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Biomedical subjects

B L Paterson

Publications and source records attributed to B L Paterson.

18 recordsLinked to original sources
PubMed2001

Health care professional support for self-care management in chronic illness: insights from diabetes research.

While it has long been recognized that health care professionals play an important role in supporting self-care management in chronic illness, the nature of that support is not well understood. This paper represents an analysis of findings drawn from qualitative research into the development of self-care decision-making expertise in adults with longstanding Type I diabetes, specifically addressing ways in which health professionals' interactions support or fail to support such processes. These findings highlight issues associated with the disease trajectory, the assumptions about intended outcome, and the complex contexts in which individuals live with chronic disease, illustrating the manner in which varying kinds of support may be required at different points within the learning process. They further challenge notions of standardized communication and informational strategies, demonstrating the complexities inherent in the support needs of chronically ill persons as they change over time and context.

Adult↗
PubMed2001

Critical analysis of everyday self-care decision making in chronic illness.

AIMS OF THE PAPER: The purpose of the paper is to (1) identify prevalent assumptions that underlie the traditional conceptualization of everyday self-care decision making and (2) contrast these with the findings of relevant research. BACKGROUND/RATIONALE: Current understandings of self-care decision making in chronic illness tend to be extrapolated from knowledge gained in relation to one-time decisions, or decision making in contexts that are only superficially related to the complexity and pervasiveness of living with a chronic disease. FINDINGS: The authors challenge the assumptions with which current understandings represent self-care decision making in chronic illness, using evidence from their research on what it is like to live with and manage the implications of having a chronic disease on an everyday basis. CONCLUSIONS: The paper concludes with a call for a new conceptualization of self-care decision making in chronic illness which sufficiently addresses the unique and complex nature of such decisions.

Adaptation, Psychological↗
PubMed2001

The shifting perspectives model of chronic illness.

PURPOSE: To present the Shifting Perspectives Model of Chronic Illness, which was derived from a metasynthesis of 292 qualitative research studies. DESIGN: The model was derived from a metasynthesis of qualitative research about the reported experiences of adults with a chronic illness. The 292 primary research studies included a variety of interpretive research methods and were conducted by researchers from numerous countries and disciplines. METHODS: Metastudy, a metasynthesis method developed by the author in collaboration with six other researchers consisted of three analytic components (meta-data-analysis, metamethod, and metatheory), followed by a synthesis component in which new knowledge about the phenomenon was generated from the findings. FINDINGS: Many of the assumptions that underlie previous models, such as a single, linear trajectory of living with a chronic disease, were challenged. The Shifting Perspectives Model indicated that living with chronic illness was an ongoing and continually shifting process in which an illness-in-the-foreground or wellness-in-the-foreground perspective has specific functions in the person's world. CONCLUSIONS: The Shifting Perspectives Model helps users provide an explanation of chronically ill persons' variations in their attention to symptoms over time, sometimes in ways that seem ill-advised or even harmful to their health. The model also indicates direction to health professionals about supporting people with chronic illness.

Adaptation, Psychological↗
PubMed2000

Attitudes toward patient expertise in chronic illness.

Although it has become an accepted standard to acknowledge the patient as a full partner in health care decisions, replacing traditional authoritative relationships with those based on an emancipatory model, the experiences of persons living with chronic illness confirm that this paradigm shift is not yet apparent in many health care relationships. In this paper, the authors present a qualitative secondary analysis of combined data sets from their research into chronic illness experience with two quite different chronic diseases - Type I Diabetes (a socially legitimized chronic disease) and Environmental Sensitivities (a disease which is currently treated with considerable scepticism). Comparing the experiences of individuals with diseases that are quite differently socially constructed, it becomes possible to detect common underlying health professional values and attitudes that powerfully influence the experience of living with and negotiating health care for a chronic illness. In the discussion of findings from this study, the authors examine the implications of the spiral of behaviors that fuels mutual alienation in chronic illness care relationships if professionals are unable to value patient expertise.

Attitude of Health Personnel↗
PubMed2000

Two decades of insider research: what we know and don't know about chronic illness experience.

Chronic illness in a general sense and certain chronic diseases in particular have attracted considerable attention from qualitative researchers in nursing as well as in other health and social sciences. This review critically examines the body of available research about the experience of living with a chronic illness from an "insider" perspective. From this foundation the authors interpret the manner in which this large body of writing both contributes to and complicates our theoretical understanding of what it is like to live with a chronic disease. In so doing they illuminate themes within the knowledge that can be gleaned from qualitative inquiry into the chronic illness experience, as well as inherent limitations that must be taken into consideration when applying such knowledge to practice.

Adaptation, Psychological↗
PubMed2000

Nursing research.

Explore the source record for details and available documents.

Brain Injuries↗
PubMed1999

A protocol for researcher safety.

Although there is an abundance of literature about how to conduct qualitative research and some consideration of possible threats to researchers' psychological well-being, there is little mention of the personal safety issues that researchers face while in the field. Few researchers have attempted to address the issue of researcher safety as a methodological concern. Consequently, there are minimal guidelines available to researchers to prevent and avoid dangerous incidents in the course of their research. The following is a discussion of the general guidelines for developing a protocol to address the issue of researcher safety in the field. These guidelines have been extrapolated from safety guidelines and policies written for students and clinicians who enter a client's home in their role as health care practitioners, relevant literature in the area of safety for researchers in violent settings, resources such as safety guidelines for employees, and the personal experiences of several researchers.

Accidents, Occupational↗
PubMed1998

Adapting to and managing diabetes.

PURPOSE: To advance understanding of the lived experience of diabetes as described in published research and theses. Meta-analysis extends the analysis of individual research studies beyond individual experience to incorporate dominant system beliefs and health system ideologies. ORGANIZING FRAMEWORK: Curtin and Lubkin's (1990) conceptualization of the experience of chronic illness. SOURCES: Forty-three qualitative interpretive research reports in six computerized data bases 1980-1996 pertaining to the lived experience of diabetes and published in nursing, in the social sciences, and in allied health journals were used. METHODS: Meta-ethnography in which trustworthiness was achieved by using multiple researchers, identifying negative or disconfirming cases, and testing rival hypotheses FINDINGS: Balance is the determinant metaphor of the experience of diabetes. People learn to balance diabetes through their experience and experimentation with strategies for managing their illness. CONCLUSIONS: Learning to balance is a developmental process in which one learns to assume control of diabetes management. Support for such development requires that nurses know their clients as individuals and value the expertise they have gained in living with diabetes. Control of blood sugar levels within a prescribed range may be a goal established by professionals, but the goal of healthy balance determines a person's willingness to assume an active role in self-care.

Decision Making↗
PubMed1997

The negotiated order of clinical teaching.

The clinical teacher and students in traditional nursing education programs represent a temporary system within the permanent culture of the clinical area in which they teach. Temporary systems are a set of diversely skilled people working together on a complex task over a limited period of time. A member of a temporary system struggles to maintain a differentiated identity within the permanent system, while at the same time seeking a sense of collegiality and belonging. Clinical teachers experience a feeling of being somewhat akin to the nursing staff in the clinical area in which they teach because they are nurses. At the same time, clinical teachers are alienated from the nurses because the staff has developed a permanent structure that excludes clinical teachers from many aspects of nurses' working lives. The focus of research concerning clinical teaching has been the tasks assigned to the clinical teacher rather than the experience of teachers as members of a temporary system. This article presents one aspect of a year-long exploratory and descriptive qualitative research study designed to explore and describe what takes place in the realm of clinical teaching in nursing education. The discussion will focus on the experience of clinical teachers as temporary systems according to the sociological framework of negotiated order.

Attitude of Health Personnel↗
PubMed1996

Critical care nurses' lived experience of unsuccessful resuscitation.

Although approximately 58% of patients in critical care units die despite resuscitation efforts, the experience of nurses who participate in unsuccessful patient resuscitation has been largely unexamined. The article is a description of a phenomenological research study designed to investigate this experience. Nine nurses employed in cardiac or intensive care units of a tertiary care hospital participated in the study by contributing paradigm narratives concerning unsuccessful patient resuscitation. The lived experience of unsuccessful resuscitation was described by the participants as one in which they fortified themselves for the emotional consequences and sense of loss associated with this experience while establishing a connectedness with the patient and his/her significant others.

Adult↗
PubMed1996

Learning to care: gender issues for male nursing students.

The following article is a description of one aspect of a phenomenological research study designed to investigate the lived experience of male nursing students as they learned to care as nurses. Data-collection strategies included paradigm case narratives and interviews. Data analysis was characterized by four major strategies: analysis, synthesis, criticism, and understanding. These strategies were used to identify meanings of the text of transcribed interviews and to generate interpretive commentary. Learning to care was described by the participants as a complex entity that incorporates the gender of the student, the patient, the teacher, and the nurse. As students progressed through the program, their experience of gender issues in learning to care was shaped by personal experiences, the expectations of a predominantly female faculty and nursing staff, and their evolving understanding of the ways of caring that are gender based.

Adolescent↗
PubMed1995

Developing and maintaining reflection in clinical journals.

There is a pressing need in today's world for nurses who are willing and able to transform health care. Teaching strategies that foster reflection are in order. The use of dialogue journals has been widely reported in the nursing literature as an effective strategy for assisting students to reflect about learning experiences in the clinical area. Despite the promise that journal writing will enhance students' ability to reflect on their clinical learning experiences, not all students respond positively to journal writing as a learning tool. The paper is a discussion of some of the common difficulties that arise in the use of clinical journals as a reflective strategy in nursing education. Common problems in the use of clinical journals include procrastination; superficial, nonreflective entries; waning enthusiasm about the activity; and unwillingness or inability to reflect. The possible etiologies for these problems will be explored. Specifically, the paper will focus on ways to prevent or minimize these concerns by maintaining and enhancing the factors required for students to reflect in clinical journals.

Autobiographies as Topic↗
PubMed1995

How male nursing students learn to care.

the current definitions of caring in nursing education denote a mutual relationship between teachers and students in which they interact to provide an environment which supports the students' personal and professional development. The learning of caring in an interactional context is typical of the female experience. It is unknown if this is representative of the male experience. The lived experience of 20 male students as they learned to care as nurses was the focus of this phenomenological research study. The participants concurred that, although caring as a nurse could be learned if one was 'open to learning', teachers could only facilitate this learning; they could not directly teach it. The interactional strategies of storytelling, modelling, being cared for, the 'aha' encounter, and observing and giving care, were used by the participants in learning to care as nurses. The implications of these findings for nursing education and research are presented.

Adult↗
PubMed1994

A framework to identify reactivity in qualitative research.

A significant consideration in the provision of rigor in qualitative research is the occurrence of reactivity, defined as the response of the researcher and the research participants to each other during the research process. This article presents a review of common sources of reactivity in qualitative research. It also describes a reactivity analysis framework that assists the researcher to analyze qualitative research data for reactive effects in a reflexive manner.

Cultural Characteristics↗