The Challenges of Using Ethnographic Methods to Research End-of-Life Decision Making in Older Hospitalised Patients

2.50
Hdl Handle:
http://hdl.handle.net/10755/304131
Category:
Abstract
Type:
Presentation
Title:
The Challenges of Using Ethnographic Methods to Research End-of-Life Decision Making in Older Hospitalised Patients
Author(s):
O'Neill, Catherine Sarah
Lead Author STTI Affiliation:
Alpha Nu
Author Details:
Catherine Sarah O'Neill, PhD, BA, MA, MSocSc, RGN, coneill@rcsi-mub.com
Abstract:

Session presented on: Wednesday, July 24, 2013

Purpose: 'This 'paper examines the ethical and methodological challenges of using ethnographic methods to develop knowledge around the processes involved when decisions relating to medical treatments are made in the care of older patients in hospitals. For some patients, decisions to withdraw 'medical treatments or not to treat, resulted in the end-of -life.

Methods: An ethnographic approach was used to generate data. This involved extensive fieldwork over a period of two years in two acute university hospitals in Dublin, Ireland. The study participants were family members, patients, doctors, nurses and other allied health care practitioners. In total, '42 interviews were carried out and '13 patient cases were followed.'

Results: 'The findings evidenced that frequently, older patients, because of their illness, were unable and uninterested in being actively involved in the treatment decision making process. They left decisions to family members, nurses and doctors. Clinicians used thin technical scientific discourses to talk to patients and family members about diagnoses and treatments. Family member's decision making processes drew on the themes of the patient's biography, the patient's values and the social knowledge of other people in similar situations.''Balancing of the dual roles of professional responsibility as a researcher, while engaging in human relationships and generating data around the sensitive issues of death and dying were challenging. 'Issues of representation in the final write up demanded continued ethical sensitivity to maintain the dignity, privacy, and integrity of all participants, while simultaneously constructing an academically robust text.'

Conclusion: There are many ethical dimensions embedded in the use of ethnographic research methods. These ethical dimensions, however, should not preclude research on sensitive topics related to patient care. In particular older patients preferences concerning treatments at what may, ''for some, be 'an end- of- life decision.

Keywords:
Ethnographic Methods; Older Patients and Family Involvment; Treatment Decisions
Repository Posting Date:
22-Oct-2013
Date of Publication:
22-Oct-2013 ; 22-Oct-2013
Conference Date:
2013
Conference Name:
24th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Prague, Czech Republic
Description:
24th International Nursing Research Congress Theme: Bridge the Gap Between Research and Practice Through Collaboration. Held at the Hilton Prague Hotel.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.language.isoenen
dc.type.categoryAbstracten
dc.typePresentationen
dc.titleThe Challenges of Using Ethnographic Methods to Research End-of-Life Decision Making in Older Hospitalised Patientsen
dc.contributor.authorO'Neill, Catherine Sarahen
dc.contributor.departmentAlpha Nuen
dc.author.detailsCatherine Sarah O'Neill, PhD, BA, MA, MSocSc, RGN, coneill@rcsi-mub.comen
dc.identifier.urihttp://hdl.handle.net/10755/304131-
dc.description.abstract<p>Session presented on: Wednesday, July 24, 2013</p><b>Purpose: </b>'This 'paper examines the ethical and methodological challenges of using ethnographic methods to develop knowledge around the processes involved when decisions relating to medical treatments are made in the care of older patients in hospitals. For some patients, decisions to withdraw 'medical treatments or not to treat, resulted in the end-of -life. <p><b>Methods: </b>An ethnographic approach was used to generate data. This involved extensive fieldwork over a period of two years in two acute university hospitals in Dublin, Ireland. The study participants were family members, patients, doctors, nurses and other allied health care practitioners. In total, '42 interviews were carried out and '13 patient cases were followed.' <p><b>Results: </b>'The findings evidenced that frequently, older patients, because of their illness, were unable and uninterested in being actively involved in the treatment decision making process. They left decisions to family members, nurses and doctors. Clinicians used thin technical scientific discourses to talk to patients and family members about diagnoses and treatments. Family member's decision making processes drew on the themes of the patient's biography, the patient's values and the social knowledge of other people in similar situations.''Balancing of the dual roles of professional responsibility as a researcher, while engaging in human relationships and generating data around the sensitive issues of death and dying were challenging. 'Issues of representation in the final write up demanded continued ethical sensitivity to maintain the dignity, privacy, and integrity of all participants, while simultaneously constructing an academically robust text.' <b></b><p><b>Conclusion: </b>There are many ethical dimensions embedded in the use of ethnographic research methods. These ethical dimensions, however, should not preclude research on sensitive topics related to patient care. In particular older patients preferences concerning treatments at what may, ''for some, be 'an end- of- life decision.en
dc.subjectEthnographic Methodsen
dc.subjectOlder Patients and Family Involvmenten
dc.subjectTreatment Decisionsen
dc.date.available2013-10-22T20:29:43Z-
dc.date.issued2013-10-22-
dc.date.issued2013-10-22en
dc.date.accessioned2013-10-22T20:29:43Z-
dc.conference.date2013en
dc.conference.name24th International Nursing Research Congressen
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen
dc.conference.locationPrague, Czech Republicen
dc.description24th International Nursing Research Congress Theme: Bridge the Gap Between Research and Practice Through Collaboration. Held at the Hilton Prague Hotel.en
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