Author Identifier
Fiona Foxall
ORCID : 0000-0002-9073-1645
Deborah Sundin
ORCID : 0000-0003-4477-9813
Amanda Towell-Barnard
ORCID : 0000-0002-2475-7724
Beverly Ewens
ORCID : 0000-0003-2008-7214
Vivien Kemp
ORCID : 0000-0001-6577-2720
Davina Porock
ORCID : 0000-0003-4161-9697
Document Type
Journal Article
Publication Title
International Journal of Qualitative Methods
Publisher
SAGE
School
School of Nursing and Midwifery / Centre for Research in Aged Care
RAS ID
36245
Funders
Edith Cowan University - Open Access Support Scheme 2021
Abstract
This paper considers the effectiveness of narrative inquiry as a research method in collecting and analyzing stories from a purposive sample of intensive care nurses and doctors, regarding their perceptions of the factors that influence decision-making in relation to the withdrawal of life sustaining treatment. Delaying the withdrawal of treatment when it is clearly indicated, may result in unnecessary patient suffering at the end of life, distress for the family as well as moral distress for staff. In narrative inquiry participants’ first-hand accounts of their experiences are told through story; the focus of analysis is the story, with the story becoming the object of investigation. Initially, participants’ stories were restoried to produce narratives that were co-constructed between researcher and participant. Narrative analysis, employing McCormack’s lenses and the interconnected analytical lenses, facilitated vertical analysis of each narrative. Horizontal analysis through thematic analysis facilitated the derivation of themes that were consistent within or across narratives. We detail here how narrative inquiry methodology was effective in revealing the meaning participants gave to their decision-making experiences through story, offering a broader understanding of the factors that impact on decision-making regarding the withdrawal of life-sustaining treatment. The study’s findings were powerful, derived from narratives rich and thick in description, depicting a multi-dimensional interpretation of the participants’ perceptions of their decision-making experiences. Participants experienced transformative learning through the narrative process, which led to changes in ways of working in the study setting. Recommendations arose to enhance clinical practice and education in this vital area of practice as a result of this study. The application of narrative inquiry enabled the discovery of significant findings as an avenue to challenge legislation and current opinion regarding the autonomy and role of the family in decision-making.
DOI
10.1177/16094069211028345
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License
Comments
Foxall, F., Sundin, D., Towell-Barnard, A., Ewens, B., Kemp, V., & Porock, D. (2021). Revealing meaning from story: The application of narrative inquiry to explore the factors that influence decision making in relation to the withdrawal of life-sustaining treatment in the intensive care unit. International Journal of Qualitative Methods, 20, 1-14. https://doi.org/10.1177/16094069211028345