Nursing

The purpose of this study was to generate a structure of the lived experience of making a difficult decision, using Parse's human becoming research methodology. This methodology evolved from the human becoming theory of nursing which includes an existential view of person and the nursing simultaneity paradigmatic view of man and health. The entity for study in this research was the lived experience of making a difficult decision. Parse's methodology was used and includes: participant selection, dialogical engagement, extraction-synthesis and heuristic interpretation. The structure of the experience of making a difficult decision was discovered through the experiences of four participants. This is expressed as living with feelings of self doubt that give way to assurance while searching within and reaching out to others until affirming the circumstances of the chaos generates possibilities and enables perseverance. This study demonstrates Parse's research methodology and broadens nursing's knowledge base.

The purpose for this research was to study the meaning of the lived experience of excellence in nursing practice as described by registered nurses. The phenomenon of excellence in practice is a commonly cited goal of individual nurses, as well as of organized departments of nursing service and nursing education. Ray's phenomenological method was used to describe and identify themes and to construct the meaning of excellence in nursing practice experience as used in the language by nurses. Registered nurses were interviewed by using an open-ended question technique. In addition, audiotape was employed, and the interviews were transcribed to text. The phenomenological analytic method of dwelling with and describing the data was used to identify emergent themes. The themes allowed for the emergence of a unity of meaning of the lived experience of excellence in nursing practice. Relationships with and visions for nursing were presented.

The purpose of this study was to uncover the structure of the common lived experience of health of "the experience of feeling that you belong", using Parse's research methodology. The nursing perspective for this study is that of Parse's nursing theory of human becoming. The researcher used the processes of the methodology, participant selection, dialogical engagement, extraction-synthesis, and heuristic interpretation to evolve the structure of the lived experience of health: The experience of feeling that you belong. The structure of the experience of feeling that you belong, discovered in this research with four participants, is prizing equivalent differences while illuminating light within the darkness and discovering fullness of self in community. This study demonstrates Parse's research methodology and expands the knowledge base of nursing.

The purpose of this study was to compare empathy levels of registered nurses based on three different types of academic preparation: associate degree (two-year program), diploma (three-year program), or baccalaureate degree (four-year program). The relationship of empathy to age, marital status, parental status, clinical experience, and length of time in practice was also investigated. Subjects (n = 122) for the study were registered nurses working at two acute care health settings in the southeast metropolitan area of Florida. Two instruments were used: (a) Empathy Construct Rating Scale (ECRS), and (b) a demographic information questionnaire. The ECRS was chosen because of its proven construct validity and specificity to nursing (LaMonica, 1981). The demographic questionnaire assisted the investigator to determine any relationship between level of empathy and the aforementioned variables. A regression analysis was performed first to determine any relationship between empathy levels of registered nurses and the demographic variables. No significant relationship was found between professional preparation and the demographic variables. A one-way analysis (ANOVA) was performed to assess the strength and direction of the relationship between academic preparation and empathy. Using 0.05 level of significance as the criterion, statistical analysis revealed there was no relationship between registered nurses' academic preparation and level of empathy.

The purpose of this hermeneutic phenomenological study was to understand the essence of the lived experience of women after having an abnormal prenatal ultrasound. One hundred years ago, health disciplines had limited therapies for prenatal and neonatal disorders. During this period, the eugenics movement influenced leaders to involuntarily sterilize individuals who were sought to be "unfit" to prevent disorders in offspring. ... One of these contemporary reproductive genetic technologies is the use of ultrasound and serum bio-medical markers for detection of congenital, chromosome, and genetic disorders. When ultrasounds reveal abnormal findings, the perceived perfect pregnancy vanishes and gives way to feelings of shock, disbelief, fear, guilt, loss, and threats to self and their unborn baby. Twelve women who had an abnormal ultrasound were interviewed within the context of their cultural values and beliefs. The method of van Manen's hermeneutic phenomenology illuminated the meaning for these women in their life worlds. ... They endured this experience through their own coping mechanisms, but often felt uncertainty and emotional turmoil until the birth. The women also sought comfort through their cultural values, beliefs, and traditions. In coping with the risks found on this abnormal ultrasound, women often selected silence or blocking perceived threats. With these coping methods, they were alone in their suffering. ... Health providers, in not recognizing these women's misunderstandings and emotional fears, abandoned them in their psychosocial and cultural needs. The significance reveals that nurses and health providers need to infuse human caring ways of being, knowing, and doing within advanced technological environments.

The purpose of this study was to evaluate student outcomes following implementation of a clinical scholar model of clinical education in one of four placement sites of a college of nursing grounded in a caring philosophy. The question guiding the study was to determine if the clinical scholar model has an influence on student perceptions and outcomes when used with second-degree accelerated BSN students. Watson's Human Caring theory, based on ten caritas processes, serves as the theoretical framework for this study (Watson, 2007). A sequential mixed-methods approach that combined quantitative and qualitative data collection techniques was implemented using a pre-experimental, post-test only design with non-equivalent groups to determine differences between the Traditional Model (TM) and Clinical Scholar Model (CSM) in clinical nursing education... Limitations of this study include low sample size and are partially due to limitations of the class size and low survey participation. Additionally, only CSM students attended a focus group, which prevented comparisons of qualitative feedback between groups. Even with these limitations, CSM students scored as well or better than TM students, indicating that the CSM could be a viable model for nursing clinical education.

atisfaction with diabetes care, perceived feelings of empowerment to participate in self-care management, and glycemic control in a sample of older African American men and women with diabetes. A descriptive correlational quantitative design was used. The participants in this study were 73 men and women of African descent who were at least 50 years, English speaking, and diagnosed with diabetes for at least one year. The participants were asked to complete three survey instruments: the Patient Satisfaction Questionnaire-18 (PSQ-18), which measured how satisfied the participants were with their medical care; the Diabetes Empowerment Scale-Short Form (DES-SF), which measured attitudes towards diabetes and self-management of diabetes; and a demographic form, which collected data on the demographics of each participant. The most recent hemoglobin A1c (HbA1c) of each participant was obtained from the medical records. The correlations between HbA1c, DES, and the PSQ-18 subscales were exam ined. The study data indicated all correlations were statistically significant and negative with one exception. There was no correlation between HbA1c and time spent, a satisfaction subscale. Approximately half the participants were high school graduates, married, and reported being born in the Caribbean. Most had primary care physicians, but less than half reported attending a diabetes education program. The average BMI was 33.0. The findings of this study indicated older African adults who reported higher satisfaction with the care provided by their health care provider reported feeling more empowered to participate in diabetes self-care and reported lower HbA1c levels, suggesting better glycemic control (R2 = .39; P=<.001).

Economic changes have made the immigration of women to the United States part of major political and social issues. Women from Latin America frequently immigrate alone and without legal documentation, leaving their children in the care of relatives or friends, thus becoming transnational mothers in the process. Hispanic/Latino groups comprise the largest minority in the U.S., and Latina women account for 48.9% of the total Latino population. This demographic trend is expected to continue, and Hispanic/Latino groups are projected to experience the largest population increase in the coming decades (Marshall, Urrutia-Rojas, Soto-Mas & Coggin, 2005). The separation from their family has a strong impact on the health and well-being of these women, rendering them vulnerable to health care barriers and health disparities. This qualitative research study explored the experiences of Latinas living transnational motherhood. Individual semi-structured interviews were conducted with eight Latin as living transnational motherhood between the ages 21- 39. The findings in this study describe the lived experience of Latina transnational mothers within their social, economic and cultural context. The narrative was analyzed using van Manen's (1990) interpretative hermeneutic phenomenological approach to narrative analysis. Findings indicate that Latinas experiencing transnational motherhood find meaning in mothering from afar through sacrifice, suffering, and hopefulness for a better life for their children, and for family reunification. Findings from this study inform nurses of the health care barriers that these Latinas living transnational motherhood encounter as they experience hardship in order to support their families abroad as well as themselves.

The implantable cardioverter defibrillator (ICD) is an electronic medical device that was invented by Dr. Michael Mirowski and his team in 1980. The purpose of the ICD, which is implanted in a person's chest, is to sense and shock the heart when detecting a lethal cardiac arrhythmia into a rhythm that can sustain life. While the ICD saves lives, it also has the potential to deliver painful shocks when it is activated. The ICD was initially inserted in people who had survived a sudden cardiac arrest; the device is now being implanted in older adults with heart failure and no known history of cardiac arrhythmias. When talking with patients and personal family members who had an ICD, it was unclear what influenced their decision to have an ICD implanted. Understanding the experience of decision-making for older adults who had an ICD has added to nursing knowledge, practice, and education when working with people who had an ICD inserted. To understand the lived experience, the researcher conducted a phenomenological research study, guided by the theoretical lens of Paterson and Zderad's (1976/1988) humanistic nursing and analyzed the data as outlined by Giorgi (2009). The results of the study indicated the participants' lived experience of decision-making for older adults who had an implantable cardioverter defibrillator inserted was influenced by the following : trust in their physician's decision; accepting the device was necessary; the decision was easy to make; and hope and desire to live longer.

Health care systems consist of various individuals and organizations that aim to meet the health care needs of people and provide a complete and responsive health care solution. One of the important aspects of a health care delivery system is nursing. The use of technology is a vital aspect for delivering an optimum and complete nursing care to individuals; and also for improving the quality and delivery mechanism of nursing care. The model proposed in this thesis for Nursing Knowledge Management System is a novel knowledge-based decision support system for nurses to capture and manage nursing practice, and further, to monitor nursing care quality, as well as to test aspects of an electronic health record for recording and reporting nursing practice. As a part of a collaborative research of the Christine E. Lynn College of Nursing and the Department of Computer Science, a prototype toolset was developed to capture and manage nursing practice in order to improve the quality of care. This thesis focuses on implementing a web based SOA solution for Automated Classification of Nursing Care Categories, based on the knowledge gained from the prototype for nursing care practice.