Driven by an impetus to standardize, numerous checklists have been devised to address quality in qualitative research, but these standards and the mindset driving them offer no language with which to speak about taste, or the aesthetic sensibilities that play such a key role in evaluating the goodness of any object. In this article, quality appraisal in qualitative research is considered in the context of taste, that is, in the discernment involved in judging the value of research and in the (...) recognition of the key role reviewer preferences, sensibilities and membership in one or more taste communities play in these judgements. The evaluation of a study is accomplished by evaluating one or more reports from that study, and such reports may be conceived as art forms amenable to the same criteria for appraisal as poems or paintings. Taste implies judgements about the quality of objects and a person's ability to sift through and select from a store of knowledge that knowledge appropriate to judge its value. What binds a community of practitioners (here reviewers of qualitative studies) together is taste‐making, or the constant refinements of judgements concerning what constitutes good and bad practice. (shrink)

Qualitative inquiry is increasingly used to foster change in health policy and practice. Research ethics committees often misunderstand qualitative inquiry, assuming its design can be judged by criteria of quantitative science. Traditional health research uses scientific realist standards as a means-to-an-end, answering the question “So what?” to support the advancement of practice and policy. In contrast, qualitative inquiry often draws on constructivist paradigms, generating knowledge either as an end-in-itself or as a means to foster change. When reviewers inappropriately judge qualitative (...) inquiry, it restricts the ways health phenomena can be understood. Qualitative inquiry is necessary because it enables an understanding not possible within scientific explanation. When such research illuminates, it can also shed light onto the “So what?” In order to ensure an appraisal of qualitative inquiry congruent with its paradigmatic premises, we suggest the “Illumination Test,” met when findings foster rich understanding of phenomena, resulting in a reflective “aha!”. (shrink)

BackgroundWith the enactment of Bill C-7 in Canada in March 2021, people who are eligible for medical assistance in dying (MAiD), whose death is reasonably foreseeable and are at risk of losing decision-making capacity, may enter into a written agreement with their healthcare provider to waive the final consent requirement at the time of provision. This study explored healthcare providers’ perspectives on honouring eligible patients’ request for MAiD in the absence of a contemporaneous consent following their loss of decision-making capacity. (...) MethodA critical qualitative methodology, using a feminist ethics theoretical lens with its focus on power and relationality, was used to examine how socio-political and environmental contexts influenced healthcare providers' moral agency and perspectives. Semi-structured interviews were conducted with 30 healthcare providers (13 physicians, six nurse practitioners, nine nurses and two social workers) from across Canada who provide MAiD-related care.ResultsThemes identified include; (1) balancing personal values and professional responsibilities, (2) anticipating strengths and limitations of the proposed waiver of final consent amendment, (3) experiencing ethical influences on decisions to enter into written agreements with eligible patients, (4) recognizing barriers to the enactment of MAiD in the absence of a contemporaneous consent and (5) navigating the potential for increased risks and burden.DiscussionTo our knowledge, this is the first study in Canada to explore healthcare providers’ perspectives on waiving the final consent for MAiD using a written agreement. Most participants supported expanding eligible people’s access to MAiD following loss of capacity, as they believed it would improve the patients’ comfort and minimize suffering. However, the lack of patients’ input at the time of provision and related ethical and legal challenges may impact healthcare providers’ moral agency and reduce some patients’ access to MAiD. Providers indicated they would enter into written agreements to waive final consent for MAiD on a case-by-case basis. This study highlights the importance of organizational, legal and professional support, adequate resources, clear policies and guidelines for the safety and wellbeing of healthcare providers and to ensure equitable access to MAiD. (shrink)

While a growing number of works have been published about the use of mixed methods research in nursing, scarce attention has been devoted to the issue of the quality of mixed methods within the discipline. The quality appraisal of mixed methods research poses two problems to nursing science: first, current quality criteria are not nursing‐specific and consequently, they might not facilitate the application of mixed methods research findings into nursing practice. Second, criteria were theoretically derived and as such, they might (...) not faithfully account for the decisions that nurse researchers take when appraising mixed methods research studies. This qualitative, within‐case study explored the views of nurse researchers about mixed methods research in general and, more specifically, the question of quality in mixed methods research. An international sample of 13 nurse researchers was interviewed via Skype and phone. Thematic analysis revealed that the participants favored universal, cross‐disciplinary quality criteria, and not criteria specific to the nursing discipline, and a consensual and standardized approach to appraising the quality of mixed methods research. Recommendations are put forward to strengthen the quality appraisal of mixed methods research studies by nurse researchers, as well as future works on this topic within nursing science. (shrink)

Funding agencies in Canada are attempting to break down the organizational boundaries between disciplines to promote interdisciplinary research and foster the integration of the social sciences into the health research field. This paper explores the extent to which biomedical and clinician scientists’ perceptions of social science research operate as a cultural boundary to the inclusion of social scientists into this field. Results indicated that cultural boundaries may impede social scientists’ entry into the health research field through three modalities: (1) biomedical (...) and clinician scientists’ unfavourable and ambivalent posture towards social science research; (2) their opposition to a resource increase for the social sciences; and (3) clinician scientists procedural assessment criteria for social science. The paper also discusses the merits and limitations of Tom Gieryn’s concept of boundary-work for studying social dynamics within the field of science. (shrink)