Toward an adequate understanding of phenomenological and <scp>hermeneutic‐phenomenological</scp> nursing research

Abstract

One of the main issues in phenomenological studies is in the diverse approaches to data collection, especially with the use of semi-structured or structured interview questions and the creation by researchers of interview guides. Within this article, the authors attempt to respond to the challenge by addressing the variability in the philosophies of phenomenology and hermeneutics. By means of the fundamental philosophy of hermeneutics (interpretation) with attention to the meaning of the hermeneutic circle, they have attempted to present a way to integrate the interview guide and structured interview questions into phenomenological and phenomenological-hermeneutic studies. Over the last 50 years, the phenomenological movement and research approaches have developed and evolved within the scientific community of nursing in conjunction with other qualitative research methods, such as description, ethnography, ethnonursing, and grounded theory, to name a few (Beck, 2013, 2021; Corbin & Strauss, 2015; Creswell & Plano Clark, 2018; Creswell & Poth, 2017; Giorgi, 2018; Leininger, 1985; Morse, 1994; Morse, 2017; Moustakas, 1994; Munhall, 1994; van Manen, 1990, 2014). Phenomenology, a descriptive philosophy of being of the world, focuses on the transcendental ego, intentionality, and the idea of absolute consciousness—the perceptual NOW (past, future, and present all at once) introduced by Husserl, a European philosopher, in the early 20th century. Descriptive phenomenology relates to the question of how is knowledge manifest in us (Brough, 1977; Husserl, 1931; Husserl, 1970a, 1970b). Phenomenology is the rigorous science of the meaning of the lived world of experience, that is, direct investigation and description of phenomena as consciously experienced without theories about causal explanation, and is as free as possible from unexamined presuppositions (Sokolowski, 2000). The phenomenological attitude as opposed to the natural attitude (taking things as they are) is called transcendental subjectivity or “the going beyond” such that in the process, transcendental reduction or the idea of leading away is a turn toward the ego as the agent of truth (Sokolowski, 2000, p. 50). When entering into the phenomenological attitude, philosophers/researchers suspend beliefs or bracket the things in the world (epoché), and focus on the thing or phenomenon of interest itself. “Any truth that we achieve is always surrounded by absence and hiddenness, by mystery [which can account for the spiritual], since the thing we know is always more than we can know, the reference is more than the sense” (Sokolowski, 2000, p. 176). Sokolowski (2000) remarked that, “We [phenomenologists] look at what people normally look through” (p. 50). Overall, the aim of descriptive phenomenology is to describe experience as it is lived with a focus on the prereflective, the prepredicative life of human existence as we are living it, seeking the location of meaning as it is immediately given and in original experience (Husserl, 1970a, 1970b; Sokolowski, 2000; van Manen, 1990, 2014). Husserl's ideas changed slightly over time; they were further advanced by other philosophers, each with a slightly different derivative, such as Heidegger (the ontological-the Dasein or being in the world; to be is to care), Stein (problem of empathy), Merleau-Ponty (the study of essences and lived body, lived space, lived time, lived human relations), Dilthey (we understand when life understands itself), Scheler (we are empathically able to experience other minds), Sartre (being and nothingness), Levinas (intuition of evidence/primacy of ethics), Arendt (political theory), Gadamer (the theory of understanding—all understanding is self-understanding), Ricoeur (hermeneutics/interpretation of the self; human language and action which display a sense of meaning as well as reference) (Luft & Overgaard, 2014), and van Manen (human life needs knowledge, reflection, and thought to make itself knowable to itself) (van Manen, 2014). The philosophers after Husserl included hermeneutics or interpretation to facilitate phenomenological reflection and analysis, and render explication on experience. Phenomenological-hermeneutics, thus, became a central feature in the meaning-giving method of inquiry, being in the world, not of the world as Husserl proposed, or in essence, in the search for meaning of how phenomena (that which appears) “show, present or give themselves to us” (van Manen, 2014, p. 26). Descriptive phenomenological analysis as revealed occurs primarily in the attitude of the epoché (bracketing presuppositions with no prejudging of data), and the reduction (structured reflection) for the purposes of intuiting/illuminating meaning through reflection and discovering and seeking understanding of common and unique themes. In hermeneutic phenomenology, a researcher does not impose meaning on the phenomenon, but is concerned with the cultural traditions or history that precede the interpretive analysis (Gadamer, 1990). An example of an approach from van Manen's hermeneutic-phenomenological research method (1990) is identified as the following: (1) turning to the nature of lived experience; orienting to the phenomenon; explicating preunderstandings or assumptions; (2) formulating the phenomenological question (What is it like? What does it mean?—the researcher must “pull” the participant into the question), such that the participant cannot help but ponder and share about the nature of the phenomenon under inquiry; (3) generating data by fully questioning the meaning of experience; (4) conducting thematic analysis (element or pattern which occurs frequently in the text, the structures of experience); (5) isolating thematic statements (essential and incidental); (6) composing linguistic transformations (interpretation); (7) hermeneutic-phenomenological writing by mediating reflection and understanding of the meaning of the phenomenon which is “fixed” on paper/computerized text. Van Manen (1990) stated that writing means creation of signifying relations, a search for understanding into a discursive whole which is referred to as theory (p. 132). Phenomenology deepens thought and original thinking and facilitates pedagogic competence that guides and seeks the “good”—in the case of nursing, seeking the good of care for persons, families, organizations, and communities, including the self. The criticality of the speaking of language or phenomenological writing from thematic analysis, intuiting the existence of a thing, using examples from the data, and interpretation in general relates to seeking authentic meaning or meaning of the whole of the experience under investigation. Credibility in phenomenological research relates to trustworthiness, and truthfulness—discovery of the meaning of human phenomena as it is lived, and what, for the reader has been referenced in some circles, as the “phenomenological nod”—a way of indicating that a good phenomenological-hermeneutical description is something that we can nod to or recognize as an experience that we have had, or could have had (Buytenedijk, 1962, as cited in van Manen, 1990, p. 27; 2014, p. 188). In the study of phenomenology and existentialism over the past four decades, phenomenologists, especially in North America, have been attentive to new approaches in the interpretation of classical phenomenological-hermeneutics, such as explicating the phenomenology of language, moral philosophy, and political philosophy; and the philosophies/phenomenologies of mathematics, science, religion and theology, including the phenomenologies of race, social sciences, psychiatry, medicine, and nursing (McBride & Schrag, 1983); which gives us pause in nursing inquiry to examine the wide approaches now being used in the study of lived experience that have arisen in nursing publications. The philosopher, Carel (2014), stated that phenomenology as a descriptive method has been used more frequently in nursing research, more so than in medicine (p. 623). With the growing attention to nursing as a human science in the 1970s, and the growth of the caring movement in nursing (Leininger, 1977; Watson, 1979), scholars such as Ray (1985, 1994) were influenced by the writings of Husserl (and later by Heidegger, 1962, Gadamer, 1990, and van Manen, 1990, 2014). Paterson and Zderad (1988), Parse et al. (1985), and Benner (1989, 1994) were influenced more by Heidegger and Gadamer (Beck, 2021; Carel, 2014). Phenomenology became an ideal philosophy and methodological approach to enhance the role of nurses as human scientists, and the study of human factors, such as caring science, first-person accounts of persons' life experiences of illness, and nurse–patient interrelationships (Carel, 2014). Carel (2014) noted that the blurred boundary between phenomenology as a philosophy, and its use as a research method more recently, is discussed in the literature. Should phenomenology be reduced to just a research method, or should researchers also have knowledge of classical philosophical phenomenology? This debate is far from settled, as noted by Carel (2014). We do witness that issue as editors of nursing journals question the wide variety of phenomenological or phenomenological-hermeneutic approaches in studies submitted for review for publication. Editors ask: Should researchers of phenomenology have a classical background in philosophy to conduct phenomenological or phenomenological-hermeneutic research? Should there be consistency and accuracy of phenomenological-hermeneutic methodological approaches using a particular approach by a scholar of phenomenology or phenomenological-hermeneutics, such as Parse (2001), Giorgi (2018), Colaizzi (1978, as cited in Beck, 2021, pp. 19-29), or van Manen (1990, 2014), or should researchers create their own phenomenological approaches, as in the examples of Ray (2019) and Butcher (2022)? Questions continue to arise about how a phenomenological-hermeneutic study should be structured (Peoples, 2021). What type of phenomenological questioning or interview process should be selected to reveal the meaning of experience and maintain the phenomenological attitude of epoché and reduction or structured reflection in the generation of the data of experience? Ray (2019) uses the approach of “cue-taking” in an interview so that the participants speak from their life-world experience and not from the researcher's made-up questions. Van Manen (2014) uses the term conversation when the interview process is relational and where linguistic narrative statements unfold from reflection of the researcher. Since structured interviews are prevalent in phenomenological nursing research now, what is the appropriate response in terms of phenomenological scientific rigor? What thematic linguistic transformation from the experiences shared by participants should be linguistically analyzed and recorded? What computer-assisted data collection and analytic programs should be accepted in a phenomenological-hermeneutic research study? Should nursing theory or other disciplinary theories guide a phenomenological study or should theory be advanced from the study of a phenomenon—how is a theory held in abeyance during the phenomenological interview process? How should method slurring (Beck, 2021) or method muddling be handled (Morse, 1994)? Given the new definition of nursing as a caring science and art (American Nurses Association, 2021), should nursing as caring, or caring as a sacred science be dominant in phenomenological research (Watson, 2018, 2021)? Now that mixed methods are used so widely in nursing research studies (Morse & Niehaus, 2009), and several researchers choose what they may call the qualitative part of the study, and some choose phenomenology, how should the study be conducted, reported, analyzed, and concluded? What qualitative approach of a mixed method study should be selected? Would it be a true phenomenological component of a study, since there is employed, first, a deductive approach to the research with quantitative outcomes, and then, an attempt to use a phenomenological approach to glean the meaning of the lived world of experience? These are complex questions that the community of nurse researchers, educators, and editors of journals need to ponder and address. How do we go forward in research? Currently, how does one use technology more profoundly in phenomenological research (a concept Heidegger, 1977, brought to the fore many years ago), especially with the Internet and social media? What is the role of consciousness (a central Husserlian phenomenological concept) in Information Technology, specifically in its application in nurse-centered robotic research (Tanioka et al., 2017)? As such, should there be phenomenological research in a pluralistic context or pluralistic phenomenological research? Fundamental questions continue to remain. “What makes a phenomenological study phenomenological” (Norlyk & Harder, 2010)? And what about the use of the structured interview process and the interview guide for data collection/generation? The debate continues about the variability of phenomenological approaches in peer-reviewed journals, ranging from brief to detailed descriptions of the inconsistencies to the issue of methodological clarity or rigor in phenomenological studies (Norlyk & Harder, 2010). What is the opinion of the critiques of phenomenology? Upon deep reflection, it seems to be variability. If one looks at the history of the philosophies of phenomenology and hermeneutics, we can see that philosophers agree with each other on some level of the foundational principles set by Husserl, the father of phenomenology, such as meaning and in hermeneutics, a stress on understanding of life world experiences. Each philosopher has a particular point of view they want to emphasize about the life world and meaning, from the structure of identity, prereflection, intentional consciousness, the way things present to us, whether or not the nature of consciousness is epistemological (correlated with an object) or ontological (correlated with Being), eidetic intuition or truth (essential and factual) in terms of the nature of evidence, bracketing one's presuppositions, and so forth, or hermeneutically speaking, the commitment to parts and wholes and seeking understanding of the meaning of experience (Heidegger, 1962; Husserl, 1931; Husserl, 1970a, 1970b; Skinner, 1985; Sokolowski, 2000; van Manen, 2014). We can look at the philosophies of Husserl, Stein, Heidegger, Gadamer, Merleau-Ponty, Ricoeur, and others (van Manen, 2014) to recognize the philosophical diversity when questioning the lived meaning of experience, or the lived body, mind, and spirit. From philosophical and methodological points of view, in nursing, Dr. Cheryl Beck (2021) identified eight contemporary philosophers, and each had a particular methodology for nursing researchers to consider; for example, Giorgi, Colaizzi, van Kaam, and Moustakas embraced a more descriptive phenomenology, and van Manen, Dahlberg, Smith, and Benner embraced a more interpretive phenomenology. In those methods, there are key elements to consider for data generation and analysis besides the philosophical, such as types of interview questions, use of interview guides, navigation of thematic reflection, computer-assisted program use, participant authentication, clarity, rigor, evaluation, whether or not there should be “judges” to validate the findings, and writing. Heidegger (1968) authored a book, What is Called Thinking? In many ways, he answered the question by stressing that to go forward we must return to the origins and seek a new beginning. Scientifically, we are in a remarkably interesting time in our evolution regarding how to solve complex problems in a complex world and how we are to make things work (Bar-Yam, 2004). The late physicist, F. David Peat (2002), wrote about the concept of uncertainty, first published by Heisenberg in 1927, from a century of research and development of theory in quantum physics that affects all aspects of our lives. He called for bringing creative change to a turbulent world and developing approaches wherein persons can work together to create frameworks flexible enough to tolerate multiple points of view and contexts. The concern continues in phenomenological-hermeneutical nursing research evaluation. In the data collection process within a phenomenological-hermeneutical perspective, should a researcher choose a more free-flowing or “presuppositionless” interview to probe meaning, to transform the lived experience into a textual expression of its essence (Beck, 2021), such as using a question, “What is the meaning of experience of a or “What is it to experience a (van Manen, 2014). in should the data collection process use a structured interview as an with structured questions participants to share detailed and about a phenomenon, such as using an interview guide to help the researcher for the of an interview et al., 2018; et al., The authors that they can respond to a central question of semi-structured interviews in in nursing research by the of a hermeneutic or method specifically (Beck, 2021; Gadamer, et al., 2018; 1985; et al., van Manen, 2014). 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