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

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

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

Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License

Research Themes

Health

Priority Areas

Multidisciplinary biological approaches to personalised disease diagnosis, prognosis and management

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