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International Journal of Nursing Practice 2007; 13: 81–88

RESEARCH PAPER

Feminist-informed participatory action research:


A methodology of choice for examining critical
nursing issues
Andrea M Corbett BN MPhil (Nursing)
PhD Candidate, Faculty of Medicine, Nursing and Health Sciences, School of Nursing and Midwifery, Monash University, Gippsland Campus,
Churchill, Victoria, Australia

Karen Francis RN, PhD, Med, MHlth ScPHC, Grad Cert Uni Teach/Learn,
BHlth ScNsg, DipHlth ScNsg
Professor of Rural Health, Faculty of Medicine, Nursing and Health Sciences, School of Nursing and Midwifery, Monash University, Gippsland
Campus, Churchill, Victoria, Australia

Ysanne Chapman RN, PhD, MSc (Hons), BEd (Nsg), GDE, DNE
Senior Research Fellow, Faculty of Medicine, Nursing and Health Sciences, School of Nursing and Midwifery, Monash University, Gippsland
Campus, Churchill, Victoria, Australia

Accepted for publication September 2006

Corbett AM, Francis K, Chapman Y. International Journal of Nursing Practice 2007; 13: 81–88
Feminist-informed participatory action research: A methodology of choice for examining critical
nursing issues

Identifying a methodology to guide a study that aims to enhance service delivery can be challenging. Participatory action
research offers a solution to this challenge as it both informs and is informed by critical social theory. In addition, using a
feminist lens helps acquiesce this approach as a suitable methodology for changing practice. This methodology embraces
empowerment self-determination and the facilitation of agreed change as central tenets that guide the research process.
Encouraged by the work of Foucault, Friere, Habermas, and Maguire, this paper explicates the philosophical assumptions
underpinning critical social theory and outlines how feminist influences are complimentary in exploring the processes and
applications of nursing research that seeks to embrace change.
Key words: critical social theory, feminism, participatory action research, power relationship, practice development.

INTRODUCTION development, are utilized in health-care environments to


Health professionals, including nurses and health service support clinicians to enhance their service delivery
administrators, are charged with maintaining high-quality capacity and ultimately improve health outcomes for
services to consumers. Initiatives, for example, practice consumers.1–7 Proposed studies using the framework of
participatory action research (PAR) seek to assist health
professionals to acquire the necessary skills and knowl-
Correspondence: Andrea M. Corbett, 244 St Aubyn Street, New Ply- edge required to meet these challenges.7–10 Situated
mouth, New Zealand. Email: a.corbett@witt.ac.nz within the critical naturalistic paradigm, PAR aims to

© 2007 The Authors


doi:10.1111/j.1440-172X.2007.00612.x Journal compilation © 2007 Blackwell Publishing Asia Pty Ltd
82 AM Corbett et al.

facilitate change using a recurring cyclical process of settlers’ could only be improved by a programme of col-
engagement, collaboration, cooperation, reflection and laborative research in which both parties came together to
evaluation. This paper will explore the relationship develop acceptable solutions to common problems.14
between PAR and feminist theory, arguing that both Social psychologist Kurt Lewin developed an action
philosophical premises share a common goal and might research approach that he used to explore questions raised
acquiesce to inform a process for clinical research. by communities in post-war America.12 It is believed that
It will be useful to understand that the essential differ- his experiences in Nazi Germany influenced his views of
ence between action research and PAR is that action the world and his conceptualisation of a democratically
research has been undertaken by and with people who based research approach, action research, for understand-
have power and control, such as managers and directors of ing and changing human behaviour.4 Lewin rejected the
organizations, whereas PAR has been developed and uti- positivist belief that researchers study an objective world
lized with disempowered people.3,4 separate from the intersubjective meanings as understood
by them as they act in and on their world. In this way,
ACTION RESEARCH action research not only links action and research but also
Stringer and Genat defined action research as: ‘a system- assumes an educational mission as part of the problem-
atic, participatory approach to inquiry that enables people solving process.3 The approach Lewin developed, tested
to extend their understanding of problems or issues and to and modified during the turbulent years of the 1950s and
formulate actions directed towards the resolution of those 1960s, advocated the management of provocative and
problems or issues’.11 The linking of the terms ‘action’ complex situations both critically and practically. Lewin
and ‘research’ highlights the essential features of the was the first to state that the action research process was
approach: testing ideas in practice as a means of improve- cyclical, involving a process of fact-finding, planning,
ment and as a means of increasing knowledge. This linking action, and reflection and evaluation.15
originates from the work of Kurt Lewin.12 He contended In the education sector, action research was first used in
that the two ideas of group decision and commitment to 1945 by Columbia University to investigate and enhance
improvement were inextricably linked. He believed that practice. Following several refinements, the action
those affected by planned changes had the primary respon- research methodology was recognized as a valid approach
sibility for deciding on courses of critically informed to facilitate change in educational settings in the USA,
action which would likely lead to improvement and be Britain and Australia.4 Lawrence Stenhouse and John
accountable for evaluating the results of strategies tried Elliott used action research to develop an innovative
out in practice. humanities curricula.15 Elliot promoted an individual
Although Lewin is acknowledged as the pioneer of reflective approach for understanding educational prac-
action research as a distinct research methodology by tice. He argued that the dominant paradigm supported an
many writers,13 others actually attributed the develop- institutionalized division of teachers and an academic elite
ment of this research methodology to the American phi- of educational researchers. Elliot advocated the use of
losopher, John Dewey. Dewey wrote extensively in the action research as a coupling strategy for teachers to
1930s regarding the education system and the need to engage as researchers and ultimately assured a vehicle for
reform it by democratization. Dewey analysed and wrote professionalism.4 Schon argued that the use of reflective
about reflective thinking in which practical problems work in educational practice led to intentional action to
demanded practical solutions, and the solution could only improve professional practice which was then evaluated in
be regarded as viable when it was shown that it produced an action research methodology.16,17 Kemmis and McTag-
the desired outcome in actual practice. gart spearheaded the use of Lewin’s action research in
The term ‘action research’ is credited to two men, Australia.18 They maintained that this approach to enquiry
Lewin and John Collier. Collier was the Commissioner of is useful as it provides for greater opportunity and poten-
Indian Affairs in the United States between 1933 and 1945. tial to effect change in practice environments.
He used the term ‘research-action’ to describe social
research that was cyclical in its nature: ‘action research and PARTICIPATORY ACTION RESEARCH
research action’. Collier believed that ethnic relationships Participatory action research arose as a separate research
between indigenous North Americans and the ‘free methodology within the critical paradigm out of action

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Feminist-informed research methodology 83

research. PAR has been used extensively as a research Tandon further developed his arguments by referring
methodology in developing nations undertaking commu- to the trends that contributed to the contemporary use of
nity projects associated with educational issues. Early PAR PAR.19 He referred first to how the logic of manipulation
projects were concerned with marked inequalities in the and control of nature, the basis of pure science which is
distribution of resources and power between the privileged expert-led and has a top-down centralized model of devel-
and dominant and those who were marginalized and opment, has merely contributed to the continued hege-
oppressed.1,5 Tandon believed that six premises converge mony of the ruling classes. Tandon drew attention to the
to form the methodological foundations underpinning role of education and its links to ideology that is a crucial
PAR.19 These premises continue to guide the theoretical instrument of regulation and control of the people,
principles, methodology and epistemology of PAR: moving on to acknowledge the enrichment of the theory
1. The debate concerning the sociology of knowledge and and practice of PAR that can be attributed to some femi-
its implications for epistemological development through- nist perspectives.19
out history. The writings of Habermas led this debate Feminist ways of knowing and changing reality as
which emphasized that what we know is steeped in our expressed by Maguire have strengthened the use of PAR
historical context.20 in a contemporary context.22 The scope of PAR has been
2. Adult educators in South America, among them extended from its original development in education to
Brazilian Paulo Friere, contended that in order to learn, areas such as rural appraisal, and aboriginal community
the learner must have control over their own learning. organizational development, along with its practice in
In 1974, they proposed a theory of ‘adult learning’ that human social services, counselling and therapy as well as
promulgated the term and practice of participatory other people-centred development of marginalized
research.21 groups.19 Early PAR projects were concerned with
3. Freire’s contribution to educational practice was marked inequalities in the distribution of resources and
informed by his pedagogical belief that reality was not an power between the privileged and dominant and those
objective truth or facts to be discovered,21 but included who were marginalized and oppressed in Latin America,
ways in which people interacted with their perceptions Africa and Asia.15,18,21
of truth.3 This process of knowing, he argued, was To be successful projects utilising PAR require partici-
interlinked with learning and thus gave support to the pants to engage in the entire research process. There is
arguments promoted by adult educators in support of integration of action and the practice of knowledge. It is
PAR. set apart from other forms of action-orientated research,
4. A parallel premise in the development of PAR was the according to Park,23 because of the central role of ‘non-
contribution of action research that challenged the exist- experts’ in the process. PAR deals explicitly with issues
ing concept of research as a static process. Rather, PAR that affect diverse groups of people in such wide ranging
built on Lewin’s treatise that action underpins both learn- areas as inner city and rural poverty, health, education,
ing and knowing.12 agriculture, environment, housing, community develop-
5. Phenomenology made the next significant contribu- ment, mental health, disability, women’s oppression and
tion to the development of PAR, according to Tandon,19 immigration.23
as the work of phenomenologists legitimated experience To achieve its results, PAR requires that people engage
as a basis of knowing. Human emotions and feelings as in three different activities:
reported through narrative were recognized as ways of • Inquiring into the nature of a problem;
knowing. In addition, phenomenologists recognized that • Getting together as participant units; and
experiential learning was a legitimate form of knowledge • Mobilizing for action by raising awareness of what
that could inform practice. needs to be done.
6. The question of active participation in research of the Open communication throughout all stages of the
persons seeking answers to their questions was seen as a research process is essential. The principal researcher
critical variable. This approach differentiates between makes it possible for participants to create a space in
researching ‘on’ and researching ‘with’, and realizes the which they can share experiences and information to
importance of the participatory process rather than a create common meanings and develop actions together.
process that is orchestrated from without. PAR has been described as an alternative philosophy of

© 2007 The Authors


Journal compilation © 2007 Blackwell Publishing Asia Pty Ltd
84 AM Corbett et al.

social research18 with its roots in liberation theology and The advantage that an outsider has in many research
neo-Marxist approaches to community development, and studies is that whereas they might well be from another
has often been associated with social transformation in the culture, they are often better resourced, educated and
Third World. knowledgeable of the many implications and consider-
It was but a short step to adapt action research as a ations than the participants whether this be an action
practitioner-friendly research methodology that could be research or a PAR project. Reason and Bradbury con-
used by nurses, physicians and other health professionals tended that PAR will not occur without the initiative of
to formulate appropriate service delivery practices, and someone with time, skill and commitment, someone who
appropriate health strategies. Its practitioner-friendly will inevitably be part of a privileged and educated group.1
qualities make it a suitable methodology to use when Being an outsider in this context, therefore, is not a bad
attempting to understand the ways lay people might con- thing; however, participatory by its very name demands
tribute to the development of appropriate service delivery the inclusion of all.
strategies.3,5,18,19 Reason and Bradbury in discussing the
characteristics of action research in relationship to the INFLUENCE OF FEMINISMS
dominant paradigm stated that the emergent world view Feminist perspectives have strengthened and contributed
is systemic, holistic, relational, feminine and experiential, to the development of PAR methodology. Feminisms
but its defining characteristic is that it is participatory refer to a number of perspectives that have a central
(emphasis added).1 set of tenets. Maguire22,27 indicated that these beliefs
Koch et al. reported that during a PAR project the include:
reflection phase creates a self-awareness which enables • that women face some form of oppression and exploi-
participants to give voice to topics that are important to tation, and that these oppressions and exploitations
them.24 This inclusiveness has the potential to improve are experienced differently depending on race, class,
and change practice, and to enhance the sense of belong- culture, religion, sexual preference, age, physical abili-
ing, involvement and empowerment of those involved. ties and nationality;
These changes in individuals enable group reflection to • that all feminisms have a commitment to uncover and
lead to a reconstruction of the meaning of a particular understand the forces that cause and sustain oppres-
practice situation and to enable understanding and a sense sion;28,29 and finally
of clarity of what might be possible. It is further pointed • that feminisms work to obtain individually and
out that the ability to have a voice or an opinion, to raise collectively, a commitment to end all forms of
an issue and have it heard, is potentially empowering.24 oppression.
The experience of some participants in a PAR project Participatory action research highlights the centrality of
reveals that they feel validated, as it is the first time they power in the social construction of knowledge; however,
have been heard in their lives. only feminist research has pointed out the centrality of
male power as a factor in the construction of knowledge.20
DIFFERENCES BETWEEN ACTION Paulo Freire made a major contribution through his work
RESEARCH AND PAR in adult education to the development of PAR; however,
Action research emphasizes the need to act on the basis of in his writings he presented a male bias.21,30,31 He wrote of
learning and knowing. In the Australian context, action ‘man in the world’, suggesting that it is ‘man’ that makes
research has been undertaken in the main by and with culture not woman. That he took androcentricity as the
people who have considerable power and control, such as norm could well explain why he ignores man’s domina-
teachers and managers, whereas PAR has developed with tion of woman in the social world.
disempowered people.25 Feminist critique and influence on PAR asks questions
According to Ritchie and Lewis, the major difference regarding terminology: who are the ‘poor’, who are the
between these two approaches is in the relationship ‘marginalized’, who are the ‘oppressed’; words often
between the researcher and the participants.26 With action used in PAR projects as many of the major PAR projects
research, the researcher is likely to be one of their own in the Third World have had the primary aim of empow-
kind, an ‘outsider’ sharing similar values and culture, ering the ‘poor’, the ‘marginalized’ or the ‘oppressed’.
whereas in PAR the researcher might well be an ‘insider’. There is a danger in using such terminologies, however, as

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Journal compilation © 2007 Blackwell Publishing Asia Pty Ltd
Feminist-informed research methodology 85

there is the implication that the persons to who they refer Reinharz spoke of the challenges that confronted
are homogenous. feminist researchers when undertaking effective action
Feminist criticisms of PAR ask the following questions: research because many feminist researchers believe that
1. Who are the participants in a PAR project and whose research is only feminist if it is linked to action.32 It is the
ideas are represented in the results? In the past, many of blending of knowledge and action that occurs with a PAR
these projects represented the voices of men with women methodology that leads participants to make decisions
excluded from the research. rather than merely functioning as passive subjects.
2. The use of categories such as the ‘poor’, the ‘margin- Our understanding of the influence of feminist theory
alized’, the ‘oppressed’ raises questions about the devel- on the PAR model becomes clearer when considering the
opment of theory in practice. The writings of Friere failed process of reflection, used in the early stages of the PAR
to distinguish the differences between these groups.21,30,31 spiral of planning, action and evaluation. This melding of
3. The meaning of being woman differs depending on the two approaches facilitates understanding of the power
place, situation and time.22,27–29 Ethnicity, class and age relationships and imbalances in the various experiences of
also influence the experience of being woman. research participants.
Maguire in her writings highlighted the relevance of Maguire makes a pertinent statement when she said
feminist theory and its initial emphasis on the issues of the that to utilize a more feminist approach to PAR is not to
power and dominance of men over women to PAR with use a set of techniques—it is broader than techniques.27 It
her reflections that feminisms are more about attempting is firmly situated within a larger paradigm approach to
to bring together the many voices and visions of a more human enquiry that challenges the positivist research para-
just, loving and non-violent world.22,27 In the sense that digm with its often dehumanizing assumptions, methods
feminisms and PAR share emancipatory and transforma- and implicit messages. PAR is part of an emancipatory
tive intentions, it is noted that often PAR has ignored the approach to human enquiry that encourages people to act
gender factor in oppression. During the 1970s, PAR unapologetically, and boldly with, instead of for, the less
centred on male power, perceptions and problems. powerful and voiceless.
Maguire argued that feminist perspectives have shifted
since then and that instead of being man-centred, femi- FOUCAULT AND FRIERE
nisms now talk of human-centred which automatically The principle contribution to PAR from Foucault relates
includes woman on the agenda.22,27 This shift in emphasis to his writings on power.33,34 Foucault believed that the
is stated as being a good development as it strengthens the production of knowledge was not as a result of the rela-
PAR approach where there are inequalities due to class, tionship between the use of power and the powerless.
ethnicity and gender. Foucault suggested that the expressions of power took a
The initial attraction of feminist researchers to PAR, specific form depending on the particular society (group)
according to Rose,28 was the understanding that this meth- under study and these expressions were organized in rela-
odology was committed to the emancipation of the mar- tion to class, race, gender, religion, sexual preference and
ginalized and the oppressed. Through their usage of PAR, age. Foucault purported that the production of knowl-
it was the influence of feminist researchers that demon- edge, from which power arose, has a direct relationship to
strated a lack of an awareness of how masculine concep- social practices and ways of being. Dominant knowledge
tions of knowledge and gender dynamics within the systems could be resisted by alternative perceptions and
research process impeded the full participation of research forms of knowledge, whereas alternative forms of knowl-
participants and therefore their experiences in PAR.28 As edge exist and are produced through individual and group
part of this awareness, feminists brought to PAR an under- levels that are enhanced by the PAR process. Foucault
standing of how the concept of empowerment was often taught us to look at how each participant has the potential
used in a simplistic manner and that many PAR studies to accept, challenge or ignore another’s perspective.
rarely resulted in transformation of the participant’s lives. Maguire suggested that by acknowledging the differing
Rose28 cites Gatenby and Humphries29 in concluding that perspectives held by others, PAR encourages participants
feminist researchers, particularly in the control of data to explore their own viewpoints.27
collection and analysis, acknowledge that research rela- Koch et al.24 acknowledged that the intellectual roots of
tionships, even in a PAR study, are inherently unequal. PAR have emerged from the works of Friere21,30,31 and

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86 AM Corbett et al.

Habermas.20,35 Friere linked the processes of learn- as a utilitarian problem-solving approach to make systems
ing and knowing through an ongoing cycle of action and work better.
reflection which led to a critical awareness of the world in 2. Practical knowledge is related to that gained by the
which the participant lived. The influence of the thoughts joint processes of interaction and communication, and
of Freire could have been deduced by the number of participants orient their actions to the common values of
writers on PAR that refer to his pedagogy. their cultural and social environments rather than as
Knowledge is related to power and power is related to solitary individuals.
knowledge.31 Research is not undertaken ‘on’ or ‘for’ 3. Emancipatory knowledge is related to the develop-
participants but ‘with’ research participants. PAR focuses ment of self-knowledge and the gaining of power over the
on empowerment and power relations. Empowerment is forces that control one’s life, understanding why a situa-
realized as the researcher and the participants join tion has come about based upon human actions and what
together to illuminate power inequalities and to explore the future could be.3
the power imbalances. Through this process participants Of particular applicability to health and social science
find their voice and engage fully in the research process. researchers is the belief that emancipatory knowledge is
Friere wrote of this empowerment process when he concerned with social structures, and enables the critical
stated: ‘even when one must speak to the people, one examination of existing rules, habits, traditions and ideo-
must convert the “to” to a “with” the people’.22 This inclu- logies. Emancipatory knowledge is said to expose power
siveness implies respect for the knowledge of their lived relationships that shape society.36 Park stated that the
experience. The central tenet of PAR is to focus on the influence of critical theory has been an important feature
development of knowledge through raising issues of rele- of PAR in both theory and practice because critical social
vance and salience, and the creation of critical conscious- theory argues that meaningful human knowledge must not
ness that leads to effective change.25 merely understand the world but also change it.23 Femi-
nist influences strengthen these drives to understand the
worlds and to change it in a meaningful manner.
CRITICAL SOCIAL THEORY
Habermas discussed the creation of theory and the devel- VARIATIONS IN IMPLEMENTATION
opment of practice as two separate entities.20,35 He argued PAR has been used in health research in the United
that although theory could inform practice, there was no Kingdom conducted by the National Health Service
question of a direct relationship. Habermas took this a (NHS). The NHS is a bureaucracy that is stated to be one
step further and rejected the notion of action research of the largest in Europe; it is hierarchical in nature and
altogether. He believed that participation in an action practice, and there are huge implications in any attempt to
research project would lock the researcher into the prac- make structural and/or operational changes. Although it
tical aspects of a study in such a way that the ability to is indeed difficult to change structures and practices in a
participate in theoretical discourse would be lost. Critical non-participatory, hierarchical organisation such as the
theory as proposed and supported by Habermas espoused NHS, PAR projects have resulted in improved health
that society is filled with extreme power and oppression service delivery.37
with little prospect of new rationale practices being As a research methodology, PAR is having success in
developed.1 achieving improvements in clinical practice. Practice
Habermas developed a strong desire to democratize development is a refinement of PAR in its purest form and
research in order to present a challenge to the institu- is achieving success at an organizational level in many
tionalization of research that he describes as being exclu- health-care service organizations.2,11,15 PAR is producing
sive and exploitative.20,35 His principle contentions were change for the betterment of health service delivery to the
that the generation of knowledge is based upon free, patient in a number of different sectors and in almost
uncoerced, undistorted communication and that there every country in the world. Stringer and Genat11 write
were three ways in which cognitive knowledge is devel- extensively on the use of the method and give examples
oped: technical, practical and emancipatory. ranging from continence management in patients with
1. Technical knowledge is related to knowledge gener- multiple sclerosis, community medical practice, phy-
ated by empirical, analytical science. It could be described siotherapy practice and in public health areas. Other

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Feminist-informed research methodology 87

examples cited include introducing a care pathway for 11 Stringer E, Genat WJ. Action Research in Health. Upper
patients with schizophrenia in Wales,38 introducing Saddle River, OH: Pearson, 2004.
advanced practice nurses for prostate cancer care in 12 Lewin K. Action research and minority problems. Journal of
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Ontario, Canada,39 and introducing improvement in
13 Greenwood DJ, Levin M. Reconstructing the relationships
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16 Schon DA. The Reflective Practitioner: How Professionals Think
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