In defence of Cartesian dualism and the hermeneutic horizon

How Is a Label of Borderline Personality Disorder Constructed on Twitter: A Critical Discourse Analysis

This research took a social constructionist stance and explored how Borderline Personality Disorder (BPD) is constructed by Twitter users who identify with this diagnostic label. Consistent with this position, a critical discourse analysis (CDA) methodology was employed. The data comprised two-hundred and twenty-five tweets. Tweets from professionals, or links to blogs, were excluded, in an attempt to ensure only personal tweets were used. Two interpretative repertoires were produced from the analysis: BPD as an existence of tension and BPD as a different existence. The findings indicated that authors were involved in a negotiation between themselves and BPD, which had an impact upon their felt sense of agency/control over BPD. Likewise, authors constructed themselves in opposition to individuals who did not identify with the diagnosis of BPD. Whilst this provided more favourable positions, it potentially limited access to healthcare professionals and services. The research highlights the importance of the terminology and language clinicians employ when working with clients and other professionals, as they may inadvertently disempower or stigmatise. As CDA does not assume equivalence between individuals' accounts and their internal experiences, future research may need to explore the experience of stigmatisation through social networking sites.

Stress discourse and Western biomedical ideology: rewriting stress

Popular psychosocial theories of stress and coping are based on an empiricist paradigm and a Western biomedical framework that reflect Western ideologies and values about health and illness. Problems associated with this discourse lie mainly in the ideologies that emphasize naturalism, individualism, rationalism, and objectivity. We suggest that stress and coping theory should be concerned with the ways in which power relations and social institutions produce the meaning of stress. The inclusion of alternative discourses that attend to the micro and macro social and historical factors is necessary for the further development of stress and coping theory and practice.

The concept of care in male nurse work: an ontological hermeneutic study in acute hospitals

AIMS

The aims of the study were to facilitate reflection upon an aspect of practice chosen by the participants, to explore and analyse these experiences and compare them with current literature on the concept of care in nursing practice.

BACKGROUND

The concept of care is commonly used in the attempt to define what is unique about the role of the nurse, and both nursing and the concept of care are frequently associated with womanhood. Little research has been undertaken in relation to male nurse experiences and views on the concept.

METHODS

The study used ontological hermeneutics to explore the concept of care in male nurse work in the acute general hospital setting. Eight male voluntary subjects from acute general hospital areas participated in the study and were asked to complete a summary of an experience from their practice that they felt exemplified care. Data for the study included the participants choice of practice experience, their subsequent reflections, the interview itself, the field journal and relevant literature and research.

RESULTS

Six of the participants selected positive experiences in which they felt that their performance was satisfactory even though the events chosen for reflection were difficult and/or sad. The remaining two participants chose to reflect further on the difficulties they had within the experience. A conceptual model was constructed showing that the meeting of needs, effective communication and information giving were central to these nurses' explanations of care within their practice. All but two of the participants broadened their gaze to include the significant others of the patient.

CONCLUSIONS

The reflections of these participants emphasize the emotional load of practice and a sensitivity on their part to the male stereotype of being able to cope with such pressures. It is suggested therefore that those providing and managing clinical supervision take into account the possible reluctance of male nurses to seek such support. Issues of gender should be emphasized in nurse education, as these nurses were sensitive to the impact of gender on their practice, both with patient/clients and their significant others, and with colleagues.

A nursing theory of personal system empathy: interpreting a conceptualization of empathy in King's interacting systems

This article presents a theory of empathy discovered through rational hermeneutic interpretation within King's personal system. Personal system concepts from King's general systems framework include perception, self, growth and development, body image, space, time, and learning. Propositions for each concept in the personal system were explicated and a theory of nursing empathy was developed. This nursing theory proposes that empathy organizes perceptions; facilitates awareness of self and others; increases sensitivity; promotes shared respect, mutual goals, and social awareness; cultivates understanding of individuals within a historical and social context; and affects learning.

Nursing's metaparadigm concepts: disimpacting the debates

Theoretical advances in nursing have been complicated by polarization and extreme positions regarding nursing's approach to its main metaparadigm concepts: person, health, environment and nursing. In this paper, the authors deconstruct some of the central arguments that are used to further this polarization. Using a critical interpretive approach, they explain some of the logical implications imposed by various extreme positions for the larger project of nursing's health and social mandate, and consider the effects of such polarization. On the basis of an appreciation of the serious difficulties inherent in certain philosophical and theoretical positions currently evident within nursing's literature, the authors argue for a less extreme and more integrated reference point for nursing's theory and practice.

Is there anyone in there? Psychiatric nursing meets biological psychiatry

Mental health nursing operates without a clear idea of the nature of both mind and mental. Increasingly, this lack of a defensible theoretical position has led to an increasing dependence on the concept of mind now current in biological psychiatry. But the materialist monism of biological psychiatry is itself open to doubt, particularly concerning its dependence on a priori assumptions about the nature of the relationship between mind and brain. The reductionism and objectivism inherent in this approach necessarily ignores that aspect of mind most germane to nursing, the first-person nature of the mental. An alternative is briefly sketched which stresses the mediation of behaviour by the brain, rather than viewing behaviour as causally related to brain processes. Adoption of this approach conserves nursing's focus on the subjective experience as being paramount. Nursing education should, therefore, be wary of incorporating the biological approach without a critical analysis of its suppositions and of the conception of human nature which it supports.

The value to nursing research of Gadamer's hermeneutic philosophy

In recent years there has been an increasing awareness in nursing research of the importance of accumulation of knowledge related particularly to the art of nursing. Because of this, nurses are endeavouring to understand more comprehensively the meanings given to central phenomena such as caring, comfort and reassurance, and also to research them with methodologies in such a way that these meanings are not destroyed, distorted or decontextualized. Gadamer's hermeneutic philosophy may prove to be a valuable approach in enabling nurses to gain a deeper and fuller understanding of these phenomena which are central to nursing practice.

Nursing research methodology: transcending Cartesianism

Nurses involved in research are concerned with methodological issues. This paper explores the Cartesian debate that has polarized the discourse on nursing research methodology. It is argued that methodologies exclusively based on objectivism, one pole of the Cartesian debate, or subjectivism, the other, do not provide nurses with adequate research foundations to understand the complexity of the lifeworld of nursing practice. This paper provides nurse researchers with an alternative methodological perspective, Gadamerian hermeneutics, which is in harmony with the clinical world of nursing practice.

Exploring the benefits of a subjective approach in qualitative nursing research

The increasing credibility of qualitative approaches for research in nursing has opened up new debates about methodology and rigour. Traditionally, qualitative methods have been scrutinized using some criteria that are more pertinent for quantitative research. The transition to a more subjective, reflexive approach to nursing research may be painful, but brings benefits. With the loss of scientific rigour comes the gain of eliciting true meaning, by recreating the experiences of others through co-operative enquiry. An openly subjective approach allows the researcher to be a real partner with informants, and to openly use her own experiences and reflections in order to uncover valuable meaning and to find a different type of objectivity. This paper explores some of the issues that are of concern and some of the benefits that may result from an openly subjective approach in qualitative nursing research.

A arte de curar e a arte de cuidar: a medicalização do hospital e a institucionalização da enfermagem

Trata-se de uma reflexão crítca sobre o cuidar e o curar, numa perspectiva histórica. A racionalidade científica na enfermagem engendrou-se no movimento de medicalização do hospital enquanto espaço terapêutico e de desenvolvimento de uma tecnologia e saber médicos. A institucionalização da profissão constituiu-se em duas perspectivas: a moral-disciplinar e a técnica. A configuração de uma "crise profissional" é apontada em relação à formação, mercado de trabalho, prática profissional, organização e sindicalização e pesquisa em suas articulações dinâmicas na sociedade em que estão inseridas. Atualmente, a manutenção e prolongamento da vida encaminham para projetos de maior qualidade dos cuidados e da própria vida, em termos pesoais e profissionais.

Ethics, agency and empowerment in nurse education

The ethical demands of professional nursing practice are considered, and the concept of Agency is offered as a potentially useful part of the nurses conceptual equipment for such practice. The pressures of working in large organisations are suggested to be inimical to a sense of Agency, and it is also suggested that some of the academic disciplines involved in nurse education are offering an ambiguous view of the issue of Agency. The discipline of Ethics, while also ambiguous on this issue, is presented as offering useful ways of exploring that ambiguity. Several theories of Ethics are considered in relation to human freedom and responsibility, and the issue between determinism and free will is likewise considered. It is suggested that these offer ways of helping the individual to explore and develop their own stance on freedom and responsibility, and thereby on the issue of Agency. This discussion is related to the United Kingdom Central Council (UKCC) Code of Professional Conduct, and the paradox of choice is acknowledged.

Implications of the theory/practice gap for Project 2000 students

Nursing has frequently attempted to address the gap between theory and practice. This article explores their relationship and the implications of any theory/practice gap for emergent Project 2000 students.