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To provide insights into the challenges and benefits of being an insider nurse researcher in case study research. To describe strategies used to maintain rigour and trustworthiness when conducting insider research.
Case study with insider research methodology was used to evaluate a nurse-led supportive care model for patients with Chronic Obstructive Pulmonary Disease and their caregivers.
This paper reports a reflection on using insider research within a clinical context, utilising reflexive techniques such as journaling and discussions with academic supervisors to mitigate subjectivity. Informed consent and confidentiality were maintained to ensure ethical integrity.
The study found that insider research offers both challenges and benefits. The established therapeutic relationship with patients and caregivers provided a deep understanding but also posed risks of assumptions, role conflict, and bias toward positive responses.
Insider research was effective in evaluating a nurse-led model of care, providing unique insights from patients and caregivers. This discussion demonstrates the importance of reflexive practices and maintaining ethical rigour to balance roles and manage potential biases. The paper highlights both the challenges and benefits of insider research that may be helpful for other researchers.
This study highlights the value of insider research in a nursing context, demonstrating how nurses can leverage therapeutic relationships to enhance patient and caregiver voices to inform evidence-based practice. It also provides practical guidance for researchers on reflexive practices to manage the potential for bias and role conflicts, and the maintenance of ethical standards to ensure the integrity and trustworthiness of the research process.
The study addressed the challenges and benefits of being an insider nurse researcher in the context of evaluating a nurse-led supportive care model for patients with COPD and their caregivers. While insider research can provide unique insights, it also poses risks of assumptions, role conflict, and bias. This paper describes how these can be mitigated through reflexive techniques and integration of outsider perspectives. Established nurse–patient therapeutic relationships facilitated deeper understanding in a research setting; however, they require careful management to avoid bias. Ethical integrity was maintained through informed consent, confidentiality, and reflexive journaling. The research will impact patients and caregivers by improving their access to timely and comprehensive supportive and palliative care and offers valuable strategies for other nurse researchers to enhance the quality and trustworthiness of insider research.
The development of the model of care in this study is informed by ongoing evaluation from patients with COPD and their caregivers.
To evaluate a nurse-led model of supportive care in a COPD outpatient service from patient and caregiver perspectives.
Case study methodology.
Data were collected from semi-structured interviews with patients (n = 12) and caregivers (n = 7) conducted between April 2020 and September 2022. A purposive sampling strategy was used. Interviews were transcribed verbatim and analysed using content analysis with an inductive approach. COREQ guidelines informed reporting of this study.
Eight categories were identified from the data evaluating of the model of care relating to the most helpful aspects of COPD supportive care and suggested improvements to the model of care. The categories were: guidance with managing symptoms; participating in advance care planning; home visiting; expert advice; continuity and trust; caring; caregiver support and improvements to the model of care.
In a nurse-led model of COPD supportive care, what patients and caregivers valued most was expert advice and guidance with symptom management, flexible home visiting, participation in advance care planning, caring and continuity within an ongoing trusted therapeutic relationship. Understanding what patients and caregivers value most is essential in designing and delivering models of care that meet the needs of patients living with chronic, life-limiting illness.
Nurses can lead effective models of supportive care that offer valuable support to patients living with COPD and their caregivers.
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