Implementation of the evidence for the improvement of nursing care to the critical patient's family: a participatory action research

Background: There are many descriptive studies regarding the needs of the family, as well as those regarding nursing care aimed directly at family members. However, there is no widespread application of such evidence in clinical practice. There has also been no analysis made of the evolution of patterns of knowing during the act of improving clinical practice. Therefore, the purpose of the study is to understand the change process aimed at improving care to critical patient's families, and to explore the evolution of patterns of knowing that nurses use in this process. Methods: Qualitative study with a Participatory Action Research method, in accordance with the Kemmis and McTaggart model. In this model, nurses can observe their practice, reflect upon it and compare it with scientific evidence, as well as define, deploy and evaluate improvement strategies adapted to the context. Simultaneously, the process of empowerment derived from the Participatory Action Research allows for the identification of patterns of knowing and their development over time. The research will take place in the Intensive Care Units of a tertiary hospital. The participants will be nurses who are part of the regular workforce of these units, with more than five years of experience in critical patients, and who are motivated to consider and critique their practice. Data collection will take place through participant observation, multi-level discussion group meetings and documentary analysis. A content analysis will be carried out, following a process of codification and categorisation, with the help of Nvivo10. The approval date and the beginning of the funding were December 2012 and 2013, respectively. Discussion: The definition, introduction and evaluation of care strategies for family members will allow for their real and immediate implementation in practice. The study of the patterns of knowing in the Participatory Action Research will be part of the theoretical and practical feedback process of a professional discipline. Also, the identification of the construction and evolution of knowledge will provide decision elements to managers and academics when choosing strategies for increased quality

La reflexividad y la autocrítica como fundamentos de la investigación cualitativa

Se plantean algunas tensiones y retos para la investigación cualitativa en la actualidad, las cuales son consecuencia de las dinámicas que imponen las universidades y las comunidades científicas. La ética de la investigación cualitativa y sus fundamentos se ven cuestionados por los investigadores que, desde otras perspectivas, la ven como fútil e infértil. Entre quienes hacen investigación cualitativa también empiezan a hallarse preguntas sobre la utilidad y la funcionalidad de la investigación cualitativa porque en ocasiones la asumen como una forma blanda de investigar. Se plantea la importancia de hacer investigación cualitativa desde fundamentos rigurosos y científicos que rescatan la reflexividad y la autocrítica como principios para hacerle frente a las tendencias eficientitas y pragmáticas

Where to begin?: the qualitative research question

La pregunta de investigación ha de ser congruente con la metodología que se propone en un estudio y esta pregunta refleja el paradigma en el que el investigador está situado. Hacer una pregunta cualitativa implica un proceso en el cual se determina el área, el tema de estudio, la pregunta y el lugar del estudio. Este proceso es interactivo y cambia a medida que se avanza, por ello los principios son necesariamente provisionales. La pregunta cualitativa es construida, central a todo el proceso de investigación y contiene diferencias importantes con lo que comúnmente se espera de una pregunta de investigación. Una vez hecha, se debe desarrollar el problema, esto es, argumentar su pertinencia. La justificación de un estudio cualitativo no consiste en hacer una revisión bibliográfica exhaustiva, sino que es selectiva; se escoge la información que razone que el estudio es necesario, la pregunta consecuente y pertinente. En la práctica se puede decir que en la construcción de la pregunta de investigación intervienen 2 fases: la de un razonamiento intuitivo, y la de un racionamiento práctico y teórico. Un estudio cualitativo se puede iniciar por diversos lugares, son comunes la experiencia personal, la conversación con colegas, las líneas de investigación y la biblioteca.A qualitative research question reflects the researcher’s paradigm and should be consistent with the proposed research method. A research question implies engaging in a process that defines the research area, subject, question, and place of the study. Because this process is interactive and changes during the course of the investigation, the beginnings are necessarily provisional. The qualitative research question is constructed, is central to the research process, and differs from what is commonly expected of a research question. Once formulated, the pertinence of the research question must be argued. Justifying a study does not imply an exhaustive literature review, but rather a selective one, by selecting the data that support the need for the study and the relevance of the research question. In practice, constructing a research question involves two phases: a first phase of intuitive reasoning and a second phase of theoretical and practical reasoning. A qualitative study can be prompted by distinct factors, common ones being personal experience, conversations with colleagues, lines of research, and the library