Dissertations / Theses on the topic 'Holistic nursing Nursing Philosophy'

This qualitative study critically examined nurses' perception of nursing qua nursing in an American Nurses Credentialing Center Magnet^® re-designated healthcare system in Albany NY. Watson's Theory of Human Caring is used by many Magnet^® hospitals, including the site for this study, to inform and guide nursing practice. Watson's Theory supports concepts and practices of integral health, holism, caring, healing, and the education and integration of complementary health care modalities as independent therapeutic nursing interventions. This study aimed to understand the nurse's emancipatory experience, comportment and self-agency as she/he participated in a theory guided practice; and illuminate the nurses' acquisition, understanding and utilization of knowledge and power as required for engaging independent therapeutic nursing interventions in the unitary-transformative health paradigm.

Eight nurses from the Oncology Unit self-selected to participate without recidivism from August to October 2012. The study was conducted in two parts: 1) A questionnaire was developed by the researcher to collect demographic and educational data from participants including: age, ethnicity, level of academic education, years of experience in nursing and in specialty, education to nursing theory, including education specifically to Watson's Theory of Human Caring and to holistic nursing and Complementary and Alternative Modalities (CAM), and CAM use in practice and self-care; and 2) Kim's (1999, 2007, 2010) Critical Narrative Inquiry Method was used to collect and analyze narrative data in three phases: 1) descriptive 2) reflective; and 3) critical-emancipatory. Written and audio data from in-person interviews were transcribed and analyzed by the researcher. Data was validated by participants and used to answer four research questions: 1) What are the emancipatory experiences of nurses in a Magnet^® re-designated healthcare system that promotes Human Caring Theory; 2) What are the patterns that facilitate nurses' comportment and self-agency to fully embody and practice integral nursing qua nursing in a Magnet^® re-designated healthcare system; 3) What are the patterns that create barriers to nurses' comportment and self-agency to fully embody and practice integral nursing qua nursing in a Magnet ^® re-designated healthcare system; and 4) How does the organization support nurses control over their nursing practice within this one ANCC Magnet ^® re-designated healthcare system? Findings gleaned from the patterns that occurred most frequently in the narrative data included: 1) Nurses used Human Caring and Integral Nursing theoretical concepts to inform and conduct their practice; even though they reported limited education to the theories. Elements of the theories that manifested in their practice and self-care included: advocating, educating, counseling, creating a caring-healing environment by honoring the patient and family's space and wishes, approaching patients and families non-judgmentally with an open mind and loving kindness, using complementary modalities of humor, prayer, intention, authentic presence, music, imagery, touch, and obtaining complementary therapy, palliative and spiritual care consults for patients; 2) Facilitators to practice included: the support of their manager, colleagues and team members, optimal staffing patterns, resource nurses and competent, self-motivated care technicians and support staff; and 3) Nurses in the study confirmed their Magnet^® healthcare system values: a) Supportive and participative nursing management; b) Advanced education by providing tuition reimbursement and flexible scheduling; c) Participation in and use of the most current nursing research in their practice; and d) A strong nursing mentoring culture, where nurses empower each other to provide ethical care and advocate for patients' and nurses' rights. Opportunities for nursing education and leadership include: 1) The need to revise academic and continuing education curricula to adopt integral theory guided practice at all levels; 2) The need for advanced practice nurses to translate conceptual models into practice and help nurses to articulate the value and power of nursing to impact integral health and healing.

Suggested Keywords: nursing, holistic, integral, human caring, theory guided practice, emancipatory praxis, critical narrative inquiry, ANCC Magnet^®.

As nurses, we seek to gain nursing wisdom and apply it in our daily practice, yet the process of practicing with wisdom has not been well explained for nursing. The purpose of this dissertation was to develop a theory of wisdom in action (WIA) for clinical nursing, beginning with a formal concept analysis.

In Phase 1 (Aim 1), a preliminary theory was developed deductively using derivation and synthesis, based on theories and models from psychology, education, and nursing. Pertinent concepts were identified and nursing-specific definitions created. The theory included four dimensions: person-related factors, environment-related factors, knowledge, and wisdom.

Separately, a constructivist grounded theory approach inductively captured the experience of wisdom in nursing practice (Aim 2), based on wisdom narratives from 30 emergency department nurses. The resulting grounded theory focused on two processes, technical and affective, juxtaposed on a foundation of expertise. New findings were the importance of affective characteristics such as emotional intelligence and confidence.

Finally, the theories were synthesized into the Theory of Wisdom in Action for Clinical Nursing. The theory describes two antecedent dimensions, person-related and setting-related factors, and two types of wisdom processes. General wisdom processes apply to patient care and describe the actions nurses take during a stressful or uncertain event. Personal wisdom develops afterwards, as a feedback loop with reflection, discovery of meaning, and learning, followed by increased knowledge and confidence.

Wisdom is critical for all areas of nursing practice. The Theory of Wisdom in Action for Clinical Nursing provides a working framework for translating wisdom in clinical nursing practice into theoretical and practical terms, depicting both the science and the art of nursing. This novel theory displays how nurses practice with wisdom, and reveals that wisdom in action requires clinical skills, experience, knowledge, and affective proficiency.

Using a phenomenological design, the researcher explored the question of what is the experience of suffering as voiced by male patients three to twelve months after hospitalization for blunt trauma. Seventeen male volunteers were interviewed and asked questions about how they suffered, what made their suffering more or less bearable, and how they were transformed through their suffering. Participants experienced changes in patterns resulting in a perception of suffering. Participants reported mostly experiencing physical, emotional, and social forms of suffering while fewer experienced economic and spiritual suffering. Experiences of suffering resulted from the threat to their normal state or sense of wholeness because of their injuries. Intrinsic and extrinsic factors were identified making the participants? suffering more or less bearable as they regained their lost state of normal. Positive attitude and motivation were significant intrinsic factors while quality supportive care was the most significant extrinsic factor. Poor quality care was a significant negative extrinsic factor resulting in experiences of increased suffering. Through their experiences of suffering the participants were transformed, amending their previous state of normal. Knowledge gained through this phenomenological study may be useful to nurses in guiding their care to alleviate patients? suffering.

The health care environment is transforming with new demands and expectations to improve patient outcomes including patient satisfaction. Health care organizations expect front line nurse managers to improve patient quality and satisfaction without a clear direction or meaningful understanding of the holistic role, functions, and competencies required to achieve organizational goals. The purpose of the qualitative transcendental phenomenological study was to explore the lived experiences and perceptions of the holistic and changing nature of the projected contemporary nurse manager’s roles, skills, practices, and dimensions aligned with the expectations for improving patient satisfaction. The exploration of the lived experiences and perceptions among 21 study participants, and data analysis using the modified van Kaam approach, led to the formulation of eight major themes that explained the nature of the experience with the phenomenon. The eight essential themes that encompass the context of the new contemporary and holistic role of the nurse manager to improve patient satisfaction include the following; (a) new expectations, (b) building a patient caring culture, (c) leader rounding, (d) healthy working environment, (e) staff engagement and empowerment, (f) change agent for continuous quality improvement, (g) impact of organization focus and culture, (h) challenges: sustainability of initiatives; lack of interdepartmental and interdisciplinary teamwork. The new proposed nurse manager role in transformation conceptual model aligns nurse manager contemporary and holistic role with transforming cultures for improved patient outcomes. The study findings are significant to health care organization, leaders, policy makers, and educators, in creating new patient caring and healthy working cultures for improved patient satisfaction.

I Sverige lider ca 50 000 personer av bensår vilket definieras som ”sår på ben och/eller fot nedom knät som ej läkt på 6 veckor”, ungefär hälften av dessa är venösa bensår. De flesta som drabbas av bensår är 65 år eller äldre. Syftet med denna studie var att beskriva patienters upplevelse av att leva med venösa bensår. Studien är baserad på en kvalitativ metod med en induktiv ansats. Data samlades in genom intervjuer från sex patienter och analyserades sedan med hjälp av innehållsanalys. Resultatet baseras på två kategorier; begränsat och bundet liv samt önskan att bli sedd. Dessa kategorier bildade temat; att vara hel men ändå inte. Utifrån denna studie kan personal som vårdar och behandlar bensårspatienter få ökad kunskap om hur patienter upplever att det är att leva med venösa bensår. Med hänsyn till detta vore det önskvärt att effektiva och välstrukturerade vårdrutiner utarbetas för att uppnå helhetssyn inom vården och behandlingen av bensårspatienter.

Approximately 50 000 people in Sweden are suffering from leg ulcers which is defined as "wounds on the legs and/or foot below the knee, which is not healed in 6 weeks", about half of them are venous leg ulcers. Most people who suffer from leg ulcers are 65 years or older. The purpose of this study was to describe patients' experiences of living with venous leg ulcers. The study is based on a qualitative method with an inductive approach. Data were collected through interviews from six patients and analyzed with help of content analyzing. The results are based on two different categories: limited and restricted life, and desire to be seen. These categories formed the theme; to be whole but still not. Based on this study, staff who care for and treat leg ulcer patients can increase knowledge about how patients feel it is to live with venous leg ulcers. Given this, it would be desirable that there are effective and well-structured care practices designed to achieve holistic healthcare and treatment of patients with leg ulcers.

Diss. (sammanfattning) Umeå : Umeå universitet, 1995