자연주의적 탐구조사(Naturalistic Inquiry)

Culture Care Diversity and Universality: A Theory of Nursing edited by Madeleine M. Leininger, PhD, RN, FAAN; Sudbury, MA: Jones and Bartlett, 2001; 448 pages, $34.95 This new release of a book published 10 years ago by the National League for Nursing is said to be the definitive and comprehensive source for Leininger's culture care theory. It is presented in three parts: Part I is a description of the theory and its underpinnings by Leininger. Part II, in nine chapters, describes the research method to study culture care, by Leininger, followed by research by various authors who have used the theory and method. Part III, in three chapters, all by Leininger, focuses on findings from research that have used the theory and the method and use of the theory in education and administration. A final chapter addresses the relevance of the culture care theory in projecting the future of nursing. The reissue of this book is both timely and welcome. Leininger has almost single-handedly transformed our thinking about the need for culture care in all domains, whether it be in nursing care, in educational programs, or administration of patient care services. As our country has become more and more multicultural, and as we have come to see the impact of events in other parts of the world on our daily lives, the theory of "culture care diversity and universality" assumes an importance not previously felt or understood. The author makes some attempt to place her culture care theory within the framework of the broader theory development enterprise in nursing and the different approaches used to develop theory. She concludes that culture care theory does not fit well with existing thinking on theory development approaches, and that theories in nursing have been conceptualized within the logical positivist and quantitative paradigm. Culture care theory, on the other hand, was "conceptualized within the qualitative discovery paradigm with largely inductive emic (people-centered) views and not from the researcher's a priori hypotheses" (p. 24). The central issue of concern to this reviewer is not with the utility and elegance of this theory, for it has both. It is rather, that it claims too much for itself and does not recognize the place, utility, co-existence, or indeed, complementarity, of other theoretical approaches, especially if they are developed within the positivist paradigm, and worse yet, if they demand quantitative approaches for verification of hypotheses derived from them. The book appears to claim that culture care theory and knowledge are sufficient to address all dimensions of nursing. …

Culture Care Diversity and Universality: A Theory of Nursing

Objective This study examined the influence of authentic leadership, person-job fit with 6 areas of worklife, and civility norms on coworker incivility and burnout among new graduate nurses Background New graduate nurses report experiencing high levels of workplace incivility from coworkers, which has been found to negatively impact their job and career satisfaction and increase their intention to leave The role of civility norms in preventing burnout and subsequent exposure to incivility from coworkers has yet to be examined among new graduate nurses Methods A cross-sectional mail survey of 993 new graduate nurses across Canada was conducted Results The results supported the hypothesized relationships between study variables Conclusions Civility norms play a key role in preventing early career burnout and coworker incivility experienced by new graduate nurses Leaders can influence civility norms by engaging in authentic leadership behaviors and optimizing person-job fit

The Effect of Authentic Leadership, Person-Job Fit, and Civility Norms on New Graduate Nurses' Experiences of Coworker Incivility and Burnout.

Background Academic incivility is a serious challenge for nursing education, which needs to be empirically measured and fully addressed Method A convenience sample of nursing faculty and students from 20 schools of nursing in the United States participated in a mixed-methods study to test the psychometric properties of the Incivility in Nursing Education-Revised (INE-R) Survey Results A factor analysis and other reliability analyses support the use of the INE-R as a valid and reliable measurement of student and faculty perceptions of incivility in nursing education Conclusion The INE-R is a psychometrically sound instrument to measure faculty and student perceptions of incivility; to examine differences regarding levels of nursing education, program type, gender, age, and ethnicity; to compare perceptions of incivility between and among adjunct, clinical, teaching, and research faculty; and to conduct pre- and postassessments of the perceived levels of faculty and student incivility in nursing programs to inform evidence-based interventions

Revision and Psychometric Testing of the Incivility in Nursing Education (INE) Survey: Introducing the INE-R

Purpose
Academic dishonesty is growing among nursing students. Reasons for this growth can be categorized into student, faculty, and system factors. Nursing faculty designed a study to explore this problem.

Conclusions
We identified three themes: characteristics of students with academic integrity, patient safety, and professional outcomes. Exploring student perceptions of academic integrity can help faculty design measures to prevent dishonesty in these three areas.

Practice Implications
We recommend fostering culture change through strategies that target students, faculty, and systems. These strategies include peer mentoring, role modeling integrity, enhancing awareness of what constitutes cheating, and developing policies that promote honesty.

Perceptions of academic integrity among nursing students.

Incivility affects nurses and nursing students and can negatively influence patient care and the quality of nursing education. The Institute of Medicine, The Joint Commission, and the American Association of Colleges of Nursing recommended implementation of strategies to manage incivility and build social capital. The purpose of this mixed methods study was to explore the influence of a journal club as an educational intervention to build civility and academic integrity among nursing students. Seventy-nine nursing students completed the Nurses' Intervention for Civility Education Questionnaire and the Ways of Coping Questionnaire before and after the Civility Journal Club intervention. Students involved in the Civility Journal Club were more aware of civility and incivility, more likely to be helpful to their peers, and better equipped to cope with episodes of incivility.

Journal clubs: a strategy to teach civility to nursing students.

Background Although an atmosphere of civility in which nurses respect and value each other is crucial to health care, incivility continues to be widespread. Method New graduate nurses completed an online questionnaire in which they described incivility and discussed its impact on new nurses and patients. Results Findings were categorized according to the impact of incivility on new nurses and patients. Embedded in these categories are rich descriptions of incivility in health care. Conclusions The participants witnessed uncivil interactions that negatively impacted them emotionally, professionally, and physically. They also discussed the harmful effects of incivility on patients, whose care may be impeded or their faith in caregivers eroded in hostile, uncivil care environments. Nurses in professional development play a crucial role in promoting a culture of civility through raising awareness, supporting nurses new to the profession, and helping health care workers to better cope with incivility.

Perceptions of New Nurses Concerning Incivility in the Workplace.

BACKGROUND
Civility, rooted in social justice, is a fundamental value of nursing. Homeless people are particularly at risk for experiencing uncivil behavior from nurses.

PURPOSE
The purpose of this study was to explore homeless people's perceptions of their interactions with nurses.

METHOD
In this descriptive, qualitative study, we interviewed 15 homeless adults who described their experiences with nurses. The interview guide, developed by the researchers, consisted of open-ended questions and probes. Transcriptions and field notes were analyzed through thematic analysis.

RESULTS
Three major themes emerged: nurses should be civil, self-care behaviors, and barriers to good care. Subthemes included listening, compassion, attentiveness, and judgment as components of civility; where they go for care and who cares for them as self-care behaviors; and lack of money and homeless status as barriers to care.

CONCLUSIONS AND IMPLICATIONS
Our findings indicate people who are homeless often perceive nurses to be uncivil and uncaring toward them; furthermore, our participants provide a unique description of healthcare interactions from the perspective of the homeless. These findings can be used as a basis for the development of education interventions for students and practicing nurses to assist them in learning to provide civil and compassionate care for the homeless.

Lessons from the Homeless: Civil and Uncivil Interactions with Nurses, Self-Care Behaviors, and Barriers to Care.

Purpose An integrative review was conducted to determine perceived health and gambling behavior in incarcerated adults (ages 18-49), measures of perceived health and gambling behavior, and relationships between perceived health and gambling behavior. Conclusions Adult inmates report poorer perceived health and increased levels of gambling problems than those who are not incarcerated. No research investigating the relationships between perceived health and gambling among adult inmates was found. Practice implications Knowledge of relationships between perceived health and gambling can assist healthcare providers in understanding potential healthcare needs of the inmates and begin treatment while they are still incarcerated. Nurses in settings such as free and private clinics, homeless shelters, churches, and emergency departments need to screen for problem gambling in this population. This will facilitate appropriate referrals and continued treatment as these inmates transition back into society.

Cindy Kerber

Papers

Perceptions of academic integrity among nursing students.

Journal clubs: a strategy to teach civility to nursing students.

Perceptions of New Nurses Concerning Incivility in the Workplace.

Lessons from the Homeless: Civil and Uncivil Interactions with Nurses, Self-Care Behaviors, and Barriers to Care.

Perceived health and gambling behavior of inmates: a review of the literature.