Using Historical Literature

Di Carpenter

How to Write Your Nursing Dissertation, First Edition. Alan Glasper and Colin Rees.© 2013 John Wiley & Sons, Ltd. Published 2013 by John Wiley & Sons, Ltd.

Can Historical Research Ever Be Justified in Contemporary Health-Care?

• Sue wanted to discuss larval therapy with a patient.

• As she knew it had been used historically she thought that knowing some of the details of its origin might help patients to understand it better and find it more acceptable.

• She also wondered whether an historically-based dissertation might provide useful information to other nurses in similar circumstances.

Sue Discussed Her Ideas With Sam

I think it’s an excellent idea

Although personally I’d take a

lot of convincing

If I ascertain the historical context do

you think patients would find larval

therapy more acceptable?

22

So where does historical enquiry

fit methodologically?

It is likely to unearth both

qualitative and quantitative

evidence

What About Historical Theory?

• Historians are at odds about the extent to which they use theory in making sense of their data. Although the past no longer exists, traces of it remain in texts and artefacts.

• The researcher’s task is to ascertain the truth of these as far as he or she can deduce it (Berkhoffer, 2008, pp.3-48).

• Some historical researchers let this evidence speak for itself and conform to a purist empirical approach. That is they attempt to make sense of their research findings in the context of what is already known about the period to which they are thought to belong.

What is Contextualization?

• Understanding the economic, political and social processes of the period in which the data were created helps to put them in context to make sense of them.

• Examples include the effects of the industrial revolution on city population size and spread of diseases such as cholera and typhoid. Similarly the prevailing social mores associated with class and sexual practices helps us to understand the prevalence of venereal disease.

So what is the historical research

method about?

The Historical Research Method

• Historical Researchers (i) identify the sources for their data (ii) authenticate their sources as genuine (iii) place their sources in the appropriate historical context (iv) interpret their findings and (v) place their research in relationship to other work in the field (in historiographical context).

Ethics of Historical Research

• It is important, when considering the rigour of historical research to ascertain whether ethical approval was sought.

• There is a 100-year exclusion period for access to medical records and a 30 year exclusion period for access to official administrative records. Some older records might also be kept in books which span several years and contain records within the exclusion period. In such cases ethical approval is required.

So Sam,How do I go about

undertaking a study based on

historical research?

The Process – Search and Select…

• Search for evidence in the usual way. Consider including a date range for the period in which you are interested.

• Also consider grey literature. If your historical enquiry concerns fairly recent history you may find evidence in the form of old policies, procedures, and older staff-members’ memories. Care must be taken with the use of oral history, however, as memories can often become distorted over time.

• Select your literature as you would with any other evidence-based approach i.e. in terms of its relevance to your question and / or its closeness of fit to your patient group or clinical situation.

…Appraise and Summarise

• Appraise the literature. You could use a broad qualitative framework (where this is appropriate) and / or apply the additional questions identified below.

• Summarise your findings from this process and apply them to your clinical situation. You may compare historical approaches, practices, policies, guidelines with current versions, for example. Or you may try to create a timeline and outline change in practice over time. You should aim to answer the questions (a) what have I found? and (b) what is the relevance of this exercise to contemporary practice?

Disseminate Your Results

• Disseminate your results. Take in to account who your target audience is e.g. patients, relatives, or colleagues. Consider how you will present your findings. What do you hope the outcome will be? This may include policy change, or the creation of information leaflets, or an educational package as some examples. It may be appropriate to identify whether and how you will evaluate the effect or the effectiveness of sharing your results.

Critical Appraisal Tool for Historical Research in Health and Social Care

1. Was a research question or topic clearly identified?

2. Was an historical enquiry appropriate to answer the research question or address the topic?

3. Did the researcher identify his or her sources of data clearly? Did the researcher draw upon – primary sources (go to 3a)– secondary sources (go to 3b)– both primary and secondary sources (answer 3a and 3b)

3a – Primary Data Sources

• Which Primary Data Sources were used? • Manuscript Sources: e.g. Administrative

records, clinical records, minutes of meetings, policies, procedures, other (state which)

• Contemporary Published Sources: e.g. books, directories, journal articles, letters, magazines and newspapers, Parliamentary Papers, Public General Statutes, other (state which)

3b – Secondary Sources

• Which Secondary Data Sources were used?• Published Secondary Sources e.g. books,

journal articles. • Unpublished Secondary Sources e.g.

dissertations, projects, theses.• Electronic Sources • Other (state which)

4. Were The Sources Authenticated?

• Did the researcher explain the provenance of the sources that were used?

• Hospital case books, for example, were usually clearly identified and often included an inserted label referring to relevant statutes that required them to be kept. Letters and diaries, however, are more easily faked.

Appraisal Questions 5 and 6

5. Was ethical approval necessary and sought?

6. Did the researcher use a particular paradigm or theoretical tradition with which to analyze/interpret the data?• Was this clearly identified?• Did the researcher justify his or her theoretical

perspective? • Were data interpreted consistently according to the

chosen paradigm?

Appraisal Questions 7 and 8

7. Were the findings analyzed and interpreted appropriately? • Did the researcher provide convincing

arguments to support his or her interpretations?

• Were direct quotes from primary sources used to illustrate and support the data interpretation?

8. Did the researcher contextualize the findings?

9. What Were The Conclusions?• Were the conclusions warranted by / consistent with the analysis and

interpretation of the data?• Were the conclusions believable? • Did the researcher generalize his or her findings on the basis of the study? • If so, was this justified? Was there a convincing argument based on

consistent findings to suggest they could be generalized? • N.B. evidence for practice in one nineteenth century hospital does not mean

that every hospital practiced in the same way. If, however, the researcher found similar accounts in a number of hospitals for the period, a generalized conclusion may be justified.

• Did the researcher place his or her work with respect to any other eminent work in the field (in historiographical context)?

Questions 1-9 © 2011 by D. Carpenter

Sue and Sam Celebrate the Completion of Her Project

Bibliography

Berkhoffer, R.F. (2008) Fashioning History: Current Practices and Principles. Palgrave Macmillan, Basingstoke.Carpenter, D.T. (2010) Above All A Patient Should Never be Terrified: An Examination of Mental Health Care and Treatment in Hampshire 1845–1914. Unpublished PhD thesis, University of Portsmouth, UK.Carr, E.H. (1990) What Is History? ( 2nd edn). Penguin Books, London.Elton, G.R. (1979) The Practice of History (9th Impression). Fontana , Sydney, Australia.Fulbrook, M. (2002) Historical Theory. Routledge, London.McDowell, W.H. (2002) Historical Research: A Guide. Longman, London.Tosh, J. ( 2008) Why History Matters . Palgrave Macmillan, Basingstoke.

Further Reading

Burnham, J.C. (2005) What is Medical History? Polity Press, Cambridge.Lane , J. (2001) A Social History of Medicine: Health, Healing and Disease in England, 1750–1950. Routledge, London.Porter, R. (ed.) (2006) Cambridge Illustrated History of Medicine. Cambridge University Press, Cambridge.