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Biomedical subjects

J E Hupcey

Publications and source records attributed to J E Hupcey.

15 recordsLinked to original sources
PubMed2000

The need to know: experiences of critically ill patients.

BACKGROUND: Critically ill patients vary in their memories of their experience in the intensive care unit. Some have little recall and need to learn about their critical illness. Others have more vivid memories of their experiences, some of which were extremely unpleasant. Patients' not knowing what was happening may have exacerbated the unpleasant experiences. OBJECTIVES: To elicit the experience of knowing for critically ill patients and to explore the differences in perceptions between patients who were intubated and those who were not intubated during the illness. METHODS: Grounded theory was used to explore the meaning of knowing and not knowing and the process by which knowing occurs. Unstructured interviews were done with 14 patients. RESULTS: Knowing had 2 phases: the need to know (1) during and (2) after the critical illness. The first phase had 3 facets: needing information, needing to be oriented, and having confusing perceptions. The second phase had 2 facets: needing information about what had happened and piecing together events. Many experiences with knowing during and after a critical illness were similar for both intubated and nonintubated patients. The main difference was the intensity of the experience in some categories. CONCLUSIONS: Critically ill patients have a strong need to know throughout and after their time in the intensive care unit. Nurses must address this need for constant reorientation to the past and present in these patients. In addition, adequate nursing staff must be available for these patients.

Adult↗
PubMed1999

Looking out for the patient and ourselves--the process of family integration into the ICU.

As more intensive care units (ICU) are adopting the policy of unrestricted family visiting, families are playing an increasing role in the unit. This role may be restricted to being involved in discussions and decisions related to the patient or may entail a caregiving role. This study examined how families and nurses interact to increase or decrease the family's involvement in the ICU, how nurses maintain control, how families remain on guard, endure and find their niche in the ICU. The techniques of grounded theory were used to develop a model of the process of family integration into the ICU. This model was developed around the core variable of 'looking out for the patient-looking out for ourselves'. The perspectives of ICU nurses, families and ICU patients in the process of looking out for the patient while they look out for themselves are discussed, as well as nurses maintaining the position of power and families remaining on guard and enduring the ICU experience.

Attitude of Health Personnel↗
PubMed1999

Culturalizing health care for a culturally diverse population: the Amish.

Advanced practice nurses (APNs) are often the major source of primary care for culturally diverse groups. Working with patients who have values that differ from the mainstream culture can make delivery of health care complex and challenging. The purpose of this qualitative study was to use grounded theory methods to explore the process by which APNs develop and maintain therapeutic relationships with a culturally unique group, the Amish. Nine APNs who practiced primarily with Amish patients were interviewed about their strategies to promote therapeutic relationships. The process of culturalizing health care emerged as the strategy used by the APNs. Specific themes were learning the culture, developing a relationship, individualizing care, being comfortable with abilities, and working two systems. Rather than expecting patients to conform to the mainstream cultural beliefs and practices, APN informants used a variety of methods that allowed Amish patients to blend self-care practices with conventional (i.e., English care).

Attitude to Health↗
PubMed1998

Clarifying the social support theory-research linkage.

Social support is a multi-faceted concept that has been difficult to conceptualize, define and measure. Although this concept has been extensively studied, there is little agreement among theoreticians and researchers as to its theoretical and operational definition. As a result, the concept remains fuzzy and almost anything that infers a social interaction may be considered social support. Social support researchers have consistently ignored the complexity of the concept and have measured the variable in a simplistic manner. The purpose of this article is to analyse the linkage between theory and research related to social support by categorizing definitions of social support, exploring the theoretical aspects and conceptualizations of the concept, proposing models of social support, and examining how social support is measured in current social support research (1993-1996). The inadequacy of current research and directions for future study are discussed.

Humans↗
PubMed1998

Establishing the nurse-family relationship in the intensive care unit.

The nurse-family relationship in the intensive care unit (ICU) may replace the traditional nurse-patient relationship due to the patient's compromised state. As a result, the nurse-family relationship becomes extremely important. Nurses and families may develop a relationship in which they work together to benefit the patient, or an inadequate relationship may develop. In this study, strategies used by nurses and families to either develop or inhibit the development of the nurse-family relationship were identified. Using unstructured interviews with ICU nurses and family members of ICU patients, categories of strategies were identified and behaviors described. Nurses and families perceived that they each displayed only positive behaviors yet identified inhibiting behaviors of the other. Once the behaviors were shown to nurses as secondary informants, they were able to identify with their negative behaviors. An understanding of these strategies will help nurses to reevaluate their practice and enhance their understanding of the behaviors of family members.

Humans↗
PubMed1996

Criteria for concept evaluation.

One of the roles of qualitative enquiry is the utilization of qualitative methods for the development, refinement or modification of concepts. Yet, to date, there are no criteria for evaluating the adequacy of a concept. In this paper, the anatomy of a concept is presented, methods of concept analysis critiqued, and criteria for evaluation of the level of maturity of a concept suggested. Evaluation of criteria include assessment of: the definition of the concept, the characteristics of the concept, the conceptual preconditions and outcomes, and the conceptual boundaries. The authors argue that evaluation of a concept must necessarily precede concept development research (using a Wilsonian-derived method, a critical analysis of the literature, or qualitative enquiry) and precede more formal research procedures (such as operationalization or identification of the variables).

Concept Formation↗
PubMed1996

Wilsonian methods of concept analysis: a critique.

Wilsonian methods of concept analysis--that is, the method proposed by Wilson and Wilson-derived methods in nursing (as described by Walker and Avant; Chinn and Kramer [Jacobs]; Schwartz-Barcott and Kim; and Rodgers)--are discussed and compared in this article. The evolution and modifications of Wilson's method in nursing are described and research that has used these methods, assessed. The transformation of Wilson's method is traced as each author has adopted his techniques and attempted to modify the method to correct for limitations. We suggest that these adaptations and modifications ultimately erode Wilson's method. Further, the Wilson-derived methods have been overly simplified and used by nurse researchers in a prescriptive manner, and the results often do not serve the purpose of expanding nursing knowledge. We conclude that, considering the significance of concept development for the nursing profession, the development of new methods and a means for evaluating conceptual inquiry must be given priority.

Concept Formation↗
PubMed1996

Concept analysis in nursing research: a critical appraisal.

The four major methodological approaches to concept analysis (Wilson-derived methods, qualitative methods, critical analysis of the literature, and quantitative methods) are compared. The authors suggest that qualitative methods and methods that critically analyze the literature may be selected according to the level of the maturity of the concept and the purpose of the analysis. These methods have the ability to facilitate inquiry for concept development, delineation, comparison, clarification, correction, and identification. Quantitative methods may be used for exploring concepts (e.g., delineating conceptual boundaries), and quantitative instrumentation may be used for concept validation, operationalization, and measurement, thus complementing concept analysis methods by moving inquiry into another level of investigation. The authors conclude by presenting criteria for the selection of an appropriate research approach for concept analysis and criteria for evaluating concept analysis research.

Concept Formation↗
PubMed1990

The socialization process of master's-level nurse practitioner students.

A national survey of final semester, graduate-level adult nurse practitioner students (n = 94) was undertaken to determine if they were being socialized into the role of a master's-prepared nurse practitioner and to identify factors which seemed to influence this socialization process. The results revealed that no factors relating to the students' backgrounds and almost none of those relating to their present educational experience were significantly influential on the students' expectations of nurse practitioner role behaviors. The educational factor, "opportunity to practice role behaviors," statistically increased (p less than .01) the expectations for selected master's role behaviors, suggesting that students need the opportunity to practice role behaviors to enhance the socialization process. The students also placed significantly greater importance (p less than .01) on technical instead of master's role behaviors. This study demonstrates that graduate students may not be adequately socialized into the role of a master's-prepared nurse practitioner.

Adult↗
PubMedDate not supplied

Graduate education for nurse practitioners: are advanced degrees needed for practice?

Although the number of master's prepared nurse practitioners has expanded in the last 30 years, few master's level behaviors seem to be incorporated into the role. This study compared both actual and ideal role behaviors of master's and non-master's prepared nurse practitioners. These behaviors included the technical behaviors that all nurse practitioners should perform and master's level nursing behaviors. Two hundred state-certified nurse practitioners were mailed questionnaires asking them to identify their actual and ideal role behaviors. The results showed no difference in the actual role behaviors performed by both groups. In terms of ideal role behaviors, non-master's prepared nurse practitioners rated the majority of the technical and master's level behaviors higher than master's prepared nurse practitioners. In light of the upcoming changes in our health care system and the potential demand for more nurse practitioners, this study questions the need for all nurse practitioners to be educated at the master's level.

Adult↗