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O R I G I NA L PA P E R
Journal of Research in Nursing 2008 SAGE PUBLICATIONS Los Angeles, London, New Delhi, Singapore VOL 13(3) 251261 DOI: 10.1177/ 1744987107085119
Abstract This paper relates to research practice and in particular, it explores the practice of insider research in a study carried out as part of a research training fellowship. The effects of research on the researcher and the researched are discussed and extracts from transcripts and a research diary are used to illustrate ethical dilemmas that may arise from such a study. The role of the novice researcher is central to the discussion and the concept of emotion work is used to illustrate the hidden consequences of seemingly innocuous insider research. The paper contributes to the body of knowledge relating to qualitative research methods, by combining reection with emotion work and novice insider research. Despite it being largely about the novice researcher studying within her own profession, it raises important points that may be of interest to more experienced researchers working in other domains. Key words novice researcher, emotion work, insider research, exploitation
Introduction
This paper explores the use of interviews in relation to novice insider research in health-care settings, specically midwifery. The research topic is not considered ethically challenging, as it was a study of midwives views about their career progression. However, the research was carried out by a novice researcher as part of a training fellowship; this threw up ethical issues of autonomy and veracity. The paper contributes to the body of knowledge by drawing on ethical principles and rules alongside the concept of emotion work to explain the suggested effects on the novice researcher and the research participants. I carried out semi-structured interviews as part of my research training, which led to the unexpected effect of feeling that I was exploiting the participants. This led me to question the effects of research on both the researcher and the researched. I suggest herein that whilst novice researchers need practical experience in order to develop their skills, this aspect of research training is more ethically or emotionally challenging than may be expected. Furthermore, I suggest that emotion work is required in the interaction between the researcher and the interviewee.The discussion begins with an overview of the benets and drawbacks of interviewing and insider research. It goes on to reect on the ethical aspects of novice insider research and draws on the concept of emotion work to analyse my experiences as a novice researcher.The paper is illustrated with extracts from my study. 251
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In-depth interviewing
Qualitative researchers use in-depth interviews as a key method of data collection.The positivist approach to interviewing, (Fowler and Mangione, 1990) is not commonly used; instead, less structured in-depth interviews are more often employed in order to obtain rich data (Denzin, 1989). Interviews are especially useful for examining social issues and the privacy afforded by a well set-up interview will often encourage the participant to open-up and talk. Whilst some suggest that opening up in this way is helpful for some participants, (Karp, 1996) yet others point out potential harm (Rubin and Rubin, 1995). Rubin and Rubin (1995) are particularly conscious of the participants, which is demonstrated in their referring to interviewees as conversational partners (p 97). Their concerns relate to condentiality and pressing participants, as well as to issues of consent. My study reects some of the same concerns about autonomous consent, which are explored later. It is, however, sometimes difcult to draw rm conclusions about effects on participants, due to the nature of interviews. As Denscombe (2002) points out, interview data are not really truth or reality but a picture of the truth or reality. An interview is an event-taking place between two people with one attempting to elicit something of the others perceptions, experiences, beliefs, knowledge or story. This may lead to distressing and painful memories being brought up (Oppenheim, 1992) and ethical researchers must therefore consider potential harm such as illuminating previously concealed or partially forgotten memories, and seek to take this into consideration from the outset, perhaps engaging the services of a suitable professional (counsellor), to minimise harm (Cribb, 2003). More subtle psychological consequences may also need attention (Polit et al., 2001) and when preparing for my research training, I thought about this in some depth. For example, when interviewing midwives about their practice, it is brought into sharper focus by the researcher. I wondered whether this may lead midwife participants to question and perhaps even inwardly criticise their own practice, thereby arguably affecting their condence in their practice. I thought however, that a skilful interviewer may be able to minimise this, by reectingin-action during the interviews and then by phrasing questions with particular care. The midwife participants should also be used to using reection to explore feelings about their practice; in this way the potential harm could be minimised and then the result may instead lead to positive changes in practice. However, I was not a skilful interviewer and I set out to interview my participants with some anxiety about bringing their thoughts about their career progression into sharper focus, thereby perhaps leading them to be more self-critical than necessary. These early thoughts about the effects that I might have on the researched led me to use a reective research diary from the outset. As Etherington (2004) suggests, this helped me to focus on my own responses to being a researcher as well as to think through the impact that I may have on the participants. My diary proved useful throughout the study and has had particular signicance for me in thinking through the ethical dilemmas and emotion work that are discussed here.
Insider research
Insider research may arguably lead to psychological consequences for the participants being lessened, or at least more easily identied and perhaps avoided, as the researcher may have greater understanding of the perspective of the participants (Reed and Procter, 1995). This, however, results in questions about neutrality. There has been extensive debate on neutrality in interviewing (Sword, 1999), which centres on 252
Darra Emotion work and the ethics of novice insider research suggestions about the impartiality of qualitative research interviews. However, it is now generally accepted that, if the interviewers are to practice ethically, then they must reveal their identity and something of themselves (e.g. that they are now, or have previously been health care workers), in order to obtain true informed consent and the required in-depth, qualitative data (Bowling, 2002). Feminist research on women is also an example of what may be termed insider research. Oakley (1981) rst explored the issue of women interviewing women and later went on to further explore the barriers between the researcher and the researched. She quotes some early work by Stacey (1988) in which she notes that Stacey found herself wondering whether the appearance of greater respect for and equality with research subjects (in an attempt to deect the power imbalance) in the ethnographic approach masks a deeper, more dangerous form of exploitation (Oakley, 2000, p 66). My study also threw up questions about such exploitation as I was, after all, a woman interviewing women. Power relationships in qualitative research have long been explored (Spradley, 1980; Mitchell and Radford, 1996). However, interviewees are not necessarily exploited in the research partnership. Oppenheim (1992) discusses the social desirability bias as seen in some interviewees responses. In insider health-care research, this could lead to participants denying or watering down aspects of practice, especially when it may reect badly on themselves or their colleagues. Alternatively they may talk themselves up to present an ideal impression of themselves or their practice. In this way, one could argue that the researcher is being exploited instead.
Effects of research
The inclusion of the voice and/or the body of the interviewer within research is also discussed particularly extensively in feminist literature (Oakley, 1981; Shakespeare et al., 1993; Ellingson, 2006). However, other authors also consider the researchers gender to be important, especially when exploring sensitive issues (Pollner, 1998; Lamb and Garretson, 2003). The age and race of the interviewer is also sometimes thought to be important (Moorman et al., 1999); and some theories relate in particular to the impact that the researcher may have on the participant. Etherington (2004), for example, refers to how some participants may appear to regret the consent that they have given, and they then go on to worry about how they are represented in research transcripts, despite promises of anonymity. Twigg (2006) illustrates this very well in her recollection of playing an interview tape back to an interviewee. The researcher was surprised by the response; the participant felt that she had given the researcher something of herself and as Twigg writes, Her life, her memories, her thoughts were now enclosed in that little crystal box, [the tape] to be replayed in goodness knows what circumstances and before what people (p 36).This illustrates how researchers may initially underestimate the hidden consequences of research on the researched, even though consent may have been properly sought and obtained. More serious and signicant effects are also referred to within research ethics discourse (BACP, 2002; Fine et al., 2000; Homan, 1991) and were most infamously apparent in Stanley Milgrams (1963) research. Whilst both Twigg and I are unlikely to be guilty of such malecence, Twigg did not expect her participant to be so upset following hearing her words being played back, and in my study I did not expect to feel so guilty about using the respondents largely for my own ends. In line with Reynolds (1972) ve categories of discomfort and harm, my participants are likely to have only experienced the temporary discomfort of level two on Reynolds scale. That is, they may have risked economic cost in coming 253
Journal of Research in Nursing 13(3) to the interview, they may have experienced temporary anxiety or embarrassment when answering questions and they may have thus been temporarily inconvenienced. Whilst I doubt that the midwives in my study felt any particular harm, I carried out the interviews with feelings that I was exploiting the participants and this led me to question the effects of research on both the researched and the researcher. Other authors record the effect that research has on the researcher (Homan, 1991; Beale et al., 2004). Davis (1986) refers to the emotional difculties faced by nurse researchers during an observational study based in a health care setting. Wilde (1992) reects on Davis work and offers a very interesting exploration of some unexpected issues that emerged in her research exploring nurses descriptions of their experiences in their work. Wildes discussion centres on the relationship between the researcher and the participant. She refers to role conict and difculties that arise for nurses researching in their own eld and posits four hypotheses (Wilde 1992, p 239241); 1. Rather than attempting to maintain a purely research role, the nurse researcher benets from utilizing other roles acquired throughout her career. These roles may include clinician, counsellor, therapist and teacher. 2. Intervention by the researcher during data collection does not have an undesirable inuence on the informant. Rather, it can open up new avenues of enquiry previously unexplored. 3. The research process can be used effectively for the benet of both researcher and participant and not purely to collect research data. 4. It is difcult and disadvantageous for the nurse researcher to maintain a detached relationship with the informant in qualitative research. Self-disclosure by the researcher has an enhancing effect in information exchange and results in a more honest and meaningful sharing by the informant. Wilde notes that she did not come to any clear conclusions following postulating these hypotheses, but states that they led her to be clear about the questions that needed to be asked about such insider research. Whilst she does not state what these are; she quotes I have not succeeded in answering my problem.The answers I found only serve to raise a whole new set of questions. In some way I am as confused as ever, but I believe I am confused at a higher level, and about more important things (p 242). I would further suggest that a consideration of emotion work and ethics form part of such reections on insider research. Reed and Procter (1995) explore insider research in some depth and refer to both positive and negative aspects of it. They conclude that it is essential to use insider research ethically to achieve the research aims. They do not however explore ethical principles in detail, nor do they focus on the effect that insider research may have on the researcher. The ethical principle that concerns me following my experience of insider research is autonomy, and the ethical rule in question is that of veracity (Beauchamp and Childress, 2001). Aside from these specic ethical concerns, the effects of insider research have been debated for many years, particularly in relation to participant observation (Spradley, 1980; Bonner and Tolhurst, 2002; Rager, 2005). Arber (2006) discusses this in some depth, through exploring her emotional responses when carrying out insider research in a hospice; she discusses ways in which the researcher may offset such responses by the adoption of marginal positioning, between being a practitioner and a researcher, which is similar to that described by Junker (1960). Loand and Loand (1984) also explored the sources of emotional stress associated with eldwork and produced a typology of those sources which was used by Arber (2006) to examine her own responses to her eld work. These included how to manage a balance between detachment and involvement by standing back in difcult situations whilst carrying out insider research. This appears to be similar to 254
Darra Emotion work and the ethics of novice insider research the afore-mentioned marginal positioning. It is clear, therefore, that being a researcher requires some emotion work, which may for example, be offset by marginal positioning in eld work. I propose, however, that emotion work is not only expended in participant-observation eld work, but also in qualitative interviewing, when marginal positioning, at least in the way that Junker and Arber suggest, is not possible.
Emotion work
Emotional stress is thought to require emotional work in order to deal with it. Hochschild (1979, 1983 and 2003) is a key thinker in the eld of emotion in the workplace; her germinal work was based on a study of ight attendants in the USA (Hochschild, 1983). Her research drew attention not only to the signicance of emotions within the workplace, but also to the work expended in managing these emotions. Emotions are identied as an intrinsic part of social processes, not only because they have a function in maintaining the social order, but also because they are adapted according to the social context. Hochschild states that the individual is required to induce or suppress feeling in order to sustain the outward countenance that produces the proper state of mind in others (Hochschild 1983, p 7). She states that this emotion management is in accordance with feeling rules i.e. social norms relating to feeling and display. These rules determine not only what emotions should be displayed in a given situation, but also what should be felt. Feeling rules generally go unnoticed until a mismatch occurs between what is felt and what the individual perceives s/he should feel. Emotional labour has been explored in relation to nursing (James, 1989, 1992; Smith, 1991, 1992); for example, Boltons (2000, 2001) work explores how the change towards an enterprise culture in the NHS impacted on nurses emotion work. She suggests that changes within the NHS have arguably led to increased acting with nurses putting on their smiliest happiest face (Bolton, 2001, p 93); this resonates with Hochschilds ndings in her research with ight attendants. In midwifery, research has been carried out in relation to the emotional labour of caring in midwifery (Hunter, 2004). Some of the issues that were encountered were similar to those identied by Arber (2006); the midwives were found to be expending emotional labour in coping with conicting ideologies in their workplace(s), rather than what may have been expected, in the sometimes difcult client-care situations that arise in midwifery practice. My study was not as obviously emotion-provoking as those described by Smith (1991, 1992), Bolton (2000, 2001) and Hunter (2004); therefore, it perhaps did not require as much emotion work. However, some studies have identied other sources of emotion work such as in interactions between workers and management, and in collegial interactions (Copp, 1998; Kunda and Van Maanen, 1999; Lively, 2000). Following my study and the consequent reection on the experience, I suggest that emotion work is also required in the interaction between researcher and participant. The emotion work I expended during and after the study related to managing my novice status as an interviewer and to my feelings about using the participants largely as a means to my end. I interviewed ex-students following informed consent to participate in a real study; but its primary purpose was my research training, with the participants becoming collaborators (Punch, 1986) in my research enterprise. The study was intended to add to the knowledge base about the career progression of diploma and graduate midwives. However, the other purpose of the study was actually more of a priority; my aim was chiey to develop my research skills for the future. 255
Journal of Research in Nursing 13(3) I shall now reect on this, drawing briey on the ethical principle of autonomy and the rule of veracity (Beauchamp and Childress, 2001), as well as the concept of emotion work, using examples from my study.
In the work of Erving Goffman (1959), when playing a part in the world, one implicitly requires that the observer takes the impression that is offered seriously. As a novice researcher, I felt that I was not yet completely comfortable with the part I was playing as a researcher, but it was clear that the participant seemed to be taking me 256
Darra Emotion work and the ethics of novice insider research seriously in this role. I must have, as Goffman suggests, learned enough pieces of expression to be able to ll in and manage, more or less, (p 79). This research diary extract indicates the powerful position that the researcher is in, perhaps reecting Oakleys point about exploitation in insider ethnographic research (2000). Had I, by appearing to have greater respect for and equality with the participants when seeking their consent and when playing the part of a researcher, been exploiting them in a deeper sense, as Oakley discusses?
In this extract I asked the midwife what she thought about practice-based learning:
Interviewer What about practice based learning, then? You said a couple of times about being well supported do you think you were also well educated in practice, do you think you learned a lot from practice placements? Midwife 4 I think so, sometimes I felt when I rst umm came out on the wards cos the only thing I knew about CTGs [Cardiotocographic examination of fetal heart rate patterns] and abdominal palpation and things like that was what I looked at in myself before I came out on placement. And then it was ages, I mean months and months and months into our course we started doing about CTGs and palpations and I dont know, sometimes I thought, well, wouldnt it be better if theyd done a basic thing on CTGs and palpations, that sort of thing for us before wed gone out on placement. Cos I thought, I think my rst placement was a community placement and I think she [the students mentor] thought I would just know, that Id know more than I did and I didnt know a thing, really at all, only what Id read at home in my own textbooks before I went out. Me Mmm Midwife 4 But then, are you supposed to learn, is that, is that why you come onto placement, to be taught how to palpate and how to read CTGs. . .it is, I suppose then, perhaps it would have be nicer to have a basic, like one lecture this is what to expect Me Mmm yeah Midwife 4 . . .thats what I I felt.Theres a same in nursing I remember not being told anything about B/Ps or anything like that, then I suppose, thats why you go out on placement I suppose?
I allowed the participant to think through her thoughts on practice-based learning and to come to her own conclusions about it. I was surprised, however, about how much her conclusion matched my own; had I unwittingly changed her view on what was a previously fairly strongly held belief? I realised that it was not likely to harm the participant to talk about her education programme and her career plans. Despite this, 257
Journal of Research in Nursing 13(3) if I could do this on this occasion, it leads to the question; what if I and other researchers are doing similar mind-changing in more critical situations? The potential for harm is clear. During and following my rst experience as a researcher, I realised that being ethically minded about research interviews is not only about consent, anonymity, condentiality and about avoiding harm in asking probing questions. It can be much more subtle than this and the potential for such mind-changing should be considered particularly in research where the aim of the study may be more ethically critical and the clear and expressed view of the participant is paramount. It is this, which forms the nub of the issue for me, reecting again Oakleys (2000) views about exploitation. As a novice researcher, but an experienced midwife/lecturer, I was able to achieve the co-operation of very busy professional people for my own ends; and whilst interviewing them I also became aware of the possibility of affecting them in perhaps a lasting way.
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Darra Emotion work and the ethics of novice insider research I appreciate that it would generally be seen as quite appropriate to ask midwives to participate in my study for the Fellowship. However, as Hochschild (2003) notes in her discussion about feeling rules, there was a pinch between this feeling that arguably I should feel and how I actually felt. I could not easily reconcile my feeling that the participants were not entirely clear about exactly how much of a novice I was. I managed this by using my experiences as a midwife/lecturer and through attempts to behave as I believed an experienced researcher would. In this way, emotion work was required not only to reconcile myself with the feelings that I had about my role as a novice interviewer, but also in relation to the surface acting (Hochschild, 2003) that I undertook within the interview situation itself. These two aspects are intimately interlinked in my dilemma, along with the ethical rule of veracity; just how far should one go to explain the rationale for ones research and ones experience as a researcher, to prospective participants? As previously stated, all the midwives in my study were aware that it was my rst research study, but perhaps due to my successful surface acting and my use of experience from other roles, they took part in a study which was not exactly what they might have thought it was. Hammersley and Atkinson (1983) discuss how it is difcult to assess the benets and costs for those actually involved in research; they suggest that this clearly involves judgements but conclude that such judgements are always open to possible disagreement.When initially setting out on the study, I judged that little if no harm was likely to come to the participants and that I would obtain autonomous consent in an acceptable way. I judged that the benets for the participants were minimal and that any costs to them were likely to be temporary (Reynolds, 1972). However, reection during the study and afterwards focused on my concerns about mis-use of participants time and effort as well as about compromising their full autonomous consent through a) capitalising on my novice status (as suggested by Barbour, 2005), b) successful emotion-work in surface acting and c) uncertainty about the extent of veracity required for informed consent. As for me, I believe that the benets and costs to me have been inextricably linked; the emotion-work has required much effort, the feelings of guilt have needed in-depth reection for reconciliation and I have done all this at the same time as reaping the benets of building research experience.
Conclusion
In conclusion, I believe that I have done considerable emotion work both during and following the training fellowship.This has largely been in relation to surface acting and then reconciling myself with the ethical issues around autonomy and veracity that I suggest arise from novice research. The topic I chose was perhaps less ethically challenging than others might have been, but it served to open my mind to the pleasures and possible pitfalls of research. As Wilde (1992) notes, the research process beneted me and was clearly not simply about collecting the data. Therefore, one should not denigrate the good that has come from the whole experience. Being able to reect (I think, effectively) and to work through the emotional labour has led me to be able to realise the benets of the experience. During the interviews, I used emotion work to present myself as the researcher I thought I should be. The emotion work involved in relation to feeling rules and surface acting whilst training in research practice is shown to be considerable, particularly if one is reexive as a researcher. Reection can be very empowering (Johns, 2000) and being reexive as a new researcher has been invaluable in being able to work through the emotional labour to aim to be a thoughtful novice researcher, whilst not forgetting that I was able to produce some useful data. 259
Journal of Research in Nursing 13(3) The purpose of this paper is to encourage debate about the (I believe) questionable nature of novice research and position of the novice researcher, in particular those like me who are starting out with insider research. It recognises the important contribution of in-depth, insider interviewing to qualitative research, referring to the importance of recognising the person and the role of the researcher in obtaining rich data; but it has also identied some pitfalls of such an approach. My role as a novice researcher testing out my interviewing skills on participants as collaborators in my training presented troublesome ethical dilemmas for me. I utilised a reexive approach to work through the emotion work that I had expended to help me in the work and to think through all the issues that arose, both during and after the study. The discussion has moved through a recognition of some negative aspects of the emotion work in research and has, through the use of in-depth reection demonstrated how the positive can come out of the negative. To reect Wildes (1992) thoughts, I am still not completely clear about the ethics of novice insider research and I wonder about the emotion work that will be required throughout my research career, but perhaps I am now confused at a higher level, which may not be an entirely bad thing. Acknowledgement I would like to offer my gratitude to Professor Billie Hunter for her support and words of wisdom during the writing of this paper. References
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Susanne Darra (BSc (Econ) (Hons, MA, PGCE) I have been a midwifery lecturer for seven years, with a keen interest in education and in midwifery in general. I previously practised for 17 years as a midwife in various settings. I am currently due to commence PhD studies in relation to investigating how childbirth is described by users of maternity services and midwives, thereby gaining insights into perceptions of normal birth. I plan to examine literature aimed at midwives and their clients about normal birth and to interview women and the midwives involved in their births.The data will be analysed through narrative and/or rhetorical analysis to obtain views about normal birth in hospital in the twenty-rst century. This paper arose out of the work done for my Health Professions Wales Research Training Fellowship, which I completed last year. E-mail: S.Darra@swansea.ac.uk
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