Collaborative Health Care

There are many difficulties that arise from using an ethnography study. Even though there are the advantages of this test being conducted in the informants natural settings and the research is being done in flexible time and is a good experiment to do on kids or mental patients etc from whom it is difficult to collect data from. There are also a number of problems of the researchers presence which may invertible affect the social situation as the informants being observed may feel judged or evaluated and act different if they know they are being watched.

The problem of intervention may arise in the situation and there may be the sense of conflict for example if the researcher is trained in the field of the setting they are observing should the researcher respond if the incorrect practise is being observed (Hilton, 1987). Another problem that may occur is that the researcher may become to relaxed in the situation which will make the data collected limited and distorted due to the researcher becoming over-friendly and over-identifying, to solve this it is better if the researcher has previous experience of the settings so they have knowledge and feels more relaxed (Hammersley and Atkinson, 1995)

Using ethnography as a research project brings up a number of ethical issues. There are two types of observational data that can be collected for ethnographical research, covert data is when the informant does not actually know there is a researcher observing and that data is being collected whereas overt data collection is when the researcher fully informs the informant that they are being observed and analysed. But most ethnographers feel guilty about observing and exploiting a relationship for data that is confidential to the researcher (Hilton, 1987). There is a particular issue that researcher feels they are exploiting the informants, as they may feel betrayed as many researchers manipulate and deceit the situation. Many ethnographers pretend to be naive when they are not others may misrepresent them in order to gain their data.

Also they may be gathering data from other peoples troubles like attending funerals etc. which could be seen by others as an invasion of privacy ( Warin, 2000 ). Trying to obtain informed consent may be problematic to the research as it could affect the data as the participant may act different if they know they are being watched, but it would be most important when trying to avoid exploitation of informants and would also help the researcher if he/she was not treated as a colleague or a consultant and is just aloud to stand and watch ( Pryer & Grossbart, 2005 ). Todahl did an experiment on Collaborative Health Care in a Primary Care Setting were he invited participants to participate after the institutional review board approval, also all the patients that were used also gave there agreement, the researchers are fully licensed marriage and family therapists.

The investigators were only directly connected with the site as researchers and treated in that way (Todahl et al, 2004). Another study done by (The, 2002) did a study on elderly patients with dementia, in this case it was not possible to get writen permission from elderly patient so to work around this issue permission was granted by management teams of the care homes they lived in, the doctors of each patient, the nursing staff of the home , and representatives (mostly relatives) of the patients. This study was looking at the withholding artificial administration of fluids and food. Another study that was done was looked at how many errors were given in intravenous drug doses given out by nurses.

Taxis and Barber (2003) looked at the preparation or the administration of almost half of intravenous drug doses in 10 wards in two UK hospitals. The observation of this ethnographic study was a disguised study and non of the nurses knew they were being observed and data written on them. Potentially moderate errors occurred in 29% of the intravenous drug doses, and potentially serious errors in 1%. The most common errors were giving bolus doses too fast and poor preparation of drugs that required several steps. But this was probably because nurses were only sent on a day course to administrate intravenous drugs.

Ethnography is a qualitative approach with origins in anthropology, and has been used in a variety of studies. The strength of this study is that it is done in the field of the research and first hand observation and data is collected which gives history and in depth data of first hand account information. But it does have its doubts that the researcher may not have enough experience and become to self involved in the project and not pick up key data or may not be able to build up trust with the participants/informants which can lead to lose of data from key roles within the researcher field. Many informants are vulnerable to exploitation of then researcher if consent is not gained from all involved and that no one is put in danger or affected from the research.

Even though there are some problems with using ethnography as a type of research it may be the best and many situations like hospitals as ethnography looks at data and research that other types of methods like interviews cannot look at. As it looks at what people really do rather than what they say or think they do. It helps look at the meaning of certain behaviours of people and how they act in certain situations.

References

Atkinson, P., & Hammersley, M. (1994). Handbook of qualitative research. Thousand Oaks, CA: Sage.

Darnell, R. (1974), Readings in the History of Anthropology, Harper & Row Publishers, New York, NY, .

Elliott, R., Jankel, Elliott, N., (2004) Using ethnography in strategic consumer research. Emerald. 6 (4). 215-223

Ethnographic research (2004) What’s going on?. [online] Kansas City. Available from: http://www.ethnographic-research.com/pdf/whatisethnography.pdf [Accesed on 11th November 2006]

Hammersley M, Atkinson P. (1995) Ethnography: Principles in Practice. Second Edition. London, Routledge.

Hilton, A., (1987) The ethnographic perspective. London, South Bank Polytechnic Open Learning Centre.

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In this study, researchers attempt to find out the causes of mistakes and errors in the preparation and administration of intravenous medications by utilizing the human error theory. The study was done in 10 wards of two hospitals in the …

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