Showing papers in "Journal of Advanced Nursing in 1996"
TL;DR: Gadamer's post-modern sensibility regarding text and the framework of Guba & Lincoln's fourth generation evaluation are compatible within a hermeneutic inquiry and it is recommended that Gadamer's primacy of application to the understanding of texts can also be applied to understanding of health environments.
Abstract: The thesis of this paper is that researchers working in interpretive traditions need to address three central issues: philosophy, rigour and representation. This paper discusses the process of an hermeneutic inquiry as a research methodology used in seeking to understand the experiences of older patients admitted to an acute hospital. The methodology includes the philosophical framework and assumptions underpinning the research. Philosophical hermeneutics guides the inquiry as a reflection of the research process. Three issues concerning legitimation of the hermeneutic research process arise: the philosophical underpinnings of the methodology, representation, or the participation of the researcher in making data, and rigour, or the way in which trustworthiness of hermeneutic research can be established. I recommend that Gadamer's primacy of application to the understanding of texts can also be applied to understanding of health environments. I conclude that Gadamer's post-modern sensibility regarding text and the framework of Guba & Lincoln's fourth generation evaluation are compatible within a hermeneutic inquiry.
570 citations
TL;DR: An analysis of the concept of empowerment and its use in nursing practice, education, research and health promotion demonstrates that empowerment is a helping process; a partnership valuing self and others; mutual decision making; and freedom to make choices and accept responsibility.
Abstract: This paper is an analysis of the concept of empowerment and its use in nursing practice, education, research and health promotion. The paper adopts an eclectic approach to concept analysis, incorporating the methods advocated by Walker & Avant and Rodgers. The concept is analysed and a theoretical definition given. Defining attributes, related concepts, antecedents and consequences of empowerment are proposed and a model case presented. The analysis demonstrates that empowerment is: a helping process; a partnership valuing self and others; mutual decision making; and freedom to make choices and accept responsibility. Implications for practice conclude the paper.
402 citations
TL;DR: The origins of this philosophy within the work of Heidegger and especially Gadamer are detailed with an explanation of some major concepts intrinsic to their hermeneutic writings, and an analysis is offered of the ontological, epistemological and methodological perspectives of the tradition.
Abstract: The wise choice of the postmodern tradition of hermeneutic phenomenology for nursing research is partly dependent upon an awareness of that tradition's base of philosophical hermeneutics. The origins of this philosophy within the work of Heidegger and especially Gadamer are detailed with an explanation of some major concepts intrinsic to their hermeneutic writings. Subsequently an analysis is offered of the ontological, epistemological and methodological perspectives of the tradition which is considered thereby to reside within an interpretivist/constructivist paradigm of inquiry. The contemporary use within the discipline of nursing of hermeneutic phenomenology is discussed, and the growing trend for using the tradition, across continents, is identified. However the question is posed as to whether all such research is accurately identified as belonging to the tradition. A further analysis suggests that hermeneutic phenomenology will increasingly be applied to the research of nursing phenomena.
396 citations
TL;DR: Practical advice is offered for nurses and other health care professionals to increase patient compliance with therapeutic regimens, including factors involved in the patient-provider relationship, communication skills and information-giving, and the mobilization of existing social support networks.
Abstract: Patient compliance is paramount in the effectiveness of therapeutic regimens Without compliance therapeutic goals cannot be achieved, resulting in poorer patient outcomes The social and psychological factors thought to influence compliance are identified as (a) knowledge and understanding including communication, (b) quality of the interaction including the patient-provider relationship and patient satisfaction, (c) social isolation and social support including the effect of the family, (d) health beliefs and attitudes-health belief model variables, and (e) factors associated with the illness and the treatment including the duration and the complexity of the regimen Noncompliance is a significant problem and a major challenge for the health care team Practical advice is offered for nurses and other health care professionals to increase patient compliance with therapeutic regimens These include factors involved in the patient-provider relationship, communication skills and information-giving, and the mobilization of existing social support networks Further research is needed to provide more conclusive results into the factors involved in patient compliance and to test the effectiveness of compliance-enhancing strategies
346 citations
TL;DR: An in-depth analysis of the concept of patient participation is presented using the method described by Walker and Avant and the value of concept analysis in relation to precise communication, critical thinking and the advancement of the knowledge base of nursing is discussed.
Abstract: The purpose of this paper is to present an in-depth analysis of the concept of patient participation. The analysis was undertaken using the method described by Walker and Avant. Patient participation is defined and the critical attributes are identified. Model, borderline and contrary cases illustrate what the concept is and is not. The meaning of patient participation is compared with patient partnership, patient collaboration and patient involvement, three related cases. The antecedents and consequences of patient participation are investigated to further refine the critical attributes. Empirical referents are illuminated. The value of concept analysis in relation to precise communication, critical thinking and the advancement of the knowledge base of nursing is discussed.
293 citations
TL;DR: It is argued that the view that triangulation is merely the combination of different methods of investigation is a narrow one, and it is recommended that nurse researchers increase their utilization of the four less frequently used types of triangulations: data, investigator, theoretical and unit of analysis.
Abstract: Triangulation is proposed by many nurse researchers as a means of solving the quantitative/qualitative debate and integrating the two approaches. While this view is accurate, it does not take into account the possible complexity and usefulness of triangulation, nor does it fully recognize the two goals of triangulation: confirmation and completeness of data. In this paper the five types of triangulation (data, investigator, theoretical, methodological, and unit of analysis) are described and the advantages and disadvantages of using this method are discussed. It is argued that the view that triangulation is merely the combination of different methods of investigation is a narrow one, and it is recommended that nurse researchers increase their utilization of the four less frequently used types of triangulation: data, investigator, theoretical and unit of analysis. When using triangulation of methods, researchers should also consider whether the use of within-method triangulation would be beneficial to their study. Sequential use of quantitative and qualitative methods to develop and refine tools of enquiry may also be more effective for certain studies than the more usual simultaneous use. The 'triangulation state of mind', the conscious employment of multiple data sources and methods to cross-check and validate findings continuously, should permeate all studies and lead to the goal of confirmation. Above all, triangulation must be chosen deliberately, for the correct reasons, and an adequate description of the rationale, planning and implementation of procedures should be given in reports, to give credence to this emerging method of research.
278 citations
TL;DR: This summary draws together the findings form over 80 studies published over three decades, finding that nursing is among the high risk occupations with respect to low back problems, and one of the popular notions is generally proven, that more frequent patient handling appears to correlate with increased incidence of low back pain.
Abstract: This summary draws together the findings form over 80 studies published over three decades. The studies reviewed are categorized into three groups: (a) epidemiological; (b) 'testing out'; and (c) exploratory. There has been agreement on a number of points, in particular that nursing is among the high risk occupations with respect to low back problems, with a point prevalence of approximately 17%, an annual (period) prevalence of 40-50% and a lifetime prevalence of 35-80%. When considering the contributory factors there is some divergence, but one of the popular notions is generally proven, that more frequent patient handling appears to correlate with increased incidence of low back pain. However, the traditional approach of training in lifting and handling techniques alone has been shown to be of little, or no, long-term benefit and the value of ergonomics remains to be seen. Much work has also been done by taking aspects of nursing work into the laboratory, using experimental studies which have mostly focused on specific sub-tasks (of the generic task of patient handling), looking at specific transfers and procedures (e.g. bed to chair) or transfer techniques ('stoop versus squat'). Although a level of quantification can be made about the different techniques, it is questionable whether this is of any practical use, especially when considering the wide variation of loads encountered during manual handling of patients. The limitations of using quantitative methodologies is revealed in the very small number of exploratory studies. All of the studies cited in this review used methodologies based in the positivist paradigm. There does not appear to be any published work using participative or interview methods to obtain qualitative data which might identify contributory factors in the onset of occupational low back pain in nursing staff.
273 citations
TL;DR: Information about sexual attractiveness was ranked last at both the newly diagnosed and follow-up stages, and information about the risk to family members of getting breast cancer showed a significant increase in importance.
Abstract: This paper reports a study which examined the specific information needs and sources of information for 105 women with breast cancer at two time points, the time of diagnosis and a mean of 21 months from diagnosis. At diagnosis the priority information needs concerned survival issues. Further from diagnosis survival issues were still a concern, but information about the risk to family members of getting breast cancer showed a significant increase in importance. Information about sexual attractiveness was ranked last at both the newly diagnosed and follow-up stages. Information sources at the time of diagnosis centred around the specialist breast care service, while further from diagnosis few professional or voluntary sector sources were utilized, with women receiving most of their information from media sources such as women's magazines. The relevance of these findings for nurses and other health care professionals is discussed.
270 citations
TL;DR: It is argued that evaluation of a concept must necessarily precede concept development research and precede more formal research procedures (such as operationalization or identification of the variables).
Abstract: One of the roles of qualitative enquiry is the utilization of qualitative methods for the development, refinement or modification of concepts. Yet, to date, there are no criteria for evaluating the adequacy of a concept. In this paper, the anatomy of a concept is presented, methods of concept analysis critiqued, and criteria for evaluation of the level of maturity of a concept suggested. Evaluation of criteria include assessment of: the definition of the concept, the characteristics of the concept, the conceptual preconditions and outcomes, and the conceptual boundaries. The authors argue that evaluation of a concept must necessarily precede concept development research (using a Wilsonian-derived method, a critical analysis of the literature, or qualitative enquiry) and precede more formal research procedures (such as operationalization or identification of the variables).
243 citations
TL;DR: The development of the palliative care quiz for nursing (PCQN) entailed the convening of an advisory committee, a wide process of consultation, the development of a conceptual framework, determination of format, generating of items and pre-testing, piloting and further testing of the quiz.
Abstract: This paper descrihes the process and outcomes of a study to develop a tool to measure nurses' knowledge of palhative care The development of the palhative care quiz for nursing (PCQN) entailed the convening of an advisory committee, a wide process of consultation, the development of a conceptual firamework, determination of format, generating of items and pre-testing, piloting and further testing of the quiz The PCQN is a 20-item true, false and 'I don't know' test of knowledge that is easily administered and has utility for assessing knowledge, stimulating discussion and identifying misconceptions ahout palliative care nursing
230 citations
TL;DR: The theoretical proposition that qualified nurses lack adequate knowledge related to oral health, resulting in inadequate oral care of patients on medical wards is tested, which revealed gaps in knowledge of oral care procedures.
Abstract: This study tested the theoretical proposition that qualified nurses lack adequate knowledge related to oral health, resulting in inadequate oral care of patients on medical wards. The research was undertaken in a local district general hospital during January 1995. The project aimed to look at local practices of qualified nurses related to oral care of patients hospitalized in medical wards. Extent of knowledge and current practice of care was examined using a questionnaire. Open and closed style questions were used. The sample comprised nurses on one elderly care ward and three general medical wards and the sample size was 34. The results revealed gaps in knowledge of oral care procedures. In particular, a lack of assessment and documentation was highlighted. However, the nurses indicated a high level of interest at updating themselves in this area of nursing. The limitations of this study are discussed.
TL;DR: An analysis of the concept of patient satisfaction, specifically as it relates to contemporary nursing care, provides an excellent vantage point to more closely examine this key measure of health care quality.
Abstract: Patient satisfaction has become an established indicator of the quality of health care yet, despite the abundance of measurement surveys reported in the literature, there are few theoretical underpinnings for this important concept. An analysis of the concept of patient satisfaction, specifically as it relates to contemporary nursing care, provides an excellent vantage point to more closely examine this key measure of health care quality. A review of pertinent literature is presented, followed by examination of the uses of the concept in professional literature as well as more general sources. Defining attributes cited throughout the literature are identified along with the concept's antecedents and consequences. Empirical referents, definitions, and measurements are also presented. The analysis concludes with re-examination of some of the assumptions underlying patient satisfaction literature in general, and thoughts regarding the significance of patient satisfaction with nursing care in particular. Suggestions for future inquiry are offered.
TL;DR: This analysis looks at what empathy is: is it trait or state, is it dynamic or static, and how is it recognized and measured?
Abstract: The concept of empathy lies amid much confusion This analysis addresses that confusion using Walker and Avant's model of concept analysis, and looks at what empathy is is it trait or state, is it dynamic or static, and how is it recognized and measured' Implications of these findings are discussed, limitations of the study are acknowledged and areas for further work suggested
TL;DR: The challenges that have arisen in attempting to combine traditional research activities with more practice-based development work are shared, highlighting the variety of partnerships to be established in order to achieve the goal of integrating research into practice.
Abstract: This paper describes a framework used by the National Institute for Nursing in Oxford to integrate research, development and practice. With the increasing attention given to the topic of how research findings are implemented into clinical practice, it was felt important to share the challenges that have arisen in attempting to combine traditional research activities with more practice-based development work. The emerging conceptual framework, structures and functions are described, highlighting the variety of partnerships to be established in order to achieve the goal of integrating research into practice. While the underpinning principles of the framework-generating knowledge, implementing research into practice and evaluating the effectiveness of programmes-are not new, it is the way they have been combined within an organizational structure that could be helpful to others considering such a strategy. Both the strengths and weaknesses of the framework are discussed, a number of conclusions drawn as to its robustness and consideration given to its replication.
TL;DR: It is argued that effective training should be made more available for staff at risk of assault and it is established that violence is a problem across a number of general hospital departments and occupations.
Abstract: The problem of aggression to staff in a general hospital was examined from the perspective of Poyner & Warne's (1986) model of workplace violence. A total of 396 staff (39% response rate) provided information on their experience of violence in the past year and a subsample were additionally interviewed about their current levels of mental health (GHQ). Some 72 staff (21% of respondents had been physically assaulted and 90% of these assaulted staff worked beyond the accident and emergency department, e.g. in medical wards. Nurses were physically assaulted, threatened and verbally abused at higher rates than other professionals. Employee factors (younger age, shorter National Health Service experience and attendance at violence training) were significantly associated with assault (P < 0.05). Postoperative confusion, receiving treatment and delayed treatment were common precursors of aggression. Mental health was significantly worse amongst staff exposed to threats (P < 0.01). This exploratory study establishes that violence is a problem across a number of general hospital departments and occupations and we argue that effective training should be made more available for staff at risk of assault.
TL;DR: A core concept of trust is presented which is applicable to nursing in both clinical and organizational settings, and the relationships of the two states to measurement of the concept are identified.
Abstract: Trust is an important and pervasive concept. In nursing, it has been considered primarily from two perspectives. Clinically, it is an important aspect of the nurse-patient relationship. Organizationally, trust is associated with various outcomes and levels of effectiveness. Much of the nursing literature that discusses trust relies upon vague conceptualizations or borrows from other disciplines. The absence of a clear conceptualization of trust has been cited. A core concept of trust is presented which is applicable to nursing in both clinical and organizational settings. Established methods for concept analysis are supplemented by a sequential step model developed by the author. The concept is developed as both process and outcome, and the relationships of the two states to measurement of the concept are identified. The utilization of the core concept in context-specific instances is discussed, and suggestions are made for further research.
TL;DR: This paper argues that the Walker & Avant model is based on untenable assumptions, and that the writings of those who adopt it inevitably contain a serious flaw that vitiates the procedure and renders the results arbitrary.
Abstract: Concept analysis and conceptual clarification form an identifiable genre within the nursing literature, with most recent examples drawing on the model proposed by Walker & Avant (1988). This paper argues that the Walker & Avant model is based on untenable assumptions, and that the writings of those who adopt it inevitably contain a serious flaw that vitiates the procedure and renders the results arbitrary. In particular, the relationship between concept and theory, a topic to which the philosophy of science has devoted much attention, has been misunderstood by these authors. Concepts are not the 'building blocks' of theory, but the niches created by theory; and any 'conceptual clarification' that anticipates theoretical commitment becomes a vacuous exercise in semantics.
TL;DR: It is concluded that simple skills training is insufficient to change clinical behavior, and other factors which should be addressed in future training programmes are discussed.
Abstract: Patient assessment underpins every aspect of nursing care However, there is much evidence to suggest that many nurses lack the skills necessary to communicate effectively with their patients, and so assess their individual problems and concerns Communication studies to date have been descriptive, or have concentrated on acquisition of skills without addressing the impact this has on patient care This paper reviews a study of 44 hospice nurses who were taught assessment skills It discusses the impact of training not only on their skill level, but also on their ability to elicit their patients’ concerns It concludes that simple skills training is insufficient to change clinical behaviour, and discusses other factors which should be addressed in future training programmes
TL;DR: The findings showed that an intense process of change and development was occurring regarding nursing documentation, however, there were limitations in the use of the entire nursing process, especially in the specification of patient problems and the formulation of nursing diagnoses and nursing interventions.
Abstract: The VIPS model for the documentation of nursing care in patient records was scientifically developed and published in 1991, with the aim of supporting the systematic documentation of nursing care and promoting individualized care. As the model seemed to be accepted and used in many parts of Sweden, a study was conducted in order to gather further information on the validity of the model, to describe the clinical and educational experience of its use and to refine it. Experience of the use of the model was gathered from a review of the scientific papers and other reports on it, from questionnaires addressed to nurses (n = 514), from comments by key informants, and from interviews with faculty members at all the nursing schools in the country. The findings showed that an intense process of change and development was occurring regarding nursing documentation. However, there were limitations in the use of the entire nursing process, especially in the specification of patient problems and the formulation of nursing diagnoses and nursing interventions. The keywords (Swedish spelling) of the VIPS model had good content validity in different areas of nursing care. The findings also indicated the need for further elaboration and revision of some of the keywords. A revised version of the VIPS model based on these findings is presented.
TL;DR: Some of the difficulties in arriving at a definition of spirituality are explored and the extent to which nursing theories incorporate the concept of spirituality is examined, as well as the potential for meeting the spiritual needs of patients in the context of the changes occurring in the British National Health Service.
Abstract: Nursing, over the past 2 decades, has been concerned with the development of theories which will inform practice and help to establish nursing as an emerging discipline. The view that the individual is a biopsychosocial being has occupied a prominent position in the existing catalogue of nursing theories. The literature reveals that, although some existing theories do acknowledge that humans do have the advantage of a spiritual dimension, very little significant work appears to have been done in this area. This paper explores some of the difficulties in arriving at a definition of spirituality and goes on to examine the extent to which nursing theories incorporate the concept of spirituality. Additionally, nurse education does not appear to prepare practitioners adequately to meet the spiritual needs of patients. The paper concludes with a discussion of the potential for meeting the spiritual needs of patients in the context of the changes occurring in the British National Health Service.
TL;DR: The use of the Nominal Group Technique and its practical application in bridging the gap between researchers and practitioners in one particular study of community nursing is described.
Abstract: The use of group-based techniques to generate ideas and offer solutions to problems is commonplace in many disciplines and for many purposes. What were originally useful adjuncts to market research have become valuable and illuminating tools in education, policy and research. This paper will describe the use of one such technique, the Nominal Group Technique, and its practical application in bridging the gap between researchers and practitioners in one particular study of community nursing.
TL;DR: A psychosocial typology of chronic illness is presented and the importance of time phasing is discussed and a conceptual framework for analysing the interaction of Chronic illness with family and individual life-cycles is outlined.
Abstract: Chronic illness is currently the outstanding health issue in the United States. It creates increased family stress, requires constant adaptation by the family members and poses a challenge to nurses to better understand and meet the needs of the family as well as the individual. This paper presents a psychosocial typology of chronic illness and discusses the importance of time phasing of the chronic illness. A conceptual framework for analysing the interaction of chronic illness with family and individual life-cycles is outlined. Knowledge of life-cycle stressors is essential for nurses to better delineate the relationship between the vertical and horizontal life stressors which affect the family system.
TL;DR: The results of a recent study investigating the meaning of the experience of feeling healthy for people living with a chronic illness and/or disability are presented and provide for a reconceptualization of health and illness.
Abstract: The concept of health within illness is beginning to gain recognition in nursing. However, there has been little research to explore and describe this phenomenon. The results of a recent study investigating the meaning of the experience of feeling healthy for people living with a chronic illness and/or disability are presented. An interpretive phenomenological study was undertaken with eight participants living with a variety of different chronic conditions. The results provide a rich mosaic of themes describing the participants' health experiences. These themes include: (a) honouring the self; (b) seeking and connecting with others; (c) creating opportunities; (d) celebrating life; (e) transcending the self; and (f) acquiring a state of grace. The significance of these results is that they provide for a reconceptualization of health and illness. Such a reconceptualization calls for a transformation in nursing care, from a problem focus and a deficit perspective, to one which focuses on the client's capacity and the promotion of health and healing.
TL;DR: The literature on female genital mutilation within a feminist theoretical context is discussed and parallels with other similar practices in developed and developing countries will be drawn and policy strategies discussed.
Abstract: The literature on female genital mutilation (also known as female circumcision) within a feminist theoretical context is discussed. Issues of culture, politics and religion in the literature will be examined in relation to feminist thought and the paper will also assess the effects of female genital mutilation on women's health and status within developing societies. Parallels with other similar practices in developed and developing countries will be drawn and policy strategies discussed.
TL;DR: This small study sought to find out what student nurses themselves thought about mentorship, and found that mentorship for these students seemed to be more about control than support.
Abstract: Increasing awareness of the incidence of stress amongst nurse learners, the introduction of continuous assessment of basic courses and successive and continuing ambiguous directives from the English National Board for Nursing, Midwifery and Health Visiting have led to widespread implementation of mentorship systems in this country. Considerable variation in terms of mentor selection, preparation, role and function clearly exists, against a background of questionable cultural relevance and suspect research. This small study, conducted as part of an honours' degree programme and completed in 1992, sought to find out what student nurses themselves thought about mentorship. Using group discussion and individual interviews, the views of 16 third-year students on a traditional RGN programme were explored, and the resulting qualitative data organized and presented using a method of thematic analysis. A ward culture is revealed, that not only continues to separate those with knowledge from those who need to learn, but also reinforces the position of the student through both covert and overt mechanisms of control. Examples of supportive, non-supportive and dissupportive relationships were described. Mentorship was described in terms of assessment and appraisal; the students apparent preoccupation with achieving a satisfactory ward report clearly influenced both their relationships and behaviour with trained staff. Mentorship for these students seemed to be more about control than support.
TL;DR: Investigators described that knowing the patient comprises two components: the nurse's understanding of the patient and the selection of individualized interventions, which has implications for practice, including thatKnowing the patient may result in positive patient outcomes.
Abstract: Knowing the patient is an important concept emerging from recent studies of nursing practice. The concept is relevant to therapeutic decision-making. Also, knowing the patient actualizes a cherished value in nursing: the treatment of persons as unique individuals. Investigators described that knowing the patient comprises two components: the nurse's understanding of the patient and the selection of individualized interventions. In addition, the nurse's experience with caring for patients, chronological time and a sense of closeness between the patient and nurse, are three factors consistently related to knowing the patient. The concept has implications for practice, including that knowing the patient may result in positive patient outcomes. Also, expert nurse decision-making may be characterized by knowing the patient. Recommendations for further research in this area include the clarification and refinement of the concept, as well as the examination of relationships between knowing the patient and outcomes of care.
TL;DR: The results revealed that limitation of physical activity was the most troublesome stressor followed by decrease in social life, uncertainty about the future, fatigue and muscle cramps, and problem-solving methods were considered to be more effective than affective measures in dealing with stressors.
Abstract: The aim of this study was to determine the significant stressors and coping methods which are related to quality of life in dialysis patients. A survey was conducted on patients in two dialysis centres in Sydney. The response rate was 58% (n = 64). The results revealed that limitation of physical activity was the most troublesome stressor followed by decrease in social life, uncertainty about the future, fatigue and muscle cramps. Although their ranking was not identical to that found in prior studies, these five stressors were considered to be compatible with the high stressors identified in previous studies. Problem-solving methods were considered to be more effective than affective measures in dealing with stressors. Quality of life was perceived as below average in both haemodialysis and continuous ambulatory peritoneal dialysis (CAPD) patients. However, CAPD patients were experiencing a higher quality of life than haemodialysis patients. The length of time on the dialysis programme was not significantly related to coping behaviour. The findings of this study can further facilitate nurse practitioners in providing support, information, alternative solutions and in assisting patients to better utilize problem-solving methods to enhance their quality of life on dialysis.
TL;DR: It is argued that the theory-practice gap in nursing is being compounded by a more fundamental divergence of approaches to the delivery of health care and that this represents a major challenge to nurse educators.
Abstract: The existence of a theory-practice gap in nursing in the United Kingdom has been an issue of concern for many years. However recent events have resulted in a new dimension of the theory-practice gap emerging. This paper explores the origins of the contrasting values attributed to nurses and health care managers and identifies areas of conflict. It is argued that the theory-practice gap in nursing is being compounded by a more fundamental divergence of approaches to the delivery of health care and that this represents a major challenge to nurse educators. Nursing is at a crossroads in its development, and if it is to survive it must incorporate some elements of the new managerialism whilst demonstrating to managers the importance of recognizing professional values. The future of nursing can be secured, but it will involve partnership and cooperation with the new managers.
TL;DR: The model of concept analysis described by Chinn and Kramer is used to further clarify the concept and develop the ideas of Mairis and dignity is found to be connected to the shared humanity of patient and nurse, whilst acknowledging the uniqueness of individuals.
Abstract: The word dignity is used frequently in nursing and is deemed important to maintain or promote in patients. Its meaning, however, remains unclear. This paper uses the model of concept analysis described by Chinn and Kramer to further clarify the concept and develop the ideas of Mairis. A tentative definition and indicators are suggested to ascertain if dignity is present in a given interaction and context. Dignity is found to be connected to the shared humanity of patient and nurse, whilst acknowledging the uniqueness of individuals. It emerges through the analysis that, in order to effectively promote the dignity of patients, the nurse should also possess dignity.
TL;DR: The meaning of parent participation is explored, the concept remains poorly defined, and urgent clarification is needed to benefit children and their families, and to increase understanding among practitioners.
Abstract: Parent participation has become a central tenet of paediatric nursing in the United Kingdom. The purpose of this paper is to explore the meaning of parent participation, to clarify the concept to benefit children and their families, and to increase understanding among practitioners. The concept analysis utilized was directed by Rodgers' "evolutionary approach' that views concept development as an ongoing dynamic process. A review of British literature and research studies indicated that parent participation is a complex and multi-dimensional concept. In the evolution of parent participation, the terminology changed from "parental involvement' to "partnership in care', to "care-by-parent' and finally to "family-centred care'. The analysis reveals a lack of coherence in the descriptions, with the terminology changing but the underlying theme remaining parent participation. Parent participation can be conceptualized as a composite of attributes that relate to the family, the nurse and their relationships. Those attributes include: negotiation, control, willingness, competence and autonomy. The concept of family-centred care is gradually assuming importance in the literature. This acknowledgement of the family is long overdue. However the concept remains poorly defined and urgent clarification is needed in this area. To adopt a family-centred care approach, a radical paradigm shift is required.