefits of Phenomenology
It is the best approach in Healthcare for improvement in patient care and healthcare services
Inexpensive method of collecting data.
There is direct Interaction with Participants
The researcher can ask probing questions for Sclarification and better understanding
Researcher can also observe nonverbal responses
Data is narrative in the participants’ own words
A great opportunity to understand lived experience of humans in their life world
The researcher gets deeply involved in the research topic
It’s a flexible method
The rich data can be collected at different settings
Limitations of Phenomenology
It is difficult to study large population
Opinionated participants may dominate the thoughts of other participants
Result is difficult to analyse keeping the parameters in mind
There is a critical opinion that it is difficult to analyse the data without being biased
This kind of approach may require a moderator.
Discussion
Phenomenology is a Qualitative research practice established in the 20th century philosophical beliefs of Edmund Husserl (descriptive) and Martin Heidegger (interpretive) approach.
Husserl philosophy. was linked to an individual’s personal experience where everyday conscious experiences were described while preconceived opinions were set aside or bracketed.
Martin Heidegger was Husserl’s student and disagreed with the ideology of description.
Heidegger established interpretive phenomenology by broadening the concept of Hermeneutics and came up with the philosophy of interpretation2.
He broadened Hermeneutics by studying the concept of being in the world and having preconceived ideas. Hermeneutics is more than just describing or experiencing ,it has meanings based on everyday lived experiences. The basic principle of the Hermeneutic interpretive school of thought is that researchers cannot separate themselves from the interpretations obtained from the data and ideas ,opinions cannot be bracketed .
Phenomenological approach in healthcare interviews provide in-depth, contextualised, open-ended responses from research participants about their views, opinions, feelings, knowledge, and experiences. Interview is the most versatile method used in qualitative research. It is the means to gain insight to participants’ views and opinions. Interpretive phenomenology is used when the research question asks for the meaning of the phenomenon . Descriptive phenomenology is used when the researcher wants to describe the phenomenon under study and brackets their biases 5.
In article 1the interviews conducted by Hermeneutic approach gave the opportunity to analyse the data without any influence of the researcher. The women disclosed the maternity experience in the rural health care. The focus of this approach is to understand the meaning from lived experience descriptions bringing knowledge and unbiased interpretation of data. This would help healthcare providers to better their treatment and services.
Article 2 was based on Transcendental phenomenology. A research was conducted with 15 students from 4 different health professional programmes. They belonged to nursing, medicine, pharmacy, dentistry, and physical therapy. The participants came from a different profession and different country having no knowledge of the patients in Ecuador. The differences of culture fulfilled the requirement of Transcendental phenomenological study. Triangulation methods were used. There were semi structured interviews conducted, recorded, and transcribed. The results showed limitation of knowledge and some bias when writing descriptive result.
In article 3 a study was conducted using both transcendental phenomenology for patients interviews and Hermeneutic phenomenology for healthcare professionals’ interviews
The semi structured interview of patient were taken to understand and record their lived experience with the medication according to their experience without any bias or interpretation and the knowledge received was bracketed. Transcendental approach gave patients the opportunity to share their lived experience and to be able to express their agreement and disagreement. The healthcare professionals’ interviews were conducted on Hermeneutic strategy regarding the medications they prescribe for life threatening illnesses. Such approach is helpful in designing better options for patients.
In article 4. The interviews were conducted using Hermeneutic approach. There were nine patients selected and in depth semi-structured interviews were conducted. The patients shared their experience of living with a life limiting illness. It gave the researcher to analyse the palliative patients an opportunity to explore their lived experience and interpret it and get meaning out of it. The interpretations are done by the researcher were based on previous knowledge about the life limiting illnesses and their life worlds.
Conclusion
The selection of an appropriate phenomenological research method should be compatible with the philosophical principles of either Husserl’s descriptive or Heidegger’s interpretive phenomenology based on the integrity of the proposed research.
In-depth interviews with phenomenology approach in healthcare provides deep knowledge and insight of the lived experience of the participants.
The clinical questions related to health care are complex and they must be designed carefully. Research in healthcare can be done using in depth semi-structured interview method. The rich data provided by the participants must be utilized for the betterment of healthcare.
References
- 1.Audrey M Johnson, Dana M Howell. (2017) International service learning and interprofessional education in Ecuador: Findings from a phenomenology study with students from four professions. , Journal of Interprofessional Care 31(2), 245-254.
- 2.J W Creswell. (2009) . Research Design: Qualitative, Quantitative, and Mixed Methods Approaches. 3rd ed. Thousand Oaks:SagePublications .
- 3.Crowther S, Smythe E. (2016) Open, trusting relationships underpin safety in rural maternity a Hermeneutic phenomenology study. , BMC Pregnancy and Childbirth 16(1), 370.
- 4.DiCicco‐Bloom B, B F Crabtree. (2006) The qualitative research interview. , Medical Education 40(4), 314-321.
- 5.Idczak S E. (2007) I am a nurse: Nursing students learn the art and science of nursing. , Nurs Educ Perspect 28, 66-71.
- 6.Kafle N P. (2011) Hermeneutic phenomenological research method simplified.Bodhi: Interdiscip J. 5, 181-2.
- 10.Reiner’s G M. (2012) Understanding the differences between Husserl’s (descriptive) and Heidegger’s (interpretive) phenomenological research. , J Nurs Care 1, 1-3.
- 11.Robertson M. (2015) Experiences of time: A qualitative inquiry into experiences of time as described by palliative care inpatients. Palliative & Supportive Care. 13(1), 67-73.
- 12.Rodriguez A, Smith J. (2018) Phenomenology as a healthcare research method Evidence-Based Nursing BMJ. 21, 96-98.
- 13.G M Scott, Garner R. (2012) Doing qualitative research designs, methods, and techniques Pearson Education.
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