Shanmughan Chettyar S1, Graftton K2
1Sheffield Hallam University, Centre for Health and Social Care Research, Sheffield, United Kingdom, 2Sheffield Hallam University, Department of Allied Health Professionals, Sheffield, United Kingdom
Background: Physiotherapy researchers over the years have favoured quantitative methods. Increasingly physiotherapists are using qualitative methods to generate knowledge regarding organisational practices, relationships, and procedures. Ethnography is a qualitative methodology that enables the researcher to investigate both the micro and macro level of social process happening in an institutional setting such as the healthcare. The dialectical nature of Critical Discourse Analysis (CDA) not only considers language as a resource, to discover how practice is constructed but also, analyses how the social practices influence the language by shaping the context and mode in which they are produced. A combination of ethnography and CDA is a conceptual framework that is rarely used in the field of physiotherapy research. This study discusses how ethnography and CDA enabled the researcher to identify the underlying social phenomena of the therapeutic relationship in the physiotherapy practice.
Purpose: To identify the interactional features, contextual factors and power issues associated with the therapeutic relationship in south Indian physiotherapy settings by using the ethnographic-CDA approach
Methods: This study illustrates the iterative process of data collection by utilizing the ethnographic participant observation, in the form of audio recorded conversation between patient and therapist, informal conversation and field notes, and supplementary semi-structured interviews. The findings were analysed using the descriptive (textual), interpretive and explanatory stages of Fairclough's CDA.
Results: The data collected in the form of audio-recorded interviews were analysed in the descriptive stage. Field notes and informal interviews obtained during the participant observation and semi-structured interviews were analysed in the interpretive and explanatory stages. Based on the over-all analysed data constructed three different models of therapeutic relationship. Each of these models had an inner, middle and outer layer comprising of the textual features of the data, the interpreted institutional contextual factors and the wider socio-cultural contextual factors associated with the identified discourse respectively. By using these three models a linear theoretical framework was constructed, which illustrated the power flow between patient and therapist.
Conclusion(s): The complementary nature of ethnography and CDA enabled the physiotherapy researcher to explore the underlying social phenomena of the therapeutic process by investigating multiple elements (the contextual factors, power issues and the interactional features) in a single study.
Implications: This study acknowledges and provides an insight to the global physiotherapist to think further about the important role of the power discourse and the social exchange happening between the therapist and patient in different aspects of the therapeutic process.
Keywords: Ethnography, Critical Discourse Analysis, Therapeutic relationship
Funding acknowledgements: Self-funding
Purpose: To identify the interactional features, contextual factors and power issues associated with the therapeutic relationship in south Indian physiotherapy settings by using the ethnographic-CDA approach
Methods: This study illustrates the iterative process of data collection by utilizing the ethnographic participant observation, in the form of audio recorded conversation between patient and therapist, informal conversation and field notes, and supplementary semi-structured interviews. The findings were analysed using the descriptive (textual), interpretive and explanatory stages of Fairclough's CDA.
Results: The data collected in the form of audio-recorded interviews were analysed in the descriptive stage. Field notes and informal interviews obtained during the participant observation and semi-structured interviews were analysed in the interpretive and explanatory stages. Based on the over-all analysed data constructed three different models of therapeutic relationship. Each of these models had an inner, middle and outer layer comprising of the textual features of the data, the interpreted institutional contextual factors and the wider socio-cultural contextual factors associated with the identified discourse respectively. By using these three models a linear theoretical framework was constructed, which illustrated the power flow between patient and therapist.
Conclusion(s): The complementary nature of ethnography and CDA enabled the physiotherapy researcher to explore the underlying social phenomena of the therapeutic process by investigating multiple elements (the contextual factors, power issues and the interactional features) in a single study.
Implications: This study acknowledges and provides an insight to the global physiotherapist to think further about the important role of the power discourse and the social exchange happening between the therapist and patient in different aspects of the therapeutic process.
Keywords: Ethnography, Critical Discourse Analysis, Therapeutic relationship
Funding acknowledgements: Self-funding
Topic: Research methodology & knowledge translation
Ethics approval required: Yes
Institution: Medical-College Hospital , Medical-Trust Hospital and Cosmopolitan Hospital, South India
Ethics committee: Sheffield Hallam University Research Ethics Committee
Ethics number: 2014-15/HWB-HSC-31
All authors, affiliations and abstracts have been published as submitted.
