Discovering a dialectic of care

Using data from a recent study on the outcomes of child psychiatric hospitalization, the author presents a critique of the intervention-outcome movement that dominates the health care agenda. Employing an exploratory descriptive study design and Denzin's interpretive interactionism method, she presents data that illustrate how interventions can become distorted by contextual factors, conflicting ideologies, agendas, and failure to thoughtfully consider patient needs. She posits that research agendas are heavily tilted toward outcomes research that often discount the nature of structure and process. The marketplace emphasis of health care may result in environments in which a structure and process of caring is replaced by a focus of profits over patients. The value of focusing on interventions and outcomes in research without addressing broader ecosystem variables that influence practice is questioned in view of in-depth data that emerge from practice settings.