Qualitative observation in a clinical setting: Challenges at end of life

Nursing and Health Sciences

Volumn 14, Issue 1, 2012, Pages 25-31

  Bloomer, Melissa J ^a   Cross, Wendy ^a   Endacott, Ruth ^a   O'Connor, Margaret ^a   Moss, Cheryle ^a  

^a MONASH UNIVERSITY   (Australia)

Author keywords

Clinical setting; Death; Dying; End of life; Non participant observation; Observation; Qualitative

Indexed keywords

ARTICLE; AUSTRALIA; CULTURAL FACTOR; ETHICS; HUMAN; HUMAN RELATION; METHODOLOGY; NURSE PATIENT RELATIONSHIP; NURSING CARE; NURSING METHODOLOGY RESEARCH; OBSERVATION; QUALITATIVE RESEARCH; RELIGION; TERMINAL CARE;

AUSTRALIA; CULTURAL CHARACTERISTICS; HUMANS; NURSE-PATIENT RELATIONS; NURSING CARE; NURSING METHODOLOGY RESEARCH; OBSERVATION; PROFESSIONAL-FAMILY RELATIONS; QUALITATIVE RESEARCH; RELIGION; RESEARCH DESIGN; TERMINAL CARE;

EID: 84857194745     PISSN: 14410745     EISSN: 14422018     Source Type: Journal    
DOI: 10.1111/j.1442-2018.2011.00653.x     Document Type: Article

References (52)

1. Addington-Hall J, Bruera E, Higginson I, Payne S (eds). Research Methods in Palliative Care. Oxford: Oxford University Press, 2009.
2. Aleksandric V, Hanson S. Health System Reform and Care and the End of Life: A Guidance Document. Canberra, ACT: Palliative Care Australia, 2010a.
3. Australian Nursing and Midwifery Council. Code of Professional Conduct for Nurses in Australia. Dickson, ACT: Australian Nursing and Midwifery Council, 2005.
4. Beattie ERA, VandenBosch TM. The concept of vulnerability and the protection of human subjects of research. Res. Theory Nurs. Pract. 2007; 21: 156-173.
5. Biros MH, Baren JM. The ethics of observation. Acad. Emerg. Med. 2009; 16: 908-910.
6. Bloomer M, Moss C, Cross W. Problems associated with care at the end of life in acute hospitals. End of Life J (ePub) 2011. [Cited 30 June 2011.] Available at URL:
7. Bonner A, Tolhurst G. Insider-outsider perspectives of participant observation. Nurse Res. 2002; 9: 7-19.
8. Boroujeni A, Mohammadi R, Oskouie S, Sandberg J. Iranian nurses' preparation for loss: finding a balance in end-of-life care. J. Clin. Nurs. 2008; 18: 2329-2336.
9. Boucher J, Bova C, Sullivan-Bolyai S etal. Next-of-kin's perspectives of end-of-life care. J. Hosp. Palliat. Nur. 2010; 12: 41-50.
10. Burns N, Grove S. Understanding Nursing Research: Building An Evidence-Based Practice. Maryland Heights, MO: Elsevier Saunders, 2011.
11. Caldwell K, Atwal A. Non-participant observation: using video tapes to collect data in nursing research. Nurse Res. 2005; 13: 42-54.
12. Chater K, Tsai C. Palliative care in a multicultural society. Aust. J. Adv. Nurs. 2008; 26: 95-100.
13. Chiesa M, Hobbs S. Making sense of social research: how useful is the Hawthorne effect? Eur. J. Soc. Psychol. 2008; 38: 67-74.
14. Cross WM, Bloomer MJ. Extending boundaries: clinical communication with culturally and linguistically diverse mental health clients and carers. Int. J. Ment. Health Nurs. 2010; 19: 268-277.
15. Davies B, Browne J, Gannon S etal. The ambivalent practices of reflexivity. Qual. Inq. 2004; 10: 360-389.
16. Davies, E & Higginson, IJ (eds). Better Palliative Care for Older People. World Health Organization, 2004. [Cited 21 June 2011.] Available at URL:
17. Department of Health. End of life care strategy: first annual report. National Health Service 2009; London: Department of Health.
18. Endacott R. Clinical research 2: legal and ethical issues in research. Accid. Emerg. Nurs. 2007; 15: 166-169.
19. Fowell A, Russell I, Johnstone R, Minto L. Cluster randomisation or randomised consent as an appropriate methodology for trials in palliative care: a feasibility study. BMC Palliat. Care 2004; 3: 1.
20. Glaser B, Strauss A. The social loss of dying patients. Am. J. Nurs. 1964; 64: 119-121.
21. Glaser B, Strauss A. Dying on time. Arranging the final hours of life in a hospital. Hosp. Top. 1965; 43: 27-31.
22. Gold R. Roles in sociological field observations. Soc. Forces 1958; 36: 217-223.
23. Griffiths P. Ethical conduct and the nurse ethnographer: consideration of an ethic of care. J. Res. Nurs. 2008; 13: 350-361.
24. Hillman K. Vital Signs; Stories from Intensive Care. Sydney, NSW: University of NSW Press, 2009.
25. Ingleton C, Gott M, Kirk S. Editorial: the beginning of the end (of life care strategy). J. Clin. Nurs. 2009; 18: 935-937.
26. Jack BA, Gambles M, Murphy D, Ellershaw JE. Nurses' perceptions of the Liverpool Care Pathway for the dying patient in the acute hospital setting. Int. J. Palliat. Nurs. 2003; 9: 375-381.
27. Jennings B. Improving end-of-life care: why has it been so difficult? Hastings Cent. Rep. 2005; 35: S2-S4.
28. Johnson M. Notes on the tension between privacy and surveillance in nursing. Online J. Issues Nurs. 2005; 10: 1-14.
29. Komesaroff P. Experiments in Love and Death: Medicine, Postmodernism, Microethics and the Body. Carlton: Melbourne University Press, 2008.
30. Lather P. Fertile obsession: validity after poststructuralism. Sociol. Q. 1993; 34: 673-694.
31. Leonard K, Masatu M. Outpatient process quality evaluation and the Hawthorne effect. Soc. Sci. Med. 2006; 63: 2330-2340.
32. Liamputtong P. Qualitative Research Methods. Melbourne, Vic.: Oxford University Press, 2009.
33. Minichiello V, Sullivan G, Greenwood K, Axford R (eds). Handbook of Research Methods for Nursing and Health Science. Sydney, NSW: Pearson Education Australia, 2004.
34. Moore L, Savage J. Participant observation, informed consent and ethical approval. Nurse Res. 2002; 9: 58-69.
35. Morse JM. Perspectives of the observer and the observed. Qual. Health Res. 2003; 13: 155-157.
36. Mulhall A. In the field: notes on observation in qualitatitve research. J. Adv. Nurs. 2003; 41: 306-313.
37. Murphy D, Bolger M, Agar R. Best practice for care in the last days of life. Working with Older People 2007; 11: 25-28.
38. Murphy E, Dingwall R. Informed consent, anticipatory regulation and ethnographic practice. Soc. Sci. Med. 2007; 65: 2223-2234.
39. Murphy F. Preparing for the field: developing competence as an ethnographic field worker. Nurse Res. 2005; 12: 52-60.
40. National Health and Medical Research Council, Australian Research Council and Australian Vice-Chancellors' Committee. National Statement on Ethical Conduct in Human Research. Canberra, ACT: Australian Government, 2007.
41. O'Connor M, O'Brien A, Griffiths D etal. What is the meaning of palliative care in the Asia-Pacific region? Asia Pac. J. Clin. Oncol. 2010; 6: 197-202.
42. O'Leary Z. Researching Real-World Problems: A Guide to Methods of Inquiry. London: Sage Publications, 2005.
43. Parahoo K. Nurisng Research: Principles, Process and Issues. New York: Palgrave MacMillan, 2006.
44. Payne S, Field D, Rolls L, Hawker S, Kerr C. Case study research methods in end-of-life care: reflections on three case studies. J. Adv. Nurs. 2007; 58: 236-245.
45. Pincombe J, Brown M, McCutcheon H. No time for dying: a study of the care of dying patients in two acute care Australian hospitals. J. Palliat. Care 2003; 19: 77-86.
46. Pugh EJ, McEvoy M, Blenkinsopp J. Use of the proportion of patients dying in and end of life pathway as a quality marker: considerations for interpretation. Palliat. Med. 2010; 24: 544-547.
47. Schneider Z, Whitehead D, Elliott D, Lobiondo-Wood G, Haber J. Nursing and Midwifery Research: Methods and Appraisal for Evidence-Based Practice. Chatswood, NSW: Elsevier, 2007.
48. Tabor B, Tracey E, Glare P, Roder D. Place of Death of People with Cancer in NSW. Sydney, NSW: Cancer Institute NSW, 2007.
49. Thompson G, McClement S, Daeninck P. "Changing lanes". Facilitating the transition from curative to palliative care. J. Palliat. Care 2006; 22: 91-98.
50. Turnock C, Gibson V. Validity in action research: a discussion on theoretical and practice issues encountered whilst using observation to collect data. J. Adv. Nurs. 2001; 36: 471-477.
51. Verbeek L, van Zuylen L, Gambles M etal. Audit of the liverpool care pathway for the dying patient in a dutch cancer hospital. J. Palliat. Care 2006; 22: 305-308.
52. Verbeek L, van Zuylen L, Swart S etal. The effect of the Liverpool Care Pathway for the dying: a multi-centre study. Palliat. Med. 2008; 22: 145-151.