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Breast cancer support businesses, retail stores selling mastectomy-related products, are playing an expanding role within healthcare in the USA. As commercial spaces separate from the medical settings where most cancer treatment occurs, these businesses have been largely overlooked in studies of medical care providers and their experiences. The purpose of this paper is to seek to bring to light the meanings and dimensions of the care work provided by breast cancer support staff to newly diagnosed patients.

This project employed an ethnographic approach centered on the workers at one breast cancer support business. The first author carried out participant observation over a 20-month period and supplemented the observations with staff member interviews.

The analysis of field notes and interviews revealed two themes or purposes as central to the employees’ understanding of their work: defining the organizational setting as a nonmedical space and balancing image enhancement with comforting care. The findings show how values of client-centered care can be enacted in a for-profit healthcare setting.

This study is limited to one for-profit support business in the southeastern USA.

Mastectomy supply businesses appear to offer a kind of support that patients may not be finding elsewhere or at the particular time they need it. Thus the study holds relevance for practitioners and health policy makers who are seeking to develop more comprehensive care for surgical patients within the established healthcare system.

This study gives a detailed picture of breast cancer support work, including the value premises and meanings it holds for support workers.

This paper revolves around the central question: is it possible to do “proper ethnography” without complete participant observation? The authors draw upon a student's experiences of negotiating National Health Service (NHS) ethical approval requirements and access into the student's research field, a British NHS hospital and having to adapt data collection methods for the student's doctoral research. The authors examine some of the positional (insider/outsider, native gone academic), methodological (long-term/interrupted, overt/covert) and contextual challenges that threatened the student's ethnographic study.

The paper draws on reflexive vignettes written during the student's doctorate, capturing significant moments and issues within the student's research.

The authors highlight the temporal, practical, ethical and emotional challenges faced in attempting an ethnography of nursing culture within a highly regulated research environment. Having revealed the student's experience of researching this specific culture and finding ways to overcome these challenges, the authors conclude that the contemporary ethnographer needs to be increasingly flexible, opportunistic and somewhat covert.

The authors argue that it is possible to do “proper” and “good” ethnography without complete participant observation – it is not the method, the observation, that is the essence of ethnography, but whether the researcher achieves real understanding through thick descriptions of the culture that explain “what is really going on here”.

The authors hope to assist doctoral students engage in “good” ethnographic research within (potentially) risk-averse host organisations, such as the NHS, whilst being located in neo-liberal performative academic organisations (Foster, 2017; McCann et al., 2020). The authors wish to contribute to the journal to ensure good ethnography is accessible and achievable to (particularly) doctoral researchers who have to navigate complex challenges exacerbated by pressures in both the host and home cultures. The authors wish to see doctoral researchers survive and thrive in producing good organisational ethnographies to ensure such research is published (Watson 2012), cognisant of the pressures and targets to publish in top-ranked journals (Jones et al. 2020).

Having identified key challenges, the authors demonstrate how these can be addressed to ensure ethnography remains accessible to and achievable for, doctoral researchers, particularly in healthcare organisations. The authors conclude that understanding can be attained in what they propose as a hybrid form of “propportune” ethnography that blends the aim of the essence of “proper” anthropological approaches with the “opportunism” of contemporary data collection solutions.

The main purpose of this paper is to document the first author's experience of using institutional ethnography (IE) to “take sides” in healthcare research. The authors illustrate the points with data and key findings from a study of cardiovascular disease prevention.

The authors use Dorothy E Smith's IE approach, and particularly the theoretical tool of “standpoint”.

Starting with the development of the study, the authors trouble the researcher's positionality, highlighting tensions between institutional knowledge of “prevention” and other locations where knowledge about patients' health needs materialises. The authors outline how IE's theoretically and methodologically integrated toolkit became a framework for “taking sides” with patients. They describe how the researcher used IE to take a standpoint and map institutional relations from that standpoint. They argue that IE enabled an innovative analysis but also reflect on the challenges of conducting an IE – the conceptual unpicking and (re)thinking, and demarcating boundaries of investigation within an expansive dataset.

This paper illustrates IE's relevance for organisational ethnographers wishing to find a theoretically robust approach to taking sides, and suggests ways in which the IE approach might contribute to improving services, particularly healthcare. It provides an illustration of how taking a patient standpoint was accomplished in practice, and reflects on the challenges involved.

Current and predicted continued dramatic increases in international migration and ethnocultural diversity of older adult cohorts pose challenges for health care services. Review studies on ethnoculturally diverse older adults and health care show a lack of focus on their service use experiences. This study aims to report a meta-ethnography that addresses this knowledge gap through answering the review question: How do ethnoculturally diverse older adults who are immigrants experience health careservices?

The authors applied a seven-phase method of meta-ethnography to guide the review. The authors conducted two literature searches (April 2018 and June 2020) in MEDLINE, CINAHL, Embase, Sociological Abstracts and Abstracts in Social Gerontology that yielded 17 papers eligible for review.

“There’s always something positive and something negative” is the overarching metaphor for answering the review question. Findings highlight positive and negative tensions within ethnoculturally diverse older adults’ health care use experiences of understanding and being understood, having trust in providers and the health care system, having needs, preferences and resources met and desire for self-care over dependency. The majority of experiences were negative. Tipping points towards negative experiences included language, fear, provider attitudes and behaviours, service flexibility, attitudes towards Western and traditional health care and having knowledge and resources.

The authors propose concrete actions to mitigate the tipping points. The authors discuss policy recommendations for health care system changes at the micro, meso and macro service levels to promote positive experiences and address mainstream service policy inequities.

Dichotomous “gap” thinking about professionals and managers has important limits. The purpose of this paper is to study the specific ontology of “the gap” in which different forms of distances are defined.

In order to deepen the knowledge of the actual day-to-day tasks of Dutch healthcare executives an ethnographic study of the daily work of Dutch healthcare executives and an ontological exploration of the concept “gap” was provided. The study empirically investigates the meaning given to the concept of “distance” in healthcare governance practices.

The study reveals that healthcare executives have to fulfil a dual role of maintaining distance and creating proximity. Coping with different forms of distances seems to be an integral part of their work. They make use of four potential mechanisms to cope with distance in their healthcare organization practices.

The relationship between managers and professionals is often defined as a dichotomous gap. The findings in this research suggest a more dynamic picture of the relationship between managers and professionals than is currently present in literature. This study moves “beyond” the gap and investigates processes of distancing in-depth.

The purpose of this paper is to reflect on the tensions between being covert and overt during ethnographic observations. The example of an ethnographic study of the culture in a diagnostic imaging department will be used to provide examples.

This paper is a reflection on an ethnographic study, focussing on the participant observation.

This paper discusses the author’s reflections on the covert and overt nature of ethnographic observation.

The discussion is of value to all ethnographic researchers who experience this tension.

Problem‐based learning (PBL) focuses on organising the content of the curriculum around problem scenarios rather than subjects or disciplines. Under the guide of academic tutors (facilitators), students work in groups to creatively solve or manage problems. The traditional approach to PBL is to look for the problem, carry out a diagnosis, and aspire to a solution. Since the primary focus is on what is wrong or dysfunctional, students often emphasise and amplify the problems. In response, this research proposes introducing appreciative inquiry (AI) as a dimension within PBL. A qualitative phenomenological approach was adopted using semi‐structured interviews and interpretative phenomenological analysis (IPA) to make sense of the tutors’ “lived experiences”. Purposive samples of 18 academic staff that facilitate PBL on occupational therapy programmes in English universities were recruited. Findings show that the problem solving focus of PBL may inhibit creativity in students’ thinking and learning, and lead to the adoption of a rational approach. AI involves looking for what works first by using an appreciative eye. What PBL has as a limitation, AI offers as its strength; the two appear to be naturally complementary. The development of transferable skills through this newly proposed model may enhance the learning experience and clinical practice of students. As there have been limited studies into the implementation of AI within PBL, further action research is recommended to evaluate the perspectives of both tutors and students on its application, synthesis and practice.

The purpose of this paper is to argue for an improved conceptualisation of health service research, using Stengers' (2018) metaphor of “slow science” as a critical yardstick.

The paper is structured in three parts. It first reviews the field of health services research and the approaches that dominate it. It then considers the healthcare research approaches whose principles and methodologies are more aligned with “slow science” before presenting a description of a “slow science” project in which the authors are currently engaged.

Current approaches to health service research struggle to offer adequate resources for resolving frontline complexity, principally because they set more store by knowledge generalisation, disciplinary continuity and integrity and the consolidation of expertise, than by engaging with frontline complexity on its terms, negotiating issues with frontline staff and patients on their terms and framing findings and solutions in ways that key in to the in situ dynamics and complexities that define health service delivery.

There is a need to engage in a paradigm shift that engages health services as co-researchers, prioritising practical change and local involvement over knowledge production. Economics is a research field where the products are of natural appeal to powerful health service managers. A “slow science” approach adopted by the embedded Economist Program with its emphasis on pre-implementation, knowledge mobilisation and parallel site capacity development sets out how research can be flexibly produced to improve health services.

The purpose of this paper is to share two researcher's experience about the challenges associated with shadowing within the health care context.

Institutional ethnography and shadowing.

Shadowing is increasingly being used as a data collection method, however, before proceeding to use this approach in today's health care environment, the researcher must give thoughtful consideration to the context.

This paper provides a reflexive elaboration of the differences between the insider and outsider perspective when using the shadowing data collection method within health care organizations.