Hermeneutic research in nursing: developing a Gadamerian-based research method

© 2003 Blackwell Publishing Ltd

Nursing Inquiry 2003; 10(2): 113–120

F e a t u r e

Blackwell Publishing Ltd.

Hermeneutic research in nursing:developing a Gadamerian-based

research method

Valerie Fleming, Uta Gaidys and Yvonne RobbGlasgow Caledonian University, Glasgow, Scotland, UK

Accepted for publication 4 November 2002

FLEMING V, GAIDYS U and ROBB Y. Nursing Inquiry 2003; 10: 113–120Hermeneutic research in nursing: developing a Gadamerian-based research methodThis paper takes the stance that although there are many different approaches to phenomenological and hermeneuticresearch, some of these have become blurred due to multiple interpretations of translated materials. Working from originaltexts by the German philosophers, this paper reconsiders the relevance of phenomenology and hermeneutics to nursingresearch. We trace the development of Gadamer’s philosophy in order to propose a research method based in this tradition.Five steps have been identified as a guide for nurse researchers. These are deciding upon a question, identification of pre-understandings, gaining understanding through dialogue with participants, gaining understanding through dialogue with textand establishing trustworthiness.

Key words: Gadamer, gaining understanding, hermeneutics.

In recent years the amount of qualitative research publishedby nurses has increased dramatically. This has providedinsight into relevant phenomena not previously articulatedand is therefore of immense value to the profession. Writerssuch as Benner (1984), Morse (1996) and Diekelmann(1992) were particularly influential in shaping both the workof clinical nurses and nurse researchers. Several nurseresearchers claim to base their work either within the tradi-tion of phenomenology, hermeneutics or both (Sigurdardottir1999; van der Zalm and Bergum 2000). A challenge to thework of these researchers was mounted by Crotty (1996) who,from a review of 30 studies, concluded that the focus onexperience adopted by nurse researchers was problematic andnot in keeping with the original intentions of phenomen-ology. He suggested that phenomenological researchersshould return to the original intent of phenomenology andseek the essence of the phenomenon under investigation.

He believed that through the process of phenomenologicalreduction, in which the researcher’s preconceptions aresuspended, such essences may be brought to the fore.

While such suggestions appear to embrace only thephenomenological approach advocated by Husserl (1965),Crotty’s criticisms were supported by Paley (1997, 1998).Paley (1997) suggested that nurses misused Husserl’snotion of essences and therefore ‘they should abandon theirattempts to ground phenomenological research … in hisphilosophy’ (192). He took this argument further (Paley1998), arguing that Heidegger’s phenomenology did nothave the methodological implications usually ascribed toit in the nursing literature. Various nurse scholars haveresponded to these critiques. For example, Lawler (1998)claimed that nurses sometimes have to invent researchdesign to manage phenomenological research. Further,Darbyshire, Diekelmann and Diekelmann (1999), respond-ing to Crotty’s (1996) criticisms of the work of Heideggeriannurse researchers, return to a 1962 translation of Seinund Zeit (Being and Time) (originally published in 1927;Heidegger 1994) to argue it is Crotty’s position which ismisinformed because of his ‘narrow, existentialist view ofHeidegger’s work’ (17). In addition, Caelli (2000) traces the

Correspondence: Valerie Fleming, School of Nursing and Midwifery, CommunityHealth, Glasgow Caledonian University, Cowcaddens Road, Glasgow G40BA,Scotland, UK. E-mail: <[email protected]>

V Fleming, U Gaidys and Y Robb

114 © 2003 Blackwell Publishing Ltd, Nursing Inquiry 10(2), 113–120

differences between European and American phenomeno-logy, suggesting that culture is a key element contributing todifferent views of the essence of phenomenology itself.

The present authors acknowledge these debates but wishto approach the topic from a different direction. Under-pinning this article are two major contentions. The first isthat there appears to be an underlying assumption in somenursing research that phenomenology and hermeneuticsare the same thing (Annells 1996; Ruangjiratain and Kendall1998), although some authors, noticeably Geanellos (1998a,b,2000) have moved away from this stance. Our secondcontention highlighted by Geanellos (1998a) is that much ofthe debate has been informed by translated (and thereforeinterpreted) works of the German philosophers, of whichmany translations exist, each of which has a slightly differentfocus. Thus there have come to be a number of taken-for-granted assumptions as to the meanings of some translatedmaterial that may distort the original intent of the writer.

This paper begins from the stance that hermeneuticsand phenomenology are not one and the same, nor is thereone phenomenology or one hermeneutic. We believe thatalthough none of the philosophers such as Husserl,Heidegger and Gadamer develop research methods, theywere concerned with and developed philosophies, which areoften used to underpin qualitative research today.

Working from the most recent version of Wahrheit undMethode (Truth and Method), Gadamer (1990), we propose amethod for hermeneutic research, which may be appropriatefor investigating some topics in nursing. We utilise the latestreprints of the German texts of the original authors and,where for the purposes of quotation or interpretation, wehave found it necessary to translate, we jointly agreed on themeaning of that translation. By so doing, without recourseto translated materials, we contribute to the substantial bodyof work in this area.

We consider briefly the relevance of phenomenologyand then hermeneutics. We continue by presenting acritique of some major research methods used by nurseresearchers. Finally, we propose a five-step approach toconducting nursing research in the Gadamerian hermeneutictradition.

PHENOMENOLOGY

According to Heidegger (1994) the meaning of phenom-enology has undergone considerable change from its Greekorigins, in which the Greek word ‘phenomenon’ stands forsomething which shows itself by bringing itself into daylight.Some nurse researchers, who claimed to base their workon Husserl or Heidegger, supported this (Omery 1983).

However the present meaning of phenomenology, whichdistinguishes clearly between a phenomenon and its appear-ance, emerged for the first time in Husserl’s (1993) workLogische Untersuchungen (Logical Investigations), whichHeidegger (1993) claimed to be the basis of his investiga-tions. Husserl’s work, which was firmly placed within theframework of the traditional logic of the time, still demandeda traditional scientific approach with its associated assum-ptions of objectivity and neutrality. Husserl believed this wasthe only way of assuring methodological trustworthiness.

For Husserl (1993), the interest of logic was found intheoretical thinking, which happened within the field ofconsciousness. He believed that a certain kind of thinking,which could be reflected in words, and which was connectedwith meanings, had to be the topic of phenomenologicalconsideration. This meant that theoretical thinking shouldbe made clear so as to provide a reliable foundation forthe further development of knowledge (Heidegger 1994).Husserl (1993) went on to state that in order to understandthe nature of a phenomenon all prejudice must be elim-inated. This process must occur through reduction of thecomplexities to variables, which can then be objectivelymeasured (Paley 1997).

According to Heidegger (1994), however, Husserl’s(1993) definition of phenomenology is burdened with thecategories of natural science, namely the idea of certaintyand absolute clarity. As such, Heidegger believed thatHusserl’s preconceived idea of science led to him missingthe original subject matter being investigated. Heidegger(1994) believed that Husserl’s understanding of conscious-ness as an object was derived from the Cartesian dogma,where, if consciousness was an object, it would be possibleto look at it in an objective way. Husserl’s concerns werethe conditions of knowing and the provision of a reliablefoundation of knowledge. Conversely Heidegger was inter-ested in the possibilities of Being, in which existence knowsitself only in relation with others and other objects. Hebelieved that in comparison with nature there were a varietyof direct experiences in consciousness. Thus no experiencecould be like another. Every perceived experience is unique.Heidegger (1994) also opposed the idea of validity equatedwith the idea of truth. He criticised traditional philosophybased on Plato’s beliefs with its view ‘There is no science ifthe idea of validity is not absolutely certain’ (Heidegger1994, 96).

HERMENEUTICS

Heidegger did not use the term hermeneutic in an effortto free himself from the traditional scientific approach of

A Gadamerian-based research method

© 2003 Blackwell Publishing Ltd, Nursing Inquiry 10(2), 113–120 115

Husserl. Instead, as his work evolved, he replaced theconcept of knowing with that of understanding. He believedunderstanding was not possible because of knowing, ratherit was possible because of relationships. Heidegger (1993)represented understanding in his main work Sein und Zeit,not as a method of the humanities but as a mode of beingwhich makes knowing possible. In brief, Heidegger’s workdescribes an interpretation of Dasein, which directly trans-lated means being there. However, for Heidegger, Daseinincludes awareness of one’s being, belonging to the world,availability and use of the world and relating with others. Fornurses who cannot access Heidegger’s original texts, suchdeeper meanings may not be fully appreciated.

Gadamer (1990), following on from Heidegger, asked:‘How is understanding possible?’ He used this question tooutline his Philosophical Hermeneutic, in which he claimsthat a hermeneutical form of interpretation is called for.In the nineteenth century Dilthey (1999) developed sucha form of interpretation through a system of rules ofunderstanding. For Gadamer, however, this seemed to beburdened with more disadvantages, because it would havethe same limitations as the ideas of validity and truth withinthe paradigm of the natural sciences. Gadamer’s Philosoph-ical Hermeneutic denies that the ability of understandingneeds an awareness of rules. Nor does he believe that thereverse is correct, i.e. that an awareness of the rules of under-standing leads to understanding. Philosophical Hermeneuticmeans to reflect on the ability of understanding and theknowledge on which it is based (Gadamer 1993). Gadamer’sHermeneutic does not criticise scientific methods inthemselves, it criticises the legitimacy of those methods.

Gadamer (1990) emphasised the notion of historicalawareness and valued it as a positive condition for know-ledge and understanding. According to Gadamer (1993), weare all part of history and it is thus not possible to step outsidehistory to look at the past objectively. He saw consciousnessas being determined by the fusion of the individual’shorizon within the prejudices of history, including thoseprovided by people and/or texts. Therefore, consciousnessis not independent of history. Because Gadamer believedthat understanding could only be possible with historicalawareness, it therefore carried certain prejudices.

It is important to identify that, in this context, theconcept of prejudice does not have the negative connota-tion of the modern usage of the word. Here its meaning ismore in keeping with the word preunderstanding. It is notpossible to lose one’s preunderstandings as everyone alwayshas a preunderstanding of the topic in question. Althoughresearchers in the natural sciences see this as negative andmake significant efforts within their selected methods to

control their preunderstandings, Gadamer (1990) con-sidered it is only through one’s preunderstandings thatunderstanding is possible. If one does not recognise one’spreunderstandings, there is a risk that one will fail to under-stand or will misjudge meaning. Gadamer’s explanation ofpreunderstanding is directed against Husserl’s opinion ofreduction and is one of the main differences between philo-sophical Hermeneutic and Husserl’s Phenomenology.

TOWARDS A RESEARCH METHOD: A BRIEF CRITIQUE OF EXISTING INTERPRETIVE

APPROACHES IN RELATION TO GADAMER’S HERMENEUTIC

Although Gadamer (1990) offered valuable insights intohow one may develop a deep understanding of texts, he didnot offer either a methodology or a method for doing so.Nevertheless it is Gadamer’s opinion that in order to reachunderstanding, methodical direction through a systematicapproach is needed. Gadamer (1975) explained that thetask of hermeneutics is not a simple matter of recommend-ing a method, but this poses difficulty for the hermeneuticresearcher, who requires structure in order to begin theresearch process. This is supported by van Manen (1997),who indicated it is necessary to discover an approach, whichhelps to guide inquiry. In addition, he stated that reflectionon the choice of method is necessary in order to findan approach which facilitates interpretation. A number ofauthors, notably Colaizzi (1978), van Manen (1984), Giorgi(1989) Diekelmann (1992) and Koch (1995, 1996) havesuggested methods for undertaking phenomenological orhermeneutic studies. The relevance of such approaches ishighlighted by Van Manen (1984, 36) when he states that, ‘itmakes us thoughtfully aware of the consequential in theinconsequential, the significant in the taken-for-granted’.However, as previously stated, it must be borne in mind thatphenomenological and hermeneutic research are often notdifferentiated.

Colaizzi’s (1978) method for conducting Heideggarianphenomenological research in the field of psychology offersthe researcher a stepwise approach for carrying out sucha study. He indicated that his steps need to be consideredflexibly by the researcher and that they may need to bemodified, but significant modification would be necessary tomake the method suitable for a study underpinned by thework of Gadamer. Colaizzi, for example, recommended thatresearchers go back to participants to validate data analysisand represent the views of participants as faithfully aspossible. Although researchers using Gadamerian philosophy



would also do this in order to ensure rigour, they are,however, aiming to develop their own understandings ofthe phenomenon. Their interpretations must be anchoredin the experiences of participants (Walsh 1996) and in theco-created texts of research interviews.

A further problem with Colaizzi’s (1978) method is thatalthough he stated researchers should identify their pre-suppositions of the topic, he did this only with the view ofgenerating research questions. He did not suggest that allunderstanding is dependent upon preunderstanding. Thissets Colazzi’s work in direct contrast to Gadamer’s so render-ing it unsuitable for use with projects underpinned by hisPhilosophical Hermeneutic.

van Manen (1984) developed a methodological outlinefor doing phenomenology, which involves a dynamic inter-play between the following steps: turning to the nature oflived experience, existential investigation, phenomenologicalreflection and phenomenological writing. Although thesesteps are largely consistent with the work of Gadamer, thereare inconsistencies such as in the role of one’s preunder-standings. Van Manen (1984), for example, suggested thatknowledge gained from identification of one’s preunder-standings be turned against itself, thereby exposing itsshallow or concealing character. Gadamer (1990) has amuch more positive view of the value of identifying one’spreunderstandings. As with van Manen, he believes that nounderstanding is possible without preunderstandings of thephenomenon of interest but for Gadamer these preunder-standings are visited time and time again during the processof gaining understanding through a process of reflection.Understanding, therefore, always implies a preunderstanding(Gadamer 1975).

Giorgi (1989), also a psychologist, developed a phenomeno-logical approach for the exploration of psychologicalissues. His approach is firmly grounded in the phenomen-ology of Husserl, a key concept being the phenomenologicalreduction, associated with the metaphor of bracketing(Paley 1997). The aim of bracketing is for researchers to putaside their preconceptions of the phenomenon beingstudied so they do not distort it. The aim is to see thephenomenon in its pure form (Cohen and Omery 1994).Not only would it be very difficult, if not impossible, to putaside one’s preconceptions but, as previously stated,Gadamer (1990) considers all understanding to be depen-dent upon preunderstanding. The approach developed byGiorgi (1989) is also unsuitable for a study grounded inGadamerian philosophy.

The approach developed by Diekelmann (1992), who basesher research on Heideggarian hermeneutic phenomen-ology, also poses difficulties for the researcher trying to

adhere to Gadamer’s work, as she describes a team approachto data analysis. Selected interview transcripts were analysedby the individual members of her team prior to being dis-cussed by the whole team. Disagreements in analyses wereresolved by returning to the transcripts and sometimes byreturning to participants. The aim was to reveal contradic-tions and inconsistencies in analysis between team members,with Diekelmann (1992) suggesting this method could serveas a method of bias control. The problem with Diekelmann’sapproach is that team discussion of the interpretation isused as a method to control bias, rather than identifyingthe biases that interpreters held, which Gadamer (1975)considers necessary for full understanding. These diffi-culties exclude this approach from further consideration.However, if team discussion was utilised to develop a deeperor fuller understanding, this could be considered a usefulGadamerian approach.

Koch (1995) distinguished Husserlian phenomenologyand Heideggerian hermeneutics, although in 1996 herresearch was grounded in the Philosophical Hermeneutic ofGadamer (Koch 1996). Koch (1996) utilised three Gadamerianconcepts in this research, namely preunderstanding, thehermeneutic circle and ‘openness’ (in her interview style).However she failed to articulate a clear relationshipbetween her utilisation of these concepts and the work ofGadamer.

It therefore became the task of the present authorsto develop a clearly articulated method from Gadamer’sown works. This forms the basis of the next part of thisarticle.

A RESEARCH METHOD

In the previous section we discussed some of the key issuesrelated to phenomenological and hermeneutic research. Inthis section, we outline one way in which researchers can useGadamer’s ideas as a foundation for their work. We identifyfive stages in this research process.

Deciding upon a research question

Essential to any research process is the appropriateness ofthe research question in relation to underpinning method-ological assumptions. The area of interest must therefore becongruent with the aims of interpretative hermeneutics, asnoted previously, so that data obtained and conclusionsreached will be appropriate and useful. As stated by Flemingand Moloney (1996) this is essential to ensure internalconsistency as well as contributing to the expansion ofknowledge in the discipline of nursing.



Research carried out in a Gadamerian tradition isdeveloped from a desire to achieve a deep understandingof a phenomenon. The essence of the question, accordingto Gadamer (1990), leads to the opening up of possibilitiesfor this understanding. Gadamer (1990) emphasised theinfluence of the right questions for elaboration of thehermeneutic situation. That means the initial researchquestion influences the whole research process. He furtherstated there is no understanding without the activity ofquestioning. According to Gadamer (1990) the narrowrelation between questioning and understanding gives senseto the hermeneutic experience, in this case to hermeneuticresearch. It is important however, that, throughout theresearch process, researchers must keep both themselvesand their participants oriented to the subject under study inorder to continue asking relevant questions throughout theresearch process.

Identification of preunderstandings

Pre-understandings become discernible through confront-ation with different beliefs such as opinions of other research-ers, colleagues or traditional texts (Gadamer 1990, 1993).Researchers underpinning their work with the philosophy ofGadamer are required to identify their preunderstandingsor prejudices of the topic. Reflecting upon these will enablethem to move beyond their preunderstandings to under-stand the phenomenon and so transcend their horizon. Thisin turn will influence the research findings. Geanellos(1998b, 241) emphasises the importance of bringing pre-understandings into consciousness by ‘working out fore-structures’ in terms of the things themselves’ and by writingstories. However, it should be remembered that Gadamer(1990, 1993) declares prejudice has to be provoked to berealisable.

One appropriate approach to provoking one’s pre-understanding is a conversation with a colleague. Researchers’pre-understandings, which become visible within thisdiscussion, should then be described and analysed inthe research report. During the research process thesepreunderstandings will change through the collectionand interpretation of data, further relevant reading andthe keeping of a research journal. Researchers must con-stantly ensure that they focus actively on changes to theirpreunderstandings as the project develops. Once more aconversation with a colleague can facilitate this process.By thus explicating and periodically reviewing their pre-understandings, researchers are enabled to enter thehermeneutic circle (Geanellos 2000) and remain orientatedto the phenomenon.

Gaining understanding through dialogue with participants

‘To gain information’ or ‘to collect data’ does not seem thecorrect expression in a Gadamerian sense, therefore we usethe term ‘gaining understanding’. During this stage of theresearch it is essential that researchers understand themeanings of the texts gained from participants. Gadamer(1993) pronounced that understanding may only be pos-sible through dialogue, with researchers being open to theopinion of the other. In this sense, the notion of dialoguedoes not only mean a conversation between two people, it isalso possible to have a dialogue between reader and text.In both instances language is considered the constitutivemoment and it is through language that understandingbecomes possible (Gadamer 1990).

For Gadamer, the major aim of a conversation is to allowimmersion into the subject matter, therefore a conversationbetween researcher and participant is a suitable method ofachieving understanding of a phenomenon of interest. Forthis reason, as noted by van Manen (1984), this stage shouldnot be delegated to others such as research assistants. Byusing themselves as the research instrument, the researcheris helped to find ways of developing deeper understandingof the phenomenon under investigation.

Understanding will appear through the fusion of thehorizons of participant and researcher. Horizon is the fieldof vision, which includes and comprises everything that canbe seen from one perspective (Gadamer 1990). However, asthe horizon of the present is in continuous development,understanding of the participants and researcher will mergeinto a new understanding. During the research therefore,the researcher should thus attempt to understand howpersonal feelings and experiences affect the research, thenintegrate this understanding into the study.

It is important to note that understanding the other cannever be achieved totally, as it is constantly evolving. AsGadamer (1990) stated, if one understands at all, one under-stands differently. He also questions the demand to put one-self in someone else’s position. Gadamer (1990) argues thatif someone tries to do that he or she withdraws him- or her-self from the situation of understanding, because one’s ownpreunderstanding will be ignored. It is simply not pos-sible, as proposed by Johnson (2000), to put oneself in some-one else’s position, because of different pre-understandingwith respect to historical awareness. It is thus important thatthe researcher does not attempt to see through the eyes ofthe participants to understand the phenomenon of inter-est. Instead they work together to reach a shared under-standing. This is called the hermeneutic difference and is



a structural element of hermeneutic understanding(Lamnek 1995).

Gadamer (1993) further discussed the temporality ofevery remark within a conversation. It is also difficult there-fore, for a third person to assume the same understandingof the statements of that conversation. Because two givenpeople meet within a conversation through a communicativeprocess (Gadamer 1993), it means that they speak differentlythan they would have without questions or explanations ofthe other person.

Because of Gadamer’s (1990) assumption that under-standing depends on the particular historic situation, it isessential to speak two or three times with participants. Theirunderstanding of the subject matter and the understandingof the researcher will change over time. Gadamer (1990)refers to his idea of change, or development of understand-ing, as the hermeneutic circle. The researcher is able,through his or her preunderstanding, to understandthe participant in a certain way. The understandings of theparticipants will influence the understanding of the re-searcher. Again, she or he will understand the participantwith this changed preunderstanding in a different way insubsequent conversations. Over this period of time under-standings of participants will change through meetings withthe researcher. The research process should therefore facili-tate this change of understanding and it should be reflectedin the research findings. Consequently, the conversations withparticipants should be recorded and transcribed verbatim tocapture the historical moment and provide a text with whichto engage in dialogue. Returning the transcripts togetherwith the researcher’s preliminary analysis may stimulate theshared understandings. However it must be cautioned thatunderstanding remains transient as such conversationscould continue indefinitely.

Gaining understanding through dialogue with text

Although Gadamer consistently reiterates the power ofthe spoken word over the written, it is usually necessary totranscribe research interviews. In analysing these, however,the researcher must take care not to be totally reliant on thewritten transcript, but to read these while listening to thewords on tape where the two partners are working togetherto create a common understanding (Gadamer 1990). Itshould be noted that ‘text’ not only refers to the writtentranscript, but also to taped words, written commentsabout the interview situation and observations made by theresearcher. Non-verbal expressions also influence under-standing and therefore can be considered ‘text’.

Analysis of the conversation with participants shouldoccur with the hermeneutic rule of movement from thewhole to the part and back to the whole (Gadamer 1990).This rule goes back to ancient rhetoric and was transferredto Hermeneutics (Gadamer 1993). In order to facilitate theprocess of understanding, the first series of interviews shouldbe analysed before proceeding with the next sequence.At this stage, different researchers will adopt differentstrategies of feedback to their participants. Some will returntranscripts, while others may offer a summary of theinitial analysis. Yet others will begin a subsequent interviewwith a discussion of key points from the previous interview.While such flexibility exists, it is essential that to be true toGadamer’s description of the hermeneutic circle, thatfeedback and further discussion take place, otherwise thehermeneutic circle will not be fully experienced. Throughsuch feedback and subsequent dialogue, shared understand-ings in relation to the phenomenon will be reached betweenthe researcher and participant. However, the researchermust accept responsibility for the final interpretation.

The cycle of four steps inherent within this stage are notunlike those identified by van Manen (1990). These stepsare not mutually exclusive and may occur simultaneouslyor out of the sequence identified. The process of gainingunderstanding needs to be systematic, with every phasebeing enriched through the entire process.1 All interview texts should be examined to find an expres-

sion that reflects the fundamental meaning of the text asa whole. Gaining understanding of the whole text shouldbe the starting point of analysis, because the meaning ofthe whole will influence understanding of every other partof the text. Already the first encounter with the text isinfluenced by a sense of anticipation, which has developedthrough the preunderstanding of the researcher.

2 In the next phase every single sentence or section shouldbe investigated to expose its meaning for understandingof the subject matter. This stage will facilitate the identific-ation of themes, which in turn should lead to a rich anddetailed understanding of the phenomenon under inves-tigation. These themes should then be challenged by, andin turn, challenge the researcher’s preunderstandings.

3 Every sentence or section is then related to the meaningof the whole text and with it the sense of the text as a wholeis expanded. This is the significance of expansion ofthe unity of the understood sense (Gadamer 1990). It isimportant to emphasise this, because it is different to whatvan Manen (1990) proposed. van Manen’s method ofanalysing research data does not regard the movementback to the whole. The hermeneutic circle, which is essen-tial for gaining understanding, is only fully experienced if



the movement back to the whole is included in researchbased on Philosophical Hermeneutic. With the expandedunderstanding of the whole text, meaning of the parts canwiden.

4 This step involves the identification of passages thatseem to be representative of the shared understandingsbetween the researcher and participants. Such passages,which may appear in the research report, should give thereader insight into that aspect of the phenomenon, whichis being discussed.

The whole process could go on indefinitely, because everyunderstanding will change as time goes on. However, adecision, normally based on time or resources, will have tobe taken on the number of times the cycle is repeated.

Establishing trustworthiness

As with any research, the researcher following a Gadamerianapproach is responsible for establishing the trustworthi-ness of the research process and the truthfulness ofhis or her analysis. While there is overlap between thesetwo aspects, we discuss them separately, because of theirimportance.

In dealing with the trustworthiness of a qualitativeresearch process, clear criteria have been laid out byLincoln and Guba (1985). These criteria are applicable toa Gadamerian research process. Lincoln and Guba (1985)state that the steps of the research process must be clearlyidentifiable by interested parties; that is auditability is acriterion of truth in qualitative research. This has to includeclear documentation of the various decisions made duringthe different stages of analysis.

Credibility and confirmability are also considered tobe foundation components of trustworthiness (Clayton andThorne 2000). The researcher can establish credibility byensuring that perspectives of participants are represented asclearly as possible. The use of direct quotations from thetexts can help the reader to make a judgement in this matter.Confirmability can be dealt with by returning to participantsat all stages of the research process. Objective understand-ing is only possible in the respect that it can be achieved onthe basis of common characteristics such as language,culture and time. Therefore understanding is not possibleindependent of language and culture. Objectivity in herme-neutic research can be understood by faithfully representingthe texts and even this is an ideal and cannot be achievedentirely as readers will interpret research findings from theirown horizons (Bollnow 1966). It is at this point that the trust-worthiness of the research process and the truthfulness ofthe analysis come together.

Turning to the truthfulness of the analysis, research inthe Gadamerian tradition may differ from other qualitativeapproaches. If the reader is presented with the conditionsunder which a statement emerged, he or she may be able toappreciate the truth of that statement. Gadamer (1993)however, explained there is no statement that is universallytrue, because no statement can escape the complexitiesof interpretation. For Gadamer (1990), understanding canonly be achieved by consensus of the whole and the parts ofthe text. This offers a standard for trustworthiness related tothe processes rather than simply to the conclusions of theresearch. The responsibility of the Gadamerian researcheris thus to provide sufficient detail of the processes, as well asthe findings in the research report.

CONCLUSION

In this article we discussed some of the common understand-ings and misunderstandings which occur in nursing researchcarried out in the phenomenological and hermeneutictraditions. We critiqued some popular approaches utilisedby nurses in undertaking such research. We then returnedto the original works of Gadamer (1990, 1993) to offer astep by step approach for carrying out research, based uponhis philosophical thinking. By so doing we have added tothe rich debate surrounding this exciting area of nursingresearch.

REFERENCES

Annells M. 1996. Hermeneutic phenomenology: Philosoph-ical perspectives and current use in nursing research.Journal of Advanced Nursing 23(4): 705–13.

Benner P. 1984. From novice to expert: Excellence and power inclinical nursing practice. Menlo Park, CA: Addison-Wesley.

Bollnow OF. 1966. Zur Frage Nach der Objektivität derGeisteswissenschaften. In Philosophische hermeneutik, ed.HU Lessing, 149–74. München: Alber.

Caelli K. 2000. The changing face of phenomenologicalresearch: Traditional and American phenomenology innursing. Qualitative Health Research 10(3): 366–77.

Clayton A and T Thorne. 2000. Diary data enhancing rigour:Analysis framework and verification tool. Journal of AdvancedNursing 32(6): 1514–21.

Cohen MZ and A Omery. 1994. Schools of phenomenology:Implications for research. In Critical issues in qualitativeresearch methods, ed. JM Morse, 136–56. London:Sage.

Colaizzi PF. 1978. Psychological research as the phenomen-ologist views it. In Existential-phenomenological alternatives



for psychology, eds RS Valle and M King, 48–71. New York:Oxford University Press.

Crotty M. 1996. Phenomenology and nursing research. Melbourne:Churchill Livingstone.

Darbyshire P, J Diekelmann and N Diekelmann. 1999.Reading Heidegger and interpretive phenomenology: Aresponse to the work of Michael Crotty. Nursing Inquiry6(1): 17–25.

Diekelmann NL. 1992. Learning-as-testing: A Heideggerianhermeneutical analysis of the lived experiences ofstudents and teachers in nursing. Advances in NursingScience 14(3): 72–83.

Dilthey. 1999. Das verstehen anderer personen und ihrerlebensäußerungen. In Philosophische hermeneutik, ed. HULessing, 75–92. München: Alber.

Fleming VEM and J Moloney. 1996. Critical social theoryas a grounded process. International Journal of NursingPractice 2: 118–21.

Gadamer HG. 1975. Hermeneutics and social science.Cultural Hermeneutics 2: 307–30.

Gadamer HG. 1990. Wahrheit und methode: Grundzügeeiner philosophischen hermeneutic. Tübingen: JCBMohr.

Gadamer HG. 1993. Wahrheit und methode, ergänzungen undregister. Tübingen: JCB Mohr.

Geanellos R. 1998a. Hermeneutic philosophy. Part 1: Impli-cations of its use as methodology in interpretive nursingresearch. Nursing Inquiry 5: 154–63.

Geanellos R. 1998b. Hermeneutic philosophy. Part II: Anursing research example of the hermeneutic imper-ative to address forestructures/preunderstandings.Nursing Inquiry 5: 238–47.

Geanellos R. 2000. Exploring Ricoeur’s hermeneutic theoryof interpretation as a method of analysing research texts.Nursing Inquiry 7: 112–19.

Giorgi A. 1989. Some theoretical and practical issuesregarding the psychological phenomenological method.Saybrook Review 7: 71–85.

Heidegger M. 1993. Sein und zeit. Tübingen: M. Niemeyer.Heidegger M. 1994. Einführung in die phänomenologische

forschung. Frankfurt am Main: Vittorio Klostermann.Husserl E. 1965. Philosophie als strenge wissenschaft. Frankfurt

am Main: Vittorio Klostermann.Husserl E. 1993. Logische untersuchungen. Prolegomena zur

reinen logik/untersuchungen zur phänomenologie und theorie

der erkenntnis/elemente einer phänomenologischen aufklärungder erkenntnis. Tübingen: M. Niemeyer.

Johnson ME. 2000. Heidegger and meaning: Implicationsfor phenomenological research. Nursing Philosophy 1:134–46.

Koch T. 1995. Interpretive approaches in nursing research:The influence of Husserl and Heidegger. Journal of AdvancedNursing 21: 827–36.

Koch T. 1996. Implementation of hermeneutic inquiry innursing: Philosophy, rigour and representation. Journalof Advanced Nursing 24: 174–84.

Lamnek S. 1995. Qualitative sozialforschung, band i, methodologie.Weinheim: Beltz-Psychologie-Verlags-Union.

Lawler J. 1998. Phenomenologies as research methodologiesfor nursing: From philosophy to researching practice.Nursing Inquiry 5(2): 104–11.

Lincoln YS and EG Guba. 1985. Naturalistic inquiry. London:Sage.

van Manen M. 1984. Practicing phenomenological writing.Phenomenology and Pedagogy 2(1): 36–69.

van Manen M. 1990. Researching lived experience: Human sciencefor an action sensitive pedagogy. Canada: The Althorne Press.

van Manen M. 1997. From meaning to method. QualitativeHealth Research 7(3): 345–69.

Morse JM. 1996. Is qualitative research complete? QualitativeHealth Research 6(1): 3–5.

Omery A. 1983. Phenomenology: A method for nursingresearch. Advances in Nursing Science 5(2): 49–63.

Paley J. 1997. Husserl, phenomenology and nursing. Journalof Advanced Nursing 26: 187–93.

Paley J. 1998. Misinterpretive phenomenology: Heidegger,ontology and nursing research. Journal of AdvancedNursing 27(4): 817–24.

Ruangjiratain S and J Kendall. 1998. Understanding women’srisk of HIV infection in Thailand through criticalhermeneutics. Advances in Nursing Science 21(2): 42–51.

Sigurdardottir AK. 1999. Nurse specialists’ perceptions oftheir role and function in relation to starting an adultdiabetic on insulin. Journal of Clinical Nursing 8(5): 512–8.

Walsh K. 1996. Philosophical hermeneutics and the projectof Hans Georg Gadamer: Implications for nursingresearch. Nursing Inquiry 3: 231–7.

van der Zalm JE and V Bergum. 2000. Hermeneutic-phenomenology: Providing living knowledge for nursingpractice. Journal of Advanced Nursing 31(1): 211–8.

Documents

Hermeneutic research in nursing: developing a Gadamerian-based research method