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Biomedical subjects

Judith E Hupcey

Publications and source records attributed to Judith E Hupcey.

12 recordsLinked to original sources
PubMed2006

Community dwelling adults' perception of interpersonal trust vs. trust in health care providers.

AIMS: This study investigated community dwelling adults' definition of trust in health care providers vs. interpersonal trust, description of the attributes of a trustworthy provider, factors that influenced the development and loss of trust. BACKGROUND: Trust is an important part of health care relationships, however, the meaning of trust for patients is not well understood. Health care providers need to understand the meaning of trust in order to build and maintain therapeutic relationships with their patients. DESIGN: A descriptive qualitative research design was used to investigate perceptions of trust. METHODS: Semi-structured open-ended interviews were carried out with 32 community dwelling adults. The participants were recruited from church groups, senior health programs and other community programs. The interviews were thematically analysed for: definitions of interpersonal trust vs. trust in a health care provider, attributes of a trustworthy provider and factors that were pivotal in the development and loss of trust in a health care provider. RESULTS: Trust in health care providers differed from interpersonal trust in the role-specific attributes of the individuals. Trust, although influenced by having confidence in the provider's competence, was strongly tied to the interpersonal caring attributes of the provider. Loss of trust, on the other hand, was more closely allied with the issues of competency. CONCLUSIONS: Perceptions of trust varied greatly among this sample, reinforcing the significance of tailoring our approach to patients on an individual basis. RELEVANCE TO CLINICAL PRACTICE: Assuming that we will be trusted based on our role as nurses may not facilitate the development of a therapeutic relationship with some patients. Nurses and other health care providers need to be acutely aware of our patient's trust and clues of pending loss of trust because, as this study and other prior studies have shown, once trust in a provider is lost, it is nearly impossible to rebuild.

Adult↗
PubMed2005

Nursing telephone triage and its influence on parents' choice of care for febrile children.

Nursing telephone triage is a mechanism whereby parents call for advice and referrals. One common call in pediatrics concerns children's fever, which may be managed at home. Giving parents proper advice may avoid unnecessary visits. This study investigated whether home-care advice given by nurses changed parents' original preference for care. Data were collected using an existing database to determine parents' preference for location of care before and actual location of care after a call. Of the 110 calls, 73 parents wanted a physician or emergency department visit but 53 followed nursing advice for home care. Findings suggest that although most parents wanted to have their child seen, a majority followed nursing advice for home care.

After-Hours Care↗
PubMed2005

Enhancing methodological clarity: principle-based concept analysis.

AIMS: The aim of this paper is to operationalize the principle-based method of concept analysis. BACKGROUND: While nursing has embraced the use of concept analysis as a valid and significant entree into an area of research, methodological development has created strategies of inquiry that vary in purpose and in the nature of their findings. DISCUSSION: We propose that, as the primary utility of concept analysis is to determine the existing state of the science so that further work may be strategically and appropriately planned, the method described as principle-based concept analysis is superior in providing evidence to support subsequent inquiry into the concept of interest. Three problematic issues are discussed in an effort to clarify and procedurally explicate the strategies employed in this approach: selecting disciplinary literatures for inclusion in the analysis; conceptually-driven sampling issues; and within- and across-discipline analytic techniques. CONCLUSION: In this form of concept analysis, each principle contributes to an understanding of the strengths and limitations of the present state of the concept in the scientific literature. We believe that this perspective will enable nursing to begin to harness the power of concept analysis for advancing science rather than simply imagining what a concept could be or constructing what we believe it should be.

Concept Formation↗
PubMed2005

Concept advancement: Extending science through concept-driven research.

As methods for concept analysis have evolved, scholars have confounded the initial exploration of a concept with techniques for developing the conceptual unit, extending nursing theory, and establishing nursing knowledge. We argue that nursing is at a critical juncture in the methodological development of concept-driven research. In order to maximize the potential contribution of this type of research, approaches to concept analysis must be held separate and distinct from approaches to concept advancement. We advocate the use of principle-based concept analysis to determine appropriate techniques for advancing a concept. Concept advancement refers to strategic concept-driven inquiries that incrementally build the specification of conceptual meaning to a more precisely defined unit of meaning that has greater utility for research application. Examples of a project that employed strategic techniques for concept advancement are used to illustrate the flow of serial small projects.

Aged↗
PubMed2005

Concept analysis: examining the state of the science.

As methods for analyzing concepts have proliferated in nursing, a critical methodological issue has arisen. Analytic techniques for examining conceptual meaning have incorporated varied strategies for advancing the concept under the rubric of concept analysis, concept development, and theory building. The authors argue that this evolution has created methodological confusion. Following a discussion of a conceptualization of concepts and concept-theory-truth linkages, methods of concept analysis are critiqued in terms of the purpose and the nature of the findings produced by analyses using both traditional and emergent methods. The authors argue that concept analysis is a process of strategic examination of the scientific literature that results in an integrated perspective of the state of the science, or what is known about the concept. In contrast, concept advancement refers to techniques that emphasize the synthesis of new or deeper knowledge that is relevant to the discipline. The authors conclude that disentangling concept analysis from techniques for concept advancement is critical to enhancing the utility of concept-based research in nursing.

Concept Formation↗
PubMed2004

Expectations for care: older adults' satisfaction with and trust in health care providers.

This study sought to determine whether community-dwelling older adults' expectations for care were met by identifying factors that influence trust in and satisfaction with health care providers. Data were collected using a demographic questionnaire and focus group methodology. A total of 39 older adults participated in 8 focus groups. Three categories of themes were identified: a sense of personal touch, technical proficiency, and environmental factors. These categories related to individual providers or practice environments. When providers and practice settings met expectations for care, then the elderly individual was satisfied. Trust was more complex, as the older adults indicated they could be satisfied but not trust providers or they could trust providers but not be satisfied. Implications for practice include spending quality time with older adults and treating them as individuals.

Activities of Daily Living↗
PubMed2003

Concept advancement: enhancing inductive validity.

Enhancing inductive validity while advancing a concept has always been a dilemma for qualitative researchers. This dilemma is paramount for researchers completing a series of small discrete projects all focused on the same concept. How do researchers use knowledge from their earlier research while maintaining an inductive paradigm? Template comparison, a method of sequential triangulation, is proposed as a solution to this problem. Template comparison allows the researcher to use findings from earlier studies, which employed the same or different qualitative methods, as a guide for the data collection, interpretative, and theoretical phases of the new study. The authors' research of the concept of trust is used as an example of the application of template comparison.

Concept Formation↗
PubMed2002

Incidence and nature of farm-related injuries among Pennsylvania Amish children: implications for education.

INTRODUCTION: Farming is a dangerous occupation and results in injuries not only to farm workers, but also to families living on farms. Children raised on a farm are at particular risk because the farm is a place where they live, play, and work. Farming is the main Amish occupation, and because Amish farming techniques differ from those used on other us farms, it is important that health care providers recognize the causes of injuries that may occur on Amish farms. However, little is documented about farm-related injuries in Amish children, so we decided to document the incidence and nature of these injuries in Pennsylvania. METHODS: This study was done by reviewing the die botschaft, a weekly newspaper written by the Amish. All references to farm-related injuries among children in Pennsylvania were recorded. RESULTS: During a 5-month period, a total of 89 injuries, including 5 fatalities, were found: male children sustained 64 injuries, and female children sustained 25 injuries. Falls were the most commonly reported mechanism of injury, followed by incidents involving livestock. Both types of events most often resulted in an orthopedic injury. DISCUSSION: Injury to children in the Amish community is a significant problem that needs to be addressed and evaluated by the Amish themselves and in coordination with other health care providers, including emergency nurses. With the information obtained in this study, injury prevention strategies tailored to the Amish way of farming could be developed and implemented.

Accidents, Occupational↗
PubMed2002

Integrating concepts for the development of qualitatively-derived theory.

The development of qualitatively-derived theory (QDT) remains a challenge for researchers wishing to retain the complexity of reality. The techniques of concept integration provide a means to link concepts according to their shared attributes and logically according to their mutual interactions, reactions, and responses. While retaining all of the advantages of qualitative induction, integrating concepts in this manner places QDT theory at the upper end of mid-range theory, or disclosive theory, to produce a theory of higher abstraction and broader scope.

Concept Formation↗
PubMedDate not supplied

The development of trust in parents of hospitalized children.

ISSUES AND PURPOSE: The purpose of this study was to investigate the development of trust in parents of hospitalized children. METHODS: Using grounded theory, semistructured interviews were conducted with 15 parents of children previously hospitalized, focusing on parents' experiences during their child's hospitalization. Data were analyzed using a constant comparative process. Themes and the core variable were identified and a model of trust developed. RESULTS: The core variable related to the development of trust in healthcare providers was whether parents' expectations for care were met. Thematic areas that influenced whether expectations for care were met included preexisting trust; evaluation of care, including evaluation of technical skills and the meeting of parental and child needs; and behaviors of nurses and other healthcare providers that inhibited and fostered trust. PRACTICE IMPLICATIONS: Strategies to enhance trust are discussed.

Adult↗
PubMedDate not supplied

A retrospective study of left ventricular assist device-related infections.

Left ventricular assist devices (LVADs) represent considerable technological advancements, which are increasing survival and maintaining the highest quality of life for patients with chronic heart failure. A retrospective analysis of outcomes was conducted on 90 patients during LVAD support with either a Thoratec (n = 41) or HeartMate (n = 49) device, with a median of 56 days (range 3-350 days). Device-related infections occurred in 18 of the 90 subjects (20%). A significant increase in device-related infections was noted with the HeartMate LVAD (chi 2 analysis, P < .05). The drive line was the most common site of device-related infections, accounting for 52.1%, with 31.1% occurring in the pocket and 15.1% in the LVAD itself. There was little if any correlation that existed between time spent in the hospital prior to implantation of an LVAD and the development of device-related infections.

Adolescent↗