The experiences of adult ventilator‐dependent patients: A meta‐synthesis review

Studies exploring the perceptions of patients whose lives are maintained by mechanical ventilation highlight the stressful nature of this type of experience. The objective of this meta‐synthesis study was to describe the nature of the experience of adult ventilator‐dependent patients. A systematic literature search of English and Chinese databases was undertaken, covering the period between 1970 and 2012. Qualitative research findings were extracted and pooled using the Joanna Briggs Institute Qualitative Assessment and Review Instrument. A total of 1004 papers were identified from various database and hand searches. Nineteen papers were critically appraised and 16 met inclusion criteria. Five meta‐synthesis themes emerged from the analysis: (1) the feelings of fear due to being dependent on a ventilator and the loss of control of life; (2) disconnection with reality; (3) impaired embodiment; (4) construction of coping patterns; (5) trust and caring relationship. Suggested implications for practice include enhancing the trust relationship with health professionals, as well as nursing actions throughout the suction procedure relating to release of patient's psychological distress and empowering their resilience factors.     

A qualitative exploration of nursing students’ perceptions of the homeless and their care experiences

The health care needs of the homeless are more complex than those of the population at large. The purpose of this qualitative study was to explore undergraduate nursing students’ perceptions of the homeless. Thematic content analysis of responses from 19 undergraduate nursing students yielded four themes describing student experiences with the homeless, their perceptions of homelessness and the health care of the homeless, and their suggestions for best teaching strategies. Students in this study had varying amounts of experience with and knowledge of the homeless. While our participants strongly believed that homeless people deserved compassionate, equitable nursing care, many of their statements suggested an implicit bias toward the homeless. This suggests that student nurses need more comprehensive education concerning the homeless and the health care needs of this vulnerable population. Few interventions aimed at educating student nurses about homelessness and changing their attitudes to mitigate bias are based on research, particularly research conducted from the perspective of the homeless, and few explore the impact of civil interactions on health outcomes. The findings of this study may assist nurse educators in developing education interventions to improve students’ knowledge of homelessness.     

Health,utilisation of health services, ‘core’ information,and reasons for non‐participation: a triangulation study amongst non‐respondents

Aim. To explore health, use of health services, ‘core’ information and reasons for non‐participation amongst males. Background. Gender may provide an explanation for non‐participation in the healthcare system. A growing body of research suggests that males are less likely than females to seek help from health professionals for their problems. The current research had its beginnings with the low response rate in a prior voluntary survey and health examination for Finnish males born in 1961. Design. Data triangulation among 28 non‐respondent middle‐aged males in Helsinki was used. Methods. The methods involved structured and in‐depth interviews and health measurements to explore the views of these males concerning their health‐related behaviours and use of health services. Results. Non‐respondent males seldom used healthcare services. Despite clinical risk factors (e.g. obesity and blood pressure) and various symptoms, males perceived their health status as good. Work was widely experienced as excessively demanding, causing insomnia and other stress symptoms. Males expressed sensitive messages when a session was ending and when the participant was close to the door and leaving the room. This ‘core’ information included major causes of concern, anxiety, fears and loneliness. Conclusions. This triangulation study showed that by using an in‐depth interview as one research strategy, more sensitive ‘feminist’ expressions in health and ill‐health were got by men. The results emphasise a male’s self‐perception of his masculinity that may have relevance to the health experience of the male population. Relevance to clinical practice. Nurses and physicians need to pay special attention to the requirements of gender‐specific healthcare to be most effective in the delivery of healthcare to males.     

The use of theory in qualitative approaches to research: application in end‐of‐life studies

Title. The use of theory in qualitative approaches to research: application in end‐of‐life studies. Aim. This paper is a report of an analysis of the use of theory in qualitative approaches to research as exemplified in qualitative end‐of‐life studies. Background. Nurses researchers turn to theory to conceptualize research problems and guide investigations. However, researchers using qualitative approaches do not consistently articulate how theory has been applied, and no clear consensus exists regarding the appropriate application of theory in qualitative studies. A review of qualitative, end‐of‐life studies is used to illustrate application of theory to study design and findings. Data sources. A review of theoretical literature was carried out, focusing on definitions and use of theory in qualitative end‐of‐life studies published in English between 1990 and 2008. Discussion. The term ‘theory’ continues to be used in a variety of ways by theorists and researchers. Within the reviewed end‐of‐life studies, the use of theory included theory creation or provision of a comparative framework for data analysis and interpretation. Implications for nursing. Nurses who conduct qualitative studies should examine the philosophical and theoretical bases of their selected methodological approach, articulate a theoretical framework that fits the phenomenon being studied, and adopt a critical, flexible and creative attitude when applying theory to a study. Conclusion. Theory can be put to several uses in qualitative inquiry and should guide nurse researchers as they develop and implement their studies. Nurse educators who teach qualitative approaches to research should emphasize a variety of ways to incorporate theory in qualitative designs.     

The experience of being 30–45 years of age and depending on haemodialysis treatment: a phenomenological study

Scand J Caring Sci; 2010; 24; 693–699
The experience of being 30–45 years of age and depending on haemodialysis treatment: a phenomenological study The aim of this study was to describe how haemodialysis (HD) patients, between 30 and 45 years of age, experience their dependence on HD treatment. Nine patients undergoing HD treatment were interviewed. The transcribed texts were analysed according to Giorgi′s four basic principles. Being between 30 and 45 years of age and needing HD treatment meant experiencing a total lack of freedom, which was illuminated through the sub‐themes: a sense of fear, dependency on caregivers, time lost in dialysis, feelings of loneliness and the stress of being on the waiting list for a new kidney. The participants felt that being dependent on HD treatment was ‘not a real life’ and that they were experiencing a double life of sorts: the life of dialysis versus their ordinary life outside treatment. The dependency on HD treatment was also expressed as a feeling that life ‘stood still.’ The results also indicate that the participants expected to encounter competent healthcare professionals, and they emphasised the importance of providing support for younger HD patients by focusing on their ability to cope with their life situation.