Exploring the meaning of nurse-patient intimacy in oncology care settings: Utilisation of phenomenology and feminism

This chapter presents the methodological journey and findings of a study exploring the meaning of nurse-patient intimacy in oncology care settings. The 'data' for this study is provided by the dialogue that took place through feminist conversational interviewing with thirty oncology patients, interviewed once, and twenty-three oncology nurses, interviewed twice, over a ten month period. The study findings reveal nurse-patient intimacy as a process, which begins when the nurse and patient first meet, and nurse empathy for the patient follows identification. This identification is influenced by the patient's characteristics and response to their cancer and its treatment. Reciprocal self-disclosure characterises the intimacy that develops in the context of the nurse assuming a 'professional friend' role in a homely atmosphere where care is delivered. The outcome of intimacy is satisfaction for the nurse, but also emotional effects. Peer support among nurses in sustaining intimacy with patients is also revealed. At first glance, it would appear that utilising phenomenological and feminist approaches simultaneously is philosophically and methodologically unsound. After all, many feminists consider phenomenology an essentialist doctrine, and essentialism is a central target of feminist criticism. However, such arguments fail to acknowledge the various phenomenological approaches available to researchers. The phenomenological approach adopted for this study was guided by the work of phenomenologist Gadamer, whose work is also referred to as philosophical hermeneutics or interpretive phenomenology. Gadamer views the research interview as a dialoguebetween researcher and participant, and like feminist research, the dialogue becomes a shared project. Moreover, intimacy between study participants and researcher is espoused in feminist research, and with interpretive phenomenology, the researcher is the instrument, which suggests intimacy in the interview process. Therefore, in the context of this study, 'feminist' is viewed as a qualitative approach, in which the subjectivity of both the researcher and participants, is central, and a close and mutual relationship between researcher and participant is seen as important. Furthermore, a diffusion of power between study participants and researcher is paramount in feminist research. Similarly, with hermeneutic understanding, the researcher and participants work together to reach a shared understand of the phenomenon being explored. The methodological approach presented is this chapter is representative of the inter-disciplinary nature of qualitative inquiry. Moreover, in the context of the literature surrounding nurse-patient intimacy, the views of nurse theorists, such as Travelbee and Peplau are not sufficient alone. Therefore, the views of philosophers such as Scheler and Stein and moral theologian Campbell, are also provided to support the interpretations revealed in the study findings. The hybrid nature of the methodological influences adopted in this study therefore reflects the qualitative researcher adopting the role of bricoleur, and mirrors the characteristics of the qualitative researcher who has to be flexible, responsive and reflexive. This hybrid approach is not surprising since nursing gains its theoretical underpinnings from diverse philosophical and theoretical standpoints.