METHODOLOGICAL ISSUES IN NURSING RESEARCH

Ecomapping: an innovative research tool for nurses

Robin A. Ray MHSc BEd RN
Lecturer, School of Nursing and Midwifery, La Trobe University, Victoria, Australia

Annette F. Street PhD BEd

Professor, School of Nursing and Midwifery, La Trobe University, Victoria, Australia

Accepted for publication 29 November 2004

Correspondence: R A Y R . A . & S T R E E T A . F . ( 2 0 0 5 ) Journal of Advanced Nursing 50 (5), 545–552

Robin Ray, Ecomapping: an innovative research tool for nurses
School of Nursing & Midwifery, Aim. This paper explores the use of ecomaps as a research tool for capturing data,
La Trobe University,
using the example of the dynamic nature of social networks from which informal
Bundoora 3086,
carers of people living with motor neurone disease draw their support.
Victoria,
Australia.
Background. The need for social support in relation to health maintenance and
E-mail: r.ray@latrobe.edu.au disease management has been identified in the literature but little has been published
about ways to investigate support networks. Existing discussion in the literature
about the use of ecomaps as a clinical tool in social work creates a valuable
framework for data collection which can be readily adapted by nurse researchers.
Method. We used ecomaps as part of a repertoire of research tools to gather data
about the social networks of carers of people living with motor neurone disease.
Primary carers participated in three interviews and collaborated in ecomap con-
struction over a period of 10 months during 2003. Analytical correlations were
made between ecomaps and interview data.
Findings. Ecomaps provided a visual means of facilitating discussions around the
structure and strength of networks. Being able to represent the social networks
visually through ecomapping enabled people to identify each member of the net-
work, examine the strength of each relationship and ascertain the sources of nurture
and tension over time. Limitations to this type of data collection arise when par-
ticipants try to quantify relationships that have been visually produced.
Conclusion. Ecomapping is a valuable research tool because it provides visual
representation of supportive care networks, capturing strategic data through sym-
bols expressing relationships that may be inadequately portrayed in words. The
ecomap incorporates the use of consistent symbols that standardize recipient
responses, enabling data comparisons to be made.

Keywords: qualitative research, ecomap, care networks, nursing

conversational interviews and diagrammatic representations

Introduction
The ecological map or ‘ecomap’ has been used as an effective
clinical tool to depict the structure and strength of family or
social relationships. In this paper, we discuss the use of
ecomaps as a research tool, drawing on their use in our
research into enhancing supportive care through mapping the
care networks of people living with motor neurone disease
(MND). We undertook an ethnographic case study using
of networks in the form of ecomaps to identify the needs and
support available to families caring for people living with
motor neurone disease in Victoria, Australia. Discussion of
detailed research findings are beyond the scope of this paper,
as the focus is on examining an innovative methodological
strategy.
The capacity to identify the strength of social support is
important as it has been found in longitudinal epidemiological

! 2005 Blackwell Publishing Ltd 545

R.A. Ray and A.F. Street
studies that effective social networks play a vital role in the
maintenance of health and capacity to survive serious illness
(Berkman 1995). Likewise, social support is important for
patients and carers coping with the psychological distress of
illness (Baider et al. 2003). Family and friends have been
identified in the literature as sources of social support and
supportive care (Nolan et al. 1995, Waltrowicz et al. 1996,
Jarrett et al. 1999, Bolmsjo & Hermeren 2001, McGarry &
Arthur 2001). Evidence shows that lack of social support, or
disengagement from support, can engender feelings of isolation
(Rose 1995, van Teijlingen et al. 2001, Aoun 2004), hopeless-
ness and fatalism (Cattell 2001). Findings from the Social
Withdrawal Scale (Rigby et al. 1999) indicate a direct
correlation between lack of social support and depression
and other negative emotions. Social support is also directly
correlated to coping, as people with significant unmet needs are
those without direct social support from family and/or friends
(Soothill et al. 2001, van Teijlingen et al. 2001). Finding
effective strategies to improve social support is essential to raise
confidence, increase a sense of control and improve self-worth
(Cattell 2001). Thus, the literature on social support in health-
related situations is focused on the family or friendship
networks. What is missing from the nursing literature is the
role that health care professionals and other community
supports play in the development of effective social networks
for carers. We consider that ecomaps can provide a useful data
collection strategy in studies examining social networks by
incorporating all the supportive relationships identified by
carers.
Ecomaps were developed in 1975 by Hartman as part of
her practice in the Child Welfare Learning Laboratory in
the School of Social Work at the University of Michigan
(Hartman 1995). The term ecomap is derived from the
word ecology – the study of the connection between a
living thing and its environment, and how that connection
is maintained and enhanced. Hartman uses only the human
elements of ecology, and has developed a tool to represent
the social relationships and social systems that people have
created enabling them to interact more effectively with the
physical and social environment in which they live and
work. This notion implies that people develop relationships
that provide resources, including information, practical
assistance and emotional support needs, as they negotiate
their everyday lives. An ecomap is a visual representation
of relationships through the depiction of the network that
exists between members of a social group and their
connections with larger social networks (Wright & Leahey
2000), providing the researcher with evidence of the
size, structure and function of that network (Tracy et al.
1994).
546 ! 2005 Blackwell Publishing Ltd, Journal of Advanced Nursing, 50 (5), 545–552
The three key concepts integral to the development of
ecomaps are relationships, social networks and support. The
word relationship refers to any interpersonal interaction or
sense of connection arising from mutual dealings or feelings
(Wilkes & Krebs 1998). These relationships adapt and
change over time within individual social systems (Hartman
1995). Following the work of Cattell (2001), we have defined
a person’s social network as a cooperating group of signifi-
cant others with whom the person interacts in their daily life.
The concept of social networks implies both social interac-
tions or the actions and communications among groups of
people, and social relations or bonds that exist between
people in the context of their day-to-day lives (Giddens
1990). Supportive networks include those whom the person
nominates as having positive or beneficial influences in their
lives. Network members may arise from personal relation-
ships, including families and communities; or institutional
relationships including work connections or interactions with
formal structures, such as the health care system.
The concept of support and a carer’s need for support is well
represented in the literature. More specifically, it identifies
support as emotional and tangible support (Garwick et al.
1998, Goldstein & Leigh 1999), mutual aid (d’Abbs 1991),
trust, including someone to talk to (Bolmsjo & Hermeren
2001, Cattell 2001), and assistance with household chores,
financial assistance and personal care (Schofield et al. 1998). A
variety of terms, including words like strengthening, encour-
aging or sharing the burden, are all relevant when discussing
the needs of carers of people with MND.
Early et al. (2000) used a modified ecomapping process in
social work practice to identify the relationship between the
needs of people who were dying and the formal and informal
support provided. Mapping enabled the researchers to
promote awareness of the composition of the support
network and to identify the association between the types
of relationships, for example intimate, kinship, or formal,
and the kind of support available to the people who were
dying. Given the value of ecomaps as a clinical tool, we
decided to use the strategy as part of a repertoire of research
tools to gather data about the social networks of carers of
people living with MND. Informal caregiving is a complex
and often isolating role. As researchers, we wanted to identify
the people who are potentially available to informal carers as
part of their support network throughout the caring traject-
ory. We considered that visually mapping a social network
and its relationships could provide insight for carers about
who is available to them and could help them to identify any
untapped resources (Tracy et al. 1994). It could also be useful
to be able to identify the type of relationship held with
different people and to correlate this with the level of
Methodological issues in nursing research
emotional and material support, or the types of actions that
would be acceptable for that person to be involved in as part
of caregiving. Relationship types would include professional
or acquaintance, casual friendship, close friendship and
intimate relationships. We anticipated that relationship types
would vary according to perceptions of the basis for the
relationship, the norms governing the relationship, and its
length and closeness. We were looking for a way of
representing the diversity of relationships, including practical
support in the form of errands and meals, alongside
emotional support or more intimate personal care require-
ments. We decided to use ecomaps because of their capacity
to capture diagrammatically the current situation in a
consistent, standardized format that provided a visual trigger
for discussion of stressors and available support (McGoldrick
et al. 1999) in subsequent interviews.
Constructing an ecomap
Ecomaps are diagrams consisting of an inner circle that
normally contains the household in a geogram (family tree)
format, surrounded by other circles representing the elements
in their social network. Relationship lines are constructed
between the inner circle and each individual circle depicting
the strength of the relationship and the flow of resources. The
strength of the relationship can be illustrated in a variety of
ways. Common among these are either the thickness of the
line or the number of lines used (Hartman 1995) to depict the
difference between a professional- or acquaintance-type
relationship and a close relationship (Wright & Leahey
2000). When using ecomaps with families, the multiple line
option enables them to draw their own lines, reducing the
conjecture that might occur over interpreting thickness of
lines (see Figure 1). Further clarification can be added with a
Golf Lions
partner club
Brother
Sister
Daughter
Work
mate
Son
Neighbour
GP
Figure 1 Format of an Ecomap.
! 2005 Blackwell Publishing Ltd, Journal of Advanced Nursing, 50 (5), 545–552
Ecomapping as a research tool
brief comment written on the connecting line (Hartman
1995). A slashed or squiggled line is used to indicate
problematic relationships and may be used alongside straight
lines when necessary. Arrows can also be included on the
lines to indicate the flow of resources. The lines into and out
of the household circle depict the strength of the relationship
and the energy and resources that flow between the house-
hold and the resources. In our study, arrows were used when
a carer specifically identified that they were the initiator of
the interaction. In other instances, the arrows indicated a
mutual relationship. Multiple lines were one indicator of the
strength of the relationship, as defined by the carer’s
perception of the satisfaction that they derived from the
relationship at that point in time (McCarty 2002). Circles are
constructed outside the household circle, and the family or
participants identify their network by naming these circles.
Prompts to begin this process of network mapping could
include health care professionals; work, school, community,
religious, or sporting groups, family members, neighbours
and friends (Tracy et al. 1994).
When mapping is carried out over several interactions with
families rather than as a single assessment, more reliable data
are collected. However, Tracy et al. (1994) caution that
accuracy in reporting relationship types may be compromised
by relationships between those present when the map is
constructed. For example, a stressful relationship between
partners may be represented as more positive when construct-
ing the map with other members of the family unit present.
The process of ecomapping in data collection
In this section, we explain the processes we used to introduce
the ecomap and undertake the collaborative mapping exer-
cise. After spending a few minutes getting to know the people
present in the room at the time of interview, an overview of
the study was given and the outline of the interview clarified.
At this stage the ecomap was introduced and the relationship
mapping process explained with the aid of two diagrams. The
first diagram was a simple ecomap with examples of the
different relationships indicated (Figure 1). The simplicity
enabled the process of mapping to be explained without the
distraction of complex detail often found in a completed
map. Participants were able to visualize how different
relationships could be depicted and begin thinking about
who might be included in their ecomap.
A modification to the ecomap was developed to meet the
needs of the study. The circle that usually represents the
boundary between household and community was modified
to include only the dyad consisting of the primary carer and
the person living with MND. This enabled all peripheral
547
R.A. Ray and A.F. Street
carers, including other members of the household, to be
represented outside the circle, giving a clearer picture of the
support network for the dyad within the circle. The lines into
and out of the dyad circle depicted the resources and strength
of the interaction that flowed between the dyad, with the
identified resources indicating the strength of the shared
experience. Members of social network and the dyad could
be located differently within these networks. Occasionally,
the relationship between the primary carer and an individual
in the network was different from their relationship with the
person living with MND. In these cases individual lines were
constructed directly between the people involved. Field notes
made on completion of the interview recorded those present
during interview.
The second diagram, a completed detailed ecomap repre-
senting the diversity of possible resources, helped the carer to
visualize the reality of ecomapping and was shown to them as
an example of the process. In our study, to maintain
confidentiality of the data in the preparatory stage, an
illustration from a textbook was used. The researcher then
produced a previously prepared A4 sheet in landscape format
with the date and carer code at the top of the page, ready to
develop this participant’s ecomap.
Collaborative ecomapping and validation of data
Ecomaps can be constructed in three ways. The interviewer
may represent data as they perceive it, the interviewee may do
this with assistance from the interviewer, or there may be
collaborative discussion between the interviewer and the
interviewee (Hartman 1995).
The first option of representing the data as constructed by
the interviewer as outsider (an etic view) means that the
participants have no control over the resulting ecomap,
especially if the data were collected in a single interview. We
considered that the validity of this approach would be limited
because it would not give participants an opportunity to
interact with the ecomap and further explore the nature of
their social network for themselves or with the researcher. If
the researcher employed the second option, where partici-
pants as insiders (emic view) developed the ecomap them-
selves, it could be argued that the resulting ecomap might be
incomplete as the participant might forget to include elements
(Tracy et al. 1994); this would reduce the effectiveness of the
ecomap in displaying all sources of support and nurture, and
would risk the validity of the data. The third option of
developing the ecomap in collaborative discussion enables an
interactive and reflexive relationship to occur as the partici-
pant represents their perceptions of the social network, while
at the same time being prompted by the researcher to
548 ! 2005 Blackwell Publishing Ltd, Journal of Advanced Nursing, 50 (5), 545–552
consider elements that they might have forgotten. Research-
ers need to ensure that control of the ecomapping process is
constantly negotiated with the participant, being careful not
to influence the outcome, while accurately reporting the data
as perceived by the participant (Grbich 1999). Using this
collaborative approach enables the participant to visualize
their social network and the value of these relationships to
them. The researcher is also able to use the ecomap data as
they emerge to ask questions relevant to the research topic.
In our study, we took the collaborative discussion
approach. None of the participants was familiar with
constructing ecomaps, and the time and effort required to
learn would have increased interview burden. If they had
been constructed only by interviewer perception this would
have left too many gaps in the diagram and reduced the
validity of the data. Collaborative discussion in which the
ecomap was constructed in full view of the carer (inter-
viewee) ensured that continuous validation checking could be
undertaken, with additions and alterations evident to both
parties. The ecomap could also be modified as the interview
progressed and the carer became more comfortable with this
type of data representation. As issues were discussed and data
arose, the interviewer drew the information on to the
ecomap, indicating the role and validating the strength of
the relationship with the carer.
Data generated by the ecomap were mostly supplied by the
primary carer; however, in some interviews the person diag-
nosed with MND had input into the content and validation of
the maps. This may have influenced the categorizing of the
relationship as carers can have a different perspective on care
from that of the person being cared for (Goldstein & Leigh
1999). However, the reality for most people living with MND
is that life is constructed principally around the diagnosed
person and the primary carer or the caregiver and care receiver
dyad (Coeling et al. 2003), and therefore this tension is part of
the context of caring and needs to be captured faithfully as part
of the perceived reality (Grbich 1999, McCarty 2002). If
categorizing of the relationship was different between the
primary carer and the person living with MND, then the
researcher could choose to dissolve the dyad on the map and
construct two separate maps, or seek to reschedule the
interview for a time when the person living with MND was
not present and construct the map with the primary carer only.
Clarity around these decisions would be evident in interview
transcriptions and recorded in field notes. No dissention
between the carer and person diagnosed was evident during
the interviews, but in one interview the decision-making power
exercised by person living with MND was very evident. In
other interviews, where the diagnosed person had input into
the ecomaps the dyad relationship appeared to be very open,
Methodological issues in nursing research
with the person diagnosed often including people the carer
had forgotten and the dyad concurring on categorizing the
relationship.
Once the interview was completed, the ecomap was copied
and filed ready for the second round of interviews. In
preparation for the second and later the third interview, a line
was drawn through the date to indicate the change, while
preserving the legibility of the original date, and the new date
was added. After the initial greeting, the format of the second
or third interview was outlined and the primary carer
reviewed a photocopy their ecomap in preparation for the
ensuing questions. Again, the ecomap was positioned on a
surface between primary carer and the researcher so that it
could be referred to and modified at any stage. Changes to the
original ecomap were made in blue to ensure that they were
easily distinguishable from the grey/black of the photocopy.
The use of red ink was avoided because of its association with
corrections. The researcher did not want to be seen as passing
judgement or degrading what had previously been occurring.
Participants needed to be able to add people, change
relationship lines and or delete people from the ecomap as
their network had evolved and changed over the intervening
months. Participants, now familiar with this form of data
representation, keenly engaged with their original data and
made the necessary modifications in what appeared to be a
more relaxed manner.
Carer use of ecomaps
All participants from the 18 families in the study actively
engaged in providing data for their ecomap, and by the second
interview some participants took responsibility for making the
changes to the ecomaps themselves as the conversation
progressed. Questions focusing on the composition of carers’
networks elicited responses that included both formal or paid
health care workers and informal carers such as family,
friends and associates. Carers represented the relationships
with most formal carers and health care professionals by using
single lines; however, some indicated the need for two lines to
general practitioners, community nurses and/or specific staff
members employed by the MND Association. For example,
carer 4B, discussing agency carers, said, ‘They’re good. Yeh,
I’d give them two, they are good’. Carers depicted relation-
ships between friends, associates and family members with
anything from one to three lines, and frequently spoke about
their involvement in the care trajectory to date. A précis of this
information was added to the diagram to assist with subse-
quent discussions. Comments such as the following were
appended to the ecomap: carer 11B: ‘ADLs (activities of daily
living) on Thursday’; carer 2W: writes letters to (person
! 2005 Blackwell Publishing Ltd, Journal of Advanced Nursing, 50 (5), 545–552
Ecomapping as a research tool
diagnosed with MND – cannot speak), phones (primary carer)
every week’; carer 9L: ‘Feeds lunch’.
Visual representation of relationships can be confronting
for carers, especially if difficulties with a particular relation-
ship are being experienced. Therefore, it is essential that time
is taken to build rapport before the researcher can expect to
obtain an indication of the types of relationship among the
potential support networks. Some carers orally reported
friction or dissatisfaction with a relationship but were hesitant
to display this as a visual representation. For example, carer
9L said: ‘Their personal relationship is very tight (meaning
close). Um (hesitation) Three (lines), but some tension, do you
think?’ The words tension or strain were used to express
interpersonal difficulties, such as occurred when the person
living with MND was very demanding, or a peripheral carer
wanted to direct the care. Carer 10B reported that his mother-
in-law always wanted to puree his wife’s food and pushed for
the use of formal care when this was not consistent with the
desires of the person living with MND. The first author
prompted with, ‘It sounds like we need a squiggled line here’.
Some carers agreed, while others hesitated and questioned
who would see the ecomap. Even when reassured that this was
a confidential document that was coded and not named, some
carers would not allow this representation to be made on the
first map, but were more receptive as trust was built in the
second interview. McCarty (2002) recognizes that perception
rather than actual relationship is an issue for researchers
recording social network data, however perception has a
direct correlation to behaviour and therefore is a reasonable
representation of network relations.
Some participants had difficulty in categorizing their
relationships, especially when there were individual incidents
that led to intermittent tensions in relationships. For exam-
ple, carer 9L said: ‘Three or four of them want to see (person
diagnosed with MND) every week but he doesn’t want to see
anybody’. As the ecomap was used concurrently with the
interview process, the nature of any tension was recorded in
the interview data and correlated with the ecomaps during
data analysis. This tension was overlaid by the nature of the
illness and intensity of caregiving, thus magnifying sources of
tension external to the caregiving context. For example, carer
18S said: ‘‘My brother’s asking me, ‘Why, what have I
done?’, I don’t know, I’ve tried (to explain) and can’t’’. Carer
15D described the friction as: ‘She came up here (to help) and
caused fireworks’. Participants were willing to involve
themselves in ecomapping, and by the second interview were
keen to ensure that everyone was represented. Carer 8S said:
‘I think we have Bill there somewhere, didn’t we?’ In some
situations the role of the person was very important and
carers would talk about that for some time.
549
R.A. Ray and A.F. Street
Similarly, the need to think about the number of lines used
to categorize people assisted carers to reflect on the focus and
strength of their support.
Carer 8S: ‘I think it helps me…doing something else…outside the
house…absolutely three lines’;
Carer15D: ‘She’s about one (line) we won’t go too far with her’.
Carer 11B: ‘She’s re-establishing; I think she’s making an effort to
become a two line person’.
Interestingly, some carers expressed constraints with the one
to three line system, and Carer 4B asked: ‘Can I give her ten
(lines)?’ In order to maintain a standardized approach to the
data collection, this variation was not allowed. Sometimes
the tenor of the interview made it important just to note the
source of support at that time but not draw in the
relationship lines until later in the interview when the topic
could be broached again and data obtained in a more relaxed
interchange.
Drawing in the changes
When carers reviewed their ecomaps from a previous inter-
view, changes occurred. Some discovered the need to include
people they had forgotten, while others changed the nature of
the relationship and the type of support provided by making
changes to the number of lines allocated and adding tension
lines where needed. For a small number of dyads, the ecomap
remained relatively unchanged. These were usually people who
had been living with the illness for several years with a very
slow-moving trajectory. Carer 6C did not make any changes to
his ecomap. He, together with his wife and sister, had
immigrated in their retirement, their network was small from
the beginning and contained people with their own health
problems who could not increase their level of supportive care.
Over the period of the study, the disease progressed to the point
of the woman with MND dying at home, cared for mostly by
her husband, supplemented by district nurses.
Carer 8S drew a circle and two lines to add in some
cousins – ‘the type you only see at weddings and funerals’ –
who had become a significant part of the supportive network.
Others changed the relationships with formal carers. Lines to
therapists who had been useful in the early stages of the
illness but were no longer part of the care were deleted, while
lines to other formal carers were strengthened or tension-
laden as the care trajectory continued. In the second
interview, two carers indicated tension lines with personal
care agency staff that were constantly changing and therefore
needing to be trained by the informal carer, or not staying
long enough to build rapport. For others, the changes were
550 ! 2005 Blackwell Publishing Ltd, Journal of Advanced Nursing, 50 (5), 545–552
more problematic as they noted that their network declined.
One participant, who had moved the family unit after the
diagnosis, to be geographically closer to the extended family,
depicted some tension lines mixed with closer ties in the first
ecomap. During the second interview about 4 months later,
she drew a purposeful line through the family members and
said, ‘They’ve all gone’. Her family, whom she had depended
on to help, could not cope with the situation and had ceased
interaction. Other carers noted that some people had become
distant as the complexity of the illness increased. Connections
that had been depicted by two lines previously were now
changed by carers to one line or removed altogether.
Discussion
Ecomaps are a very useful tool for mapping and tracking
relationships between clients and the systems with which they
interact over time, capturing their own perceptions (McCarty
2002) in a standardized, visual manner (Hartman 1995). In
our research project, ecomaps provided a rich source of
ethnographic data while at the same time presenting an
opportunity for primary carers to identify sources of nurture
and tension (Hartman 1995). They thought about the roles
various members of their networks played in caregiving and
evaluated what this meant to them before they decided how
many relationship lines to draw within the scope of the
standardized diagrammatic representations. Illustrations on
the ecomaps gave us insight into the availability of support
for primary carers, how their interpersonal relationships
affected the roles they adopted and, more specifically, the
kinds of relationships that enabled people to be involved in
different levels of caregiving. An advantage of ecomaps was
their capacity to denote and distinguish between emotional
support and direct care through additional notation. Revis-
iting this information over three interviews enabled expan-
sion and further validation of the data.
The ecomap also provided a basis for further questioning
to examine how decisions about the type of involvement were
made, the characteristics of the relationship that enabled
continual involvement or disengagement from involvement
over the trajectory of the illness. Thus, ecomaps were a
catalyst for obtaining more in-depth data, with the illustra-
tions providing discussion triggers for both researchers and
interviewees. The visual representation provided by the
ecomap was easily modified and updated at each interview.
Changes in the support network were evident at a glance, and
the dynamic nature of available supportive care was dis-
played for ready analysis. These data were correlated with
oral data, giving a more complete picture of deficits and
resources contained in the support network. These data can
Methodological issues in nursing research
be analysed using computer-assisted data analysis software.
In our study, the ecomaps were connected to the interview
transcripts in the NVivo computer program (Bazeley &
Richards 2000) via DataBites and cross-checked with inter-
view data to add insight into the changing supportive care
needs of people living with MND as the trajectory
progressed.
Lessons learned
It is essential that a trusting relationship between carer and
researcher is facilitated so that the data recorded resembles
the carer’s construction of their world. Occasionally, reas-
surance that the ecomap was only coded and no names were
used facilitated the representation of problematic relation-
ships that might not have been discussed otherwise. Although
some misrepresentations could have occurred, especially
when interviews were conducted in family groups or with
both members of the dyad present (Tracy et al. 1994), a
similar problem is faced regularly in family interviews.
Researchers also need to be sensitive to the dynamic nature
of caregiving and the influence this might have on a carer’s
perception of a relationship at any one time. Fluctuations in
relationship lines need to be further tested by asking
qualifying questions.
During the process of data collection it became evident
that people needed to identify who was in their network
first, and then go back and categorize the relationships and
add the lines. Researchers need to be aware that asking
participants to categorize each time they mention someone
in the network can disrupt the flow of the discussion,
risking the loss of data when recall is interrupted.
Categorization is sometimes better left until a later time
in the interview; however, each case needs to be evaluated
at the time. The scope of diagrammatic construction
required in the ecomapping process was a limitation for
some participants. Three lines were inadequate to capture
the strength of a number of supportive networks. This
needs to be explored in further research.
Harper (1994) confirms the validity of using visual images
in conjunction with text to give deeper insights in sociological
research. While ecomapping is an excellent visual tool, its use
is limited to research on the composition and content of
networks. The mapping process needs to be undertaken in
conjunction with a qualitative interview and/or participant
observation to give contextual information necessary to gain
a wider perspective on the situation. If interview data alone
were used, many questions would need to be asked about
specific people in the support network to ascertain their
changing roles and identify those who had moved in and out
! 2005 Blackwell Publishing Ltd, Journal of Advanced Nursing, 50 (5), 545–552
Ecomapping as a research tool
of the support system. Ecomapping throughout the interview
process enables data collection to be as rich as possible, and
ensures that opportunities to explore the issues raised by the
mapping are not overlooked. Participants found it valuable to
review the ecomaps gaining insight into their sources of
support and the changing dynamic of their support network.
Ecomapping could be applied in other nursing research
seeking to identify available resources to support health.
Following on from our study, ecomapping could be used in
studies of the support available to people experiencing other
diseases that require long-term care in the community.
Mapping supportive care networks would be a useful
inclusion in research exploring more effective discharge
procedures and follow-up care after hospitalization, provi-
ding important information for health care professionals
when planning for resource provision for community care.
Ecomapping would be an effective research tool to demon-
strate the social support available to people seeking to change
health and lifestyle behaviours, indicating the impact that the
support system may have on the efficacy of behavioural
change.
Conclusion
We found that ecomaps were an innovative and effective
research tool for mapping the supportive care networks of
informal carers. They gave a visual representation of both
actual and potential sources of nurture, while also indicating
possible sources of strain that were further explored in
interviews. Being able to see the network and to track its
changes over time provided us with systematic visual repre-
sentations of changing relationships systems. However,
caution needs to be exercised in situations when carers may
not feel comfortable enough to map their story, and data may
need to be collected over time, responding to the context,
building rapport and considering carers’ perceptions of the
dynamic caregiving role.
Acknowledgements
The authors acknowledge the Motor Neurone Disease Associ-
ation for their support and the carers of people living with
Motor Neurone Disease for their willingness to participate.
Author contributions
RAR and AFS conceived and designed the study and drafted
the manuscript. RAR performed the data collection and
analysis. AFS supervised the study. AFS, RAR and JB
critically revised the paper.
551
R.A. Ray and A.F. Street
What is already known about this topic
• Ecomaps have been successfully used clinically by
social workers to assess family supports, but the
literature discussing them is limited.
• Ecomaps are identified as a tool in family nursing
assessment, but research has not been found about
ecomap application and its value as a research tool.
What this paper adds
• Ecomaps are an innovative, participatory data collec-
tion tool for nursing research.
• Ecomapping networks over time gives insight into the
ongoing supportive care needs of family caregivers.
• Ecomaps can be used in further research associated
with discharge planning and health management.
References
d’Abbs P. (1991) Who Helps: Support Networks and Social Policy in
Australia. Monograph Number 12, Australian Institute of Family
Studies, Melbourne.
Aoun S. (2004) The Hardest Thing We Have Ever Done: The Social
Impact of Caring for Terminally Ill People in Australia 2004: Full
Report of the National Inquiry into the Social Impact of Caring for
Terminally Ill People. Palliative Care Australia, Canberra.
Baider L., Ever-Hadani P., Goldzweig G., Wygoda M.R. & Peretz T.
(2003) Is perceived family support a relevant variable in psycho-
logical distress? A sample of prostate and breast cancer couples.
Journal of Psychomatic Research, 55, 453–460.
Bazeley P. & Richards L. (2000) The NVivo Qualitative Project
Book. Sage Publications, London.
Berkman L.F. (1995) The role of social relations in health promotion.
Psychosomatic Medicine, 57, 245–254.
Bolmsjo I. & Hermeren G. (2001) Interviews with patients, family
and caregivers in amyotrophic lateral sclerosis: comparing needs.
Journal of Palliative Care, 17, 236–240.
Cattell V. (2001) Poor people, poor places and poor health: the
mediating role of social networks and social capital. Social Science
& Medicine, 52, 1501–1516.
Coeling H.V., Biordi D.L. & Theis S.L. (2003) Negotiating dyadic
identity between caregivers and care receivers. Journal of Nursing
Scholarship, 35, 21–25.
Early B.P., Smith E.D., Todd L. & Beem T. (2000) The needs and
supportive networks of the dying: an assessment instrument and
mapping procedure for hospice patients. American Journal of
Hospice and Palliative Care, 17, 87–96.
Garwick A.W., Patterson J.M., Bennett F.C. & Blum R.W. (1998)
Parents’ perception of helpful vs unhelpful types of support in
managing the care of preadolescents with chronic conditions.
Archives of Paediatrics & Adolescent Medicine, 152, 665–671.
Giddens A. (1990) Structuration theory and sociological analysis. In
Anthony Giddens: Consensus and Controversy (Clark J., Modgil
C. & Modgil S., eds), The Falmer Press, London, pp. 249–315.
552 ! 2005 Blackwell Publishing Ltd, Journal of Advanced Nursing, 50 (5), 545–552
Goldstein L.H. & Leigh P.N. (1999) Motor neurone disease: a review
of its emotional and cognitive consequences for patients and its
impact on carers. British Journal of Health Psychology, 4, 193–208.
Grbich C. (1999) Qualitative research design. In Handbook for
Research Methods in Health Sciences (Minichiello V., Sullivan G.,
Greenwood K. & Axford R., eds), Addison-Wesley, Frenches
Forest, pp. 124–145.
Harper D. (1994) On the authority of the image: visual methods at
the crossroads. In Handbook of Qualitative Research (Denzin N.K.
& Lincoln Y.S., eds), Sage Publications, Thousand Oaks, pp. 403–
412.
Hartman A. (1995) Diagrammatic assessment of family relationships.
Families in Society, 76, 111.
Jarrett N.J., Payne S.A. & Wiles R.A. (1999) Terminally ill patients’
and lay-carers’ perceptions and experiences of community-based
services. Journal of Advanced Nursing, 29 , 476–483.
McCarty C. (2002) Structure in personal networks. Journal of Social
Structure, 3.
McGarry J. & Arthur A. (2001) Informal caring in late life: a qua-
litative study of the experiences of older carers. Journal of Ad-
vanced Nursing, 33, 182–189.
McGoldrick M., Gerson R. & Shellenberger S. (1999) Genograms:
Asessment and Intervention. W W. Norton & Co., New York.
Nolan M., Keady J. & Grant G. (1995) Developing a typology of
family care: implications for nurses and other service providers.
Journal of Advanced Nursing, 21, 256–265.
Rigby S.A., Thronton E.W., Tedman S., Burchardt F., Young C.A. &
Dougan C. (1999) Quality of life assessment in MND: develop-
ment of a social withdrawal scale. Journal of Neurological Sci-
ences, 169 , 26–34.
Rose K. (1995) Palliative care: the nurse’s role. Nursing Standard, 10 ,
38–44.
Schofield H., Bloch S., Herrman H., Murphy B., Nankervis J. &
Singh B. (eds) (1998) Family Caregivers: Disability, Illness and
Ageing. Allen & Unwin in Association with Victorian Health
Promotion Foundation, St Leonards.
Soothill K., Morris S.M., Harman J.C., Francis B. & Thomas C.
(2001) Informal carers of cancer patients: what are their unmet
psychosocial needs? Health and Social Care in the Community, 9 ,
464–475.
van Teijlingen E.R., Friend E. & Kamal A.D. (2001) Service use and
needs of people with motor neurone disease and their carers in
Scotland. Health and Social Care in the Community, 9 , 397–403.
Tracy E.M., Whittaker J.K., Pugh A., Kapp S.N. & Overstreet E.J.
(1994) Support networks of primary caregivers receiving family
preservation services: an exploratory study. Families in Society, 75,
481–489.
Waltrowicz W., Ames D., McKenzie S. & Flicker L. (1996) Burden
and stress on relatives (informal carers) of dementia suffers in
psychogeriatric nursing homes. Australian Journal on Ageing, 15,
115–118.
Wilkes G.A. & Krebs W.A. (eds) (1998) The Collins Concise Dic-
tionary of the English Language. Collins/Angus and Robertson,
Pymble, Australia.
Wright L.M. & Leahey M. (2000) Nurses and Families: A Guide to
Family Assessment and Intervention. F.A. Davis Co., Philadelphia,
PA.