Ethical Challenges of Conducting Qualitative Research in the Intensive Care Unit

2.50
Hdl Handle:
http://hdl.handle.net/10755/157745
Type:
Presentation
Title:
Ethical Challenges of Conducting Qualitative Research in the Intensive Care Unit
Abstract:
Ethical Challenges of Conducting Qualitative Research in the Intensive Care Unit
Conference Sponsor:Western Institute of Nursing
Conference Year:2009
Author:Hansen, Lissi, PhD, RN
P.I. Institution Name:Oregon Health & Science University
Title:Assistant Professor
Contact Address:3455 SW US Veterans Hospital Rd., Portland, OR, 97239, USA
Contact Telephone:503-418-3357
Co-Authors:Judith Kendall, PhD, RN, Professor; Nancy Press, PhD, Professor; Susan Rosenkranz, MA, Research Associate
The nature of qualitative research in the intensive care unit (ICU) raises ethical questions not only about how we behave as researchers and nurses, but also as individuals confronted with the critical illness of others. This paper addresses unique ethical challenges our research team encountered while conducting a qualitative prospective longitudinal case study to capture the complexity of life sustaining treatment (LST) decision making in the ICU from the perspectives of three distinct participant groups: 1) patients with end-stage liver disease, 2) family members, and 3) health care providers. We present ethical challenges that emerged as the study unfolded, drawing upon 244 hours of data collection in the ICU, which included five cases - a total of five patients, 14 family members, and 95 health care providers. Data were collected from the time patients were admitted to the ICU to when they left the unit. Our study design using ethnographic methods including direct observation and interviews proved fruitful for our research, but the methods also raised serious ethical dilemmas. We describe actual strategies used by the research team to address these challenges encountered during all phases of the study and provide recommendations for nursing practice. First, we address ethical challenges met during the enrollment of each participant group. What we found was that each group presented a unique set of challenges to the consent process and our ethical responsibility to study participants' well-being. We also consider motivation for participation. The fact that the study was a potential intrusion at a time of crisis and vulnerability meant it was crucial that we paid extra attention to the motivation and voluntariness of participants' choices when asking for consent at such times. We found it helpful to continually assess motivation for participation throughout the study, taking cues from daily interview and observation data. Next, we discuss how interviewing and observation data collection methods raised unique challenges, particularly in terms of our roles as researchers, nurses, and individuals, each with its own set of ethics. For example, when the researcher was a nurse, there was the added complexity that participants expected us to respond with technical advice, information, and nursing care. Thus, at times we found ourselves caught between the demands of rigorous research and the ethical responsibilities of the nursing profession. Finally, we address issues of role conflict as we ended data collection with participants. Of concern was how we balanced our role as researchers and our sense of responsibility to the relationships we built over time with participants. As we met ethical challenges during the research, we reflected upon how our multiple roles intersected and, at times, merged and considered how our responses to ethical challenges might have been interpreted by our participants. This study (1R21 NR009845-01A2) is funded by the National Institute of Nursing Research/National Institutes of Health.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleEthical Challenges of Conducting Qualitative Research in the Intensive Care Uniten_GB
dc.identifier.urihttp://hdl.handle.net/10755/157745-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Ethical Challenges of Conducting Qualitative Research in the Intensive Care Unit</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2009</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Hansen, Lissi, PhD, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Oregon Health &amp; Science University</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">3455 SW US Veterans Hospital Rd., Portland, OR, 97239, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">503-418-3357</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">hansenli@ohsu.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Judith Kendall, PhD, RN, Professor; Nancy Press, PhD, Professor; Susan Rosenkranz, MA, Research Associate</td></tr><tr><td colspan="2" class="item-abstract">The nature of qualitative research in the intensive care unit (ICU) raises ethical questions not only about how we behave as researchers and nurses, but also as individuals confronted with the critical illness of others. This paper addresses unique ethical challenges our research team encountered while conducting a qualitative prospective longitudinal case study to capture the complexity of life sustaining treatment (LST) decision making in the ICU from the perspectives of three distinct participant groups: 1) patients with end-stage liver disease, 2) family members, and 3) health care providers. We present ethical challenges that emerged as the study unfolded, drawing upon 244 hours of data collection in the ICU, which included five cases - a total of five patients, 14 family members, and 95 health care providers. Data were collected from the time patients were admitted to the ICU to when they left the unit. Our study design using ethnographic methods including direct observation and interviews proved fruitful for our research, but the methods also raised serious ethical dilemmas. We describe actual strategies used by the research team to address these challenges encountered during all phases of the study and provide recommendations for nursing practice. First, we address ethical challenges met during the enrollment of each participant group. What we found was that each group presented a unique set of challenges to the consent process and our ethical responsibility to study participants' well-being. We also consider motivation for participation. The fact that the study was a potential intrusion at a time of crisis and vulnerability meant it was crucial that we paid extra attention to the motivation and voluntariness of participants' choices when asking for consent at such times. We found it helpful to continually assess motivation for participation throughout the study, taking cues from daily interview and observation data. Next, we discuss how interviewing and observation data collection methods raised unique challenges, particularly in terms of our roles as researchers, nurses, and individuals, each with its own set of ethics. For example, when the researcher was a nurse, there was the added complexity that participants expected us to respond with technical advice, information, and nursing care. Thus, at times we found ourselves caught between the demands of rigorous research and the ethical responsibilities of the nursing profession. Finally, we address issues of role conflict as we ended data collection with participants. Of concern was how we balanced our role as researchers and our sense of responsibility to the relationships we built over time with participants. As we met ethical challenges during the research, we reflected upon how our multiple roles intersected and, at times, merged and considered how our responses to ethical challenges might have been interpreted by our participants. This study (1R21 NR009845-01A2) is funded by the National Institute of Nursing Research/National Institutes of Health.</td></tr></table>en_GB
dc.date.available2011-10-26T20:09:49Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:09:49Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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