5.9 Hermeneutics Hermeneutics is the process of coming to understand a text (where text is includes written and pictorial documents). Hermeneutics as an approach has been primarily used in the recovery of the meaning of historical documents (See Section 188.8.131.52.4.
One of its earliest forms was used to analyse the Bible to try to understand the underlying meaning of various biblical texts. Hermeneutics, in the last fifty years, has also been used in social research to as a method to explore the understanding of social phenomena; in its critical form it attempts to dig beneath the surface of appearances.
Hermeneutics is often referred to as an interpretive approach and has close links to, for example, Weberian Verstehen , however, it goes beyond Verstehen approaches in its concern with historical context and, in its critical form, the social-economic and ideological context.
Details of the genesis and different forms of hermeneutics are available in the Social Research Glossary and this Section will discuss the approach using social research studies that have adopted a hermeneutic approach.
One important point about hermeneutics is that it is a way of thinking rather embodying a a methodic prescription. A hermeneutic approach is concerned with understanding rather than any attempt to provide a causal explanation; it presupposes social events are historically specific and thus generalisation and causality are not applicable.
Hermeneutics also takes into account the vagaries of language and thus the social and historical context in which any text is constructed. It also accepts, similar to semiology, that language has both denotations and connotations.
Hermeneutic analysis is thus a process of uncovering an understanding and accepting that the process comes ever nearer an understanding of the original intention of the text but that there is no final definitive and unchangeable interpretation.
Romualdo Abulard (2007), for example decries any notion of a hermeneutic method:
First of all, let us repeat that hermeneutics is the art of interpretation. Because it is an art, we are hereby not constructing a set of fixed and rigid guidelines for a valid interpretation of a text. In this we are only following the cue from the hermeneutes we have mentioned in this paper, especially Gadamer himself whose book Truth and Method might as well have been entitled Truth Against Method. In a way, method kills the art, especially since art requires a creative spirit. Each creation is a free process whose source is the interplay of faculties unique to each artist. The author thus follows a procedure which cannot be mechanically reproduced inasmuch as every artistic product is a singular and inimitable achievement. This is the case with both artwork and interpretation. An interpreter follows his or her own inspiration, and mechanical rules are hereby out of the question.
5.9.1 Example of practical study Marikken Høiseth and Martina Keitsch (2015) used a hermeneutic approach, which they referred to as phenomenological hermeneutics, to understand stakeholder perspectives in a health care setting. The particular study involved the design of nebulizers for use in the treatment of very young children (aged 0–3 years old) in hospital with respiratory diseases. They argued that 'While a lot of design research addresses children, very little deals with the context of young children's medical treatment and possible implications for medical product design (Allsop & Holt, 2013)'.
They restate Heidegger's view that 'the assumed superiority of an objective reality over a reality of daily life practice is a misapprehension, based on a concealed philosophical prejudice'.
Høiseth and Keitsch maintained that Gadamer's approach to hermeneutics is not the provision of a 'method of interpretation' but 'rather a reflection on what
happens "over and above" our understanding'. Understanding using his hermeneutic circle approach situates the text in the historical context of both the author and the artifact.
The hermeneutic circle refers methodologically to the idea that a person's understanding of a text or an artifact as a whole is established by referring to their [own] history and cultural background. The person and the text are referring to each other in a way that cannot be excluded from the other. The interpretation of an artifact has to be explored within its cultural, historical, and in situ context, as well. Through phenomenological hermeneutics, the researcher aims to "disclose truths about the essential meaning of being in the life world" (Lindseth & Norberg, 2004, p. 151). A key method is to go beyond the data and look for hidden meaning, rather than assuming that data will "speak" for themselves (Maggs-Rapport, 2001). (Høiseth and Keitsch, 2015, np)
Høiseth and Keitsch refer to van Manen (1990) asserting that researching from a phenomenological perspective is 'about questioning the way we experience the world and desiring to know the world in which we live as human beings', which involves the principle of intentionality: 'that knowing the world is inseparable from being in the world'. This, they suggested, means that 'research can be understood as a caring act, as van Manen (1990, p. 6) points out: "We can only understand something or someone for whom we care"'.
Respiratory syncytial virus (RSV) commonly causes respiratory infections. To receive the medication, the child wears a face mask covering the mouth and nose and inhales the medication through passive breathing for between 5 and 10 minutes. The treatment is typically repeated every 2–4 hours, often over several days.
The overarching challenge is that many children resist nebulizer treatment, and it is suggested that approximately 30% of young children are distressed during the treatment.... Distress expressed through struggling, crying, screaming, and turning away from the mask reduces the amount of medication reaching the lungs.... Different forms of distress and lack of cooperation lead to tense interactions between children and their caregivers. It is not unusual for physical coercion to occur, and sometimes, nurses decide to terminate the treatment. (Høiseth and Keitsch, 2015, np)
The research set out to understand care as a phenomenon through an interpretative dialogue that draw on observation and interviews conducted with nurses and parents who have experienced nebulizer treatment of young children. The initial aim was to get an impression of what the treatment entailed for the children and their caregivers.
Semi-structured interview were used to 'obtain people's descriptions of their lifeworld' and to 'interpret the meaning of the described phenomena'. Nine parents and six nurses were interviewed, some more than once, resulting in 17 interviews.
Such interviews come close to an everyday conversation, but they differ because the researcher has a professional intention and asks an open question about predefined themes. The role of the researcher is to ask a series of structured open questions and to probe more deeply into respondents' beliefs, attitudes, and inner experiences by following up their answers (Gall, Gall, & Borg, 2003). (Høiseth and Keitsch, 2015, np)
The interviews for parents and the nurses lasted between 20 and 40 minutes. They consisted of predefined questions, repeating questions, slightly reformulating questions and further probing, which the authors claimed reflected the phenomenological hermeneutics approach. The questions covered both parents' and nurses' experiences of participating in pediatric nebulizer treatment, their perception of the children's experiences, their understanding of the social interactions that take place during treatment and suggestions for improved treatment.
Interpretation of the 17 verbatim interview texts was achieved, using Lindseth and Norberg's, (2004) approach, by moving between the following steps: 'naive reading, thematic structural analysis, and comprehensive understanding'.
First, Høiseth read the interview texts several times to grasp the meaning of each single text as a whole.
She [Høiseth] recalled the atmosphere during each interview and could, as such, revive how the interaction with the other person unfolded–how experiences were conveyed and shared through words, moments of silence, gazes, gestures, and sounds. Through a reflective dialogue with the text, the first author got an impression of what caring "is about" in the specific case.... When the authors discussed together, another reflective dialogue was initiated, which gradually led to an integrated impression. (Høiseth and Keitsch, 2015, np)
The second stage, structural analysis, was to construct themes 'by dividing the texts into meaning units'. The authors explained that a meaning unit 'is part of a text, ranging from just a few words to several paragraphs, which conveys one essential meaning that is relevant for illuminating the phenomenon'. Based on the clustered meaning units for parents and for nurses separately the comprehensive understanding (the third stage) was developed.
They focused on care as an overarching phenomenon.
Through discussions, the two authors collectively refined the themes further and used the lifeworld existentials as reflection guides. We reflected on how the themes conveyed different, albeit connected, meanings of care. The themes were considered in relation to our impressions of each single interview text as
well as relevant literature and theoretical perspectives.... Moreover, we reflected on own pre-understanding and how the themes broadened our awareness in terms of challenging our first notions of "the problem." This also included a discussion of how designers could make use of the themes to increase understanding of stakeholders and use contexts. (Høiseth and Keitsch, 2015, np)
The three steps, reflects a fluent circular movement between the whole (care as a phenomenon) and the parts (perspectives on care as a phenomenon). As they stated:
The authors entered the hermeneutical circle with their own pre-understandings. Even though prior understanding is difficult to account for, as it is embedded in one's life, we can reflect on our motivations for conducting this study—that is, our professional pre-understanding. With a background in industrial design, the first author arrived with the view that designers have a special responsibility when it comes to adapting products that take part in medical treatment and healthcare contexts to the users. The second author has a background in philosophy, and her research revolves around welfare and design. Our intentions, assumptions, experiences, and backgrounds have contributed to the interpretative process. However, the interpretative process does not stop here. In line with phenomenological hermeneutic thinking, this article can be seen as an invitation for other people who represent different fields to continue the work of analyzing and interpreting the themes that are presented in the following. (Høiseth and Keitsch, 2015, np)
Based on interviews with parents and nurses Høiseth and Keitsch constructed five themes that capture the phenomenon of care: feeling helpless, which refers to parents' vulnerability as caregivers; feeling cared-for, which reveals how parents have a need for care in the situation that enables them to be better caregivers to their children; being in an ambivalent struggle, in which parents and nurses are strongly affected by struggles in their experiences of administering treatment; finding ways to establish an authentic caring relation with the child, which is how parents and nurses try to contribute to children's acceptance of the treatment; understanding the nebulizer as a care object, which refers to parents' and nurses' experiences of using the device and how the it could be improved.
For example they illustrated how parents in the study frequently referred to feeling helpless. One quote cited was:
When we were at home and he was at his worst I felt pretty small and terrified actually...because I didn't know what to do.... When feeling he almost doesn't breathe in the evenings...it becomes a bit like...almost a bit like hysteria.... You get stressed
throughout. (Diane, mother) (Høiseth and Keitsch, 2015, np)
In conclusion, they argued that 'phenomenological hermeneutics is coherent with a human-centered view, which rests on
acknowledging human agency, competence, and participation' and that it is 'a starting point for thinking design iterations differently'. They suggested that phenomenological hermeneutics encourages the researcher to listen and learn, 'rather than delimiting people's opportunity to express and share their experiences, which is typically the case when using a survey or conducting a controlled
experiment'. They argued that the results showed that 'for facilitating improved healthcare experiences, the human-centered designer can benefit by taking stakeholders' lived experience as a starting point for design'.