A description of approachable nurses: An exploratory study, the voice of the hospitalized child

Purpose: The 1989 Convention on the Rights of the Child drew international attention to the right of a child to be heard. Researchers have enhanced the child’s voice in many settings, albeit few in the hospital. Nurse researchers investigating the hospital experiences of children have identified positive and negative patterns of communication. Potential characteristics of an approachable nurse were hinted at, although none explored the concept of approachability. Design and methods: A qualitative, descriptive research design, including semi-structured interviews with seven school age children (ages 8-12, four girls and three boys) in a pediatric oncology service, was used to gain children’s perceptions and descriptions of approachable nurses. Drawings were used to supplement and glean a greater understanding of descriptive characteristics. All but one child had endured multiple hospitalizations related to their diagnosis of cancer. Interviews were recorded and data were content analyzed using immersion/crystallization and editing organizational styles. Results: The children had experiences with more than one approachable nurse and described approachable nurses as smiling and happy, playful, creative, competent and willing to talk and listen to them. Conclusion and practice implications: The school age children in this study were able to describe their perceptions of an approachable nurse. The voices of these children illuminate the importance of nurses’ words and behaviors and provide exemplars of approachable nurses. It can be argued that the responsibility remains with nurses to create an environment where in hospitalized children feel their voices are heard, they are understood and respected with unprecedented dignity

Home: The place the older adult can not imagine living without

<p>Abstract</p> <p>Background</p> <p>Rapidly aging populations with an increased desire to remain at home and changes in health policy that promote the transfer of health care from formal places, as hospitals and institutions, to the more informal setting of one's home support the need for further research that is designed specifically to understand the experience of home among older adults. Yet, little is known among health care providers about the older adult's experience of home. The aim of this study was to understand the experience of home as experienced by older adults living in a rural community in Sweden.</p> <p>Methods</p> <p>Hermeneutical interpretation, as developed by von Post and Eriksson and based on Gadamer's philosophical hermeneutics, was used to interpret interviews with six older adults. The interpretation included a self examination of the researcher's experiences and prejudices and proceeded through several readings which integrated the text with the reader, allowed new questions to emerge, fused the horizons, summarized main and sub-themes and allowed a new understanding to emerge.</p> <p>Results</p> <p>Two main and six sub-themes emerged. Home was experienced as the place the older adult could not imagine living without but also as the place one might be forced to leave. The older adult's thoughts vacillated between the well known present and all its comforts and the unknown future with all its questions and fears, including the underlying threat of loosing one's home.</p> <p>Conclusions</p> <p>Home has become so integral to life itself and such an intimate part of the older adult's being that when older adults lose their home, they also loose the place closest to their heart, the place where they are at home and can maintain their identity, integrity and way of living. Additional effort needs to be made to understand the older adult's experience of home within home health care in order to minimize intrusion and maximize care. There is a need to more fully explore the older adult's experience with health care providers in the home and its impact on the older adult's sense of "being at home" and their health and overall well-being.</p

Learning to Endure Long-Term Musculoskeletal Pain in Daily Life at Home: A Qualitative Interview Study of the Older Adult’s Experience

Background: Worldwide, there is an increasing number of older adults, the majority of whom remain living at home. Not infrequently they live with long-term pain, especially musculoskeletal pain, which is associated with increased disability (physical, psychological, social) and a negative impact on quality of life. A deeper understanding of how older adults experience living with this type of pain is needed in order to improve well-being and quality of life. The study focused on the actual experience by living with this global, prevailing and disabling type of pain. The aim was to describe commonalities in how older adults endure long-term musculoskeletal pain in their daily life at home. Methods: This inductive, descriptive study included qualitative semi-structured face-to-face interviews with 19 participants (66 to 88 years) in their homes. Qualitative content analysis by Graneheim and Lundman was used to identify themes crossing participants’ experiences of enduring long-term pain in their daily life. Interviews were audio recorded and transcribed verbatim. Results: All participants felt forced into “learning to live with pain” (main theme), in order to endure their pain. In time, they learned that: taking the pain as it comes, one day at a time; balancing the pain with activity, thoughts and emotions; self-talking; decreasing the burden to family and others; and capturing, enjoying and valuing moments of pleasure (sub-themes) helped them endure the pain. Conclusions: This experience was dominated by learning. The approaches generated to learn to endure pain in daily living by these participants should be discussed with older adults in similar situations for further additions, refinements and validation. Nurses can help to ease the older adult’s suffering by tailoring individualized and holistic care focused on guiding the older adult in learning to live with pain and preserving and promoting health and well-being with a maximum of care and a minimum of intrusion

Making sense of it: a neuro-interactional model of meaning emergence in critically ill ventilated patients

Emphasis on meaning underpins a current thrust of knowledge development in nursing, especially in the client domain. Examination of meaning in the interactional context and through varying levels of consciousness has not been examined. Initially, an integrated model was developed deductively from philosophical, theoretical and research-oriented sources. This model was meant as a guide to begin examining how patients with varying levels of consciousness make sense of their intensive care unit experience. Over a 10-month period of fieldwork, this author observed patients twice daily through their intensive care unit stay to capture the nature and content of thinking processes. The resulting neuro-interactional model describes patients\u27 thinking processes and scope of meaning as a function of levels of consciousness as well as factors which affect thinking and meaning. Theory, research and practice implications are presented

Perceptions of emotional eating behavior. A qualitative study of college students

Approximately one-third of college students are overweight or obese and the average student gains 5kg during college. Previous research has identified a relationship between emotional eating and weight gain in young adults, but outside the realm of eating disorders, few studies qualitatively capture why individuals cope with emotions by eating. Exploratory qualitative research was conducted, including 3-day food journals and indepth interviews, with proportionate quota sampling of eight male and eight female undergraduate students to gain an understanding of students\u27 perceptions of their emotional eating behaviors. Participants were purposively selected based on their emotional eating scores on the Weight Related Eating Questionnaire from a larger survey assessing student eating behaviors. Participants\u27 (n=16) mean age was 19.6±1.0years and all self-reported their race to be white. Mean Body Mass Index (BMI) for females and males was 24.1±1.2kg/m2 and 24.8±1.7kg/m2, respectively. Findings from the qualitative analyses indicated gender differences and similarities. Females identified stress as the primary trigger for emotional eating, frequently followed by guilt. Males were primarily triggered by unpleasant feelings such as boredom or anxiety turning to food as a distraction; however, males were less likely to experience guilt after an emotional eating episode than females. During emotional eating episodes, both genders chose what they defined as unhealthful foods. These findings indicate a multidisciplinary intervention focusing on emotion and stress management in addition to dietary behavior change should be developed to reduce the potential for weight gain associated with emotional eating in the college-aged population. © 2012 Elsevier Ltd

Overcoming obstacles to behavior change in diabetes self-management

PURPOSE: This study describes how 5 individuals with type 2 diabetes overcame obstacles that interfered with maintaining behavior changes in diet, exercise, and self-monitoring of blood glucose (SMBG). METHODS: In-depth interviews provided the framework for this descriptive study. During audiotaped, face-to-face, follow-up structured and unstructured interviews, the participants shared their experiences about obstacles encountered and strategies used to overcome them. Each case was examined independently, and all cases were then compared with each other. RESULTS: Obstacles that interfered with maintaining a diet plan were hunger, planned and unplanned meal events, and the desire for new foods. Physical illness and unexpected life events were obstacles to maintaining an exercise and SMBG plan. CONCLUSIONS: Health professionals who assist patients who are beginning behavior change or having difficulty maintaining changes need to have an understanding of the various obstacles and how patients can maintain behavior changes over time

Risk Taking Among Diabetic Clients

Diabetic clients must make daily decisions about their health care needs. Observational and anecdotal evidence suggests that vast differences exist between the kinds of choices diabetic clients make and the kinds of chances they are willing to take. The purpose of this investigation was to develop a diabetic risk-assessment tool. This instrument, which is based on subjective expected utility theory, measures risk-prone and risk-averse behavior. Initial findings from a pilot study of 18 women clients who are on insulin indicate that patterns of risk behavior exist in the areas of exercise, skin care, and diet. © 1992, Sage Publications. All rights reserved

Visiting hours in the ICU: finding the balance among patient, visitor and staff needs.

TOPIC: Visiting hours. PURPOSE: To explore the experience of nurses who have been identified as experts at working with visitors in a critical care setting. METHODS: A qualitative research design incorporating in-depth interviews of eight intensive care nurses, limited participant observation, and a review of selected documents was used to investigate how expert nurses incorporate visitors into their daily practice. CONCLUSION: Incorporating visiting family members in to the plan of care is complex and requires balancing the visitors\u27 needs for information and access to a loved one with the nurse\u27s need to safely manage the care of a critically ill individual