Abstracts fra Bibliotek for Læger 3/2009

Introduktionsartikel: Kvalitative metoder i sundhedsvidenskaberne
Hanne Andersen & Lone Schmidt

Qualitative research methods in the health sciences. An introduction.

Bibl Læger 2009;201:302–10.

During recent decades, qualitative research methods have been successfully introduced in many areas of the health sciences. This introductory article offers a brief overview of the history of qualitative research methods and their introduction into the health sciences with an emphasis on Scandinavian contributions. Before introducing the three articles of the special issue, the paper provides a short discussion of the characteristics of qualitative research methods and discusses why they have become popular.

Originalartikel: Bemærkninger om kvalitative undersøgelsers erkendelsesteori
Klemens Kappel & Finn Collin

Notes on the epistemology qualitative research.

Bibl Læger 2009;201:311-34.

This article deals with the epistemology of qualitative methods, especially in their application to human and social phenomena. Two main epistemological problems are investigated. The first problem is that of justification of theoretical interpretations of a particular body of qualitative data, using »inference to the best explanation« as its tool. The second problem is that of generalizing such interpretations to a broader domain of phenomena. Some pains are taken to show that these problems are special cases of challenges that pertain to all scientific research, including such using quantitative methods; indeed, they reflect aspects of man’s cognitive predicament as such. Investigation of human phenomena, whether qualitative or quantitative, does indeed involve methods that have no place within natural science, such as intentional analysis (sometimes referred to as phenomenological or hermeneutical methods), but these do not in themselves constitute novel or unique problems. In particular, like all research methods, qualitative methods employed in the study of human phenomena should aim at reliability, that is, serve as reliable tools for the generation of true claims about the world.

Originalartikel: Aftrapning af respiratorbehandling. En case til belysning af kvalitative metoders brug i sundhedsvidenskaberne
Ingrid Egerod

Mechanical ventilator weaning – a case for illustrating qualitative research methods in health care sciences.

Bibl Læger 2009;201:335–49 .

Background: Long-term mechanical ventilation is associated with patient discomfort and increased morbidity and mortality. In Denmark weaning is formally a responsibility of the doctor, while the process is often delegated to critical care nurses. Studies on weaning have mostly been directed toward biomedical issues, while the present study offers a new approach by viewing weaning as a social process rather than a biomedical technology. 

Methodology: Weaning was explored using case study research, including triangulation of sources and methods. The study had an instrumental multiple-case multi-center design with a predominantly qualitative approach. 

Results: The study demonstrated that nurses participate in decision making, which in turn promotes the process of weaning. Although nurses lack formal competencies they are relied upon to act dynamically to the patient response during the process of weaning. The study demonstrated inconsistent perceptions of the stages of weaning among doctors and nurses, affecting communication and decision making. Nurses participated in decision making using a variety of decision modalities, mostly collaborative and interdisciplinary. 

Conclusion: A qualitative approach to mechanical ventilator weaning has provided new insights into social interaction in clinical practice, which might impact the patient outcome. Clinical practice guidelines are recommended to support decision making and improve consistency, while maintaining an individual patient approach.

Originalartikel: Den kvalitative artikel. En analyse af forskningsformidling som en spejling af forskningspraksis og videnskabssyn
Beth Elverdam & Lina Klara Hoel Felde 

The qualitative article

Bibl Læger 2009;201:350–70.

The aim of this article is to reflect on something unreflected: the art and tradition of writing scientific research articles. How to write a scientific article is not something decided by the individual researcher. Health care research is a field where different research traditions meet – where the natural science tradition (medicine) meets the traditions of the humanities and the social sciences. Each scientific tradition has its own praxis and theory of science and each tradition has its standards for good research praxis. The different research traditions are reflected in the expectations for how research is written up and presented. Comparing medicine (as a science) and social constructivist social science we compare and reflect the different approaches and traditions as an argument and take-off for contemplating diversity in writing traditions and especially the position of writing qualitative medical research. The differences in writing up research illustrates the difference between the ideal of the independent researcher seeing one and only one world, and the researcher who is aware of being an active co-constructor in a research praxis – the difference between research as a technique and research as a reflexive process.

Forside: Den amerikanske seksualforsker Alfred C. Kinsey (1894–1956) i en karakteristisk interviewsituation anno 1950. Kinsey baserede sine opsigtsvækkende afhandlinger om amerikanske mænds og kvinders seksualliv på tusindvis af sådanne samtaler. Han benyttede en kombineret kvali- og kvantitativ metodik, idet han forholdt sig åbent lyttende til sine respondenters seksuelle livshistorier, som han undervejs kodificerede i et selvopfundet spørgeskema med mange hundrede svarkategorier. 

Hans rapporter udkom i 1948 og 1953 og blev i Danmark fulgt op af psykiateren Kirsten Auken (1913–1968), som i 1953 disputerede med afhandlingen »Undersøgelser over unge Kvinders sexuelle Adfærd«. Kinseys enorme materiale befinder sig i dag under lås og slå på Indiana University i Bloomington. (Foto fra Jonathan Gathorne-Hardys biografi »Sex – the measure of all things«, 2000).