The experiences of familial mental illness stigma among individuals living with mental illnesses.

Persons with mental illnesses may experience stigma from their immediate family members in addition to other forms of stigma. Using semi-structured interviews, we investigated experiences of familial mental illness stigma among 15 people diagnosed with mental illnesses in a mid-sized city in Canada. We identified five themes that speak to participants' experiences of familial mental illness stigma and ways to reduce it. The themes include the following: diagnosis as a 'double-edged sword,' potential familial isolation, familial stigma as societal stigma localized, stories of acceptance, and confronting potential familial mental illness stigma. Participants' narratives indicate that familial mental illness stigma is rooted in the broader social or public stigma, which sees its way into familial relations as well. This stigma takes various forms, including relationship bias or unfair treatment, breakdown in romantic relationships, loss of status, verbal and emotional abuse, exclusion from decision-making, and alienation within their immediate and extended families. Familial mental illness stigma experiences negatively impact participant's psychological well-being and personal empowerment. However, participants also shared ways that family members create supportive environments or actively confront or prevent stigma. Overall, this study has contributed to knowledge on mental illness stigma, particularly familial mental illness stigma from the perspective of participants living with a mental illness in a high-income country. Suggestions for future research include a focus on strategies to prevent ongoing familial mental illness stigma and large-scale studies to explore familial mental illness stigma to understand why families might perpetrate stigma.

The indelible role of the interpretive researcher's fore-structure in traversing the hermeneutic circle.

Phenomenological researchers are obliged to grasp the epistemological and ontological differences between the Husserlian and Heideggerian branches of phenomenology to avoid misappropriating phenomenological terms or mischaracterizing study design. To that end, we spell out the key differences between both phenomenological traditions as background for describing the indelible role that the researcher's background assumptions, or fore-structure, play in interpretive studies. We draw on our four studies to illustrate how we traversed the hermeneutic circle to disclose, challenge, and refine the personal, cultural, clinical, and scientific assumptions hidden in our fore-structures. Our reflections highlight how understanding evolves, not by bracketing or disengaging ourselves from the phenomena we study, but by engaging in an open dialog that seeks understanding as lived by patients and families.

"Organizing practice": The hidden work of homecare nurses in fighting health inequity and advancing social justice.

The nursing profession has a long history of advocating for social justice and health equity, and both values profoundly infuse nursing ethics, theory, and education. Homecare nursing occurs between the patient's daily life at home and the public health care system. Therefore, homecare nurses ideally possess insight into the living conditions and social determinants of health that their patients experience. This interpretive phenomenological study explores the strategies employed by homecare nurses to fight health inequity and advance social justice. Data were collected through participant observations, situational interviews, and small group interviews with 12 homecare nurses from two municipalities. Three analytical approaches were used: paradigm cases, exemplars, and thematic analysis. The data identified two primary strategies homecare nurses use to circumvent, solve, and mitigate the negative consequences of social determinants of health on patients' care and treatment: "Negotiating practice" and "Aligning practice." "Negotiating practice" ensures that care and treatment are delivered in a way acceptable to all involved. "Aligning practice" ensures cohesion, progression in the treatment and care trajectory, and support for patients and relatives in navigating the system. Both strategies are part of nurses' largely hidden work, reflecting the nursing profession's position as nested between the individual patient and the system.

Shared experiences among successful hearing aid users with high hearing aid self-efficacy.

OBJECTIVE: While targeted rehabilitation can enhance hearing aid self-efficacy (HASE), little research has been done to determine the factors contributing to its predictive value. By investigating the experiences of individuals who successfully use HAs and have high levels of HASE, we hoped to illuminate specific strategies and/or sources of support these individuals share that might explain why high HASE is often linked to successful outcomes. DESIGN AND STUDY SAMPLE: This qualitative study explored the experiences of five older adults who were successful HA users and reported having high HASE. Semi-structured interview guides were developed using the transtheoretical model of behavioral change as a framework. Interviews were analyzed thematically and holistically. RESULTS: Participants attributed their HA success to: intrinsic motivation to improve their hearing, confident self-reliance when making health decisions, willingness to act on advice from trusted others, pro-social personal attributes, positive expectations about HA outcomes, and actively pursuing an optimal HA outcome. CONCLUSIONS: For these participants, internal factors related to emotional state and source of motivation, and, to a lesser extent, verbal persuasion played a crucial role in their long-term success. This suggests that external influencers might be less impactful in facilitating success for those with high HASE.

The lived experience of severe maternal morbidity among Black women.

Black women are 3-4 times more likely to die from a pregnancy-related complication and twice as likely to experience severe maternal morbidity when compared to white women in the United States. The risks for pregnancy-related maternal mortality are well documented, yet Black women's experiences of life-threatening morbidity are essentially absent in the nursing literature. The purpose of this interpretive phenomenological study was to understand the experiences of Black women who developed severe maternal morbidity. Face-to-face, one-to-one, in-depth conversational interviews were conducted with nine Black women who experienced life-threatening complications during childbirth or postpartum. Five essential themes emerged (1) I Only Know What I Know; (2) How You Cared for Me; (3) Race Matters; (4) Faced with Uncertainty; and (5) Still Healing. These themes illuminate the complexity of Black women's subjective interpretations of severe maternal morbidity, and reveal ways in which racism, not race, places Black women at risk for poor maternal health outcomes. The author envisions greater equity for Black mothers entrusted to nursing care, guided by nursing theories informed by these study findings.

The experiences of foundation doctors with dyspraxia: a phenomenological study.

Dyspraxia, otherwise known as Developmental Coordination Disorder (DCD), is a specific learning difficulty (SpLD). Its main difficulties manifest as problems with motor coordination, organisation, academic and social difficulties. There are now more students arriving at university with SpLDs, and, therefore, a similar rise may be expected within medical education. There has been no previous research focusing on dyspraxia in doctors. An interpretive phenomenological approach was used. Six UK foundation schools disseminated the announcements. Three participants took part in loosely structured telephone interviews regarding their experiences of undertaking medical school and foundation school with dyspraxia. These were transcribed verbatim and then thematically analysed. The themes could be split into two main categories: "Weakness and Coping Strategies" and "Perspectives of Dyspraxia". "Weakness" included: clumsiness, organisation and needing extra time. The participants focused on their "Coping Strategies" that included: Ensuring safety, adapted learning preferences and external support. "Perspectives of Dyspraxia" included: diagnosis, career choice, stigma, "normalisation" and the "difference view" or "medical deficit" view of dyspraxia. Doctors with dyspraxia often mask their difficulties through sophisticated coping strategies. These were determined and hardworking individuals who believe that their dyspraxia was a positive aspect of their identity, adopting a "difference view". They felt further education is needed about dyspraxia to change the perceived stigma. There is now a need for further research in this area.

Illustrating a novel methodology and paradigm applied to Emergency Department research.

AIM: To provide a practical example of how a novel methodology and paradigm was applied to a mixed methods study exploring the healthcare experiences of Australian adults who frequently use emergency department services. DESIGN: Discussion Paper. DATA SOURCES: We explored published literature discussing philosophical and methodological issues related to mixed methods research. Literature searches were performed between July 2019 and February 2021. IMPLICATIONS FOR NURSING: Phenomenology is a powerful methodology to explore the lived experience of research participants, but it is not without limitations. Mixed methods phenomenology allows nurse researchers to bring further clarity to their research phenomena, however, including phenomenology in mixed methods studies may be seen to be philosophically incompatible. The philosophical metaparadigm of dialectical pluralism provides nurse researchers with a new coherent methodological and philosophical framework for combining participants' descriptions of lived experience with a variety of data collection methods. It is effective when working with transdisciplinary research teams, and stakeholders representing diverse values and disciplines. CONCLUSION: Complex healthcare environments require sophisticated, flexible research approaches. This paper presents mixed methods phenomenological research combined with the metaparadigm of dialectical pluralism providing a methodological framework that can support multifaceted nursing research. IMPACT: The combination of mixed methods phenomenology and dialectical pluralism represents a novel solution for nurse researchers to articulate a research methodology and philosophical paradigm reflecting the complexity embedded in everyday nursing practice. This methodology offers a unique approach to exploration of challenging clinical and patient scenarios with multifaceted elements, and overcomes theories of philosophical incompatibilities between divergent methods.

An interpretive phenomenological analysis of formative feedback in anesthesia training: the residents' perspective.

BACKGROUND: Consistent formative feedback is cornerstone to competency-by-design programs and evidence-based approaches to teaching and learning processes. There has been no published research investigating feedback from residents' perspectives. We explored the value residents place on feedback in routine operating room settings, their experiences, and understanding of the role of feedback in their training and developing professional identity. METHODS: Interpretive phenomenological analysis of residents' experiences with feedback received in clinical settings involved two focus groups with 14 anesthesia residents at two time points. Analysis was completed in the context of a teaching hospital adapting to new practices to align with nationally mandated clinical competencies. Focus group conversations were transcribed and interpreted through the lens of a social constructivist approach to learning as a dynamic inter- and intra-personal process, and evidence-based assessment standards set by the International Test Commission (ITC). RESULTS: Residents described high quality feedback as consistent, effortful, understanding of residents' thought processes, and containing actionable advice for improvement. These qualities of effective evaluation were equally imperative for informal and formal evaluations. Residents commented that highest quality feedback was received informally, and formal evaluations often lacked what they needed for their professional development. CONCLUSION: Residents have a deep sense of what promotes their learning. Structured feedback tools were seen positively, although the most important determinants of their impact were faculty feedback- and broader evaluation-skills and motivations for both formal and informal feedback loops.

When Family Don't Acknowledge: A Hermeneutic Study of the Experience of Kinship Stigma in Community-Dwelling People With Inflammatory Bowel Disease.

Recent evidence suggests that kinship stigma-the experience of being or feeling stigmatized by family members-arises in the stories of people with inflammatory bowel disease (IBD). Adopting Goffman's definition of stigma as "an attribute which is deeply discrediting," we used hermeneutic (interpretive) phenomenology to further explore the meaning of kinship stigma for people with IBD and reveal its significance. In total, 18 unstructured interviews took place in participants' own homes in the United Kingdom, between July 2015 and April 2016. Transcripts were analyzed using a hermeneutic method to reveal three relational themes and one constitutive pattern. Referring to relevant literature, the presence and impact of kinship stigma on people with IBD is revealed. Kinship stigma-experienced as and meaning a lack of acknowledgment-may have wide-ranging implications for health and social care professionals caring for persons with IBD or other chronic illness and their families.

Experiences of coeliac disease in a changing gluten-free landscape.

BACKGROUND: Coeliac disease is an autoimmune disorder triggered by the ingestion of gluten. In recent years, there has been considerable increase in the availability of gluten-free products in North America. The present study investigated how the recent proliferation of the gluten-free industry has affected individuals living with coeliac disease, with a primary focus on their social lives and relationships. METHODS: Interpretive phenomenology was utilised for study design and analysis. Semi-structured interviews were conducted with 17 adults diagnosed with coeliac disease in Calgary, Alberta. Interviews were audio recorded and then transcribed for analysis. RESULTS: People living with coeliac disease experience the growth of the gluten-free industry as a 'double-edged sword'. Although they are grateful for more palatable gluten-free options, they are increasingly faced with misunderstandings about the severity of coeliac disease as a result of many noncoeliac disease individuals subscribing to the gluten-free diet. This 'double-edged sword' made certain types of social situations more easily manageable (e.g. more gluten-free options available at restaurants), whereas others produced distress (e.g. increased risk of inadvertently consuming gluten). Participants also felt they may be perceived or even perceived themselves differently (e.g. felt high maintenance). To help mitigate these social ramifications of following the gluten-free diet, participants utilised various strategies. CONCLUSIONS: The sole medical recommendation of a gluten-free diet fails to acknowledge the ongoing difficulties those with coeliac disease can endure in the current gluten-free landscape. Recommendations beyond the gluten-free diet are advisable to alleviate many of the indirect burdens revealed in the present study.

Occupational values of nurses who succeeded their mothers in nursing.

AIMS: To investigate how nurses who succeeded their mothers in the occupation are affected by their mothers and to explore how such nurses value their occupation. BACKGROUND: Although children who succeed their parents in an occupation have shown high job satisfaction and persistence, no study has presented this phenomenon in nursing perspectives. DESIGN: A qualitative study using interpretative phenomenological analysis. METHODS: Data were collected from July 2016-September 2017 through in-depth interviews with seven mother-daughter nurse dyads. Data were analysed using dyadic analysis and interpretative phenomenological analysis. RESULTS: Three essential themes were derived: having affection for nursing per se; regarding the person per se as the primary value in nursing, instead of the person as a patient; and making a resolution to become a good nurse to follow their mothers' footsteps. Person-centred nursing was the core occupational value of nurses who succeeded their mothers in nursing. CONCLUSION: Although daughters felt burdened by following their mothers into the nursing profession, they had a sense of responsibility to fulfill their duties in nursing and indicated that maintaining a balance between being responsible and feeling burdened was more important than anything else. IMPACT: The present study can serve as a useful educational material for understanding the consequences of the succession of parents' occupation in the perspective of nursing. It illustrates how nurses who succeed their mothers in the profession are influenced by their mothers to value person-centred nursing and subsequently their rapid clinical adaptation.

Biculturalism in couple support for diabetes care in U.S.-born Chinese Americans.

Support in couples living with type 2 diabetes is associated with better health outcomes but support provision in collectivistic cultures has received limited research attention. To address this gap, we focused on couple dynamics and support in type 2 diabetes in U.S.-born Chinese Americans. Acculturation processes, particularly biculturalism, that is, the capacity to enact habits and practices from both the heritage and U.S. mainstream culture, were explored. Employing interpretive phenomenological methods, we conducted multiple narrative interviews with each of 15 couples regarding illness challenges and couple responses. Interviews were conducted in varied contexts, including with the couple, and in group interviews with people with diabetes or spouses. The unit of analysis was the couple, and narrative themes within the text were explored within the context of holistic couple summaries. We identified three key aspects of couple support: (i) Assisting with the diabetes treatment regimen; (ii) Moderating social and contextual factors that impede diabetes care; and (iii) Providing relational care and empathy for living with this challenging chronic condition. Support reflecting cultural maintenance of Chinese beliefs and practices include other directedness, family centeredness, and concerns for harmony and balance. Bicultural support patterns were also apparent in spousal communication that was both indirect and direct, and relationships marked by both interdependence and respect for independence or autonomy, reflecting both Chinese and U.S. cultural orientations, respectively. Working clinically with second and third generation Chinese immigrants requires clinical assessment of and responsiveness to couples' acculturation levels and bicultural skills.

Focused on the Objective: Experience of Male Combat Veterans in BSN Programs.

Background Veterans may provide a recruitment source to increase the diversity of the nursing workforce and increase the percentage of baccalaureate-prepared nurses. This study sought to understand the lived experience of male combat veterans in pre-licensure baccalaureate degree nursing programs. Method Using Van Manen's interpretive phenomenology methodology, a purposive sample of seven male combat veterans in pre-licensure baccalaureate degree nursing programs participated through written lived-experience descriptions (n = 2), photo-elicitation (n = 2), and unstructured interviews (N = 7). Findings The essential nature of the phenomenon is focused on the objective and four themes describing the participant's experiences were identified: tools of the trade, identity, turbulent waters, and fuel. Conclusion Despite the presence of barriers and frustrations, participants applied their identity and used the strengths gained through military service along with supports to focus on their objective of becoming a nurse. Thus, this research has implications for nurse educators.

Exploring the lived experience of migrants dying away from their country of origin.

PURPOSE: Migrants experience challenges settling into a new society, while retaining their cultural and religious values. Concurrently facing an end-of-life illness can result in existential distress affecting quality of dying. This study aimed to explore the lived experience of migrants dying away from their country of birth or origin. METHODS: The study design used a phenomenological approach using Heidegger's philosophy to gather and interpret dying migrants' stories. Participants were a purposive sample of New Zealand immigrants experiencing end-of-life illness and under hospice care. Participants were interviewed at home. Coherent stories were drawn from the transcribed interviews and analysed using iterative methods. Interpretive notions were formed through contemplation and writing. RESULTS: The ten participants, seven males and three females, were of different ethnicities and countries of origin. Three notions emerged. The first was dual possession of a new hybrid identity developed in their adoptive country, and an inner ethnic and cultural identity, in varying degrees of harmony with each other. The second was being in life review-reliving homeland memories and letting go of dreams. The third notion showed how they sought resolution by enacting continuity through their children, hoping for a final homeland visit, or conveying their dying wishes. CONCLUSIONS: How life review was enacted for each migrant and resolution depended on finding some degree of belonging in their country of adoption. Implications for end-of-life care include education to increase practitioner awareness and use of formal and informal life review. Enhancing spiritual well-being can assist resolution of end-of-life adjustment.

Care coordination: Identifying and connecting the most appropriate care to the patients.

Although nurses are increasingly expected to fulfill the role of care coordinator, the knowledge and skills required to be an effective care coordinator are not well understood. The purpose of this study was to describe the knowledge and skills required in care coordination practice using an interpretive phenomenological approach. Fifteen care coordinators from 10 programs were interviewed over a 6-month period. Semi-structured face-to-face interviews were audio recorded, transcribed, and analyzed using interpretive phenomenology. The central theme of care coordination practice was bridging the patient and the healthcare systems. To bridge, care coordinators needed to have knowledge of the patient and healthcare system as well as the skills to identify and negotiate treatments appropriate for the patient. The most salient finding and new to this literature was that care coordinators who used their medical knowledge about available treatment options to discern and negotiate for the most appropriate care to the patient made differences in patient outcomes. Nurses with medical and healthcare system knowledge, combined with the skills to navigate and negotiate with others in an increasingly complex healthcare system, are well situated to be care coordinators and generate optimal outcomes. Further investigations of critical care coordinator competencies are needed to support nurses currently enacting the role of care coordinator and to prepare future nurses to fulfill the role.

Patients and families realising their future with chronic obstructive pulmonary disease-A qualitative study.

AIMS AND OBJECTIVES: To gain insight into the lived experience of learning about having chronic obstructive pulmonary disease for patients and their families. BACKGROUND: Chronic obstructive pulmonary disease often progresses for years. Adjustment to declining health is gradual, and the disease may have developed considerably when health care is sought and people are diagnosed. Reaching patients at early stages is necessary to delay progression of the disease. DESIGN: Interpretive phenomenology. METHODS: Data were collected in four family focus group interviews (N = 37) and a subsample of eight family-dyad interviews. Patients were eight men, and 14 women aged 51-68 years. Majority of the patients (n = 19) were at GOLD grades II and III, with three at grade IV. The family members were eight men, and seven women aged 29-73 years. Data were collected between June-November 2012. RESULTS: Five, not mutually exclusive themes, revealed a long and arduous process of learning about and becoming diagnosed with chronic obstructive pulmonary disease and how unaware participants were of the imminent threat that the disease imposes on life. The themes were as follows: burden of shame and self-blame, enclosed in addiction, living in parallel worlds, realising the existence of the disease and a cry for empathy. CONCLUSIONS: Learning about and realising the existence of chronic obstructive pulmonary disease and what it entails at present time and in the future was bleak for the participants. The patients tended to put aside the thought of being a person with chronic obstructive pulmonary disease and defer actions that might halter progression of the disease, particularly to quit smoking. RELEVANCE TO CLINICAL PRACTICE: Individuals and families need support early in the disease process to realise and accept the existence of chronic obstructive pulmonary disease and particularly to deal with the challenges that nicotine addiction, shame and self-blame present. Increased public awareness about this enormous, but hidden, health problem is necessary.

Women's perspectives on home-based care for family members with chronic illness: An Interpretive phenomenology study.

The number of people with chronic illness who need home-based care is increasing globally. Home-based care is socially constructed to be work carried out by women. However, little attention has been paid to the opinions of middle-aged women caring for family members with chronic illness at home. In this study, Thai women's perspectives on home-based care for family members with chronic illness using interpretive phenomenology were identified. Fifteen middle-aged women were interviewed twice, and the data were analyzed using thematic analysis. Four major themes emerged: (i) role obligation; (ii) social life change; (iii) doing good things; and (iv) lack of support. Important findings were that care was considered a woman's duty owing to cultural beliefs. Most participants sacrificed their own needs to care for others, as doing good things is considered an important Buddhist belief. Caring for others decreased women's social networks, but they cared more for their own health. Support with finances, information, workplaces, and care recipients should be provided to women with care responsibilities. These results can help nurses to better understand women's caring roles and the consequences of home-based care that influence woman's health.

Barriers and facilitators to effective tuberculosis infection control practices in Madang Province, PNG - a qualitative study.

INTRODUCTION: Tuberculosis (TB) remains a major public health problem in many countries. There is a greater threat of exposure to TB in congregate settings including healthcare facilities, prisons and households where health workers treat patients with TB. In healthcare facilities, the key areas of risk of infection include settings where people with undiagnosed TB, including multidrug-resistant TB, congregate, such as outpatient waiting areas, pathology waiting areas, radiology departments and pharmacies, and wards where untreated patients await investigation results. With high levels of TB in the community, and symptoms leading people to seek treatment, health services can be TB 'hot spots', and in the absence of good TB infection control (TBIC) a clinical service may actually promote the spread of TB, rather than contain it. Practical and relevant control measures are, therefore, necessary to monitor the spread of TB. METHODS: The purpose of this hermeneutic phenomenological research was to explore rural health workers' perspectives of barriers and facilitators to effective TBIC practices in rural health facilities in Madang Province, Papua New Guinea (PNG). The conceptual framework was adopted from WHO policy on TBIC in healthcare facilities, congregate settings and households as a benchmark to guide the study. Qualitative individual and group interviews (with an average time of 30 minutes) and field notes were conducted with 12 key informants comprising clinicians (n=9) and support staff (n=3) from the health facilities. Trustworthy steps were taken during the semi-structured interview to ensure data validity through member check and repeating participants' narratives to ensure accurate representation of participants' experiences. All interviews and field notes were analysed using standard phenomenological methods. RESULTS: The findings showed that numerous interconnected factors have influenced the implementation of TBIC measures in the rural health facilities in Madang Province. They include issues related to inadequacies in the healthcare systems, access to personal protective equipment, separation procedures, sputum status, monitoring and control, training, and health services as TB 'hot spots'. CONCLUSIONS: The study found evidence that health system factors do impact on the capacity to implement TBIC. Further, factors beyond TBIC such as sociocultural factors have an important influence on the way TBIC is implemented. The results of this study are useful for clinicians, health administrators and policymakers to improve the interventions and application of TBIC procedures at the rural health facilities in PNG. The study is limited to health services in Madang Province, and therefore the findings cannot automatically be generalised to other district hospitals and health centres in other parts of PNG. However, the WHO TBIC is a standardised policy and the results of the findings may be useful for other health facilities that manage TB patients in PNG and for future health systems researchers to help improve the generalisability of the findings. Further research is needed to explore health workers' experiences of conditions, actions and everyday practical issues affecting the application of TBIC measures in the rural health facilities of PNG.

Meanings and experiential outcomes of bodily care in a specialist palliative context.

OBJECTIVE: The objective of this study was to enhance the depth of existing knowledge about meanings and experiential outcomes of bodily care in the context of an inpatient specialist palliative setting. METHOD: Interpretative phenomenology was chosen as the study sought to explore individuals' lived experiences related to bodily care. Nine participants (five women, four men) of various ages and with various metastasized cancers and bodily-care needs, all from one specialist palliative care ward, participated. Data were collected with repeated narrative interviews and supplementary participating observations. Analysis was informed by van Manen's approach. RESULTS: The following meanings and experiential outcomes of bodily care were revealed by our study: maintaining and losing body capability, breaching borders of bodily integrity, being comforted and relieved in bodily-care situations, and being left in distress with unmet needs. These meanings overlap and shape the nature of each other and involve comforting and distressing experiences related to what can be described as conditional dimensions: the particular situation, one's own experiences of the body, and healthcare professionals' approaches. SIGNIFICANCE OF RESULTS: The results, based on specialist palliative care patients' experiences, outline the meanings and outcomes that relate to the quintessence and complexity of palliative care, deriving from dying persons' blend of both basic and symptom-oriented bodily-care needs. Moreover, the results outline how these two dimensions of care equally influence whether comfort and well-being are facilitated or not. Considering this, specialist palliative care may consider how to best integrate and acknowledge the value of skilled basic nursing care as part of and complementary to expertise in symptom relief during the trajectories of illness and dying.

Differentiating between descriptive and interpretive phenomenological research approaches.

AIM: To provide insight into how descriptive and interpretive phenomenological research approaches can guide nurse researchers during the generation and application of knowledge. BACKGROUND: Phenomenology is a discipline that investigates people's experiences to reveal what lies 'hidden' in them. It has become a major philosophy and research method in the humanities, human sciences and arts. Phenomenology has transitioned from descriptive phenomenology, which emphasises the 'pure' description of people's experiences, to the 'interpretation' of such experiences, as in hermeneutic phenomenology. However, nurse researchers are still challenged by the epistemological and methodological tenets of these two methods. DATA SOURCES: The data came from relevant online databases and research books. REVIEW METHODS: A review of selected peer-reviewed research and discussion papers published between January 1990 and December 2013 was conducted using CINAHL, Science Direct, PubMed and Google Scholar databases. In addition, selected textbooks that addressed phenomenology as a philosophy and as a research methodology were used. DISCUSSION: Evidence from the literature indicates that most studies following the 'descriptive approach' to research are used to illuminate poorly understood aspects of experiences. In contrast, the 'interpretive/hermeneutic approach' is used to examine contextual features of an experience in relation to other influences such as culture, gender, employment or wellbeing of people or groups experiencing the phenomenon. This allows investigators to arrive at a deeper understanding of the experience, so that caregivers can derive requisite knowledge needed to address such clients' needs. CONCLUSION: Novice nurse researchers should endeavour to understand phenomenology both as a philosophy and research method. This is vitally important because in-depth understanding of phenomenology ensures that the most appropriate method is chosen to implement a study and to generate knowledge for nursing practice. IMPLICATIONS FOR RESEARCH/PRACTICE: This paper adds to the current debate on why it is important for nurse researchers to clearly understand phenomenology as a philosophy and research method before embarking on a study. The paper guides novice researchers on key methodological decisions they need to make when using descriptive or interpretive phenomenological research approaches.