Taking the pith out of reality: a reflexive methodology for psychiatric nursing research

Positivist knowledge, although well respected, is only one kind of knowing. Positivist methodology has made a partial contribution to knowledge of psychiatric nursing practice. Knowledge that relates directly to practice is the most sought after by practitioners themselves. Practitioners are in the best position to undertake 'insider' research that allows the process, rather than the outcome, of practice to be explored. A social constructionist approach is congruent with an insider research position. Social constructionism entails more tolerance concerning how we know our world. However, this tolerance breeds difficulty in evaluating research findings. Overall, knowing from practice is problematic. Tacit knowledge acquired through professional socialization is, by definition, difficult to articulate. Social realism deals with this issue by theorizing about mechanisms that would account for practice phenomena. However, social realism may simply represent a dilution of other inquiry positions without offering enough compensating strengths. A new methodology, based on reflexivity, is suggested. The researcher is required to continually reflect on her/his relation to the research process, both in relation to the choice of method and in the gathering and interpretation of data.