Applying a phenomenological method of analysis derived from Giorgi to a psychiatric nursing study

METHODOLOGICAL ISSUES IN NURSING RESEARCH

Applying a phenomenological method of analysis derived from Giorgi to a psychiatric nursing study Kaisa Koivisto

MNSc RN

Doctoral Student, Social and Health Care, Oulu Polytechnic, Oulu, Finland

Sirpa Janhonen

PhD RN

Professor, Department of Nursing and Health Administration, University of Oulu, Oulu, Finland

and Leena Va¨isa¨nen

MD PhD

Senior Lecturer, Psychiatric Clinic, University Hospital of Oulu, Oulu, Finland

Submitted for publication 11 December 2001 Accepted for publication 24 April 2002

Correspondence: Kaisa Koivisto, Social and Health Care, Oulu Polytechnic, Professorintie 5, 90220 Oulu, Finland. E-mail: [email protected]

¨ ISA ¨ N E N L . ( 2 0 0 2 ) Journal of Advanced K O I V I S T O K ., J A N H O N E N S . & V A Nursing 39(3), 258–265 Applying a phenomenological method of analysis derived from Giorgi to a psychiatric nursing study Background. The experience of mental ill health is fundamentally disempowering. The processes of psychiatric hospital care and treatment may also add to the personal feeling of disempowerment. This disempowerment is partly due to the failure of others to afford a proper hearing to the person’s story of his/her experiences and problems in life. Hence, there is a need to investigate patients’ experiences of being mentally ill with psychosis and being helped in a psychiatric hospital. Aim. This paper describes the application of a phenomenological method of analysis derived from Amadeo Giorgi to an investigation of psychiatric patients’ experiences about being mentally ill with psychosis and being helped in a psychiatric hospital ward in Northern Finland. Method. This phenomenological study was conducted with nine voluntary adult patients recovering from psychosis. In 1998, patients were interviewed regarding their experiences of psychosis and being helped. The verbatim transcripts of these interviews were analysed using Giorgi’s phenomenological method. Giorgi’s method of analysis aims to uncover the meaning of a phenomenon as experienced by a human through the identification of essential themes. Patients’ experiences of psychosis and being helped were clustered into a specific description of situated structure and a general description of situated structure. Findings. The Giorgian method of phenomenological analysis was a clear-cut process, which gave a structure to the analyses and justified the decisions made while analysing the data. A phenomenological study of this kind encourages psychiatric nurses to focus on patients’ experiences. Conclusion. Phenomenological study and Giorgi’s method of analysis are applicable while investigating psychiatric patients’ experiences and give new knowledge of the experiences of patients and new views of how to meet patients’ needs.

Keywords: phenomenology, psychosis, patient’s experience, Giorgi, method, analysis, psychiatric nursing

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Methodological issues in nursing research

Introduction Psychiatric nursing in Finland is shifting towards noninstitutional care with an emphasis on outpatient functions, and the episodes of hospital treatment are quite short. Thus, psychiatric hospital care should be based on the person’s real experience of mental illness with psychosis and empower the patient to manage outside the hospital in daily life. Therefore, more research will be needed in the future to evaluate the effectiveness of different nursing and health care interventions (Va¨lima¨ki 2002). Mental illness, mental disorder and psychiatric disorder have been defined from different perspectives. Although there is a considerable literature on functional illnesses, especially psychosis and schizophrenia, there is not much nursing research on how patients experience mental illness with psychosis and psychiatric treatment. Patients’ experiences of mental illness with psychosis can mostly only be read in the literature produced by mental patients themselves (Jenson 2000). However, Barker et al. (1997) have pointed out that patients’ experiences should also be the focus of psychiatric nursing research. Patients’ experiences can be studied using a phenomenological approach. This approach aims to describe and/or to understand the phenomenon under study (Polit et al. 2001). The central element of a phenomenological approach is a rational and intuitive process, and the value of the phenomenological focus lies on the subjective and particular aspects of participants’ actual experiences (Hallett 1995). Further, one object of phenomenologically inspired research is the person’s state of health and responses to sickness and health, which constitute an important and very specific aspect of nursing (Gastmans 1998). Over the past 20 years, ÔphenomenologyÕ has become a frequently used term in nursing research. However, it is unclear whether all those who claim to be practising phenomenological research share a similar understanding of the label they apply their work (Hallett 1995, Koch 1995, Walters 1995, Paley 1997). Wertz (1985) used the technique developed by Giorgi (1985) while investigating the topic of ÔBeing Criminally VictimizedÕ. Informants’ descriptions were analysed through a process of intuitive analysis and description. In the Haase study (1987), nine chronically ill adolescents were asked to describe their experiences of courage, with the aim of identifying the essential structure of courage. In psychiatric nursing, research by Moyle and Clinton (1997), for example, the methodological difficulties that arise when one tries to gain insight into the conscious experience of being an inpatient with depression on a psychiatric ward were discussed. The problem was to identify participants’

A phenomenological psychiatric study

meanings without embracing one’s own assumptions and Husserl (1965) suggests that the researcher depends on the phenomenological reduction. The conclusion of that study was that, despite the methodological difficulty, a phenomenological perspective based on Husserl’s philosophy can point nurses in the direction of meeting their patients’ needs (Husserl 1965, Moyle & Clinton 1997). However, there is only scarce information about how phenomenological methods of analysis have been applied while investigating psychiatric patients’ experiences of being mentally ill with psychosis and being helped in a psychiatric hospital. This paper describes a phenomenological study where Giorgi’s method of analysis was used to investigate the experiences of patients recovering from mental illness with psychosis in a psychiatric ward.

What is mental illness? Traditionally, mental illnesses have been defined from biological, biomedical or behavioural viewpoints through generalizations by other people (Barker et al. 1997, Barker 2001). The American Psychiatric Association (APA 1994) defines mental disorder as a clinically significant behavioural or psychological syndrome or pattern that occurs in an individual and is associated with distress or disability or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom. The concept of psychosis has been defined as an inability to recognize reality (because of delusions and hallucinations) or bizarre behaviours or an inability to deal with life’s demands (APA 1994). Psychotic symptomatology involves a broad range of features commonly associated with schizophrenia, schizo-affective disorder, manic-depressive illness and delusional disorders (Holland et al. 1999). Wallace et al. (1997) have criticized the foundations of DSM-IV (Diagnostic and Statistical Manual of Mental Disorders) for its viciously circular definition of mental disorder as a clinically significant phenomenon. They refer to the patient’s freedom, as DSM-IV leaves the fundamental relationship between the person and their disorder unquestioned and undefined, i.e. fails to address the main ontological problem raised by mental diseases. Modern classifications give inadequate attention to the profound meaning of subjective experience as well as to the patient’s history (Wallace et al. 1997). According to Abma (1998) and Owen et al. (1998), professional psychiatric practice developed from the stories of therapists, which described psychiatric patients as dependent on the therapists’ expertise, care and protection. The conclusion was that patients’ stories differ from those of therapists because patients’

2002 Blackwell Science Ltd, Journal of Advanced Nursing, 39(3), 258–265

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behaviour was interpreted as pathological and symptomatic of the diseases from which they were suffering, while professionals claimed that they knew what was good or better for patients (Abma 1998, Owen et al. 1998). According to some authors, the task of nursing is to help people deal with the problems they experience – their responses to what other people call various forms of mental illness (Barker et al. 1997). Barker (2001) has pointed out that it behoves psychiatric nurses to give up the notion of a disease such as schizophrenia and to think exclusively of patients as persons (Barker 2001). Furthermore, patients with schizophrenia make a definite distinction between their illness and their sense of being a person (Abma 1998). According to Dzurec (1994), little attention has been given to the characteristics of power held by people with schizophrenia (Dzurec 1994). Abma (1998) claims that people give meaning to their chaotic experiences and try to persuade others of their perspectives by telling stories. In the process of meaning-making, some stories maintain the status of a standard story. The study points out that psychiatric patients are not only fragile and helpless but also powerful and competent to take responsibility for the direction of their lives (Abma 1998). Barker et al. (1997) points the need for effective relationships with people-incare, especially in psychiatric nursing, underlining that such relationships may imply respect for the unique experience of a psychotic person, but might also mark the beginning of their search for the truth about themselves and their life experiences (Barker et al. 1997, Kralik et al. 1997). Thus, psychiatric nursing should focus on patients’ experiences and narratives while planning the care. Instead of translating patients’ stories into professional language with such terms as psychosis, nurses should try to understand what patients themselves mean.

Phenomenological method Phenomenology, which is rooted in the philosophical tradition developed by Husserl (1859–1938) and Heidegger (1889–1976), is an approach that analyses people’s life experiences. There are two ÔschoolsÕ of phenomenology: descriptive phenomenology and interpretive phenomenology. Descriptive phenomenology was developed first by Husserl (1965), who was primarily interested in the question: What do we know as persons? His philosophy emphasized descriptions of the meaning of human experience. Meanings are the intentional correlates of acts or ideal contents of conscious acts (Husserl 1965, Giorgi 1985, Sadala & Adorno 2001). Husserl (1965) developed a philosophical method for systematically investigating the structures of consciousness 260

(essences). He concluded that essences, i.e. the things that make a phenomenon what it is, exist in conscious experience, and that it is through consciousness that a person is present to the world (Husserl 1965, Giorgi 1985, Koch 1995, Moyle & Clinton 1997, Sadala & Adorno 2001). The essence of consciousness is intentionality, which means that all mental acts are intentional in that they point to something or some object that is not consciousness itself, including mental objects such as memories and anticipations (Husserl 1965, Giorgi 1985, Moyle & Clinton 1997). The building of our knowledge of reality should therefore start with conscious awareness (Giorgi 1985, Koch 1995, Sadala & Adorno 2001). There are no universally accepted models for such analysis, and the difficulties in communication are hence numerous: a lack of history; a lack of a clear view of psychological phenomenology as opposed to philosophical phenomenology; and the question of face validity (Giorgi 1985). Analyses applying the frameworks of Giorgi (1985) follow the Husserlian tradition and are based on decontextualization and recontextualization (Koch 1995, Polit et al. 2001). The researcher begins by studying ÔparticularsÕ – individual examples of a larger phenomenon – and progresses via a process of inductive reasoning towards an understanding of ÔuniversalsÕ or Ôfirst principlesÕ, which are presented descriptively (Giorgi 1985, Hallett 1995, Koch 1995, Walters 1995).

The study Ethical guidelines Ethical guidelines are especially important when the participants are vulnerable people, such as people recovering from psychosis (Koivisto et al. 2001, Owen 2001). In this study, I reviewed official documents, i.e. codes and laws, before and during the research. I underlined the need for autonomy and self-determination. I also discussed with the staff while recruiting the patients. The permission to carry out this study was issued by the IRB of Oulu University Hospital and the Research Board of the hospital. I signed a written agreement on confidentiality concerning everything that was observed and heard during the data collection process. The data were to be kept safe and destroyed as soon as possible when they were no longer needed. All the participants signed informed consent at the beginning of the interview. I often discussed with the participants the purpose and the aims of the study, the ethical principles of voluntariness, privacy, beneficence and nonmaleficence and the choice to withdraw at any time they wished. I took into account the interaction




process from the viewpoint of ethics (Koivisto et al. 2001, Owen 2001).

to comprehend the meanings the person had expressed precisely as intended by them.

Applying Giorgi’s method while studying patients’ experiences of being mentally ill with psychosis

Discrimination of meaning units from a psychological perspective and focusing on the phenomenon being studied

In this pilot study, the method of analysis follows the general outlines derived from Giorgi (1985). The stages of Giorgi’s analysis (1985) are: reaching the sense of the whole statement by discrimination of meaning units from a psychological perspective and focusing on the phenomenon being studied; transforming the subject’s everyday expressions into psychological language with an emphasis on the phenomenon being investigated; synthesis of transformed meaning units into a consistent statement of the structure, in this case Ôbeing mentally ill with psychosis and being helpedÕ. The structure is described as follows: first, a specific description of the situated structure of being mentally ill with psychosis and being helped; and second, a general description of the situation of being mentally ill with psychosis and being helped (Giorgi 1985). Participants and data collection In this study, the data were gathered in the psychiatric clinic of a university hospital in Northern Finland in January, February and December 1998. I interviewed nine voluntary patients recovering from mental illness with psychosis in acute psychiatric wards. The interviews were open-ended, i.e. patients were asked to describe their experiences of hospital care and mental illness. They were also told, after open discussions, that they could describe the process of their admission to hospital and the events following it. Apart from this, questions and comments by the interviewer were restricted to requests for clarification or elaboration and reflections on what the interviewee had already said. Below, I will give examples of the interviews and process of analysis.

The analysis Reaching the sense of the whole statement First, I read the entire description in order to develop a general idea of the whole statement and tried to understand the informant’s language. Then, I read the text freely and openly as often as necessary to get a good grasp of the whole (Giorgi 1985). In this study, the data consisted of 330 pages of transcribed interview text. At this stage, I attempted to put myself into the interviewee’s shoes and to live through the experience from the inside, not as a mere spectator, but trying

Second, having grasped the essence of the whole, I started the process all over again and read through the text once more with the specific aim of discriminating meaning units from a psychological perspective and with a focus on the phenomenon being studied. Once I had delineated the meaning units, I went through all of them and perceived them more directly. Then I identified the constituents that would be relevant for my study, in this case the patients’ experiences of being mentally ill with psychosis and being helped. The researcher should re-group the relevant constituents based on their intertwining meanings and place them in a temporal order in such a way that they accurately reflect the structure of the original event (Giorgi 1985). I decided about the constituents after having read each description with concentration. The constituents of this study were: • experience of self, network and coping with everyday life; • experiences of ways of coping with the onset of illness, progress of illness and admission for treatment; • experience of being helped, the status of the presence and the future.

Transforming the everyday expressions into psychological language with an emphasis on the phenomenon being investigated Third, I transformed the everyday expressions into psychological language with an emphasis on the phenomenon being investigated, in this case the patients’ experiences about being mentally ill with psychosis and being helped. The transformations take place basically through a process of reflection and imaginative variation. These transformations are necessary because descriptions by naive subjects reflect multiple realities in a cryptic way, and the psychological aspects should be elucidated at a depth appropriate for the understanding of the events (Giorgi 1985). I aimed at the essence of the experience expressed by every unit with meaning, and presented the variations/transformations as clearly as possible, avoiding any commitment to theoretical concepts. In this analysis, the interviewees’ descriptions were retained as far as possible. The following is an example of the translation of the meaning units I identified in the experiences of coping with the onset and progress of illness and the admission for treatment into the language of


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research (nursing science). The transformations are shown in brackets in capital letters:

structures of the patients’ experience about the onset and progress of illness and admission for treatment.

I had been taking part in a course and practising the tasks I had been assigned there. I also had an operation, and after that I had more feelings of soaring somewhere and being outside my body. I felt that I couldn’t come back into my body. (SHE FOUND THAT, AFTER TAKING THE COURSE AND HAVING THE OPERATION, SHE HAD FELT LIKE SOARING, BEING OUTSIDE HER BODY AND NOT GETTING BACK INTO IT.) After the operation I felt quite depleted and didn’t have any thoughts anymore. (SHE EXPERIENCED HERSELF AS EMPTY AND DID NOT HAVE ANY THOUGHTS). So, I felt that I wasn’t myself. (SHE EXPERIENCED THAT SHE WAS NOT HERSELF ANYMORE). I couldn’t control myself and quarrelled with the others at home because I tried to protect my significant others against the evil I felt by crossing and blessing them in inadequate situations. (SHE EXPERIENCED AN INABILITY TO CONTROL HERSELF. SHE QUARRELLED WITH FAMILY MEMBERS BECAUSE SHE TRIED TO PROTECT THEM IN INADEQUATE WAYS.) So, I went to seek help for the first time. (SHE SOUGHT HELP FOR THE FIRST TIME.)

Before last year, she had never had mental health problems. Now she was in a psychiatric hospital for the first time. She found that her psychological feelings had begun when she had participated in a course where the lives and personalities of people had been discussed. After the course, she had had an operation. After the operation she had found herself unable to control her mind and body and had felt that someone from space took control over her. She experienced that these outside forces shattered and re-created her. She had fears that she could harm others, which made her very frightened. She could not think about anything else except her feelings, which depleted all her energy and power. She related these feelings to real incidents at home, which, in turn, caused quarrels between the family members.

The general description of situated structure was formed as follows

Synthesis of the transformed meaning units into a consistent statement of structure Finally, I synthesized all of the transformed meaning units into a consistent statement of the structure of the interviewee’s experiences of being mentally ill with psychosis and being helped. The consistent statement of structure contains a specific description of the situated individual structure and a general description of the situated structure of patients’ experiences about being mentally ill with psychosis and being helped (Giorgi 1985). It should be mentioned that one rarely conducts studies of this type with only one subject because it is difficult to derive an essential general structure based on a single instance. The more subjects there are, the better the researcher is able to identify the essential elements. On the other hand, specific situated structures might still be sought for, and these could be based on only one subject. In this synthesis, all transformed meaning units must be taken into account. The criterion would be that all of the meanings of the transformed meaning units are at least implicitly contained in the general description (Giorgi 1985).

Specific description of situated structure The meaning units transformed into the language of research (nursing science) were placed into the constituents described earlier. I will present one example of the specific situated

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Woman, middle-aged, family, working in the service sector

The general description of situated structure is derived from a large number of actual events. Therefore, it does not necessarily pertain to only one person’s private reality. Further, ÔstructureÕ is a term describing knowledge and, as such, is different from the original individual’s life from which it was extracted. The researcher must determine which features of a situated specific structure manifest a general truth and which do not. The investigator must therefore compare each individual’s situated specific structures to the others and identify the convergences and divergences. The similarities, when expressed as language, are general statements that may become part of the general description of the situated structure of the phenomenon. Thus, to be generally valid, an insight must have already been made explicit in the previous phases, but only in such a way that it can be found in the other cases upon further reflection. The researcher must express in language the necessary and sufficient conditions, constituents and structural relations that constitute the phenomenon in general, including all instances of the phenomenon under consideration (Giorgi 1985). Below, I will present examples of formulating the general description of the situated structure of patients’ experiences about being mentally ill with psychosis and being helped. I placed every subject’s specific situated structure into a general structure. Each example is compatible with the case described earlier and the general transformations of that case into the



specific constituent experience of the onset and progress of illness and admission for treatment. First, the individual phenomenological structure is divided into meaning units that no longer represent the individual experience. The transformation is presented in capital letters. Experience of the onset and progress of illness and admission for treatment: EARLIER MENTAL HEALTH PROBLEMS RARE. FIRST HOSPITAL EPISODE IN A PSYCHIATRIC HOSPITAL. PSYCHOLOGICAL FEELINGS CONNECTED WITH A COURSE, SACRIFICING ONESELF FOR OTHER PEOPLE, FORGETTING ONESELF AND THE OPERATION. PSYCHOLOGICAL FEELINGS OF A LACK OF CONTROL OVER SELF AND BODY, DOING HARM TO OTHERS, GUIDANCE FROM OUTSIDE. UNABLE TO THINK AND ACT. QUARRELS WITH SIGNIFICANT OTHERS. STRANGE FEELINGS MIXED WITH REAL SITUATIONS AT HOME. INADEQUATE BEHAVIOUR AS SEEN BY OTHER PEOPLE, SUCH AS PROTECTING SIGNIFICANT OTHERS. Second, I classified the transformed general meaning units into themes, divided every theme into specific constituents and placed every meaning unit into a specific constituent. I


then wrote down the themes and specific constituents they belonged to: • experience of self: experience of one’s character/personality, experience of one’s relationships with other people and experience of hobbies; • experience of significant others: supporting and helping, causing worries and being unjustly cruel; • experience/notion of one’s ability to manage in everyday life: managing the demands of everyday life and managing working life; • experience of psychological feelings: experience of aspects causing psychological feelings, experience of admission for treatment, experience of psychological feelings, experience of consciousness and self-care of psychological feelings; • experience of being helped: experience of features that promote and prevent being helped, experience of the contents of the helping interventions, experience of being helped under bad conditions; • experience of the present and the future. Table 1 shows the list of the units including meanings that belong to the specific constituent experience of the psychological feelings of every participant involved.

Table 1 Specific general situated structure of the experience of psychological feelings Identification numbers of patients Feelings of changing one’s self Being re-created, pressed down, inability to be one’s own self One’s whole existence is governed by these feelings

P5, P7 P2, P3, P4, P5, P6, P7, P8

Feelings of a loss of control Causing harm to oneself Being controlled by outside powers (voices, orders, powers, machines) Being killed by something outside Feelings of being lost Lack of control over one’s body

P5, P3, P1, P4, P1,

P7 P5, P2, P5, P5,

P7 P3, P5, P7 P7, P8 P7

Emotional feelings Fears, phobia, insecurity Restlessness, nervousness, anger, irritability Anxiety, distress, tearfulness Sensitivity, vulnerability Shame, guilt

P1, P1, P1, P1, P1,

P2, P2, P2, P2, P2,

P3, P3, P3, P4, P4,

Physical feelings Tiredness, exhaustion Sleeplessness Pains

P1, P3, P4, P5, P7, P8 P1, P3, P4, P5, P7, P8 P3, P6, P7

Difficulties to brief and other Physiological difficulties Rigidity Visual problems Problems with body image

P3, P1, P3, P4,


P4, P4, P4, P5, P7,

P5, P7, P8 P8 P5, P7, P8 P8 P8

P4, P6, P7 P2, P3, P7 P4 P7

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Finally, I formulated a general description of the situated structure of patients’ experiences of being mentally ill with psychosis and being helped. Below, I will give an example of the specific general structure of the experience of psychological feelings. Patients’ experiences of psychological feelings were holistic and uncontrolled. Psychological feelings were experienced in many ways and at several levels, and included a change of one’s self, a loss of control, emotions and physical feelings. The feelings of changing one’s self consisted of a sensation of being re-created and pressed down. Feelings of losing control included doing harm to others or oneself, being guided by others, being lost or being an object of something evil. These feelings caused such emotions as fear, horror and insecurity. Further feelings were anxiety, distress, anger and irritability. The most common physical feelings were tiredness, exhaustion and sleeplessness. In addition to these, there were pains, brief difficulties, visual disorders and problems in body image. These feelings caused shame and guilt of being unable to control oneself and fears of becoming mad. In this study, an effort has been made to illuminate and clarify the essence of being mentally ill with psychosis as experienced by the patients. The main problem appears to be how to regain one’s own self and sense of control, how to get rid of the strange fears and feelings and how to restore the condition that prevailed before mental illness.

Discussion In this paper, I have described the way in which I applied the method of analysis derived from Giorgi (1985) in a phenomenological nursing study based on Husserl (1965). I was interested in how patients recovering from mental illness experience psychosis and being helped, what they know about it, and how they describe it through their present consciousness. Giorgi’s method of analysis (1985) seemed relevant to this study and turned out to be interesting, useful and powerful, because it makes explicit the process of qualitative analysis. Thus, I was able to proceed rigorously and systematically, knowing at each step exactly what advance was being made. Phenomenological research requires sensitivity, subjectivity and objectivity from the researcher because of the close relationships between researcher and participants and because of sensitive topics under study (Holloway & Wheeler 1995, Koivisto et al. 2001). In this study, because of the vulnerability and difficult experiences of the psychiatric patients, I found the process of research quite demanding. Without my personal experience of caring for psychotic patients, the study process might have been too difficult to carry out. However, most of the patients were grateful that somebody was interested in their opinions and feelings (Koivisto et al. 2001). 264

As Edmund Husserl (1859–1938), the central figure of phenomenology, has pointed out, a person’s experience and life world consist of their everyday context, and any problematic situations should be placed there (Husserl 1965, Gastmans 1998). In this study, the participants’ experiences were described through the meanings they themselves gave to experiences, and pregiven theoretical constructions were avoided as much as possible. So, what is the essence of psychosis as seen by patients? The present informants described psychosis as consisting of strange experiences and feelings that caused exhaustion, fear and shame. They tried to manage these strange experiences in different ways, for example, by seeking help, discussing with friends, engaging in sporting activities, doing something or protecting themselves in some way. They wanted to understand what was happening to them, why it was happening and how they could manage these experiences without losing their self-control. They felt guilt and shame because of these strange experiences, which other people found difficult to understand. As Barker and co-workers have pointed out, patients’ experiences should also be the focus of psychiatric nursing care (Barker et al. 1997, Barker 2001). Phenomenology provides a perspective that may illuminate and clarify some of the most central and important issues within nursing (Hallett 1995). The most important finding of this study was that patients were able to describe their life and world after their recovery from psychosis, which suggests that patients’ involvement into care should be increased. They also had useful ways of trying to cope with their strange experiences. Investigations of patients’ experiences of mental illness hence offer an opportunity to understand their experiences and life situations. The greatest value of phenomenology for nursing researchers lies in the fact that it is the only available method that deliberately takes informants’ subjective experiences as its main focus. In nursing, it may be argued, these are the experiences that have most value and are worth studying (Hallett 1995).

Conclusion The phenomenological method of analysis proposed by Giorgi provides the investigator with a framework within which he/she can follow the process of analysis in detail. This makes the process of analysing qualitative data is more clearcut and systematic and gives it a specific direction. When Giorgi’s method of analysis was applied, the patients’ experiences of being mentally ill with psychosis and being helped could be described without losing their essential quality. Thus, the structure of patients’ experiences of being mentally ill and being helped expresses the patients’ real



experiences and can be described in such a way as to provide new knowledge and a new view of meeting the needs of patients who have had mental illness with psychosis.

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