Introduction
Health services research is a constantly developing scientific field that consists of several disciplines about care quality, costs, cooperation, and future improvements. Today, investigations are necessary at different levels, including organizational structures, financial procedures, health technologies, and even personal contributions and behaviors (Agency for Healthcare Research and Quality, 2020). Thus, the proposition to diversify methodological approaches is highly recommended to comprehend the complexity of contemporary health care (Greenhalgh & Papoutsi, 2018). Phenomenology is a type of qualitative research to implement the results of lived experiences in a study, and it is commonly used in health services research. There are many ways to describe and share human experiences, and the chosen philosophical tradition has its benefits and shortages to be identified for its correct application. In this paper, the appraisal of how phenomenology can be introduced in modern health services research will be developed, focusing on its historical background, goals, importance, and existing advantages and disadvantages.
Historical Background
Health problems and illnesses have been investigated during the last several centuries, and each time, some new approaches and conclusions are made, contributing to health care and disease understanding. As well as other disciplinary philosophies and movements, phenomenology has its author who expanded its application in various directions. In the first half of the 20th century, Edmund Husserl offered a new methodological principle to explore the essential, also known as a priori, law of consciousness as an introspection kind (Gutland, 2018). Since the 18th century, experimental psychologists and researchers have followed the ideas of introspection that requires the analysis of personal thoughts and feelings in the study. The connection between these terms in history explains the development of further characteristics of phenomenology, including the attention of subjective experiences of participants. Husserl (2012) explained phenomenology as the science of facts and the essence of consciousness that can be carried on properly in the first person. As soon as the definition was formulated, this discipline was frequently chosen by many researchers in different fields, and the representatives of health services studies found this approach one of the most suitable options.
With time, phenomenologists began offering their explanations and visions of how phenomenology should be developed in research. For example, Husserl was the supporter of transcendental idealism, underlining the importance of transcendental consciousness over other impacts of the natural world (Arnold, 2020). Naturalistic phenomenologists narrowed the essence of such projects to accepting consciousness as a part of human nature. Much attention was paid to existential phenomenology because this method provides participants with freedom and the possibility to choose, depending on situations (Arnold, 2020). Interpretive or hermeneutic phenomenology aims at interpreting the descriptions offered by people under specific conditions (Picton et al., 2017). Finally, the innovation by Merleau-Ponty in the middle of the 20th century introduced embodied phenomenology for medication use to generate changes at different levels and analyze various structures (Nascimento et al., 2018). All these methods are historically positive for mental health, nursing, and medical research because, in any case, they are focused on directing people’s experiences, reflections, and outcomes.
Definitions
To appraise the use of phenomenology in medical or health services research, it is important to give clear definitions and identify the major characteristics of this research method. In addition to the definition given by Husserl (2012) as the science of consciousness, it is correct to admit that phenomenology is a philosophical study focused on real-life human experiences. One should admit that people are unique in their ability to learn from multiple sources and demonstrate their opinions and knowledge at the same time. Therefore, this method is also a form of qualitative research that includes the experiences across the globe, the analysis of which supports inquiry (Neubauer et al., 2019). In simple terms, phenomenology in health services research is an approach to describe phenomena, paying attention to the perspectives of direct and indirect participants. It is not enough to answer such questions as “How?” or “Why?” but to choose a culture, tradition, or other elements in terms of which assessment occurs.
Despite a variety of types of phenomenology, medical researchers prefer to rely on two major approaches: transcendental promoted by Husserl and hermeneutic described by Heidegger and Gadamer. In Husserl’s case, an epistemological attitude plays an important role because it helps understand the reality of the chosen phenomenon (Neubauer et al., 2019). It means that not only sensory perceptions should be taken into consideration but specific experiences like imagination or emotions. Hermeneutic phenomenology differs by the intention to learn human beings as actors and the relationships they developed in the world where they live (Neubauer et al., 2019). In other words, descriptive and interpretive phenomenology may be used to investigate the same phenomenon from two different perspectives. These definitions are necessary for further studies to recognize the role of researchers in data collection and analysis and the power of context, either social, cultural, or political.
Goals and Purposes
Phenomenology’s definitions and the analysis of its historical background allow identifying the goals and purposes of this research method, and the health services context will be chosen. One of the main goals of phenomenology, regardless of the research field, is to describe the meaning of the experience (Neubauer et al., 2019). To work effectively, this paradigm has to identify at least one subjective experience for interpretation from the participant’s point of view (Irarrázaval, 2020). In this case, the purpose is to introduce and describe an unbiased environment and learn the world in the same manner. According to Rietmeijer and Veen (2021), health practice researchers are not always able to distinguish between phenomenology and general qualitative research. That is why the goals of these two approaches should be compared. Although phenomenology is a part of qualitative research, there is one significant difference that affects the researcher’s choice. A qualitative study aims at given subjective statements, and the description of a phenomenon may be enough for achieving research objectives. Phenomenology is characterized by achieving the perception of phenomena, proving its deeper nature and a rigorous philosophical position.
Health services research also has its goals and characteristics that define the purposes of phenomenology in this process. In most cases, it is expected that health services include the ways of care management, financing, and organization to reduce medical errors, enhance safety, and improve the quality of all working processes (Adler-Milstein, 2019). Such steps of phenomenology as addressing a phenomenon, investigating experiences, reflecting on themes, describing practices, and maintaining a relationship between a theme and experience are relevant to a health service study (Rodriguez & Smith, 2018). All these tasks cannot be ignored because they help explore a topic, identify all presuppositions, and answer the necessary research questions using participants’ thoughts, knowledge, and practice. Phenomenological approaches in medical or healthcare research include the individual conscious experience, the existing therapeutic perspectives, and solutions that are more appropriate for a particular case (Sibeoni et al., 2018). The main idea of phenomenology in health services research is to clarify what can be improved and how, relying on definite experience.
Methodology Importance
There are many reasons for choosing phenomenology as the main method in health services research, but the most critical aspect touches upon the possibility of understanding the meaning of human actions and lived experiences. It is important not only to choose a phenomenon and gather several opinions but to examine this practice on the basis of a philosophical approach that is congruent with the method (Picton et al., 2017). In most cases, researchers have to work with textual information to enhance their understanding of the meaning of a topic, and phenomenology is suitable because it contains descriptions and interpretations offered by different people (Singh et al., 2019). Medical phenomenologists have access to several ways of gathering information, including face-to-face or distant communication with patients, nurses, or other medical workers who are related to the research phenomenon (Svenaeus, 2019). Thus, the vital steps in this type of qualitative research include the distribution of roles, the choice of data collection method, and the identification of analysis purposes.
In fact, conducting health services research is not an easy task because many factors should be recognized, and many orders must be followed. Phenomenology is based on real experiences of real people in real situations. Thus, it is obligatory to obtain content from every single participant. Although phenomenology is the analysis of a topic, some information for any evaluation must be taken from reliable and authentic sources (Rietmeijer and Veen, 2021). Therefore, the importance of the chosen methodologies lies in the ability to cooperate with people, explain the purposes of the study, and prove the rationality of choices. On the one hand, the description of the material, a proper presentation of personal experiences and opinions, and the integration of theoretical material are vital for phenomenological studies. On the other hand, researchers should never diminish their roles in a research process to reflect on themes, identify units for analysis, and capture reflections within the necessary context (Neubauer et al., 2019). Health services are never about one person or several people within the same group. Patients, employees, policymakers, and even the government play their specific roles.
Advantages and Disadvantages
Phenomenological studies are not the only methods to investigate and analyze health services, meaning that researchers are free to choose other approaches to discuss their topics. As a rule, a person tries to weigh all pros and cons in order to understand if phenomenology is the best option for a particular work. It is wrong to say that phenomenology is good or bad for health or medical research, but its advantages and disadvantages may define the researcher’s choice.
One of the most evident positive aspects of phenomenology is access to unique perspectives about the topic. People share their experiences on voluntary grounds, and researchers process this information (Svenaeus, 2019). Another significant benefit of the chosen research method is a detailed and clear understanding of a phenomenon. Researchers need to learn all available experiences of other people and gather background information about the subject in a specific context (Neubauer et al., 2019). These steps help remove uncertainties and work in an environment that corresponds to the necessary level of knowledge and skills. Finally, when people choose phenomenology for their studies, they obtain some guarantees to work with rich data. Singh et al. (2019) underlined the worth of bracketing in phenomenology to remove prior knowledge and experiences and create a new framework with currently gathered material. This possibility helps remove unnecessary biases and concentrate on a particular theme or practice.
At the same time, some challenges may bother researchers who make a decision to conduct a phenomenological study. The two most expected problems are subjectivity and biases in this type of research. Sometimes, it is impossible to establish the reliability and validity of such research problems because people are free to share their own thoughts and emotions, neglecting basic rules, obligations, and social norms (Irarrázaval, 2020; Sibeoni et al., 2018). Thus, low credibility is the main reason for researchers to think about other research methods and replace phenomenology.
Conclusion
Taking into consideration the properties, goals, and types of phenomenology, this strategy can be defined as a solid starting point in independent health services research. Today, it does not take much time or resources to contact people and ask them to participate in the study. The main idea of phenomenology is to examine the structure of human consciousness and interpret personal experiences for understanding a particular phenomenon. In health care, medicine, and nursing, this research method brings many positive outcomes because individuals with different levels of knowledge and skills can learn a new topic, develop their unique interpretations, and achieve the necessary research goals within the established limits and context.
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