At a time when health care quality is being defined by providers, administrators, and third-party payers, it is more important than ever to ensure that patients’ voices are heard. Patients can tell us not only what makes nursing care excellent; they can tell us how this care makes a difference. This article reports on the outcomes ascribed to quality nursing care by a group of purposively selected oncology patients who participated in a grounded theory study. One outcome was a sense of well-being comprising trust, optimism, and authenticity. A second outcome, increased fortitude, occurred when the patients felt that they had the readiness, strength, and stamina to undergo cancer treatment and bear its effects. The outcomes are described and discussed in relation to existing scholarly work.
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- Go to article: Response to “Life-Span Development: A Review of Theory and Practice for Families With Chronically III Members”
- Go to article: Response to “Needs of Spouses of Surgical Patients: A Conceptualization Within the Roy Adaptation Model”
- Go to article: Response to “A Description of the Nature and Dynamics of Coping Following Coronary Artery Bypass Surgery”
Pediatric nurses have had a long-standing interest in stress and its effect on infants and children. Recently, there has been increasing interest in the physiological stress response on the part of nurses. While in the pediatric critical care setting, nurses continually assess the physiologic stability of the critically ill child, as well as the child’s responses to a variety of interpersonal interactions, clinical interventions, and treatments. This status is continually challenged by a multitude of stressors which induce subsequent responses by the child. Only through a better understanding of the age-appropriate physiologic stress response can nurses accurately confirm its presence and evaluate its potential consequences. A concept analysis of the pediatric physiological stress response was conducted, primarily using the strategy recommended by Walker and Avant (1988). Accordingly, this analysis included: (1) a literature review; (2) determination of possible uses of the concept; (3) selection of defining attributes; (4) identification of empirical referents; (5) identification of antecedents and consequences; (6) construction of model and alternative cases; and (7) review of implications for nursing research.
Dyspnea is the subjective experience of shortness of breath, which can be very distressing to the person experiencing it. It is a growing health care problem in the United States today because of the continued rise in the incidence of respiratory disease. Patients turn to their health professionals in the hope of obtaining relief. Physicians administer medications in an attempt to relieve the underlying physiological abnormality, but often this is inadequate. Few nursing interventions have been proposed for the relief of dyspnea. Part of the reason for this may be the lack of a perspective on dyspnea. Now, however, adequate data are available for this to begin. Differing perspectives in relation to dyspnea are presented here and evaluated for their relevance to nursing. Suggestions are made for future nursing research regarding dyspnea interventions.
- Go to article: Needs of Spouses of Surgical Patients: A Conceptualization Within the Roy Adaptation Model
Within the framework of the Roy Adaptation Model, three research questions were raised: What individual needs are most important to spouses of patients undergoing major general surgery? What category of needs (factor label) best accounts for spouses’ responses to the study questionnaire? Do factors identified from the individual needs reflect the four modes of Roy’s model? The study sample was composed of 75 spouses 21 years of age or older whose husbands or wives had undergone cholecystectomy, herniorrhaphy, hysterectomy, or prostatectomy for a benign condition. Spouses were asked to respond to a 46-item Needs of Spouses of General Surgical Patients questionnaire. Individual need items considered most important to spouses were related to reassurance about quality of patient care, availability of hospital staff, and understandability of information provided about the patients’ hospitalization and surgery. When the individual need items were submitted to factor analysis, all four modes of the Roy Adaptation Model were reflected, but in a somewhat different patterning than that suggested by the model. Factors were labeled Psychosocial Needs, Physiological Needs, Staff Support/Confidence in Care Needs, and Information Needs. The category of needs that best accounted for spouses’ responses was Psychosocial Needs.
Lev has written a three-part article about the theory of self-efficacy. To best understand the implications of the article, it might be useful to consider its three parts separately: the history and origin of self-efficacy as a construct, self-efficacy applications in oncology research, and the measurement properties of self-efficacy.
- Go to article: Personal Control and Other Determinants of Psychological Well-Being in Nursing Home Elders
The purpose of this correlational study was to identify predictors of psychological well-being in nursing home elders. Predictors considered were two dimensions of personal control, physical health, functional health, socioeconomic status, length of stay in the nursing home, and interaction variables. The nonrandom sample consisted of 302 cognitively intact nursing home elders with poor to excellent self-rated physical health. Instruments used included the Life Satisfaction Index A, Affect Balance Scale, Desired Control Measure, The Index of Activities of Daily Living, and The Two Factor Index of Social Position. Regression analysis demonstrated that dimensions of personal control and self-rated physical health explained 33% (p<.001) of the variance of psychological well-being. Findings suggested predictor variables to guide the promotion and maintenance of psychological well-being in the subjects of this sample.