자연주의적 탐구조사(Naturalistic Inquiry)

Scale developers often provide evidence of content validity by computing a content validity index (CVI), using ratings of item relevance by content experts. We analyzed how nurse researchers have defined and calculated the CVI, and found considerable consistency for item-level CVIs (I-CVIs). However, there are two alternative, but unacknowledged, methods of computing the scale-level index (S-CVI). One method requires universal agreement among experts, but a less conservative method averages the item-level CVIs. Using backward inference with a purposive sample of scale development studies, we found that both methods are being used by nurse researchers, although it was not always possible to infer the calculation method. The two approaches can lead to different values, making it risky to draw conclusions about content validity. Scale developers should indicate which method was used to provide readers with interpretable content validity information.

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The content validity index: Are you sure you know what's being reported? critique and recommendations

Suicidal behavior is a major problem worldwide and, at the same time, has received relatively little empirical attention. This relative lack of empirical attention may be due in part to a relative absence of theory development regarding suicidal behavior. The current article presents the interpersonal theory of suicidal behavior. We propose that the most dangerous form of suicidal desire is caused by the simultaneous presence of two interpersonal constructs—thwarted belongingness and perceived burdensomeness (and hopelessness about these states)—and further that the capability to engage in suicidal behavior is separate from the desire to engage in suicidal behavior. According to the theory, the capability for suicidal behavior emerges, via habituation and opponent processes, in response to repeated exposure to physically painful and/or fear-inducing experiences. In the current article, the theory’s hypotheses are more precisely delineated than in previous presentations (Joiner, 2005), with the aim of inviting scientific inquiry and potential falsification of the theory’s hypotheses.

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The Interpersonal Theory of Suicide

to physical functioning and quality of life are sufficient for the recommendation that cancer survivors follow the 2008 Physical Activity Guidelines for Americans, with specific exercise programming adaptations based on disease and treatment-related adverse effects. The advice to ‘‘avoid inactivity,’’ even in cancer patients with existing disease or undergoing difficult treatments, is likely helpful.

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American College of Sports Medicine roundtable on exercise guidelines for cancer survivors.

We describe a protocol for disclosing unfavorable information—“breaking bad news”—to cancer patients about their illness. Straightforward and practical, the protocol meets the requirements defined by published research on this topic. The protocol (SPIKES) consists of six steps. The goal is to enable the clinician to fulfill the four most important objectives of the interview disclosing bad news: gathering information from the patient, transmitting the medical information, providing support to the patient, and eliciting the patient’s collaboration in developing a strategy or treatment plan for the future. Oncologists, oncology trainees, and medical students who have been taught the protocol have reported increased confidence in their ability to disclose unfavorable medical information to patients. Directions for continuing assessment of the protocol are suggested. The Oncologist 2000;5:302-311

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SPIKES-A six-step protocol for delivering bad news: application to the patient with cancer.

This article presents the findings of a study of rural palliative care nurses in Western Australia. The number of rural centres in Western Australia offering palliative care services is increasing; however, at present there is little empirical data available about the roles of the nurses involved. This study was undertaken to begin to correct this deficit. The study examined basic social processes associated with the role of rural palliative care nurses, and identifies issues that affect the nurses' professional practice. A modified grounded theory approach was used to form a conceptual framework that describes rural palliative care nursing. Theoretical sampling techniques were used to identify the six palliative care nurses working in rural Western Australia who participated in the study. Data were generated using in-depth interview and participant observation techniques. Constant comparative analysis of the data was employed to allow concepts to emerge from the data. The central theme that developed is the all-consuming nature of the rural palliative care nurse's role. Three subthemes relating to multiple roles, expectations of nurses, and coping strategies are also discussed. This research explored issues that rural palliative care nurses feel are relevant to their professional practice, and it describes the basic social processes inherent in the rural palliative care nurse's role. Recommendations for nursing research, education, administration and clinical practice are presented.

Palliative care nursing in rural Western Australia

Objective: This study aimed to develop recommendations and a related implementation resource ‘toolkit’ to facilitate implementation of pain management strategies in Australian Residential Aged Care Facilities (RACFs).



Methods: This qualitative study used written materials, focus groups and individual interviews to gather data from participants. Thirty-four health-care professionals with experience in the aged care sector were recruited from five Western Australian RACFs. General practitioners who had an interest in aged care were contacted via local general practice networks.



Results: Findings indicated that focused education sessions were needed to support implementation. A tailored toolkit was developed to assist the process. Funding and workforce constraints were found to be threats to complete implementation in some facilities.



Conclusions: A multifaceted approach is needed to promote the implementation of pain management strategies in RACFs. In particular, unlicensed care workers, who may have responsibility for recognising and reporting signs of pain, require further education to support their role in the pain management process.

Developing recommendations for implementing the Australian Pain Society's pain management strategies in residential aged care.

Palliative Care Needs Assessment Guidelines

https://www.jpsmjournal.com/article/S0885-3924(06)00442-8/pdf

Personality, Neuroticism, and Coping Towards the End of Life

Background: Men experience localized prostate cancer (PCa) as aversive and distressing. Little research has studied the distress men experience as a normal response to PCa, or how they manage this distress during the early stages of the illness. Objectives: The objective of this study was to explore the experience of men diagnosed with localized PCa during their first postdiagnostic year. Methods: This constructivist qualitative study interviewed 8 men between the ages of 44 and 77 years, in their homes, on 2 occasions during the first 3 postdiagnostic months. Individual, in-depth semistructured interviews were used to collect the data. Results: After an initial feeling of shock, the men in this study worked diligently to camouflage their experience of distress through hiding and attenuating their feelings and minimizing the severity of PCa. Conclusions: Men silenced distress because they believed it was expected of them. Maintaining silence allowed men to protect their strong and stoic self-image. This stereotype, of the strong and stoic man, prevented men from expressing their feelings of distress and from seeking support from family and friends and health professionals. Implications for Practice: It is important for nurses to acknowledge and recognize the normal distress experienced by men as a result of a PCa diagnosis. Hence, nurses must learn to identify the ways in which men avoid expressing their distress and develop early supportive relationships that encourage them to express and subsequently manage it.

Linda J. Kristjanson

Papers

Palliative care nursing in rural Western Australia

Developing recommendations for implementing the Australian Pain Society's pain management strategies in residential aged care.

Palliative Care Needs Assessment Guidelines

Personality, Neuroticism, and Coping Towards the End of Life

Responding to a diagnosis of localized prostate cancer: men's experiences of normal distress during the first 3 postdiagnostic months.