Refinement of the concept of uncertainty

AIMS: To analyse the conceptual maturity of uncertainty; to develop an expanded theoretical definition of uncertainty; to advance the concept using methods of concept refinement; and to analyse congruency with the conceptualization of uncertainty presented in the theory of hope, enduring, and suffering. BACKGROUND: Uncertainty is of concern in nursing as people experience complex life events surrounding health. In an earlier nursing study that linked the concepts of hope, enduring, and suffering into a single theoretical scheme, a state best described as 'uncertainty' arose. This study was undertaken to explore how this conceptualization fit with the scientific literature on uncertainty and to refine the concept. DESIGN/METHODS: Initially, a concept analysis using advanced methods described by Morse, Hupcey, Mitcham and colleagues was completed. The concept was determined to be partially mature. A theoretical definition was derived and techniques of concept refinement using the literature as data were applied. FINDINGS: The refined concept was found to be congruent with the concept of uncertainty that had emerged in the model of hope, enduring and suffering. CONCLUSIONS: Further investigation is needed to explore the extent of probabilistic reasoning and the effects of confidence and control on feelings of uncertainty and certainty.     

An analysis of the concept of risk

The meaning of the word "risk" has changed throughout history. Once a neutral term, risk has come to represent a combination of probability and something adverse or dangerous. Phenomena that were previously referred to as hazards, dangers, or uncertainties are now labeled as risks. Although risk touches every aspect of health and human welfare, the dimensions of risk as conceptualized in the fields of epidemiology, nursing science, medical science, and lay health are qualitatively different. Risk has not been examined as a concept in nursing literature or research, although risk and related terms are defined in a few nursing textbooks. Using the evolutionary method of concept analysis, risk is examined as a concept. This analysis was undertaken to define and clarify the concept and dimensions of risk as they relate to risk for disease. A sound understanding of risk as a concept is critical for developing an empirical knowledge base in nursing and directing nursing research examining issues related to risk for developing diseases such as cancer.     

The nurse-patient relationship in cancer care as a shared covenant: a concept analysis

The concept of the nurse-patient covenant was explored using a multiple-method research design. Analysis of the literature (167 references) was the basis for 2 focus group interviews (12 nurses) and 8 semistructured patient interviews. Attributes, antecedents, and consequences were identified through an analysis of findings across all data sources. The nurse-patient covenant in cancer care is defined as an enduring relationship, embodying caring benevolence and contextually negotiated reciprocity. It is preceded by the demonstration of nursing competence as a manifestation of nursing tradition and leads to patients' trusting and entrusting nurses, the emergence of personhood and professionhood, and benefits and obligations.     

Grieving a loss: the lived experience for elders residing in an institution

Grieving a loss is a profound and universal human experience. This phenomenological-hermeneutic study was an inquiry into the lived experience of grieving a loss. The nursing perspective was Parse's human becoming theory. Participants were 10 elderly persons residing in a long-term care facility. The study finding specifies the structure of the lived experience of grieving a loss as aching solitude amid enduring cherished affiliations, as serene acquiescence arises with sorrowful curtailments. Findings are discussed in relation to the guiding theoretical perspective and related literature. Recommendations for additional research and insights for practice are presented.     

Marginalization and school nursing.

The concept of marginalization was first analyzed by nursing researchers Hall, Stevens, and Meleis. Although nursing literature frequently refers to this concept when addressing "at risk" groups such as the homeless, gays and lesbians, and those infected with HIV/AIDS, the concept can also be applied to nursing. Analysis of current school nursing literature and research suggests school nursing may be a marginalized specialty, encompassing many of the characteristics of marginalization including isolation, role confusion, and barriers to practice. School nurses can reduce or eliminate these characteristics by increasing their visibility and collaborative opportunities in the educational and nursing communities while also providing mentoring opportunities to new school nurses.     

应用型高校"双师型"护理教师岗位胜任力指标体系的构建

目的构建应用型高校"双师型"护理教师岗位胜任力指标体系。方法整体研究时间为2020年9月—2021年2月。采用文献研究法、行为事件访谈法初步形成应用型高校"双师型"护理教师岗位胜任力指标体系。采用便利抽样法,选取齐齐哈尔医学院及其3所直属附属医院的护理专家共20名为函询对象。运用德尔菲专家咨询法对其进行2轮函询。结果2轮函询问卷有效回收率均为100%,专家权威系数分别为0.815、0.845,肯德尔和谐系数分别为0.236、0.243。最终形成的应用型高校"双师型"护理教师岗位胜任力指标体系包括5个维度23个条目。结论本研究构建的应用型高校"双师型"护理教师岗位胜任力指标体系指标明确,可作为学校和医院教育及管理者培养、考核及评价护理教师的量化参考依据。     

Disaster‐Related Community Resilience: A Concept Analysis and a Call to Action for Nurses

A paucity of nursing literature is available on disaster‐related community resilience. Using a nursing method for analyzing concepts, this article attempts to clarify the meaning of this novel concept to encourage nursing research and practice. This concept analysis provides an introduction to the phenomenon of disaster‐related community resilience for nurses and consumers of nursing research. The article proposes the definition, antecedents, attributes, consequences, and empirical referents of disaster‐related community resilience and provides suggestions for nursing research and practice. It also provides nurses a foundation for participating in resilience‐building activities that may save lives and allow communities to recover more rapidly postdisaster.     

Evaluation of the nursing diagnosis "social isolation" and the use of evidence-based nursing

In home nursing care, professionally qualified personnel have to make many decisions based on the best available evidence. The systematic review "social isolation" was carried out to evaluate the nursing diagnosis as used by the home care provider Red Cross Austria. It was examined if the interventions of the diagnosis "social isolation" were based on scientific evidence. The interventions reviewed were exclusively for home care clients. "Evidence Based Nursing" was used as the scientific approach. Individual interventions of the selected diagnosis's were compared to the Nursing Interventions Classification (NIC) to get standardized English search terms. The 10 selected research papers showed that social isolation is a growing problem for people being cared for at home. According to the scientific literature it can be recommended that a number of multi variant initiatives should be initiated either as a prophylactic or specific intervention. The use of appropriate assessment instruments should lead to effective interventions. Furthermore, in cases of particular need a tailor-made group solution can be helpful. One new aspect that surfaces in the literature is the social isolation of the relatives of the person in care. The social isolation of the relatives in turn has a strong influence on the person in care and nursing care personnel should include this in the intervention plan. Home care nursing personnel play a key role in identifying social isolation and taking the first initiatives to resolve the problem.     

“以人为本”理念在产妇产后护理中的应用效果

目的探讨"以人为本"理念在产妇产后护理中的应用效果。方法选取2018年8月至2019年8月本院收治的94例产妇作为研究对象,按照电脑数字表法将其随机分为对照组与试验组,各47例。对照组给予常规护理,试验组给予基于"以人为本"理念护理。比较两组产妇的产后并发症发生情况、干预前、后的自我护理能力测定量表(ESCA)、爱丁堡产后抑郁量表(EPDS)评分、护理满意度。结果试验组的产后并发症总发生率为4.26%,显著低于对照组的17.02%,差异具有统计学意义(P<0.05)。干预前,两组产妇的ESCA、EPDS评分比较,差异无统计学意义(P>0.05);干预后,两组的ESCA评分均升高,而EPDS评分均降低,且试验组优于对照组,差异具有统计学意义(P<0.05)。试验组的护理满意度为97.87%,显著高于对照组的80.85%,差异具有统计学意义(P<0.05)。结论"以人为本"理念可有效减少产妇产后并发症的发生,并改善其自我护理能力、产后抑郁情况,进而提升护理满意度,值得临床推广应用。     

Diagnosis "risk of pneumonia" evidence-based evaluation and comparison of nursing interventions

In home nursing care, professionally qualified nurses make decisions on their own which must be based on the latest scientific research. The goal of this systematic literature review was to examine if the interventions of the diagnosis "Risk of Pneumonia" as used by a home care service provider in Austria are based on scientific evidence. Based on the research question "Can the interventions of the diagnosis 'risk of pneumonia' be found in the scientific nursing literature?", four evidence-based guidelines from various databases and institutes were identified and evaluated using a standardized checklist. The result of the analysis is that the majority of the Nursing diagnosis interventions can be found in the guidelines. It is also recommended in the guidelines to advise and support clients to stop smoking and inoculate against influenza/pneumonia. Similarly, assessment tools should be used to estimate the severity of pneumonia. The intervention of oral hygiene as a prophylactic intervention against pneumonia should get particular attention.     

Equality as a central concept of nursing ethics: a systematic literature review

Scand J Caring Sci; 2010; 24; 824–832
Equality as a central concept of nursing ethics: a systematic literature review Background: Equality is a central concept in the Western way of thinking and in health care. In ethics research within nursing science, equality is a key concept but the meaning of its contents is more or less presumptive. Aim: The purpose of this study was to define the concept of equality as a value of nursing ethics research. Method: Data were collected through systematic literature review and analysed using deductive and inductive content analysis. Findings: Equality has been studied as a concept and in relation to ethical theories. In nursing ethics, research on equality on theoretical and functional level is presented. These levels consist of dimensions, i.e. themes, that equality is related to. The dimensions of the theoretical level are the equality of being, i.e. universal human value, and distributive equality, i.e. equal opportunities, circumstances and results. The dimensions of functional equality included themes such as critique of distributive equality, context, difference, power and care. Critique is aimed at incompatibility of theoretical level with practice. Context raises questions of each nursing situation in relation to equality. Variation within context is closely related to differences involving parties to nursing, and it is a starting point to questions of equality. Power is understood as comprising knowledge, skills and authority that create differences and questions of equality between nurses and patients and nurses and other professionals or students. Nursing as care always includes relationship between two or more persons and needs to be inspected from the point of view of equality. Conclusion: The concept of equality has been complex to achieve in practice. The dimensions of the levels of equality defined in this study provide an opportunity to reach a better understanding of equality in nursing ethics. There is still a great demand for more research on the concept of equality.     

Where Are We Now?: Concept Analysis as Foundational to Nursing Diagnosis Research Georgia Griffith Whitley, EdD, RN

"Where Are We Now" is a regular feature of Nursing Diagnosis. The column focuses on current issues and trends related to nursing diagnosis development, implementation, and evaluation. The writing in this issue focuses on the critical nature of concept analysis as it relates to clinical validation of nursing diagnosis. Dr. Georgia Whitley addresses the importance of concept analysis as a foundation for validation research on a specific diagnosis, particularly as it can be used in identifying defining characteristics und developing their operational definitions.     

Neighborhood: A Conceptual Analysis

Researchers interested in measuring neighborhood‐level effects should understand how “neighborhood” is defined within nursing sciences and other sciences, and the inherent strengths and weaknesses of current research methodologies. This concept analysis provides clarity around the concept of neighborhood within the context of health, analyzes the current state of development of the neighborhood concept, and proposes areas for future nursing research. Using the Rodger's Method of analysis, the concept of neighborhood within nursing and public health research is described based on existing literature. The concept's attributes, related concepts, antecedents, and consequences are given from the literature. Comparisons of the use of neighborhood are made between nursing, public health, sociology, and other sciences. The evolution of the concept of neighborhood throughout history is described, and important implications for future research are discussed.     

"And the suffering is also borne by the following generations"--an international literature study on the nursing care for Jewish patients

Jewish refugees from the Commonwealth of Independent States (CIS) are a constantly growing minority about whose care needs little is known in the scientific literature. Considerably more research has been done on the care needs of members of the Jewish faith outside the CIS, especially of those living in the USA, Israel and Canada. The ensuing international literature study was compiled as part of a pilot project promoted by the Robert Bosch Stiftung concerning the care needs of Jewish refugees from the CIS, with the aim of investigating available nursing experiences with the target group. The keywords "Juden", '"jüdisch", "Migranten", "jew", , "jewish" "migrants" and "nursing" were used for the analysis of altogether 67 articles from various data sources. The literature study generated the following internationally significant topics: the psychological and social situation and the resulting special features of the nursing care required by all of them viz: two generations of holocaust-survivors, their children, and Jewish migrants from the CIS; various religious orientations subdivided roughly into the categories orthodox, conservative and reform, in that each category represents different attitudes which affect nursing care; aspects of Jewish ethics relevant to nursing; the specifics of caring for gerontological Jewish patients; and socio-cultural aspects of palliative care. One of the most important results was that Jewish refugees from the CIS share in particular the experience of persecution with the holocaust-survivors and their offspring, which bears specific implications for nursing care.     

我国肿瘤患者居家护理研究文献的计量分析

目的 对我国居家肿瘤患者的护理状况进行文献回顾和分析,了解其研究现状和存在的问题,为我国居家护理实践和护理科研提供参考。方法 分别以“居家”、“肿瘤”、“护理”为关键词或主题词”对中国知网、万方、维普、中国生物医学文献数据库公开发表的我国肿瘤患者居家护理的相关文献进行检索分析,检索时限为建库至2020年4月。对题名、发表年份、期刊、著者数、第一作者(地域、机构、机构属性)、通讯作者、基金情况、文献类型、研究内容,关键词、资料收集方法等进行统计分析。结果 共获得201篇期刊文献,发文量随年份变化呈递增趋势,纳入期刊发表文献种类众多,共发表在108种期刊上,文献第一作者所属省份地区差异大,以江苏,上海等地居多。有基金支持的文献占比37%,研究类型以类试验性研究为主,研究内容集中于癌痛、PICC、用药和居家宁养等方面。结论 我国肿瘤患者居家护理相关的实验性研究质量相对较差,有待提高,且发文量地域差异大,居家护理实践需借助互联网的独特优势,突破地域限制。同时居家肿瘤患者重点护理问题突出,我国护理管理者应进一步规范相关护理技术规范,保证居家护理的规范性、安全性。     

Clinical Significance as It Relates to Evidence‐Based Practice

PURPOSE. This paper analyzes the concept of clinical significance (CS) in relation to evidence‐based practice (EBP). The purpose is to show that CS terminology is inconsistent in the nursing literature. It is argued that nursing outcomes and interventions that include findings of CS are difficult to interpret due to lack of an operational definition. It is further argued that the absence of a consistent operational definition is incompatible with EBPs which require standardization of terminology. DATA SOURCES. The current literature and research studies, particularly from the electronic databases Cumulative Index to Nursing and Allied Health Literature, ISI Web of Knowledge, PubMed, and Cochrane Database of Systematic Reviews. DATA SYNTHESIS. The disparate uses of CS negatively impact standardizing and quantifying research outcomes to discern EBPs. The authors propose a definition of CS inclusive of the multifarious uses that were revealed in the literature, and conclude that there is a need for professional nursing consensus to define the term. A standard operational definition of CS would enable consistency as clinicians interpret research findings and facilitate translating research to practice. CONCLUSIONS. Given the centrality of CS to interpreting research findings and applying them to practice, there is a need to solidify the terminology of and measurements for CS in nursing. National nursing agencies, including The National Institute for Nursing Research and Sigma Theta Tau International, should make standardizing CS a high priority for targeted funding. One method of doing so would be to support a consensus convergence to review and select the optimal measures of CS for nursing research. Research to increase knowledge about what constitutes measurement and change, or CS from the patient perspective is needed. Editors and peer reviewers should encourage authors to include a discussion of CS. Discussions of CS should receive greater emphasis in research journals. It is hoped that the preliminary findings from the concept analysis presented in this article will facilitate the work of such a consensus forum. IMPLICATIONS FOR NURSING PRACTICE. The most immediate and tangible advantages to a common conceptual definition and meaning of CS terminologies by nursing, regardless of which definition is selected, are less confusion and more clarity. Ultimately, the most enduring benefit of a common conceptual definition and measurement for CS is the bridge it provides between research and practice, and the facility with which it promotes the integration of research into EBP.     

Emotional intelligence and nursing: An integrative literature review

Aim

The purpose of this paper is to present findings of an integrative literature review related to emotional intelligence (EI) and nursing.

Background

A large body of knowledge related to EI exists outside nursing. EI theory and research within nursing is a more recent phenomenon. A broad understanding of the nature and direction of theory and research related to EI is crucial to building knowledge within this field of inquiry.

Method

A broad search of computerized databases focusing on articles published in English during 1995–2007 was completed. Extensive screening sought to determine current literature themes and empirical research evidence completed in nursing focused specifically on emotional intelligence.

Results

39 articles are included in this integrative literature review (theoretical, n = 21; editorial, n = 5; opinion, n = 4 and empirical, n = 9). The literature focuses on EI and nursing education, EI and nursing practice, EI and clinical decision-making, and EI and clinical leadership. Research that links EI and nursing are mostly correlation designs using small sample sizes.

Conclusion

This literature reveals widespread support of EI concepts in nursing. Theoretical and editorial literature confirms EI concepts are central to nursing practice. EI needs to be explicit within nursing education as EI might impact the quality of student learning, ethical decision-making, critical thinking, evidence and knowledge use in practice. Emotionally intelligent leaders influence employee retention, quality of patient care and patient outcomes. EI research in nursing requires development and careful consideration of criticisms related to EI outside nursing is recommended.     

Attitude: a concept analysis

This paper presents a concept analysis conducted as a beginning step to developing research on nurses' attitudes toward advancing formal education. A literature review, conducted by the author, confirmed that the term attitude is used prolifically in nursing research; however, the findings were inconclusive as to a definition and the attributes of an "attitude." Often this concept was either not defined or vaguely defined. Few operational definitions, required for accurate measurement of a concept, were found. An adequate definition and understanding of a concept is required for critical reflection and utilization of the term and development of measurement procedures .     

举办“护理综述报告会”的做法及体会

目的检验和提高中、高级护理人员的科研能力。方法制定综述书写要求和评分标准；由地方知名专家和本院专家相结合进行评审；选择优秀综述进行现场报告并给予奖励；对综述质量采用调查问卷反馈并进行综合分析。结果74．2％的中高级护理人员踊跃投稿，91．30％的护理人员认为基本掌握了书写方法，了解了护理新进展，提高了科研能力。结论护理文献综述报告会是护理科研管理方法创新的有益尝试，是继续教育的有效举措，能比较客观地反映护理人员的科研能力。     

An evolutionary concept analysis of caring

AIM: The aim of this paper is to identify the core, enduring attributes of nursing caring in order to increase understanding of the concept and to identify its implications for research and practice. BACKGROUND: Caring is considered a core concept in nursing as a practice discipline. During the past 20 years, research into nurse caring has been evolving, but the concept of caring remains ambiguous. METHODS: Using a rigorous evolutionary method of concept analysis, the concept caring was examined for its significance, use and application as it has unfolded over time, between 1988 and 2002. After applying inclusion and exclusion criteria and a sampling method, a total of 61 articles was included in the final analysis. RESULTS: Defining attributes, antecedents, and consequences of caring were identified. Core attributes included relationship, action, attitude, acceptance and variability. CONCLUSION: Identification of the core attributes of concepts, including caring, allows nurses to determine appropriate research questions, develop theory and identify practice priorities at a time of increasing demands and constrained resources.