Connotations of Research Speak: The Meaning of Words Used in Research Reports

Do we allow or invite people to participate in research? Do we refer to people who volunteer to be in a study as subjects or respondents or informants or participants or people?

This blog is about the language we use when we present or publish our research. The impetus for this blog was a colleague’s recent declaration that people were “allowed” to share their experiences of a health related condition for a study. The blog is a follow up to a previous blog that addressed the implication of power when using words such as compliance and adherence and, perhaps, even concordance (Fawcett, 2020), as well as another previous blog focused on diverse meanings of power (Fawcett et al., 2020).

Upon hearing my colleague state that people were “allowed,” I immediately thought: What is meant by indicating that a researcher “allows” people who volunteer to be in a study so to provide answers to the researcher’s questions in an interview format or via a numeric survey? Does stating that the researcher “allows” the people who volunteer for the study to do whatever the researcher wants them to do mean that the researcher holds power over them? Is a “power over” relationship appropriate for what many nursologists claim as a core value and approach to people, that is, “relationship-centered care?” (See Wyer, Alves Silva, Post, & Quinlan, 2014). Does “allowing” people to share experiences for the purposes of research connote “paternalism, coercion, and acquiescence” (Hess, 1996, p. 19), Should we instead “invite” people to share their experiences or answer our survey questions or accept our experimental interventions?

Although most, if not all, nursologists who conduct research no longer refer to the people who volunteer to be in their studies as “subjects,” these people continue to be referred to as “respondents,” the term frequently used when people respond to a numeric survey, or they continue to be referred to as “informants,” when they answer open-ended interview questions. Perhaps most frequently, the people are referred to as a sample or population of “participants.” Until very recently, I was content with referring to people who volunteered for research projects as “participants.” However, I have begun to think that if we nursologists truly value and support relationship-centered care, we should personalize those who volunteer for our research projects. For example, many of the people who have volunteered for my Roy Adaptation Model-guided program of research (Clarke & Fawcett, 2014; Tulman & Fawcett, 2003).) are women during the childbearing phase of life. Should I refer to these people as women rather than participants?

I invite readers to offer their ideas for words that are most compatible with nursologists’ values about our relationships with people who volunteer for our research projects.

References

Clarke, P.N., & Fawcett, J. (2014). Life as a nurse researcher. Nursing Science Quarterly, 27, 37-41.

Fawcett, J. (2020, March 17). What is Reflected in a Label about Health? Non-Nursology and Nursology Perspectives. Blog. https://nursology.net/2020/03/17/what-is-reflected-in-a-label-about-health-non-nursology-and-nursology-perspectives/

Fawcett, J., Shitaki, Y., Tanaka, K., Hashimoto, Y., Fujimoto, R., & Higashi, S. (2020, September 1). Meanings of power. Blog. https://nursology.net/2020/09/01/power-in-nursing/

Hess, J. D. (1996). The ethics of compliance: A dialectic. Advances in Nursing Science, 19(1), 18-27.

Tulman, L., & Fawcett, J. (2003). Women’s health during and after pregnancy: A theory-guided study of adaptation to change. Springer.

Wyer, P. C., Alves Silva, S., Post, S. G., & Quinlan, P. (2014). Relationship-centred care: antidote, guidepost or blind alley? The epistemology of 21st century health care. Journal of Evaluation in Clinical Practice, 20(6), 881–889. https://doi-org/10.1111/jep.12224

Posthumxnism and the Pandemic

Co-contributors with Jessica Dillard Wright:*
Jane Hopkins Walsh
Brandon Blaine Brown

One of the things that’s coming to light is how the global spread of a microscopic virus is placing the ravages of racism and inequity under the microscope. But the fact is, we don’t all see the same thing! Racism has a way of actually DISTORTING our vision. Intertwined with many other forms of social domination, racism is mercurial, innovative, even viral.” (Benjamin, 2020

Celestial Octopus

Our Celestial Octopus, emblem of the Compost Collaborative, created by nurse-artist Christian Tedjasukmana

As the Compost Collaborative,** a posthumxn rhizome of feminist, queer, nursing joy and terror, we wish to acknowledge some of the deep, enduring, and trenchant lessons of our dystopian present. As friends and scholars, we are deeply connected by a shared passion for a radical posthumxn path for the future of nursing. We first wish to convey our deep love, respect, and solidarity for the nurses who are actively engaged in the dangerous daily work of caring for folks infected with COVID19. Second, we recognize our privilege and positionality as white colonizers with access to medical care, physical goods, and material resources, knowing that power and access are not shared by all, deeply contingent on the intersections of race, gender, sexuality, class, colonial positionality. Posthumxnism is a critique of and response to humanism and its anthropocentric fixation, one that seeks to scrutinize the humxn and nonhumxn consequences of capitalism (Bradiotti, 2019). In advancing a posthumxn critique for and of nursing in the time of COVID19, we see our work growing out of the emancipatory tradition, centering critical perspectives, feminist analyses, queer inquiry, justice-oriented praxis as we navigate terra incognita (Kagan et al., 2014; Grace & Willis, 2012).

Here we sit, isolated in distant states recognizing that the dystopian imagined future is suddenly a fervent, fevered reality and nursing along with its healthcare comrades are essentially located in the interstices. Our speculative theorizing about the posthumxn present-future of nursing is in continuity with the future-oriented, space-exploring vision of Martha Rogers (1992), though our cosmic view is tempered with the urgency, pragmatism, and the reality of excavating the past while navigating the crises of our present from pandemic to scarcity to racism to climate change to colonialism to extinctions and more. The urgency for a posthumxn path forward has crashed on the doorstep and posthumxnism is ringing the bell. The posthumxn convergence is calling, Braidotti’s (2019) mash-up vision of posthumxnism and the end of life as we know it. This turn is a critical decentering of humxn in the broad landscape of our ecological terrain that subverts anthropocentric humxnism and its white, ableist, colonial, Eurocentric, cisgender, patriarchal biases, bound up in the neoliberal, capitalist world-ecology, as Jason Moore would call it. 

Humxns are a part of – not rulers over – global political economy-cum-world-ecology, underscored currently by the trans-species complexity of COVID19. In advancing posthumxnism, we also wish to respect and amplify ontological views that are foundational within Indigenous ways of knowing. Long erased by settler-colonial nations and scholars, these ontologies fashion a world in which humans exist coequally with the nonhumxn and the nonliving (LaDuke, 2017).

For a speed course in postanthropocentrism and posthumxnism, consider this novel virus, born of a pangolin, a bird, a pig, a lizard, a bat, a monkey. The viral RNA origins are non-humxn, the virus itself nonliving. Witness the impact as the virus quietly infects and swiftly overpowers contemporary humxnity, bringing powerful global enterprises, international trade, healthcare systems, educational structures, and communities to their knees. Here, the boundaries blur between the humxn and the nonhumxn, the posthumxn subject no longer bios but zoe (Braidiotti, 2019). The pandemic also highlights the communitarian imperative of humxn and nonhumxn life on this rock we call home, as we struggle with social distance and mourn the loss of normalcy. Making kin, Haraway’s (2016) concept of reordering multispecies world relations seems especially relevant in the face of this current crisis, underscoring how inextricably intertwined lives are and continue to become. Humxns shelter in place, leaving nonhumxn creatures to reclaim their once and future territories, roads and highways eerily deserted and quiet, free from the imposition of humxn interlopers. Signs of the postanthropos.

As we think of our planetary crisis, we recognize a cosmic unity similar to that advanced by Martha Rogers in her conceptual framework, the “Science of Unitary Human Beings” (1992). But we also recognize a necessary critique of the concept of “unitary,” problematically failing to account for the historical and contemporary power differentials and legacies of oppression between groups of people in the US and around the globe.  Rogers’ (1992) concept of unitary human beings included an irreducible, indivisible union of people and their worlds (p. 28). The concept of “unity,” however, obscures differentials of power that exist between different communities and their world that enforce inequality. 

We see a posthumxn reading of Rogers’ unitary framework in Posthumxnist Rosi Braidotti’s (2019) insistence that “we-are-(all)-in-this-together but we-are-not-one-and-the-same” (p. 52) that accounts for critical perspectives on how power and oppression structure inequality, even as we endure shared experiences. This reflection on our subjective experience is ever more prescient and poignant as United States political decision-making prioritizes economics and return to normal over humxn life, disappointing but far from surprising given our capitalist imperative to extract! Extract! Extract! And extract some more. As scholar Ruha Benjamin points out as governmental powers push to return to normal, the prepandemic normal was not so great for everyone (2020). 

The uneven unfolding of our dystopian crises belies the jingoistic and unitary notion of “we, the people.” “We, the people” will not experience the pandemic in equitable ways, even while viral RNA presumes to be a great equalizer, making no provision for race, gender, creed, color, sexuality, national identity. In truth, COVID19 etches the inequalities between us deeper still. The virus has and will continue to infect both the powerful and the powerless, though with uneven speed and inequitable consequences. The rich and powerful with unlimited access to viral testing with rapid results, symptomatic or no, while most are turned away. As millions lose their jobs, and with it, health insurance, the cracks in the U.S. healthcare “system” extend and grow wider.

The accretional benefits of power, access, economic and educational accumulation, family reserves built and fortified across generations through a legacy of colonial, white, cisgender, able heteropatriarchy buffer the privileged, making social distance and sheltering in place a relative luxury. White-collar workers collect salaries as they work from home facilitated by the endless, spidery connections that link us via technology, further highlighting our interspecies technological cyborg nature (Haraway, 1990). Even with this kind of padded seclusion there is weirdness, alienation, and violence of its own. The imperative to continue to produce belies the severity of the crisis at hand, even while it is bedecked in the privilege of safety from illness conferred by sheltering in place.

These same principles, sheltering in place and social distance, further marginalized those individuals already on the margins. Hourly-wage earners, the billions of global workers like shopkeepers, caterers, restaurant workers, wait staff, ticket takers wonder how they will survive, subjugated by the laws of Cheap Nature, if they do not have enough money for food and rent (Moore, 2016). Or for medical bills. Or a ventilator. The mundane slow violence of life under capitalism is amplified, writ large under times of crisis, as speculative, nightmarish hypotheticals become breathtaking realities, a startling necropolitics of neoliberalism, the biopolitical power to determine who lives and who dies as a function of capitalism (Mbembe, 2019; Nixon, 2011). This doesn’t even begin to account for the racist violence and inequities of mass incarceration and detention, the impossibility of social distancing for individuals within institutions, and the callous disposability this implies for the individuals trapped by incarceration or detention and those charged with their care.

Posthumxnism asks us to consider what we are capable of becoming, together as humxn and nonhumxn for a more just, egalitarian, and equitable future. This is our charge as posthumxn nurses – to imagine AND THEN CREATE a present-future, one that makes space for the plurality of beings and ways of being in the world, building the bridge as we leap. In building this path, we can cultivate zoecentric knowledge that subverts biocentrism, gazing past the anthropocentric, humxnistic, and exclusionary philosophies that privilege extraction and profit over nature, nonhumxns, and dehumxnized humxns.

The present-future requires that we – as nurses and everyone else – embrace methodologies for cross-pollination between, among, alongside, and interconnected with actors from all crevices of our world ecologies: ecological, geological, political, environmental, animal, mineral, pop-culture, art, media and technology. All bets are off: nothing is too weird or too daring, a radical departure from current modes of nursing thought (Braidotti, 2019). The divisions between theory and philosophy come tumbling down as we seek critical reflection, explanations, understanding, connection, fusion. In this apocalyptic present-future, multispecies posthumxn nursing knowledge can be knit, sung, woven, danced, spun, rapped, embroidered, dyed, hummed, planted in a garden, or spray-painted on train cars, the interrelation of humxn and nonhumxn all a part of the process of posthumxn-becoming. And this proposition of posthumxn knowing is congruent with fine threads of nursing thought, as we consider Rogers (1992) ideas of color, humor, sound, Carper’s (1978) aesthetic way of knowing and the emancipatory ways of knowing advanced by Chinn and Kramer (2018). 

In this space-time of pandemic ennui, which coincidentally coincides with the Year of the Nurse and the Midwife, what we must nurse is radical solidarity, a recognition that we are all in this together, even though we aren’t all the same (Haiven & Khasnabish, 2014). And the stakes are ominously high, should we fail to embrace this communitarianism. A future for healthcare, for sky, for nurses, for ALL people, for plants, for animals, for insects, for viruses, for bacteria, for trash, for compost, for kids, for terra, for seas, for space – any future at all – demands that we work together, composting the boundaries that separate us. This is not what we as nurses imagined for “our year,” but it is poetic-ironic that this is what we face. Together. 

“Despair is not a project, affirmation is.” (Bradiotti, 2019, p. 3).


**We call ourselves Compost Collaborative, a nod to feminist multispecies ecologist Donna Haraway, who captivated our collective imagination and informs our approaches to decaying boundaries of all kinds in nursing and in life. We are scholastically and tentacularly connected in our collaborative work as nurse-compost-scholars. This post was written by Jessica Dillard-Wright, Jane Hopkins Walsh, and Brandon Blaine Brown. Our collaborative is fungible, however, and our ideas are collective, part of a social process influenced by people, animals, environments, and ideas far and wide.

References

Benjamin, R. (2020, April 15). Black skin, white masks: Racism, vulnerability and Refuting black pathology. Retrieved from https://aas.princeton.edu/news/black-skin-white-masks-racism-vulnerability-refuting-black-pathology

Braidiotti, R. (2019). Posthuman Knowledge. Polity Press.

Carper, B. A. (1978). Fundamental Patterns of Knowing in Nursing. Advances in Nursing Science, 1(1), 13–24.

Chinn, P., & Kramer, M. (2018). Knowledge Development in Nursing: Theory and Process (10th ed.). Elsevier.

Grace, P. J., & Willis, D. G. (2012). Nursing responsibilities and social justice: An analysis in support of disciplinary goals. Nursing Outlook, 60(4), 198-207. https://doi.org/10.1016/j.outlook.2011.11.004

Haiven, M., & Khasnabish, A. (2014). The Radical Imagination. Fernwood Publishing.

Haraway, D. (1990). A manifesto for cyborgs: Science, technology, and socialist feminism in the 1980s. In L. Nicholson (Ed.), Feminism/postmodernism (pp. 190–233). Routledge.

Haraway, D. (2016). Staying with the trouble: Making kin in the Chthulucene. Duke University Press.

Kagan, P., Smith, M., & Chinn, P. (2014). Introduction. In P. Kagan, M. Smith, & P. Chinn (Eds.), Philosophy and Practices of Emancipatory Nursing: Social Justice as Praxis (pp. 1–20). Routledge.

LaDuke, W. (2017). All our relations: Native struggles for land and life. Haymarket Books.

Mbembe, A. (2019). Necropolitics (M. Tauch, Trans.). Duke University Press.

Moore, J. (2016). The Rise of Cheap Nature. In Anthropocene or capitalocene: Nature, history, and the crisis of capitalism (pp. 78–115). Kairos Books.

Nixon, R. (2011). Slow violence and the environmentalism of the poor. Cambridge MA:     Harvard University.

Rogers, M. E. (1992). Nursing science and the space age. Nursing Science Quarterly, 5(1), 27-34.

*About the contributors

Jess Dillard-Wright, MA, MSN, CNM, RN

A regular blogger for Nursology.net, Jess is a nurse-midwife and a PhD candidate at Augusta University. Her dissertation is an intellectual history of nursing and feminism, a history of the present untangling the faults and fissures that characterize the interrelationship between feminism and the profession, focusing specifically on Cassandra Radical Feminist Nurses Network. When she is not thinking about nursing, you’ll find Jess hanging out with her three kids and partner. Together, they like to go to the beach, play silly game(may we humbly suggest Throw Throw Burrito?), read books, and *try* to bake amazing things.

Brandon Brown MSN, RN-BC, CNL,

Brandon is a faculty member and Doctor of Education student at the University of Vermont and is one of the founding members of the Nursing Theory Collective. His research interests center upon the philosophical analysis of nursing theory, practice, and pedagogy through a critical posthuman and post-anthropocentric lens. When Brandon is not doing scholarly work, you can find him spending time with his family hiking, canoeing, and camping.

Jane Hopkins Walsh

Jane is a theory loving, Spanish speaking pediatric nurse practitioner at Boston Children’s Hospital. A Nursing PhD Candidate at Boston College, Jane is an immigrant rights activist who is co-enrolled in a certificate program at the Center for Human Rights and International Justice at the Lynch School of Education. Her main areas of interest are global health, im/migrant populations, and community based service delivery models to deliver nursing care for underserved children, emerging adults and families. She was awarded two global grants through Boston Children’s Hospital to coordinate services for children with complex care needs in remote areas of Honduras, and to explore the elevated incidence of chronic kidney disease in Central America with a transnational team. Links to her favorite NGO and volunteer immigrant rights groups can be found at the end of her blog posts on radicalnurses.com

 

 

 

Nursology’s Philosophical and Practical Knowledge: Unified and Interdependent

Guest Contributor: Martha Raile Alligood, RN, PhD, ANEF

A few months ago, Martha Alligood sent me (Jacquelyn Fawcett) this intriguing article: Rovelli, C. (2018). Physics needs philosophy, philosophy needs physics, Foundations of Physics, 48, 481-491. We decided to write a paper, which has evolved into this blog, about the relationship between philosophy and science in nursology. The specific purpose of this blog is to underscore the importance of the relationship between practical knowing and foundational (philosophical) knowing for advancement of nursology.

Alligood writes:

Rovelli (2018) wrote about the interrelationship of philosophy and science (physics). His discussion of practical and foundational knowing led me to think about nursology and the contemporary disciplinary shift to a practical focus from one that was dominated by general foundational philosophical questions. For example, nursological literature has evolved from a strong foundational philosophical knowledge development focus on nursology’s discipline-specific concepts, models, and theories to an equally strong practical focus on quality of practice and nursing education expansion in relation to practice, specifically, the development of the Doctor of Nursing Practice (DNP) degree programs.

Time has shown the value of such shifts in focus for a discipline. Advancement of a discipline calls for recognition and valuing of the complementary relationship between practical knowing and foundational knowing, as both are essential to the development of a professional discipline, such as nursology.

Practical knowledge is–or should be–based on the results of scientific research. However, if science is essential to move the discipline ahead, then philosophy ensures that we move in the right direction. But, “a broader understanding of the interdependence of practical and philosophical matters in professional nursing is needed” (Bruce, Rietze, & Lim, 2014, p. 65). Drawing from Einstein’s discussions of the influence of philosophies and philosophers on his work, Rovelli (2018) noted, “Scientists do not do anything unless they first get permission from philosophy” (p. 484).

Rovelli’s (2018) claim of an interdependent relationship between physics and philosophy for his discipline also is relevant for nursology. That is, contemporary growth and development of nursology requires an explicit interdependent relationship between foundational knowing and practical knowing. Indeed, the re-emergence of nursology as the name for our discipline after its initial introduction in the 1970s (Fawcett, 2018) is evidence of a contemporary need for terminology at a level of abstraction to incorporate all of the discipline’s knowing–both philosophically foundational and scientifically practical.

Within nursing history there are examples of practical knowing leading to foundational knowing, such as research about the impact of patient positioning that has led to foundational knowledge, but it seems that foundational knowing has the capacity to affect practical knowing in a more powerful manner. An excellent example is the clarification of the disciplinary boundaries of nursological knowledge pertaining to human beings, environment, health, and nursing goals and processes (Fawcett, 1984; Fawcett & DeSanto-Madeya, 2013). This metaparadigmatic clarification led to expansion of nursological knowledge, practice, research, education, administration, and perhaps most importantly, a clearer understanding of the theoretical knowledge that existed at that time.  Explaining the relationship of the various models or theoretical works provided clarity and understanding to move nursological knowledge development to a new level.

Ironically, recognizing the structure within which the various conceptual and theoretical frameworks fit may be seen as both practical and philosophical. Some of the very early National League for Nursing (NLN) faculty-curriculum development work that contributed to that understanding was very practical (O’Leary, 1975; Torres & Yura, 1975). Knowledge and understanding leads to future knowledge and understanding. Thus, foundational knowing and practical knowing collectively is nursological knowing that builds on all previous knowing. That is, there is no dichotomy between philosophical and practical knowing; instead, their complementary unified interrelationship may feature one or the other at periods of growth and change in nursology. Clearly, we want to ”counter those who would discard the discipline’s theoretical traditions as irrelevant or counterproductive, we need to [position] this new generation of critical scholarship to champion the intellectually exciting and complex philosophical challenge within which nursing has been engaged throughout its ideational history” (Thorne, 2014, p. 86).

Fawcett writes:

We know from Kuhn’s (1971) classic treatise on scientific revolutions that disciplinary perspectives change over time, typically as the result of scientists’ inability to continue to find support for a previous version of the disciplinary perspective. Sometimes, the revolution is in methodological shifts and sometimes it is in philosophical paradigm shifts. An example of a methodological shift is our contemporary acceptance of mixed methods research instead of the assertion—lasting into the early 2000s–that qualitative and quantitative methods are philosophically separate and, therefore, cannot ever be combined. An example of a philosophical paradigm shift is the growing recognition and acceptance of conceptual models and theories that reflect the simultaneity world view instead of those conceptual models and theories that reflect the totality world view (Parse, 1987).

The growing interest in nursology as the name for our discipline may be the beginning of major methodological and paradigm shifts from the contemporary emphasis on practical knowledge to a fuller understanding of the vital interrelationship of foundational and practical knowledge. These shifts are evident in that acceptance of nursology as the proper name for our discipline indicate that the foundational knowledge of our discipline guides the way we view our science and our practice—always within the context of an explicit nursological conceptual model and/or theory—rather than leaving the knowledge aspect of our science and our practice to the claim of being “atheoretical” (Fawcett, 2019). As Popper (1965) pointed out, everyone has a “horizon of expectations” (p. 47), such as a conceptual model or theory that guides research and practice, and as McCrae’s (2012) noted, “the legitimacy of any profession is built on its ability to generate and apply theory” (p. 222).

Finally, as Donaldson and Crowley (1978) so wisely told us,

A key point . . . is that the discipline should be governing clinical practice rather than being defined by it. Of necessity, clinical practice focuses on the individual in the here and now who has a problem requiring relevant and appropriate action. The discipline, in contrast, embodies a knowledge base relevant to all realms of professional practice and which links the past, present and future. Its scope goes far beyond that required for current clinical practice. If the discipline were so narrowly defined, professional nursing could be limited to functioning in the realm of disaster relief rather than serving as a force in the promotion of world health. (p. 118)

References

Bruce, A., Rietze, L., & Lim, A. (2014). Understanding philosophy in a nurse’s world: What, where, and why? Nursing and Health, 2(3), 65-71.

Donaldson, S. K., & Crowley, D. M. (1978). The discipline of nursing. Nursing Outlook, 26, 113–120.

Fawcett, J. (1984). The metaparadigm of nursing: Present status and future refinements. Image: The Journal of Nursing Scholarship, 16, 84 87.

Fawcett, J. (2018, September 24). Our name: Why nursology? Why .net? Retrieved from https://nursology.net/2018/09/24/our-name-why-nursology-why-net/

Fawcett, J. (2019, January 22). The impossibility of thinking “atheoretically.” Retrieved from https://nursology.net/2019/01/22/the-impossibility-of-thinking-atheoretically/

Fawcett, J., & DeSanto-Madeya, S. (2013). Contemporary nursing knowledge: Analysis and evaluation of nursing models and theories (3rd ed.). Philadelphia, PA: F. A. Davis.

Kuhn, T. (1971). The structure of scientific revolutions. Chicago: University of Chicago Press.

McCrae, N. (2012). Whither nursing models? The value of nursing theory in the context of evidence-based practice and multidisciplinary healthcare. Journal of Advanced Nursing, 68, 222–229. doi: 10.1111/j.1365-2648.2011.05821.x

O’Leary, H. J. (1975). Changes in community nursing service that affect baccalaureate nursing programs. In Faculty-curriculum development, Part V. The changing role of the professional nurse: Implications for nursing education. New York, NY: National League for Nursing, Pub. No. 15-1574.

Parse, R. R. (1987). Nursing science: Major paradigms, theories, and critiques. Philadelphia, PA: Saunders.

Popper, K. R. (1965). Conjectures and refutations: The growth of scientific knowledge. New York, NY: Harper and Row.

Rovelli, C. (2018). Physics needs philosophy, philosophy needs physics, Foundations of Physics, 48, 481-491.

Thorne, S. (2014). Nursing as social justice: A case for emancipatory disciplinary theorizing. In P. N, Kagan, M. C. Smith, & P. L. Chinn (Eds.), Philosophies and practices of emancipatory nursing (pp.79-90). New York, NY: Routledge.

Torres, G., & Yura, H. (1975). The conceptual framework as part of the curriculum process. In Faculty-curriculum development Part III: Conceptual framework-Its meaning and function. New York, NY: National League for Nursing, Pub. No. 15-1558.