Hemodialysis

Hemodialysis

Hemodialysis is a method of treatment that involves the removal of chemical wastes and water from the blood of a patient with a kidney malfunction through filtration. A dialysis machine is used together with a dialyzer to help in cleaning the blood of a patient. Hemodialysis is an essential health care need that aids the treatment of advanced kidney failure and enables patients to lead active and healthy lives despite kidney failure. The process is crucial in controlling blood pressure and maintaining the balance of essential minerals such as sodium, potassium, and calcium. Based on its excellent and reliable results, hemodialysis is the best renal replacement therapy for patients that require therapy maintenance and those in need of dialysis. Similar to other major medication solutions, hemodialysis encompasses a broad spectrum of different topics and theories. This paper aims to elaborate on these topics and the essence of their relationships to hemodialysis treatment. The topics that will be discussed include Paradigm, Ontology, Epistemology, Symbolic interaction, Classical Grounded Theory, Straussian Grounded theory, and the Constructivist Theory.

Paradigm

A scientific paradigm refers to a distinctive set of concepts or ideas pertaining to what constitutes a meaningful contribution to a particular field. Thomas Kuhn, the historian of science who gave “paradigm” its contemporary meaning, described it as a set of universal concepts or practices that define a scientific discipline at a given point in time. As such, a paradigm forms the overarching theoretical and philosophical framework within which scientific laws, theories, and experiments are formulated. However, a paradigm does not impose a rigid or mechanical approach among the practitioners within a field; instead, it provides room for both flexibility and creativity, which facilitates scientific progress. As a result of the continuous innovation and development within a particular discourse, paradigms often undergo periods of drastic change; a phenomenon referred to as the paradigm shift.

The field of medicine and nursing such drastic changes in scientific concepts, practices, and school of thought. New scientific development from research often revolutionizes the solutions to healthcare problems. Besides, the changing healthcare needs within a dynamic socio-cultural environment has spurred a paradigm shift. The past few decades have seen the paradigm in nursing shift from positivism to postmodernism and now to neomodernism. The impact of such drastic changes permeates all aspects of nursing research and practice – hemodialysis is no exception. Medical practitioners that are responsible for the development of hemodialysis must recognize the changing patterns in the scientific paradigm and the implications on the different aspects of treatment such as research, education, practice, problems, and possibilities. The neomodernist approach combines some of the fundamental elements of postmodernism and positivism while also upholding some of the traditional values in the field.

Ontology

Ontology is a broad topic that deals with the philosophical study of being, existence, reality, and the categories of being. Traditionally categorized under metaphysics, ontology focusses on what entities exist or can be considered existing, the categorization of such entities according to the differences and similarities, and their hierarchical order. The meaning of being has been an essential subject of philosophical debate since the classical times of the great Greek philosophers such a Plato and Aristotle. Besides the meaning of existence, there are several ontological questions, each probing different aspects of existence (Hofweber, 2018). The answers to the different questions result in various ontological dichotomies, some of which hold significance within the nursing discipline. For example, determinism and indeterminism, substance and accident, idealism and materialism, essence and existence, and abstract and concrete objects. According to Reed (1997), ontology in nursing entails the inherent process of well-being that is characterized by the integration of human systems. In other words, the individual “Human” patient is regarded as a complex combination of methods that function together to maintain life. Nurses and other medical practitioners act as the managers of these complex biological systems to maintain good health. Ontological inquiry indicates that human life is of significance; for this reason, medical practitioners strive to provide competent care to the patients to restore their optimal state of health.

Epistemology

Epistemology refers to the philosophical study of the nature of human knowledge, including its sources, scope, limits, validity, and the difference between opinion and proven knowledge. The nature of human knowledge is centered on the core concepts of truth, justification, and belief (Sosa, Fantl, & McGrath, 2019). The main questions that philosophers seek to address within epistemology include; “what does mean to have knowledge on something?” and “what is it that justifies a belief?” Throughout history, different facets of epistemology have drawn the attention of philosophers. Plato’s epistemological approach focuses on what it means to know and the benefits of knowledge to the knower. On the other hand, Locke’s facet of epistemology attempts to elaborate on the operations of human understanding. Kant’s epistemological approach seeks to shed light on the conditions underpinning the possibility of human knowledge, while Russel’s epistemology attempts to explain how sensory experience justifies modern science. The contemporary understanding of epistemology incorporates all the different facets from the different philosophers, and its various branches include empiricism, idealism, rationalism, and constructivism. The most recent work in the field of epistemology is concerned with how the evidence available constrains the degrees of confidence. Epistemology in nursing dictates the competencies in practice and the acquisition of clinical and research knowledge.

Symbolic Interaction

The social fabric is created and maintained through repeated interactions between individuals. Symbolic interactionism is a theoretical model that helps understand how society is shaped up through these interactions between individuals. Within social interactions, interpretation is an important aspect – it enables the individuals to create and recreate meaning out of their interactions. The interpretation process is thus a shared understanding that forms the basis for all social interactions. During these interactions, individuals act on the premise of shared meaning that objects and concepts have attached to them within the social context. Based on this perspective, it is apparent that social context entails both natural and symbolic environments. Social interactionism is a sociological theory that stems from the practical considerations within the social interactions as individuals use dialect to form images or meanings that dictate their correspondence with others. The symbolic interaction framework helps to understand how the interaction between individuals creates symbolic worlds and how these worlds impact human behavior at the individual and group levels. From the perspective of nursing practice, symbolic interaction provides valuable insight into the attitudes and behavior patterns of patients undergoing treatment. Moreover, knowledge is crucial in fostering teamwork and a shared sense of purpose among medical practitioners within a hospital by explaining how organizational behavior impacts employee behavior.

Classical Grounded Theory

The traditional hypothetico-deductive model of the research relied on an existing theoretical framework that would then be used to collect data or evidence for investigating the subject matter or the research phenomenon. The Classical Grounded Theory is a radically different approach research methodology; it relies on inductive reasoning to formulate scientific theories from qualitative data. Research using the classical grounded approach begins with the collection of data or even with a question. The researcher analyses the raw data, seeking to draw patterns from the data collected, and grouping similar ideas, concepts, or elements together within categories. Subsequently, the groups may provide the basis for a new theoretical approach. Since its development in the 1970s, the Classical Grounded Theory has gained wide acceptance within the nursing and healthcare sector. The main advantage of the theory is that it helped bridge the gap between theory and empirical research by ensuring that the theories are grounded (Alammar, Intezari, Cardow, & Pauleen, 2019). Its development came amidst a growing dissatisfaction among the scientific researchers and criticism towards fundamentalists and structuralist theories, which were speculative and deductive. In the book “The Discovery of Grounded Theory: Strategies for Qualitative Research,” Glasser and Strauss (1967) defined Grounded theory as the general inductive method that enables the systematic generation of a theoretical method based on the data or evidence acquired through a rigorous research method.

Straussian Grounded theory

The Straussian Grounded Theory focusses on the sophisticated coding techniques that will allow a scientific researcher to pinpoint an appropriate research problem and possible modalities for collecting the required data. As such, the researcher does not begin the research process with existing theory in mind; rather, the researcher relies on inductive reasoning to develop theories from the collected data. Besides, Strauss emphasizes a rigorous validation criterion, together with a systematic approach (Tavory & Timmermans, 2019). The benefit of the Straussian approach is that it offers a practical and straightforward explanation for a complex phenomenon by converting them into abstract constructs an investigating their relationships. Moreover, it legitimizes the use of qualitative data as an essential method of scientific studies. Since the grounded theories do not suffer the constraints of pre-existing theories, they offer the potential of developing scientific innovations that can revolutionize the health care sector. Besides, the grounded theories are ecologically valid in that they provide an accurate representation of real-world settings to a reasonable degree of confidence. In the nursing field, Grounded theories are particularly useful in providing competent care. For instance, hemodialysis patient records are instrumental in determining the patient’s responsiveness and better methods of improving the treatment.

Constructivist Grounded Theory

The Constructivist Grounded theories adopt a pragmatist and relativist approach making them a valuable tool for critical scientific inquiry. According to the constructivist model, neither the data nor the theories are the discoveries of the author; rather, these elements are constructions of a researcher based on his interactions with the subject matter. In other words, the results of the ground theories are subject to the attitudes, values, perspectives, positions, and interactions of the researcher. As such, the constructivist takes a middle ground between the postmodernist and realist positions. The Constructivist Grounded theory assumes multiple perspectives on the research realities based on the view of the researcher (Alammar, Intezari, Cardow, & Pauleen, 2019). Within the approach, the literature review is organized constructively and sensitively that does not impose on the data. The pragmatism of the model encourages the researcher to ask critical questions during scientific research. For instance, the researcher probes individualism in qualitative research, which is often taken for granted.

References

Hofweber, T. (2018). Ontology and the Ambitions of Metaphysics.

245. Alammar, F., Intezari, A., Cardow, A., & J. Pauleen, D. (2019). Grounded theory in practice: Novice researchers’ choice between Straussian and Glaserian. Journal of Management Inquiry, 28(2), 228-245.

Sosa, E., Fantl, J., & McGrath, M. (Eds.). (2019). Contemporary Epistemology: An Anthology. John Wiley & Sons.

Stryker, S. (2017). Symbolic interactionism: Themes and variations. In Social psychology (pp. 3-29). Routledge.

Tavory, I., & Timmermans, S. (2019). Abductive Analysis and Grounded Theory.