Comparative Ethnographic Narrative Analysis Method: Comparing Culture in Narratives

Abstract

Narrative data analysis aims to understand the stories’ content, structure, or function. However narrative data can also be used to examine how context influences self-concepts, relationship dynamics, and meaning-making. This methodological paper explores the potential of narrative analysis to discover and compare the processes by which culture shapes selfhood and meaning making. We describe the development of the Comparative Ethnographic Narrative Analysis Method as an analytic procedure to systematically compare narrators’ experiences, meaning making, decisions, and actions across cultures. This analytic strategy seeks to discover shared themes, examine culturally distinct themes, and illuminate meta-level cultural beliefs and values that link shared themes. We emphasize the need for a shared research question, comparable samples, shared non-biased instruments, and high-fidelity training if one uses this qualitative method for cross-cultural research. Finally, specific issues, trouble-shooting practices, and implications are discussed.

Attention to culture in nursing research has a deep tradition and a variety of perspectives, including Transcultural Nursing (Leininger & McFarland, 2006; Singleton, 2017) and Anthropological Nursing (Holden & Littlewood, 2015; Morse, 1989). Most of these approaches rely on ethnographic methods and narrative or qualitative interviewing data (Roper & Shapira, 2000). These methods allow nurses to understand cultural conceptions of illness and suffering, care, and cure (Dougherty & Tripp-Reimer, 1985; Vonarx, 2010). However, in an increasingly multicultural world, understanding the role of culture, suffering, and health relies on advancing cultural theories of illness, health, and care using comparative methods (Saint Arnault, 2018b). This paper explores the need for systematic comparison of our ever-growing bodies of ethnographic work and proposes a method to use comparative methods to understand ethnographic narrative data.

Narrative data gathering is an important type of qualitative data gathering that is emerging in nursing research because it facilitates person-centered care (Haydon et al., 2018). Narrative analysis is a family of related methods directed toward understanding the content, structure, or function of one’s “story” (Riessman & Quinney, 2005). The narrative is a psychosocial activity that organizes links between the self, relationships, time, and morality (Crossley, 2000). These links are essential parts of social exchange and provide ways to relate and validate each other (Wigren, 1994). Narratives usually include sensations, actors, interpretations, causal chains, a meaningful sequence, and a significant conclusion that impacts ongoing and future personal identity and worldview (Schank, 1990).There is an emerging literature that emphasizes attending to the cultural elements that contribute to the meaning of one’s narrative (Gubrium & Holstein, 2008). This paper explores one way to think about, analyze, and compare narrative interviews’ cultural aspects.

Culture in Narrative

We define culture as a collectively formed and shared conceptual understanding of the self, the world, and one’s place within the world. Culture is transmitted across generations and is also internalized as a set of perspectives, proclivities, and motivations that underlie human actions (Williams, 1995). Culture impacts our perceptions of ourselves, our world, our place in that world, and what we do as a part of that world. These perceptions motivate behavior, which in turn enforces and reinforces our “culture.” In this way, culturally based psychological functions are formed as individuals engage in practical social activities, sometimes referred to as cultural practices (Bottero & Crossley, 2011). Our position is that culture operates implicitly within individuals through encompassing systems of meanings and rules (Heijstra et al., 2013). Implicit culture is an embodied tendency that organizes how individuals perceive, react to, and behave within the social world.

Narrative Ethnography has emerged as one way to address culture in narratives. Using ethnography, which is the systematic study of people and cultures from the perspective of the subject (Hobbs, 2006), narratives may be gathered to understand the people’s interactions, beliefs, and contexts. The analysis of culture in narrative can focus on how culture fundamentally shapes the creation of narrative, examining less about the structure of the narrative and more about how the sociocultural context drives its production. Gubrium and Holstein (2008), for example, have argued that Narrative Ethnography is the ethnographic study of narrativity, or, said another way, it is the ethnographic study of how narratives are context dependent. In a similar vein, Tedlock (1991) gives the example of the production of narrativity as an ongoing dialectical political-personal relationship between researcher and the informant, resulting in “. . .the coproduction of ethnographic knowledge, created and represented . . . within an interactive dialogue” (p. 81). For her, the narrative is understood to be a co-creation between the narrator and their sociocultural world, and a co-creation between the narrator and their audience, in this case, the interviewer.

Another perspective on culture in a narrative is offered by Squire (2008), who has focused not on narrativity production but rather on how narrative is a window into the role of culture in the formation and maintenance of identity. She writes: “[s]tories operate within ‘interpretive communities’ of speakers and hearers that are political as well as cultural actors. They build collective identities that can lead, albeit slowly and discontinuously, to cultural shifts and political change” (Squire, 2008, p. 55). Narratives are a window into our consciousness and reveal (to ourselves and others) the gaps between our experience, our consciousness, and our unconsciousness (Squire, 2008). This perspective provides an avenue to analyze culture in a narrative by examining how culture and context influence how identities develop and transform and how this identity development is storied.

Squire (2008) also helps us conceptualize narratives’ elements by understanding that narratives are about the interactions between sequence, context, and meaning. Narratives include events and the context in which they occur, and how this context informs the meaning-making of the narrator. Incoherence, gaps, and confusion within a story allow the participant to “make sense” of situations, often referencing pressures, powers, constraints, or expectations within the sociocultural context. Participants are therefore making sense of the why of situations, not just for the events but also for the confusions, the lack of continuity, and the times and places in their lives where things were unclear. Narrative’s “hold” culture because they contain the meaning and morality that informs the ‘so what’ of the narrative. Narratives re-present, reimagine, or perhaps reconstruct the past. Stories emphasize the continuity of, or evolution in, personal identity, agency, decision-making, and meaning making. They convey and construct moralities, but these moralities are time-dependent, context-dependent, historically dependent, and dependent on society’s broadest sociocultural ‘traditions.’ Narratives seek closure, transformation, continuity, or change. The outcome in a narrative is a future sense relevant to, or perhaps in contrast with, the prevailing actions, norms, beliefs, or customs of both the narrator and their context (Black, 2018).

Comparative Ethnographic Analysis

Cultural comparison using ethnographic data is essential for explanation, hypothesis testing, and theory generation (Ember, 2009). Comparative ethnography is ethnographic research that explicitly and intentionally builds an argument by analyzing two or more cases. Comparative methods can help nurse scholars see ethnographic work as theoretically innovative instead of merely descriptive (Simmons & Smith, 2019), thereby advancing the science of culture and health care. The comparison of ethnographic data begins with the understanding that the two datasets being compared are explicitly related somehow. The hypothesis is that the two phenomena have a relationship that can be found. According to Schnegg (2014), cultural comparison requires defining cases, defining the dimensions to be compared, and developing some operations to determine whether the observations differ or are the same. In our case, referring to comparing narratives, the “cases” would be individual narratives. However, any given narrative is about the narrator and does not represent their culture per se (Abu-Lughod, 1990). A person references their view of their culture with regards to their story. Still, a person’s narrative is likely to represent a certain degree of coherence about the cultural norms and values that structure the narrator’s behavior and meaning (Moore, 2005).

The second issue to be considered in cultural comparison is defining the dimensions to compare. Comparing dimensions requires a shared research question, as well as a shared data collection methods. Again, Schnegg instructs us to define the dimension to be compared a priori to ensure that comparators are “. . . roughly similar, overlapping, and interlocking things (Schneider, 1976).

Finally, cultural comparison assumes that the phenomenon of interest is not shared because of some diffusion between cultures. Sharing of “culture” can result from different causes: the phenomena were transmitted or negotiated between the two cases through networks or diffusion; a larger supra-cultural context may have shaped it; or it may have developed independently. In all cases, the analysis should include a systematic comparison of similarities and differences (Schnegg, 2014).

In this paper, we describe the Comparative Ethnographic Narrative Analysis Method (CENAM) to analyze the role of culture in narrative explicitly and systematically. Specifically, we propose using the CENAM to compare culture in narratives because they contain information about the interactions among everyday experiences, socioculturally situated meanings, related identities, and motives, behaviors, and goals.

Comparative Ethnographic Narrative Analysis Method (CENAM)

The CENAM is a qualitative analysis procedure that formalizes and systematizes how culture is revealed in a narrator’s experience, meaning-making, decisions, and actions. In this section, we offer an exemplar of the early work in the development of the procedure, provide procedural detail, and provide a research exemplar illustrating its use in a study.

Early development of the method

In early research, the author developed an analytic method to guide the comparative cultural translation of research instruments (Saint Arnault et al., 2016). Comparative cultural translation (for research instruments) aims to discover whether a research concept can be expressed in various ways in another culture based on cultural beliefs and priorities or whether the concept is indeed culturally distinct. Rather than simply using the translation/back-translation model (Brislin, 1970), comparative cultural translation examines the meanings of concepts from the perspective of a culture and compares these concepts across cultures.

In the following example, we illustrate how this procedure worked in the translation of the concepts held in an English language depression instrument. We found several concepts embedded in the depression instrument that could be linguistically translated as the same but that had profoundly different cultural meanings (Saint Arnault et al., 2016). One example was the depression concept of “getting going.” This concept is an American idiom referencing turning on a car or a motor. It alludes to a sense of “forward movement,” “feeling and ability to move,” and having the energy or drive to carry out daily living activities. In the depression instrument translation, the concept of getting going was translated using the Japanese concept of “ki.” Ki refers to vital energy or perhaps energy given through a spiritual force. However, while getting going and ki arise from different cultural values and philosophical references, they are both examples of having “energy to move and do things.” In this example, we decided that these concepts were culturally nuanced but essentially similar.

In that same cultural translation project, the English language concept of hopelessness could be linguistically translated into a Japanese word for “pessimism.” However, the concept of pessimism refers to an attitude, disposition, or personality tendency. In contrast, the English concept of hopelessness references a feeling of insecurity, a lack of confidence, or negative expectations when one imagines their future. As part of our comparative cultural translation procedure, we discussed an alternative Japanese translation of hopelessness, which was the Japanese idiom of shikata ga nai (仕方が無い). This Japanese concept refers to a disposition, attitude, or philosophical position toward difficulty or tragic circumstances (Long, 1999). Shikata ga nai literately translates as “it can’t be helped” or “nothing can be done about it.” In our cultural comparison, we determined that, while there may be an element of hope within that Japanese phrase, hope within an American cultural value system was related to individual notions of will, personal power, and social autonomy (Del Vecchio Good et al., 1990). Therefore, we determined that pessimism, hopelessness, and shikata ga nai were different cultural concepts. In the end, we translated the concept of hopelessness as “a feeling that there is no hope for the future.”

The CENAM procedure

The above example shows the general processes that analyst teams can use for cultural comparison: find and affirm what is shared, note what is similar but is culturally nuanced, and affirm when concepts are genuinely different. For the CENAM method, we employ the same strategy using narrative data. CENAM facilitates identifying shared, culturally distinct, and culturally nuanced interpretations, meanings, and goals within narrative interview data. CENAM is a qualitative analysis method that involves an independent qualitative analysis of each cultural sample to answer the specific research question. After each analytic team confirms their primary themes using a trustworthy method (such as constant comparison), the cultural teams meet to compare the themes they have discovered. We refer to these as “reconciliation meetings.” We call these reconciliation meetings because our goal is to “reconcile differences” and discover what differences cannot be reconciled and require additional analysis. Reconciliation meetings should ideally be directed by a senior researcher familiar with cross-cultural analysis and ethnographic procedures.

In these reconciliation meetings, the researchers work together to compare the definitions, the grounded exemplars, and the meanings of these in their concepts respective to their culture. This first round of meetings aims to sort the codes into categories of “shared” and “culturally distinct.” The researchers come prepared with their entire data analysis set, including codes and quotes. We create a side-by-side comparison of the codes and work together to discover those that are similar but expressed differently. In this stage of the CENAM process, we are looking for the way that the concept “plays out” in the sociocultural setting. If a phenomenon is shared and ultimately deemed to be the same, then it is categorized as shared. Sometimes the concept is deemed to be phenomenologically similar but culturally nuanced. The researchers establish that both participant groups experienced or believed something, but that the cultural emphasis was different, the motivation was different, it was valued differently, or it arose from a different source. These rich discussions are captured in notes the side-by-side table and set aside until the final round of analysis. After these meetings, we generally end with a few concepts that are deemed “probably culturally distinct” or “hypothetically unshared” codes.”

The next step in the procedure is to use hypothesis testing to examine the concepts that are probably culturally distinct. These concepts require another round of analysis for a few reasons. First, we use a hypothesis testing procedure to systematize the analysis. Researchers need to approach these as “hypothetically unshared codes,” which we believe can help eliminate bias. Sources of bias include the fact that each analyst is generally analyzing data from their own culture and language, so they might miss concepts that are present but are so common or understood as to be invisible to the analyst. Alternatively, some concepts are culturally salient, in which case the one analytic research team is more likely to “see” them, be the other team could miss them even when they are present. Second, a concept might be present but might not be captured in the code list, or it might have been lumped together with another similar phenomenon. Third, we believe that this approach allows us to systematically find potentially new and relevant phenomena, which affects the trustworthiness of the overall findings. Therefore, the CENAM procedure is that each analytic team uses the “hypothetically unshared” or “probably distinct codes” from the other culture in their database. They essentially do a new round of analysis with the two or three unshared codes to confirm those phenomena are truly absent in their data or to discover whether it was present but was collapsed or otherwise omitted from the final code list.

Once the shared and distinct phenomena are verified, the research team returns to the reconciliation space to revisit the tableau of findings, confirming shared, confirming distinct, and thoroughly interpreting the culturally nuanced phenomena. We call this final round of analysis the “metanarrative” analysis. We define a metanarrative as the overarching interpretation of the cultural circumstances that provide the structure and meaning for people’s beliefs, actions, and goals. This ultimate metanarrative analysis allows the research teams to understand each cultural group’s cultural nuances while remaining true to its participants’ meanings. We return to the notes we made in the first round and what we discovered in the hypothesis testing round. By looking at different cultural priorities, the teams solidify their understanding of how culture operates in the research question at hand. Overall, the team increases their clarity about how culture manifests in a narrative—as expectations, priorities, values, motivations, and goals. We confirm our understanding and locate exemplars for the quotations that help demonstrate the shared, distinct, and shared but nuanced phenomena in the meeting.

Research Exemplar

The exemplar provided here comes from an international study that used the same methods to examine trauma recovery for women who have experienced gender-based violence in several countries (MiStory: Multicultural Study of Trauma Recovery), using data from the American and the Irish samples (Sinko et al., 2019). This study used the Clinical Ethnographic Narrative Interview (CENI) to collect trauma recovery data in both the Irish and American samples by study staff who resided in both locations. The CENI is a semi-structured interview consisting of a series of activities to understand one’s social support and conflict, physical feelings and emotions, and processing their distress experiences. The CENI was developed by the first author for an NIMH-funded research study aimed at understanding the cultural influences of depression experience (Saint Arnault, 2017, 2018a; Saint Arnault & Shimabukuro, 2012), but has since been adapted to study trauma recovery.

Participants in both countries were over 18 years. American women were recruited from a university health research portal designed to connect individuals who utilize the university health care system with research opportunities. Irish women were sampled from GBV services in Ireland. All women completed informed consent approved by the University of Michigan Institutional Review Board (HUM00091662), and all interviews were conducted by research staff trained in the same CENI interview method. We used a modified grounded theory analysis to analyze the data (Glaser & Strauss, 1967). For this illustration of our comparative method, we focus on conducting the analyses’ cultural comparison component.

The research question that guided the analysis in this study presented here was: “What is the meaning of healing for women recovering from gender-based violence?” Codes were developed based on participant healing goals and objectives and survivor’s perspectives of what the healing process entailed. ATLAS.ti qualitative software was used for data management and analysis (Muhr, 2006). An audit trail using personal, theoretical, and analytic memos was maintained. The first author reviewed codes every other week, and the research team regularly discussed coding concepts to verify accuracy.

To carry out the comparison analysis, we convened a reconciliation meeting. The researchers and the lead author examined quotations for the shared codes to affirm that they belonged to the same phenomenological domain. Because the codes were identified and defined by different researchers, we also examined the code definitions and created new definitions (if necessary) that accurately represented the shared phenomenon. We purposefully selected quotations that exemplified the shared theme and made notes about the culture’s unique cultural perspective related to the research question. Shared subthemes for the American and Irish women were finding strength, regaining control, and feeling competent. This analysis also revealed two “hypothetically unshared” themes: regaining identity (for the American sample) and feeling like a capable mother (for the Irish sample).

Next, a hypothesis testing analysis round was initiated for the possibly culturally distinct themes. To do that, each researcher took the new theme (the Irish took the American theme of regaining identity, and the American group took the Irish theme of feeling like a capable mother). Each team re-coded their dataset using these new, hypothetically culturally distinct themes. After analysis using the new themes, the reconciliation group was reconvened. This second round of analysis found that while the Irish mentioned the theme of identity, the frequencies were comparatively low (22 for the Americans and three for the Irish). The Americans mentioned the motherhood theme but had comparatively low frequencies (13 for the Americans and 45 for the Irish). Also, while the American women who were mothers mentioned their motherhood role, the emphasis was entirely different. This analysis re-confirmed that each of these themes represented a distinct cultural emphasis and were not shared.

Finally, we held the metanarrative meeting. In that meeting, we examined the cultural aspects of the shared themes. For example, the emphasis on identity in the Americans, while sometimes including motherhood, was primarily about developing a personal self that was satisfying and complex. The American sample described their identity as emerging from their occupations, education, and personal goals. Often this was described as extending beyond family roles and was often described as a personal achievement. This cultural emphasis on a person’s identity was described as a source of strength, giving them avenues to exert their independence through personal control or competence. The Irish women evaluated their strength, control, and competence in terms of how well they could carry out their central role as mothers. Independence was framed as perhaps hoped for in the future, but competence as a mother was valued as a primary source of personal acheivement and strength.

Discussion and Conclusions

There is a critical need to examine shared phenomenon from a cross-cultural perspective. We think that this deep dive into culture in narrative gives us a remarkable window into how culture shapes meaning, identity, and behavior. This kind of analysis also has the practical application of informing interventions that require understanding meaning, which is central in social services, public health, psychology, and nursing practice. Moreover, comparing qualitative data systematically has been limited by notions that qualitative data must focus primarily on what is culturally and socially specific. While this is a valuable enterprise, this paper emphasizes the possibility that, if researchers use the same methods, the same instruments, and comparative samples, they may be able to link contexts, meanings, and behaviors for diverse peoples across cultures. This method moves the science forward by locating aspects of a specific group that might be generalizable while also discovering what is indeed culturally specific. Furthermore, we believe that this technique can help research teams challenge their own biases and ideals by explicitly opening up cross-cultural dialogues about shared and specific phenomenon, decreasing the privilege of specific models or ideals, such as the dominance of western mental health models (Kirmayer & Pedersen, 2014), while also investigating what is shared.

In this research method, a hypothesis testing framework was used to examine whether phenomena are genuinely distinct. This perspective can add to the variety of existing techniques that qualitative researchers use to minimize bias and ensure rigor, trustworthiness, and integrity (Tracy, 2010). Approaches to decreasing bias in qualitative analysis includes accounting for personal biases, transparency in procedures and interpretations, meticulous record keeping (such as audit trails and bracketing), rich verbatim descriptions of participants’ accounts, working with others to reduce research bias, and respondent validation, among others (Noble & Smith, 2015). The hypothesis generation and constant comparison approachs are best articulated in grounded theory (Glaser & Strauss, 1967). This method explicitly seeks out similarities and differences across accounts to ensure that different perspectives are represented. When differences are found, the difference is deemed hypothetical, and steps are taken to confirm or refute this possible difference. In grounded theory, the researcher might use additional samples to confirm or refute the hypotheses, such as the use of theoretical sampling. We propose adding the systematic application of the “hypothetically unshared codes” to different samples, searching for references to that phenomenon in the other group. In this case, the researchers’ challenge is to establish what criterion they will use to accept or reject the hypothesis that the phenomenon is culturally specific.

For example, researchers can compare the frequencies of the phenomenon in each sample. Another possibility is to explore the emphasis placed on the phenomena in each culture. Still another criterion might be, not so much “Is it present?” but, rather, “Does it mean the same thing?” The technique described here used all three of these to explore each phenomenon from various angles before making a conclusion. Furthermore, the metanarrative analysis allows us to explore the meaning aspect of concepts holistically. This metanarrative allows researchers to combine what is shared and unshared together, making sense of the differences and how they acted to influence our research question.

Researchers can become wedded to their analytic models and findings. After all, they are saturated in their data and have “lived” with these narrator’s stories for months. The strategy proposed here requires the researchers to lift themselves out of their project, looking at them from another level, and then go back into their analysis from this different perspective. The moderators who facilitate these reconciliation meetings need complex skills to ensure success.

Comparison requires researchers need to listen to the researchers and the participants from both cultures at several levels at the same time. Research directors need to help the researchers from each project think differently about their concepts while remaining entirely faithful to the participants in each culture. Another hidden aspect in reconciliation meetings in this method might be researcher-level differences that can influence cross-cultural analysis, such as various levels of experience with analysis, differential levels of status (students of different levels, or faculty of different ranks), gender roles, and cultural communication style differences. Moderators need to be vigilant to all these dynamics, and the concepts under discussion and the comparison process, making sure all perspectives are heard. Finally, this CENAM method is facilitated by the front-end work of precisely crafting a shared research question. To the extent that all researchers are looking for the same thing, despite the diversity of their samples and contexts and cultural meanings, the team can explore similarities and differences without debating the goal of the overall analysis.

The metanarrative analysis can be an especially instructive undertaking because it aims to interpret how shared phenomenon relates to that which is unique. Using the discoveries made while examining the culturally unique phenomena, the researchers revisit their shared themes, often seeing more clearly how, even though a concept was shared, it was culturally nuanced. It is critical to tell this complex story clearly within the limits of a conventional research article when writing up comparison results. The metanarrative allows the research teams to bring the shared, distinct, and culturally nuanced stories to life in a short manuscript.

In cultural research, interview data is transcribed and often translated. Hanks et al., writing from the field of linguistics, argue that a goal of understanding culture through language involves defining the exact meaning of words within their cultural frame and explicating that choice as one of many possible alternative translations for what is most natural correspondence to the translation language (Hanks & Severi, 2014). Moreover, the translation should document usage and metalinguistic commentaries about the context (Quine, 2013). These issues are also central to comparative ethnography in general and the CENAM specifically. The CENAM relies on this critical and precise engagement with language to illuminate similarities and differences in meaning. Therefore, from a procedural perspective, we recommend that researchers use shared, rigorous transcription and translation protocols that systematically help preserve cultural connotations, idioms, and meanings. Attending to cultural meaning requires specific attention to this at the transcription and translation stage, and this prepatory work allows research teams to speak about cultural values and beliefs knowledgeably and with accuracy in the database. However, sometimes people are blind to their own culture, and membership within a community does not necessarily ensure cultural insight (Morse, 1990). The additional layers of hypotheses testing and metanarrative processes can also increase qualitative analysis rigor, along with member-checking and audit trails.

Literature exists about comparative ethnography (George, 2007; Howe, 2005; Kingfisher & Goldsmith, 2001; Simmons & Smith, 2019), however very few explain the procedural considerations or practical steps. Like Schnegg (2014), Abramson and Gong (2020) focus on the processes that inhibit the comparison of ethnographic data. They document the plethora of ways that the ethnographic data can be collected and the varieties of “units of analysis” from individuals to groups, communities, and societies. They argue that comparative ethnography relies on shared agreements on the what, the how, and the goals of the research. Primary among them is the notion that comparative cultural analysis rests on collecting comparable data. We concur and suggest that interviewing materials and instruments must also be carefully analyzed to ensure that they do not introduce biases, such as the cultural beliefs about the phenomenon embedded in the questions or the translation of the questions. A careful translation of the interview protocol like the one described above, and interviewer training must ensure that investigators carry out the protocols with similar integrity and fidelity.

Another consideration is that comparative ethnography can be time-consuming and resource intensive. It is usually impractical for single investigators to engage with multiple field sites or organizations (Simmons & Smith, 2019). This constraint leads to the analytic challenge of teams of multi-site researchers from the various comparator sites to select the comparative frame, or as Schnegg (2014) calls it, comparable dimensions. First, researchers need to share definitions about who belongs within the analytic frame and the larger team needs to agree that the participants from all sites share some experience, condition, or situation. The comparative frame for ethnographic narrative interview analysis could examine diversity in cultural contexts, subcultural diversity, differential exposure to discrimination and prejudice, diversity of economic positions, prior histories, and other differences revealed in a narrative. The data that emerges must be fundamentally similar for comparison, so the interview must ask the same questions and allow participants to describe all the essential aspects relevant to the phenomenon of interest.

To compare narrative data, the researchers need to ask the same research question, using the same instruments. Possible questions in our research were: “What are the social and internal barriers and facilitators for seeking healing after experiencing gender-based violence?” Another research question might be: “What is the meaning of violence in the family for women who have experienced domestic violence? Another question could be: “Is there a difference in the meaning of healing after domestic violence between women who have, and who have not, experienced violence as a child?” Then, using ethnographic narrative interviewing allows both cross-group and within-group comparisons, allowing a complex analytic design. If the research uses the same unbiased interviewing procedures, has high fidelity training, and the samples are with people who share a collective experience, the task of comparative qualitative analysis can be undertaken to answer a shared research question.

Comparative ethnography in nursing has been primarily cast under the rubric of “multi-sited ethnography” (Molloy et al., 2017). Multi-sited ethnography is described as a method of contextualizing multi-sited social phenomena, allowing nursing researchers to examine social phenomena produced in different geographic locations simultaneously. As proposed by Marcus (2015), multi-sited ethnography initially relied on immersive fieldwork. However, many recent multi-site ethnographies examine and contextualize care delivery in various organizations (Côté-Boileau et al., 2020; Lafferty et al., 2020; Leighton et al., 2020; van Belle et al., 2020).

These multi-sited ethnographies tend to use a multi-site case study approach (Jenkins et al., 2018), which, in contrast to immersive ethnography, tends to collapse phenomenon to allow for comparison. Like Jenkins et al., we agree that there is a paucity of analytical guidance to support researchers in these approaches. The CENAM and other emerging analytic guides seek to fill this critical analysis gap, allowing researchers to systematically craft research questions and engage with samples that are comparable, helping nurse researchers to understand how context and culture, internalized into the self, ultimately shapes how one responds to and makes meaning out of illness, health, and recovery. This analytic method can give additional analytical insights to any given narrative and ultimately help shed light on potential commonalities (and distinctions) in the human experience.

The process proposed here provides a valuable opportunity to understand the sociocultural nuances in our research questions, allowing nurses to intervene for people in a way that meets their unique cultural worldviews. While careful consideration is needed to ensure this analytic process’s integrity, ultimately, an organized and thoughtful research team should be able to execute this method, giving them a richer contextual understanding of their qualitative data.

We hope that the understanding gained through this methodology encourages creating culturally tailored, person-centered interventions that address an individual’s goals and desires, framed within their sociocultural context.

Author Biographies

Denise Saint Arnault, PhD, RN, FAAN is a professor at the University of Michigan School of Nursing, Ann Arbor MI, USA.

Laura Sinko PhD, RN, CCTS-Iis an assistant professor at Temple University, Philadephia, PA, USA.