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Biomedical subjects

J M Morse

Publications and source records attributed to J M Morse.

At least 19 recordsLinked to original sources
PubMed2001

An exploration and advancement of the concept of trust.

BACKGROUND: Trust is a concept used both in everyday language and in the scientific realm. An exploration of the conceptualizations of trust within the disciplines of nursing, medicine, psychology and sociology, revealed that trust is an ambiguous scientific concept. AIMS: In order to increase the pragmatic utility of the concept of trust for scientific application, further clarification and development of the concept was undertaken. METHODS: First, a concept analysis was conducted with the aim of clarifying the state of the science of discipline-specific conceptualizations of trust. The criterion-based method of concept analysis as described by Morse and colleagues was used (Morse et al. 1996a, 1996b, Morse 2000). This analytic process enabled the assessment of the scientific maturity of the concept of trust. The interdisciplinary concept of trust was found to be immature. Based on this level of maturity it was determined that in order to advance the concept of trust toward greater maturity, techniques of concept development using the literature as data were applied. In this process, questions were "asked of the data" (in this case, the selected disciplinary literatures) to identify the conceptual components of trust. RESULTS: The inquiry into the concept of trust led to the development of an expanded interdisciplinary conceptual definition by merging the most coherent commonalties from each discipline. CONCLUSIONS: The newly developed interdisciplinary conceptualization advances the concept toward maturity, that is, a more refined, pragmatic and higher-order concept. The refined concept of trust transcends the contextual boundaries of each discipline in a truly interdisciplinary scientific fashion.

Choice Behavior↗
PubMed2001

Toward a praxis theory of suffering.

This article revises and summarizes the major findings from a research program exploring the behavioral-experiential nature of suffering. Suffering is perceived as comprising two major behavioral states: enduring (in which emotions are suppressed; it is manifested as an emotionless state) and emotional suffering (an overt state of distress in which emotions are released). Individuals who are suffering move back and forth between these two states according to their own needs, their recognition/acknowledgment/acceptance of events, the context, and the needs and responses of others. Implications for the provision of comfort during suffering states are presented.

Adaptation, Psychological↗
PubMed2001

Steps and strategies.

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Health Services Research↗
PubMed2001

Using shadowed data.

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Health Services Research↗
PubMed2001

Exploring the technical aspects of "fit" in qualitative research.

The concept of fit and processes of fitting have been largely ignored in qualitative inquiry. In this article, the authors address the technical significance of fit as an analytic process for both data and concepts in the process of theory construction. The ramifications of violating processes of fit and examples of misfits are discussed. Finally, the procedural components and fit as a method of validation are presented.

Evaluation Studies as Topic↗
PubMed2000

Mothers and their disabled children: refining the concept of normalization.

Normalization refers to behaviors and intentions of the disabled to integrate into society by living life as do those without a disability. Although normal is assumed to be a desired state, the concept has not been explored from the perspective of disabled children and mothers and other family members. The objective of this study is to determine "what is normal" from the perspective of the person with the disability. Participant observation was conducted in a 6-day summer camp for 17 children with chronic, severe, life-threatening physical disabilities. The children normally received home care and were ventilator dependent. Data consisted of observations, field notes, photographs, and videos. To obtain data about the children's home life, audiotaped telephone interviews with their primary caregiver (16 mothers and 1 father) were conducted before and after the camp. This group had two distinct social reference groups: the "disabled world" of the disabled-as-normal and the "outside" world of the everyday-as-normal. Mothers identified with both reference groups according to the child's needs, abilities and capabilities, and the risk involved. Children with disabilities who normalize compare their abilities and capabilities to identify both within a disabled world ("like me") and the outside world, according to their needs. Normalization includes processes of identification with both the cultural dominant perceived as normal (with whom these children could identify cognitively) and handicapped children (with whom these children could identify both physically and cognitively).

Adaptation, Psychological↗
PubMed2000

Qualitative outcome analysis: evaluating nursing interventions for complex clinical phenomena.

PURPOSE: To describe a method that allows evaluating nursing interventions derived from a qualitative research project, and that shows appropriate interventions. ORGANIZING FRAMEWORK: Qualitative research has expanded over the last decade and has contributed significantly to understanding patients' experiences of health, illness, and injury. Yet the value of qualitative research in determining clinical interventions and subsequently evaluating the effects of these interventions on patients' outcomes has been limited. This method is used to confirm the efficacy of nursing interventions when experience changes over time, to extend the repertoire of intervention strategies, and to further clinicians' understanding of possible outcomes. DESIGN: From a completed study, Qualitative Outcome Analysis (QOA) enhances the identification of meaningful intervention strategies and plans for utilization. The researcher identifies the type of qualitative data that will enable the interpretation and evaluation of interventions, devises a means of data recording and analysis, and finally, disseminates the findings. CONCLUSIONS: QOA is a systematic means to confirm the applicability of clinical strategies developed from a single qualitative project, to extend the repertoire of clinical interventions, and to evaluate clinical outcomes.

Data Interpretation, Statistical↗
PubMed2000

Researching illness and injury: methodological considerations.

Circumstances surrounding the physical condition of the critically ill, the injured, and the dying make the conduct of qualitative research particularly difficult. Assumptions embedded in qualitative research are challenged or no longer apply: As sick people, participants are unfamiliar with their everyday worlds, and they are often incapable of describing their conditions and perceptions, so that researchers have difficulty obtaining data to comprehend, interpret, and generally conduct their research. Methodological problems extending from the participants' condition include the lack of everyday language to describe their experiences, the instability of the participants' reality, and the instability of the self. When researching participants who are sick, these methodological problems result in decisions about the timing of data collection, challenges to validity and reliability, and debates about who should be conducting this research.

Attitude to Health↗
PubMed2000

Evaluating the efficiency and effectiveness of approaches to nasogastric tube insertion during trauma care.

BACKGROUND: Numerous invasive, uncomfortable, and discomforting procedures are implemented almost routinely during trauma care. Previous research has shown that trauma care practitioners use comforting strategies during this care. Yet little is known of the effect of these comforting strategies on the effectiveness and efficiency of treatment. OBJECTIVES: To evaluate the effect of the caregiver's approach on the efficient and effective completion of a discomforting procedure (nasogastric tube insertion) on conscious patients during trauma care. METHODS: Ethology was used to analyze 32 attempts at nasogastric tube insertion from 193 videotaped trauma cases from 3 level I trauma centers in North America. Both qualitative and quantitative analytic techniques were used. RESULTS: The practitioner's approach was associated with the outcome of the treatment. Overall, practitioners who balanced the technical aspects of the procedure with use of comforting strategies to minimize the patient's discomfort (the blended approach) were most efficient and most effective in completing this procedure. Practitioners who were most attentive to procedural technique (with little respect to patients' discomfort) or who were overly attentive to comforting strategies (termed the technical and affective approaches, respectively) took longer and/or were less successful at completing the procedure. CONCLUSIONS: Four patterned, standardized approaches to care were found: technical, affective, blended, and mixed. This study has implications for further research into the effect of the practitioner's approach on the patient's behavioral state in trauma care.

Adolescent↗
PubMed2000

Establishing and maintaining trust during acute care hospitalizations.

The concept of trust is significant in nursing; however, it remains inadequately defined and operationalized. The purpose of this study was to advance the development of the concept of trust by exploring patients' perspectives of processes of establishing and maintaining trust in health care providers during acute care hospitalizations. Grounded theory methods, including theoretical sampling and the constant comparative processes, were used. The sample included 50 adult inpatients with a wide variety of medical-surgical diagnoses who discussed their experiences while hospitalized. The core variable linking the process of developing and maintaining trust was meeting expectations. Through a series of interactions with health care providers and other hospital personnel, patients used monitoring behaviors to evaluate congruency between their expectations of care and the actual behaviors of providers. From this evaluation, three trajectories were identified based on whether expectations were met, exceeded, or unmet. Trust was shown to be dynamic and thus permits opportunities for interventions to redirect the trajectory.

Adult↗