Clinical application research through reflection, interpretation and new understanding – a hermeneutic design

Abstract

The implementation of theoretical knowledge in clinical practice and the implementation of good clinical practice into theory have been of interest in caring science for the last 30 years. The aim of this article was to elaborate and discuss a methodology named clinical application research. The method is grounded in a hermeneutical design inspired by Gadamer's philosophy. The methodology, clinical application research, has been used in a research project A life in dignity and experiences from the researchers forms the bases for the elaboration and discussion. The project was performed in collaboration with residents, family caregivers and healthcare providers at six nursing homes in Scandinavia. The material for this article is based on the previous research, that is the results from 10 different articles showing the meaning of dignity and indignity in daily life in nursing homes. Data were generated from 56 individual interviews and 18 focus-group interviews with a total of 40 staff members with five to eight participants at every interview session. By reflection, interpretation and new understanding our results provide knowledge about dignity and how to preserve dignity for older people in an appropriate ethical way. The methodology was relevant for the research project A life in dignity and relevant to caring practice in nursing homes as it opens new possibilities and new ways of thinking when performing dignified care to older people.

But is It Hermeneutic Enough?: Reading for Methodological Salience in a Scoping Review of Hermeneutics and Implementation Science

“…Amongst the 22 papers rejected at the final review stage, we did find elements that were also present in the final five. Two studies for example used a participatory research design, where hermeneutics was used in data analysis (Dellenborg et al, 2012;Lindwall et al, 2018) but we found the analysis lacked depth or sufficient critical distance from the raw data. Several studies identified the need for some form of reflective space in which practitioners could make sense of problems arising in practice, as did two of the final five included in the scoping review (Darbyshire, 1994;Larsson & Blomqvist, 2015).…”

Dignity: An Essential Foundation for Promoting Health and Well-Being

“…In the following section, we will describe and discuss from different perspectives how we can understand and make use of the knowledge of dignity and indignity to promote health, having in mind the importance of nurturing the inner strength in old people living in nursing homes [35][36][37]. We will consider this matter in light of the results of a major Scandinavian study called A life in dignity, the main purpose of which was to explore the dignity and indignity of patients in nursing homes from the perspective of patients, family caregivers, and health personnel [31,38,39]. The overall study had a hermeneutical design inspired by Gadamer's philosophy [21].…”

Bringing People Back to the Future: The Role of Hermeneutic Temporality in Participatory Research

“…From both approaches, humans are perceived as agents who can act, speak for themselves, reflect on their lives and social worlds, shape their lives and the lives of others (Montreuil & Carnevale, 2016). When using a participatory approach to research, knowledge production is seen as a cocreative process, that is, a coconstruction between stakeholders and researchers, instead of being developed by researchers alone (Heron & Reason, 1997;Koskinen & Nystrom, 2017;Lindberg et al, 2013;Lindwall et al, 2018;Ranheim & Arman, 2014). Within this view, there is a shared interpretation of the data generated from research-a fusion of horizons-that contributes to yield a shared understanding of the meaning of the data (Gadamer, 1976, p. 39;Rodgers, 2005).…”