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Phenomenology as a healthcare research method
  1. Alison Rodriguez,
  2. Joanna Smith
  1. School of Healthcare, School of Healthcare, University of Leeds, Leeds, UK
  1. Correspondence to Dr Joanna Smith, School of Healthcare, University of Leeds, Leeds LS2 9UT, UK; j.e.smith1{at}leeds.ac.uk

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Qualitative research methodologies focus on meaning and although use similar methods have differing epistemological and ontological underpinnings, with each approach offering a different lens to explore, interpret or explain phenomena in real-world contexts and settings. In this article, we provide a brief overview of phenomenology and outline the main phenomenological approaches relevant for undertaking healthcare research.

What is phenomenology?

Edmund Husserl (1859–1938), a philosopher, established the discipline of phenomenology. In Husserl’s approach to phenomenology, now labelled descriptive phenomenology, experiences are described and researcher perceptions are set aside or ‘bracketed’ in order to enter into the life world of the research participant without any presuppositions.1 Experience is recognised to involve perception, thought, memory, imagination and emotion, each involving ‘intentionality’, as the individual focuses their gaze on a specific ‘thing’ or event.1 Martin Heidegger (1889–1976), a student of Husserl, rejected the theory of knowledge or ‘epistemology’ that influenced Husserl’s work, and instead adopted ‘ontology’, the science of being. In relation to research, ‘epistemology’ is concerned with what constitutes valid knowledge, and how knowledge is gained with a distinction between justified belief and opinion, while ‘ontology’ ‘is more concerned with the nature of reality and now we understand what exists and is experienced.

Heidegger developed interpretive phenomenology using hermeneutics, the philosophy of interpretation, and postulated about the concept of ‘being’ in the world, asking, ‘What is being?’. Heidegger was interested in interpreting and describing human experience but rejected ‘bracketing’ because he accepted that prior understandings impact on our interpretations of the world.1 Table 1, adapted from Rodriguez,2 provides an overview of the key differences between Husserl’s and Heidegger’s phenomenological perspectives.

Table 1

Key differences between Husserl’s and Heidegger’s approaches to phenomenology

What is phenomenological research?

The philosophy of phenomenology resides within the naturalistic paradigm; phenomenological research asks: ‘What is this experience like?’, ‘What does this experience mean?’, and ‘How does the lived world present itself to the participant or to me as the researcher?’ Not all health research questions that seek to describe patient or professional experiences will be best met by a phenomenological approach; for example, service evaluations may be more suited to a descriptive qualitative design, where highly structured questions aim to find out participant’s views, rather than their lived experience.

Building on the work of Husserl and Heidegger, different approaches and applications of phenomenological to research have been developed. Table 2, adapted from Rodriguez,2 highlights the differences between the main traditions of phenomenology.

Table 2

Comparison of the main phenomenological traditions

Is phenomenology an appropriate approach to undertaking healthcare research?

We will use a study that explored the lived experience of parenting a child with a life-limiting condition to outline the application of van Manen’s approach to phenomenology,3 and the relevance of the findings to health professionals. The life expectancy of children with life-limiting conditions has increased because of medical and technical advances, with care primarily delivered at home by parents. Evidence suggests that caregiving demands can have a significant impact on parents’ physical, emotional and social well-being.4 While both qualitative and quantitative research designs can be useful to explore the quality of life for parents living with a child with a life-limiting conditions, a phenomenological approach offers a way to begin to understand the range of factors that can effect parents, from their perspective and experience, revealing meanings that can be ‘hidden’, rather than making inferences. van Manen’s approach was chosen because the associated methods do not ‘break down’ the experience being studied into disconnected parts, but provides rich narrative descriptions and interpretations that describe what it means to be a person in their particular life-world. The phenomenological aim was to develop a ‘pathic’ understanding; the researcher was therefore committed to understanding the experience of the phenomena as a whole, rather than parts of that experience. In addition, van Manen’s approach was chosen because it offers a flexibility to data collection, where there is more of an emphasis on the facilitation of participants to share their views in a non-coercive way and the production of meaning between the researcher and researched compared to other phenomenological approaches (table 2).

Central to data analysis is how the researcher develops a dialogue with the text, rather than using a structured coding approach. Phenomenological themes are derived but are also understood as the structures of experience that contribute to the whole experience. van Manen’s approach draws on a dynamic interplay of six activities, that assist in gaining a deeper understanding of the nature of meaning of everyday experience:

  1. Turning to a phenomenon, a commitment by the researcher to understanding that world.

  2. Investigating experience as we live it rather than as we conceptualise it.

  3. Reflecting on the essential themes, which characterise the phenomenon.

  4. Describing the phenomenon through the art of writing and rewriting.

  5. Maintaining a strong and oriented relation to the phenomenon.

  6. Balancing the research context by considering the parts and the whole. 8

These activities guide the researcher, alongside drawing on the four-life world existentials (table 2), as lenses to explore the data and unveil meanings.

Ten parents of children with life-limiting conditions were interviewed with the aim of gathering lived experiences and generating thick descriptions of what it is like to be a parent of a child with a life-limiting condition. The essential meaning of the phenomenon ‘the lived experience of parenting a child with a life limiting condition’ can be understood as a full-time emotional struggle involving six continuous constituents, presented in figure 1. Health professional supporting families where a child has a life limiting condition need to be aware of the isolation faced by parents and the strain of constant care demands. Parents innate parental love and commitment to their child can make it challenging to admit they are struggling; support and the way care and services are delivered should be considerate of the holistic needs of these families (figure 1). 

Figure 1

Lived experience of parenting a child with a life-limiting condition. 

In summary, in Husserlian (or descriptive)derived approaches, the researcher from the outset has a concrete ‘example’ of the phenomenon being investigated, presuppositions are bracketed and the researcher imaginatively explores the phenomena; a ‘pure’ description of the phenomena’s essential features as it is experienced can then be unveiled. While in Heideggerian, hermeneutic (or interpretive) approaches, the researcher’s perspectives, experiences and interpretations of the data are interwoven, allowing the phenomenologist to provide an ‘interpretation’ rather than just a description of the phenomena as it is experienced. In all phenomenological approaches, the researcher’s role in self-reflection and the co-creativity (between researcher and researched) is required to produce detailed descriptions and interpretations of a participant’s lived experience and are acknowledged throughout the researcher’s journey and the research process. These reflections are deliberated to a greater degree in heuristic and relational approaches, as the self and relational dialogue are considered crucial to the generated understanding of the phenomena being explored.

We will provide more specific details of interpretative phenomenological analysis in the next Research Made Simple series.

References

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Footnotes

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.

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