Participatory Action Research (PAR)

PAR is a means of collaboration between researchers and community members who seek to develop knowledge about a particular problem and promote positive change. This project evolved when PICU professionals began approaching Principal Investigator Dr. Austin with questions about moral distress.

Phase 1: An Advisory Committee was formed to consult with the investigators on project development and implementation. It consisted of PICU team members and institutional policy makers.

Phase 2: Paediatricians, medical residents, clinical fellows, nurses, social workers, respiratory therapists, and dieticians from six Canadian units were invited to share their stories of moral distress in interviews lasting from half an hour to two hours.

Phase 3: The stories were analyzed through the method of narrative inquiry. This resulted in the creation of a typology.

Phase 4: Representative stories and the typology were presented to PICU professionals at national workshops. Participants were invited to provide reflections and suggestions regarding moral distress in the PICU, and to identify constraints and barriers to its resolution.

Phase 5: Using the research findings, including workshop data, the research team and the Advisory Committee created a series of recommendations to address moral distress in the PICU.

The methods of PAR may appear unscientific to those who equate research with objectivity and disengagement from real-life application. However, as a "macro method" PAR can provide an experiential context for investigating practice areas in which new knowledge is needed for action and change.

The active participation of PICU professionals as researchers and advisors in the project allowed for reflection and evaluation on actions depicted in the stories. From this the group were able to arrive at a shared understanding of the significance of individual action and its implications for team support and patient care in the difficult setting of the PICU.