Mykhalovskiy Eric, Armstrong Pat, Armstrong Hugh, Bourgeault Ivy, Choiniere Jackie, Lexchin Joel, Peters Suzanne, White Jerry
York University, Toronto, ON, Canada.
Soc Sci Med. 2008 Jul;67(1):195-203. doi: 10.1016/j.socscimed.2008.03.002. Epub 2008 Apr 21.
This paper offers an expository discussion of an approach to qualitative health research we call immanent critique. The central analytic move of immanent critique, as we have practiced it, is to explore how claims that are internal to authoritative discourse are experienced by those who have been excluded from their formulation. This paper contributes to the discussion of the politics of qualitative research methods in an age of evidence. We do so by responding to a recent call to move beyond the micro-politics of the qualitative research encounter to consider the overall political effects of qualitative research. We argue that the political effects of research are partly enabled by mundane practices internal to the research process. We explore how this is so by considering one formulation of immanent critique--a qualitative study of the introduction of continuous quality improvement in Ontario hospitals. We emphasize how practices internal to our research--trade union collaboration, our orientation to authoritative claims, and procedures for generating and representing health care workers' experiences--helped shape the political effects of our research. The latter include challenges to managerial claims about neo-liberal health reform and broadening the evidentiary terrain upon which interlocutors can participate in public debate about health care restructuring.
本文对一种定性健康研究方法进行了阐述性讨论,我们将其称为内在批判。就我们所实践的内在批判而言,其核心分析步骤是探究那些被排除在权威话语形成过程之外的人如何体验这些话语中的内在主张。本文有助于在证据时代讨论定性研究方法的政治学。我们通过回应最近的一项呼吁来做到这一点,即超越定性研究遭遇中的微观政治,去考虑定性研究的总体政治影响。我们认为,研究的政治影响部分是由研究过程中的日常实践促成的。我们通过考虑内在批判的一种表述——对安大略省医院引入持续质量改进的定性研究——来探究情况为何如此。我们强调我们研究中的实践——工会合作、我们对权威主张的取向以及生成和呈现医护人员经历的程序——如何有助于塑造我们研究的政治影响。后者包括对管理层关于新自由主义医疗改革主张的挑战,以及拓宽对话者能够参与关于医疗保健结构调整的公共辩论的证据范围。