Marian Morris, a doctoral student in the School of Nursing at The University of Texas at Austin, and a 2016 recipient of the Frances Fowler Wallace Award from the Hogg Foundation, has recently completed her dissertation, “A Discourse Analysis of How Nurses Talk about ADHD in Preschool-Age Children.” The study attempts to analyze and describe patterns of discourse that undergird diagnoses of attention deficit and hyperactivity disorder (ADHD) in young children.
Frances Fowler Wallace, the award’s namesake, was married to John Forsythe Wallace, who served as a member of the Texas House of Representatives and the State Board of Control. She died July 18, 1972, in Austin at the age of 80. The Wallace Award provides partial support for doctoral students’ dissertation research on “the cause, treatment, cure, and prevention of mental disease, mental illness, and mental disorders,” as directed in her will. The award provides up to $1,500 for research-related expenses.
We talked to Marian Morris about her research.
Tell us about yourself. At what point did you decide to pursue a career in nursing, and what influenced that decision?
I decided about 10 years ago that I wanted to pursue a doctorate in nursing, while I was working for the nursing school here at UT-Austin. I have a background in cultural anthropology and public health, and I had worked in a clinic for nine years with patients of diverse backgrounds. My experience helped me understand that I would likely never be satisfied with trying to treat problems individually when it was so clear that many of them had the same problems, problems rooted in a need for ongoing questioning and improvement on how we organize ourselves societally in relation to disease prevention and health care. My work and education background combined with this nursing doctorate process will hopefully allow me to have a breadth of knowledge and skills that prepare me for assessing people and communities, and planning research and programming that is effective at both a micro and macro level.
Your dissertation is titled, “A Discourse Analysis of How Nurses Talk about ADHD in Preschool-Age Children.” What questions are you trying to answer with this work?
Most immediately I am trying to systematically describe how nurses talk about ADHD in preschool-age children. I hope to understand more about the discourse patterns – language, interactions, and social contexts – leading to how and why these children come to be diagnosed with mental illness. Understanding more about how these patterns inform the process and outcome of working with this age group of children with behavioral and emotional struggles will help inform mental health nursing education and practice related to health promotion and disease prevention, not just for this age group but also across the lifespan.
What led to your taking a professional interest in this particular topic?
My professional interest stems from my personal and professional experiences of mental health care delivery. I saw such a wide variety in how behavioral and emotional issues in children are conceptualized and managed, out in the community and in health care settings. As I explored the evidence base related to mental health and mental illness in young children, I could see that there is still a lot of questioning about how best to approach promoting the mental health of children. I started to wonder what led to these different conceptualizations and approaches out in clinical and non-clinical settings, and to the controversies in the research literature, and a dissertation topic was born.
How do you think your research methods and approach will help you to answer the questions that you’re posing?
Critical discourse analysis (CDA) is an analytic method within the encompassing methodology of discourse analysis, or close examination of patterns of speech, text, and social interactions for how they inform our relationships to each other – how we agree on reality, and how much agency and power we have individually and collectively. CDA as directed by Fairclough (2015) is done by looking (in this instance) at interview transcripts. I will be examining them systematically for elements of text (vocabulary, grammar, and structures such as interactional conventions), interaction (or how those text elements inform interacting with others), and then social context (or how those elements of text and interaction position people in relation to each other and within society). By examining these elements of text, interaction, and social context – within interview conversations with nurses working with preschool-age children diagnosed with ADHD – I hope to understand more about the discourse patterns leading to how and why these children come to be diagnosed. How and why do our language, interactions, and social contexts result in the outcome of a diagnosis of mental illness (in this case, ADHD) for very young children?
Are there any suggested readings you can recommend for those who might be interested in learning more about this topic?
Here are readinsg on re-conceptualizing nursing’s approach to preschool-age children:
Mason, D.J. & Cox, K. (2014). Toxic stress in childhood: Why we should all be concerned. Nursing Outlook 62(6), 382-3. doi 10.1016/j.outlook.2014.09.001
For examples of discourse analysis used to examine mental health nursing and child nursing practice:
Buus, N. (2008). Negotiating clinical knowledge: a field study of psychiatric nurses’ everyday communication. Nursing Inquiry 15(3):189-98. doi: 10.1111/j.1440-1800.2008.00405.x.
Einboden, R., Rudge, T. & Varcoe, C. (2013a). Image, measure, figure: A critical discourse analysis of nursing practices that develop children. Nursing Philosophy 14(3), 212-22. doi 10.1111/nup.12023