Focused Ethnography in Medicalized Spaces: Analyzing NICU Social Dynamics and Their Impact on Preterm Care
In this study, we examine the complex networks of social interactions within the NICU environment and their impact on clinical practice and the well-being of preterm parents. Our research employs a combination of narrative interviews with medical staff and a multi-situated focused ethnography conducted in NICU and sub-NICU units across five Italian hospitals.
We argue that this methodological combination is particularly effective for analyzing highly medicalized environments with a clear hierarchical structure and established formal and informal practices that shape specific social interactions.
Focused ethnography allows us to narrow the broad scope of qualitative observations, filter out “background noise,” and focus on specific interactions, such as those between parents and NICU staff, as well as skill-intensive NICU practices. This approach yields nuanced insight even after a relatively short observation period.
Combining ethnographic techniques with interviews also enables us to explore the context of the observations and understand participants' experiences of being observed. In our study, we constructed a maximum variation sample to include diverse staff profiles, striving to capture the full social network that supports preterm parents during their NICU stay.
The proposed research design is flexible and well suited to accessing complex fields such as hospital environments. The short duration of focused ethnography allows to reduce the impact of the researcher’s presence on a difficult environment such as NICU wards, and the interviews complement the shortcomings of the reduced observation time.
This combination of techniques could be replicated in the study of other complex medical institutions as it balances the invasive role of the researcher in a closed environment and the necessity to produce significant scientific results.