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Constant Comparative Method (constant + comparative_method)
Selected AbstractsUncertainty, lack of control and emotional functioning in women with metastatic breast cancer: a review and secondary analysis of the literature using the critical appraisal techniqueEUROPEAN JOURNAL OF CANCER CARE, Issue 5 2010M. WARREN msc, clinical nurse specialist WARREN M. (2010) European Journal of Cancer Care19, 564,574 Uncertainty, lack of control and emotional functioning in women with metastatic breast cancer: a review and secondary analysis of the literature using the critical appraisal technique A diagnosis of metastatic (or secondary) breast cancer is frequently more distressing than the diagnosis of a primary tumour since it indicates that the cancer is no longer curable. Relatively little is known, however, about women's experiences of this condition in comparison with those diagnosed with primary breast cancer. This paper therefore reports findings from a secondary analysis of the published literature on the topic using tools from the critical appraisal skills programme to identify and analyse appropriate papers, and the constant comparative method as a means of identifying any overarching or dominant themes emerging from the literature. Uncertainty, lack of control and poor emotional functioning emerged as the main themes affecting women with metastatic breast cancer. These are discussed in relation to their antecedents in the original studies and their implications for nursing care. The themes demonstrate that living with metastatic (or secondary) breast cancer is a multifaceted experience that is influenced by a large number of factors, many of which are under-researched in comparison with those affecting women diagnosed with primary disease. It is clear, however, that women affected by the condition need a great deal more support than they currently receive, and new services may be required to meet these needs. [source] Decision-making in community-based paediatric physiotherapy: a qualitative study of children, parents and practitionersHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 2 2006Bridget Young BA PhD Abstract Approaches to practice based on partnership and shared decision-making with patients are now widely recommended in health and social care settings, but less attention has been given to these recommendations in children's services, and to the decision-making experiences of non-medical practitioners and their patients or clients. This study explored children's, parents' and practitioners' accounts of shared decision-making in the context of community-based physiotherapy services for children with cerebral palsy. Semi-structured interviews were conducted with 11 children with cerebral palsy living in an inner city area of northern England, and with 12 of their parents. Two focus groups were conducted with 10 physiotherapy practitioners. Data were analysed using the constant comparative method. When asked explicitly about decision-making, parents, children and practitioners reported little or no involvement, and each party saw the other as having responsibility for decisions. However, when talking in more concrete terms about their experiences, each party did report some involvement in decision-making. Practitioners' accounts focused on their responsibility for making decisions about resource allocation, and thereby, about the usefulness and intensity of interventions. Parents indicated that these practitioner-led decisions were sometimes in conflict with their aspirations for their child. Parents and children appeared to have most involvement in decisions about the acceptability and implementation of interventions. Children's involvement was more limited than parents'. While parents could legitimately curtail unacceptable interventions, children were mostly restricted to negotiating about how interventions were implemented. In these accounts the involvement of each party varied with the type of issue being decided and decision-making appeared more unilateral than shared. In advocating shared decision-making, greater understanding of its weaknesses as well as its strengths, and greater clarity about the domains that are suitable for a shared decision-making approach and the roles of different parties, would seem a helpful step. [source] Inside the black box of shared decision making: distinguishing between the process of involvement and who makes the decisionHEALTH EXPECTATIONS, Issue 4 2006Adrian Edwards MRCGP MRCP PhD Abstract Background, Shared decision making has practical implications for everyday health care. However, it stems from largely theoretical frameworks and is not widely implemented in routine practice. Aims, We undertook an empirical study to inform understanding of shared decision making and how it can be operationalized more widely. Method, The study involved patients visiting UK general practitioners already well experienced in shared decision making. After these consultations, semi-structured telephone interviews were conducted and analysed using the constant comparative method of content analysis. Results, All patients described at least some components of shared decision making but half appeared to perceive the decision as shared and half as ,patient-led'. However, patients exhibited some uncertainty about who had made the decision, reflecting different meanings of decision making from those described in the literature. A distinction is indicated between the process of involvement (option portrayal, exchange of information and exploring preferences for who makes the decision) and the actual decisional responsibility (who makes the decision). The process of involvement appeared to deliver benefits for patients, not the action of making the decision. Preferences for decisional responsibility varied during some consultations, generating unsatisfactory interactions when actual decisional responsibility did not align with patient preferences at that stage of a consultation. However, when conducted well, shared decision making enhanced reported satisfaction, understanding and confidence in the decisions. Conclusions, Practitioners can focus more on the process of involving patients in decision making rather than attaching importance to who actually makes the decision. They also need to be aware of the potential for changing patient preferences for decisional responsibility during a consultation and address non-alignment of patient preferences with the actual model of decision making if this occurs. [source] The new neighbour: Experiences of living next door to people suffering from long-term mental illnessINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 1 2003Arild Granerud ABSTRACT The transition from hospital to community care for people with long-term mental illness is of growing concern. The aim of the present study was to illuminate if and how people with long-term mental illness have affected their neighbourhood after re-establishing themselves in apartments of their own. Nineteen neighbours of group homes for people with long-term mental illness, in seven different communities in eastern Norway, have been interviewed. The grounded theory procedures as well as the constant comparative method were employed to analyse the findings. From the data, one main category was identified: the need for information. [source] Collaborative Childcare Health Consultation: A Conceptual ModelJOURNAL FOR SPECIALISTS IN PEDIATRIC NURSING, Issue 2 2008Angela A. Crowley PhD PURPOSE.,This study explored the nature of consultation between childcare providers and nurse childcare health consultants and identified factors that promote a collaborative relationship. DESIGN AND METHODS.,A qualitative study using semistructured, individual interviews of five collaborative and five conflicted pairs of nurse childcare health consultants and childcare center directors. Data were analyzed following principles of grounded theory and applying the constant comparative method of analysis. RESULTS.,Establishing a collaborative relationship was influenced by previous experiences and four themes in the relationship: open and active communication, commitment, respect, and congruent philosophies. PRACTICE IMPLICATIONS.,Preparation in developing collaborative relationships should be incorporated into the education of nurse consultants and childcare directors and providers. [source] Patients' perceptions of nursing care in the hospital settingJOURNAL OF ADVANCED NURSING, Issue 4 2003Lee A. Schmidt PhD RN Background., Patient satisfaction and patient satisfaction with nursing care data are routinely collected as an indicator of the quality of services delivered. Despite the widespread collection and reporting of these data, the theoretical basis of patient satisfaction and patient satisfaction with nursing care remains unclear. Without a clear theoretical base, interpretation of patient satisfaction findings is hampered and the entire line of patient satisfaction research is of questionable validity. It has been suggested that, to understand patient satisfaction, patient perceptions of their care must first be understood. Aim., The aim of this study was to discover patients' perceptions of the nursing care they receive in the hospital setting. Method., Grounded theory method was used in this study of eight medical,surgical patients recently discharged from an academic medical centre in the south-eastern United States of America (USA). Participants were interviewed and the verbatim transcripts analysed using the constant comparative method. Findings., Four categories of patient perceptions of their nursing care emerged from the data. ,Seeing the individual patient' captures the unique nature of the nursing care experience for each patient. ,Explaining' represents the informal explanations given by nursing staff as they provide care. ,Responding' refers to both the character and timeliness of nursing staff's responses to patient requests or symptoms. ,Watching over' represents the surveillance activities of nursing staff. Conclusions., The categories identified in this study may be used in efforts to further develop a formal theory of patient satisfaction with nursing care. These categories should also be tested with patients possessing a wider range of characteristics, to assess the transferability of the findings. [source] Interaction between caregivers and families expecting a malformed childJOURNAL OF ADVANCED NURSING, Issue 1 2003Hanna Maijala MNSc RN Background. Earlier research has shown that the care of families expecting a malformed child should be intensified and that the topic is understudied. Aim. This study aimed at generating a practical nursing theory of interaction between caregivers and families expecting a malformed child, as experienced by families. Methods. A grounded theory study was undertaken at a university hospital, Finland. Data consisted of semi-structured interviews with 29 mothers and fathers, analysed using the constant comparative method. Findings. The interaction process starts with the confirmation of the diagnosis. It usually comes as a shock to the parents, and gives rise to questions about the nature of the malformation, family members' relationship with themselves, family relationships and relationships with people outside the family. These questions are crucial to the family's coping and form the core of interaction. Families' own coping strategies are either reinforced or undermined by caregivers' actions and are reflected in parents' expectations about caregivers, which in part account for their actions and experiences of interaction. The care system as an interactive environment is part of a process which results in the experiences of being helped or being left without help. The core of the interaction process comprises two dimensions: gaining strength and losing strength in relation to malformation issues. Conclusions. The findings of the study are consistent with earlier research and complement it by providing a detailed delineation of the interaction from the perspective of the family. They can be used to formulate recommendations for improving caregivers' interactive skills and awareness of the topic through training. The care system should be developed to ensure that families receive psychological support and that the family as a whole receives proper care. Consideration of the viewpoint of siblings is a challenge for further research. [source] Caregivers' experiences of interaction with families expecting a fetally impaired childJOURNAL OF CLINICAL NURSING, Issue 3 2004Hanna Maijala MNSc Background., On the basis of earlier research, caregivers' actions when interacting with clients should be developed. However, nursing research has focused little attention on the interaction between caregivers and families expecting a fetally impaired child. Aim., The study aimed at generating a practical family nursing theory of caregivers' interaction with families expecting a malformed child. Methods., A grounded theory study was undertaken at Tampere University Hospital in Finland in 1999,2000. Data consisted of semi-structured interviews with 22 (n = 22) nurses and doctors. The data were analysed using the constant comparative method. Results., The interaction process starts when a caregiver informs the parents of the fetal impairment. The process is influenced by caregivers' attitude towards issues related to the family's life situation. Caregivers' views of their job, and of human coping and cultural attitudes towards these issues are also of importance. These factors account for their goals in the interaction, which, in turn, underlie their actions. When the caregiver's interpretation is that the family accepted the help provided, the outcome of the interaction is satisfaction with having been able to help. Correspondingly, in the case of an opposite interpretation, the caregiver experiences strain caused by inadequacy of the help he/she is providing. The core of interaction consists of two dimensions: gaining strength and losing strength in relation to impairment issues. Conclusions., Caregivers' views of helpful interaction were consistent with earlier research on the subject, but the findings of this study showed that more attention should be focused on the family as a whole. Furthermore, caregivers rarely criticized their own actions, thus their interaction skills should be upgraded by focusing on systematic self-assessment through training. Nursing research deepening our understanding of why interaction fails is warranted. Relevance to clinical practice., The study results can be used in the family nursing practice as tools in reinforcing the caregivers' ability to helpful interaction with families expecting a fetally impaired child. The results may enhance caregivers' systematic self-evaluation and conscious use of the self. [source] Becoming a success story: how boys who have molested children talk about treatmentJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 3 2003L. LAWSON PhD RN This grounded theory study was designed to generate a mid-range theory of treatment from the perspective of boys who have molested children and undergone outpatient treatment. Data included information from seven boys' charts, their written responses to open-ended questions, and audio-taped interviews. The interviews generated a series of statements reflecting the boys' experiences in treatment, which were analysed by the constant comparative method. The basic social process of treatment was ,becoming a success story'. The structural elements of becoming a success story included relapse prevention, compliance and decision-making. The boys integrated these structural elements by talking to people they trusted, listening to what people said, and using what people said to help them do what was right. Becoming a success story took place in a context of family and community support. In its current form, this theory of treatment success can be used in practice to monitor progress through treatment. [source] National Board Certification (NBC) as a catalyst for teachers' learning about teaching: The effects of the NBC process on candidate teachers' PCK developmentJOURNAL OF RESEARCH IN SCIENCE TEACHING, Issue 7 2008Soonhye Park Abstract This study examined how the National Board Certification (NBC) process, especially the portfolio creation, influenced candidate teachers' pedagogical content knowledge (PCK). In a larger sense, this study aimed to construct a better understanding of how teachers develop PCK and to establish ecological validity of the National Board assessments. Qualitative research methods, most notably case study, were utilized. Participants were three high school science teachers who were going thorough the NBC process. Data sources included classroom observations, interviews, teachers' reflections, and researcher's field notes. Data were analyzed using the constant comparative method and enumerative approach. Findings indicated that the NBC process affected five aspects of the candidate teachers' instructional practices that were closely related to PCK development: (a) reflection on teaching practices, (b) implementation of new and/or innovative teaching strategies, (c) inquiry-oriented instruction, (d) assessments of students' learning, and (e) understanding of students. © 2008 Wiley Periodicals, Inc. J Res Sci Teach 45: 812,834, 2008 [source] The use of a computer simulation to promote scientific conceptions of moon phasesJOURNAL OF RESEARCH IN SCIENCE TEACHING, Issue 3 2008Randy L. Bell Abstract This study described the conceptual understandings of 50 early childhood (Pre-K-3) preservice teachers about standards-based lunar concepts before and after inquiry-based instruction utilizing educational technology. The instructional intervention integrated the planetarium software Starry Night BackyardŌ with instruction on moon phases from Physics by Inquiry by McDermott (1996). Data sources included drawings, interviews, and a lunar shapes card sort. Videotapes of participants' interviews were used along with the drawings and card sorting responses during data analysis. The various data were analyzed via a constant comparative method in order to produce profiles of each participant's pre- and postinstruction conceptual understandings of moon phases. Results indicated that before instruction none of the participants understood the cause of moon phases, and none were able to draw both scientific moon shapes and sequences. After the instruction with technology integration, most participants (82%) held a scientific understanding of the cause of moon phases and were able to draw scientific shapes and sequences (80%). The results of this study demonstrate that a well-designed computer simulation used within a conceptual change model of instruction can be very effective in promoting scientific understandings. © 2007 Wiley Periodicals, Inc. J Res Sci Teach 45: 346,372, 2008 [source] Occupational balance of women with rheumatoid arthritis: a qualitative studyMUSCULOSKELETAL CARE, Issue 2 2004Tanja Stamm MSc MBA MagPhil OTR Abstract Objective: Occupational balance has been shown to be an important factor in maintaining health. Rheumatoid arthritis (RA) reduces functional ability and quality of life and may thus reduce occupational balance. The aim of this qualitative pilot study was to explore occupational balance in women who have RA. Methods: Nine women with RA with past, but not current, paid work experience, no other confounding neuro-motor disease and with disease duration of 0.75,31 years were selected from an Austrian rheumatology outpatient clinic. Age range of the participants was 28,68 years. A semi-structured interview was conducted with each participant and transcribed verbatim. Data were analysed by the constant comparative method from an occupational perspective. Results: Three main categories emerged: (1) The participants experienced a process of change that affected their occupational balance. (2) This new state of occupational balance was characterized by changed levels of involvement in physical, mental, social and rest occupations and by a certain level of unpredictability of symptoms. (3) Overall, the new state of occupational balance was valued differently: positively, indifferently or negatively. Conclusion: RA was found to have a considerable impact on occupational balance. The experience is not invariably seen as negative as previous literature would suggest. Further research should explore the longitudinal dimension of occupational balance in people with RA. Copyright © 2004 Whurr Publishers Ltd. [source] Promoting autonomy of the client with persistent mental illness: A challenge for occupational therapists from The Netherlands, Germany and BelgiumOCCUPATIONAL THERAPY INTERNATIONAL, Issue 3 2006Mieke Le Granse Abstract The aim of this study was to determine how occupational therapists from The Netherlands, Germany and Belgium promote the autonomy of clients with persistent mental illness. Sixty occupational therapists working in psychosocial mental health completed two semi-structured questionnaires. Data were analysed by applying the constant comparative method. The results of the study show the importance of handling motivation in relation to personal autonomy and the different strategies occupational therapists use in promoting autonomy. In conclusion, enhancing clients' personal autonomy will empower and help them to discover meaningful occupations. More in-depth information could have been obtained using an interview in combination with observations. Further research is needed to evaluate the effectiveness of strategies used by occupational therapists in promoting clients' autonomy. Copyright © 2006 John Wiley & Sons, Ltd. [source] An exploratory, interview study of oncology patients' and health-care staff experiences of discussing resuscitationPSYCHO-ONCOLOGY, Issue 11 2007Karen Cox Abstract There is little research about how patients and their families would like discussions surrounding resuscitation to take place. The purpose of this exploratory study was to investigate the experience of a discussion of resuscitation from the perspective of the participants. In-depth interviews were undertaken with 21 patients, of whom nine were interviewed together with a relative and 14 staff in an oncology setting. Data were analysed using a constant comparative method and coded using NVIVO qualitative data analysis software. Patients appeared to be accepting resuscitation discussions as necessary and important. A minority felt that the timing of the discussion could have been better, particularly if they were newly diagnosed or had recently commenced treatment. Relatives generally found the discussions more difficult and felt that discussions should take place much closer to death. Patients identified that they needed time and privacy during the discussion. Staff identified a need to present a sensitive and individualised discussion which took into account the key elements of timing, place, space, manner and pace. Patients acknowledged that the resuscitation discussion enabled them to begin to address issues relating to dying and end of life. For staff on-going communication skills training and support in this area were seen as important but often overlooked parts of the process. Copyright © 2007 John Wiley & Sons, Ltd. [source] Practitioner-researchers in occupational therapyAUSTRALIAN OCCUPATIONAL THERAPY JOURNAL, Issue 1 2000Anne Cusick Few occupational therapy clinicians are research productive even though their involvement in research is encouraged. The role of ,research-practitioner' is put forward as a means by which practitioners can be research productive. There is, however, an absence of studies exploring experience of the minority of practitioners who do produce research. This study used a qualitative approach to do this in occupational therapy. Purposive sampling was conducted of all research productive clinicians in acute-care hospitals in one Australian city. Of the 20 possible researchers, 15 participated in in-depth interviews which explored their experience of research. Results were analysed using the constant comparative method and six conceptual categories were developed to describe their experience. The key findings were that clinicians who did research perceived themselves to be different from other clinicians in terms of attributes; and they described special ways of getting research done, and ways of reflecting on outcomes of their research involvement. The study provides an empirical foundation to further consider the practitioner-researcher role in practice professions such as occupational therapy. [source] Practices and views on fetal heart monitoring: a structured observation and interview studyBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 4 2006S Altaf Objective, To assess and explain deviations from recommended practice in National Institute for Clinical Excellence (NICE) guidelines in relation to fetal heart monitoring. Design, Qualitative study. Setting, Large teaching hospital in the UK. Sample, Sixty-six hours of observation of 25 labours and interviews with 20 midwives of varying grades. Methods, Structured observations of labour and semistructured interviews with midwives. Interviews were undertaken using a prompt guide, audiotaped, and transcribed verbatim. Analysis was based on the constant comparative method, assisted by QSR N5 software. Main outcome measures, Deviations from recommended practice in relation to fetal monitoring and insights into why these occur. Results, All babies involved in the study were safely delivered, but 243 deviations from recommended practice in relation to NICE guidelines on fetal monitoring were identified, with the majority (80%) of these occurring in relation to documentation. Other deviations from recommended practice included indications for use of electronic fetal heart monitoring and conduct of fetal heart monitoring. There is evidence of difficulties with availability and maintenance of equipment, and some deficits in staff knowledge and skill. Differing orientations towards fetal monitoring were reported by midwives, which were likely to have impacts on practice. The initiation, management, and interpretation of fetal heart monitoring is complex and distributed across time, space, and professional boundaries, and practices in relation to fetal heart monitoring need to be understood within an organisational and social context. Conclusion, Some deviations from best practice guidelines may be rectified through straightforward interventions including improved systems for managing equipment and training. Other deviations from recommended practice need to be understood as the outcomes of complex processes that are likely to defy easy resolution. [source] The sexual lives of men with mild learning disability: a qualitative studyBRITISH JOURNAL OF LEARNING DISABILITIES, Issue 1 2009Evan Yacoub Accessible summary ,,We talked to some men with learning disability about sex and relationships. Some people lived in the community, and some people lived in hospital. ,,The men knew quite a lot about sex. Most people said they got good support from their keyworkers. ,,Some people were asked for sex when they did not want it. Some people were made to have sex that was not safe. ,,We have some ideas about how men with learning disabilities can speak up for themselves about sex and relationships. Summary We aimed to explore in detail the sexual lives and behaviour of men with mild learning disabilities living both in community and in secure hospital settings. We wanted to generate hypotheses about them and identify potential unmet needs. We used a narrative interview that focused on areas such as relationships, sex education, contraception and the attitudes of others towards the participants' sexual lives and orientation. We used the constant comparative method to analyse transcribed interviews. Several clients reported engaging in unsafe practices despite being aware of the risks. Participants generally felt that services had shifted from a paternalistic to a more supportive approach towards their sexual lives and orientation. Experiences with other men were commonly reported. Several participants reported being pressurised into sex as adults. In our sample, sexual knowledge did not lead to safe sexual practices. The good rapport with services reported by the participants may be utilised to provide further education and empowerment to improve the safety of sexual practices in this group. Other ways of improved service delivery are suggested. [source] | ||||||||||||||||||||||