scholarly journals Adapting protocol to the evolving context of practice: A grounded theory exploration of the strategies adopted by emergency nurses to address situations of uncertainty and change during the management of emerging infectious diseases

2020 ◽  
Author(s):  
Stanley Kam Ki Lam ◽  
Enid Wai Yung Kwong ◽  
Maria Shuk Yu Hung ◽  
Samantha Mei Che Pang ◽  
Wai Tong Chien
Keyword(s):  
Grounded Theory ◽  
Emerging Infectious Diseases ◽  
Theory Approach ◽  
Emergency Nurses ◽  
Problem Solving Skills ◽  
Individual Interviews ◽  
Research Guidelines ◽  
Core Category ◽  
Evolving Context ◽  
Training Schemes

Abstract Background: During an epidemic event, emergency care settings are fraught with urgency, uncertainty and changes to the clinical scenario and practice. Such situations challenge the capability of emergency nurses to perform their duties in a well-planned and systematic manner. To date, little is known about the coping strategies adopted by emergency nurses during an epidemic event. The present study explored the behaviours and strategies developed by emergency nurses to handle uncertainty and practice changes during an epidemic event.Methodology and methods: A qualitative design based on the Straussian grounded theory approach was established. A total of 26 emergency nurses from Hong Kong were recruited by purposive and theoretical sampling strategies. Semi-structured, face-to-face, individual interviews were conducted for data collection. The data were transcribed verbatim and analysed using grounded theory coding procedures. The Consolidated Criteria for Reporting Qualitative Research guidelines were followed.Results: Adapting protocol to the evolving context of practice was revealed as the core category. Four interplaying sub-categories were identified: (1) completing a comprehensive assessment, (2) continuing education for emerging infectious disease management, (3) incorporating guideline updates and (4) navigating new duties and competencies. The nurses demonstrated the prudence to orientate themselves to an ambiguous work situation and displayed the ability to adapt and embrace changes in their practice and duties.Conclusions: These findings explain how emergency nurses must adapt and adjust their practice and behaviours to the evolving nature of an epidemic event. These findings also offer insights on the need for education and training schemes that allow emergency nurses to acquire and develop the necessary decision-making and problem-solving skills to handle a public health emergency.

scholarly journals Investigating the Strategies Adopted by Emergency Nurses to Address Uncertainty and Change in the Event of Emerging Infectious Diseases: A Grounded Theory Study

2020 ◽  
Vol 17 (7) ◽  
pp. 2490 ◽  
Author(s):  
Stanley K.K. Lam ◽  
Enid W.Y. Kwong ◽  
Maria S.Y. Hung ◽  
Wai-tong Chien
Keyword(s):  
Grounded Theory ◽  
Infectious Diseases ◽  
Emerging Infectious Diseases ◽  
Theory Approach ◽  
Emergency Nurses ◽  
Problem Solving Skills ◽  
Individual Interviews ◽  
Core Category ◽  
Evolving Context ◽  
Training Schemes

Emergency nurses frequently encounter uncertainty and changes during the management of emerging infectious diseases, which challenge their capability to perform their duties in a well-planned and systematic manner. To date, little is known about the coping strategies adopted by emergency nurses in addressing uncertainty and changes during an epidemic event. The present study explored emergency nurses’ behaviours and strategies in handling uncertainty and practice changes during an epidemic event. A qualitative study based on the Straussian grounded theory approach was established. Semi-structured, face-to-face, individual interviews were conducted with 26 emergency nurses for data collection. Adapting protocol to the evolving context of practice was revealed as the core category. Four interplaying subcategories were identified: (1) Completing a comprehensive assessment, (2) continuing education for emerging infectious disease management, (3) incorporating guideline updates and (4) navigating new duties and competencies. The nurses demonstrated the prudence to orientate themselves to an ambiguous work situation and displayed the ability to adapt and embrace changes in their practice and duties. These findings offer insights into the need for education and training schemes that allow emergency nurses to acquire and develop the necessary decision-making and problem-solving skills to handle a public health emergency.

scholarly journals Emergency nurses’ strategies in addressing uncertainty and change in the management of emerging infectious diseases: A grounded theory approach

2019 ◽  
Author(s):  
Stanley Kam Ki Lam ◽  
Enid Wai Yung Kwong ◽  
Maria Shuk Yu Hung ◽  
Samantha Mei Che Pang ◽  
Wai Tong Chien
Keyword(s):  
Grounded Theory ◽  
Emergency Care ◽  
Emerging Infectious Diseases ◽  
Theory Approach ◽  
Emergency Nurses ◽  
Individual Interviews ◽  
Core Category ◽  
Study Results ◽  
Training Schemes ◽  
Grounded Theory Approach

Abstract Background Uncertainty and change are the inevitable challenges facing emergency nurses, as they are bound by the nature of emergency care. During an epidemic event, emergency care settings are intertwined with urgency, uncertainty, and change, which continuously pose challenges to emergency nurses on their capacity to act on their duties in a well-planned and systematic manner. However, there has been a paucity of understanding concerning emergency nurses’ actions and strategies to address the instabilities and vulnerabilities of the circumstance. The present study aimed to explore emergency nurses’ behaviours and strategies in addressing the challenges of uncertainty and change during an epidemic event. Methods A qualitative design based upon a Straussian grounded theory approach was selected as the method of inquiry. A total of 26 emergency nurses from Hong Kong were recruited in the study by purposive and theoretical sampling strategies. Semi-structured, face-to-face, individual interviews were conducted for data collection. The data were transcribed verbatim and analysed through the grounded theory coding procedures. The COREQ guidelines were applied in the reporting of the present study. Results Rehearsing for improvisation was revealed as the core category. Four interplaying sub-categories were identified: (a) sensing the unclear situation, (b) equipping for the impending battle, (c) calibrating to the evolving guidelines, and (d) navigating the new role and duties. The nurses demonstrated their prudence to orientate themselves to an ambiguous work situation and displayed the flexibility to embrace changes in their practice, roles, and duties. Conclusions The findings delineate that emergency nurses were required to prepare and equip themselves with skills and strategies to improvise and adapt to the management of an epidemic event. The findings also offer insights into the development of education and training schemes that allow emergency nurses to acquire and augment their abilities of decision-making and problem-solving in public health responses.

scholarly journals Coping Experiences: A Pathway towards Different Coping Orientations Four and Twelve Months after Myocardial Infarction—A Grounded Theory Approach

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Mari Salminen-Tuomaala ◽  
Päivi Åstedt-Kurki ◽  
Matti Rekiaro ◽  
Eija Paavilainen
Keyword(s):  
Myocardial Infarction ◽  
Grounded Theory ◽  
Care Practice ◽  
Theory Approach ◽  
Individual Interviews ◽  
Counseling Intervention ◽  
Grounded Theory Method ◽  
Core Category ◽  
State Of Mind ◽  
Negative Coping

Background. Patients recovering from a myocardial infarction (MI) are faced with a number of serious challenges.Aim. To create a substantive theory on myocardial infarction patients’ coping as a continuum.Methods. Grounded theory method was used. Data were collected by using individual interviews. The informants were 28 MI patients.Results. The core category “coping experiences—a pathway towards different coping orientations” includes 2 main categories: “positive and negative coping experiences” (4 months after MI) and “different coping orientations” (12 months after MI).Conclusion. Coping with a myocardial infarction is a long-term dynamic process of dealing with varied emotions and adjustment needs. Coping is threatened, if the patient denies the seriousness of the situation, suffers from depression and emotional exhaustion, or if there are serious problems in the interaction with family members. This study stresses the importance of recognizing the patient’s depressive state of mind and the psychological aspects which affect family dynamics. A more family-centered approach involving a posthospital counseling intervention is recommended.Relevance to Clinical Practice. The results of this study can be used in nursing care practice when organizing support interventions for myocardial infarction patients.

scholarly journals Behavioural Changes in Dementia and their Impact on Professional Caregivers: A Grounded Theory Approach

Dementia ◽  
2017 ◽  
Vol 18 (4) ◽  
pp. 1479-1491 ◽  
Author(s):  
Katie Appleton ◽  
Antonina Pereira
Keyword(s):  
Grounded Theory ◽  
Behavioural Change ◽  
Everyday Practice ◽  
Theory Approach ◽  
Behavioural Symptoms ◽  
Core Category ◽  
Professional Caregiver ◽  
Professional Care ◽  
The Impact ◽  
Grounded Theory Approach

Aim The present study aimed to explore the impact that changes in behavioural symptoms of people living with dementia have on professional caregiver and resident relationships. Method A total of 21 interviews were carried out with professional caregivers of people living with dementia. A grounded theory approach was used to investigate everyday experiences of provision of professional care in dementia settings, focussing specifically on the effect of behavioural change on such relationships. Results A core category emerged from this analysis: ‘Developing behaviour in dementia impacts relationships on a personal and professional level’. Discussion Professionals have recognized as part of their everyday practice an eventual deterioration in relationships between themselves as professional caregivers and the residents, but also between the residents and their family members and among residents themselves. Importantly, understanding patients’ behaviour and behavioural change was identified as a crucial factor to achieve and sustain good relationships between professionals and residents suffering with dementia.

scholarly journals COPING WITH AUTISM: DIFFERENTIAL & UNIQUE PARENTING MOTHERS JOURNEY TOWARDS ADAPTATION-A QUALITATIVE STUDY IN INDIAN CONTEXT BASED ON GROUNDED THEORY APPROACH

2021 ◽  
Vol 9 (02) ◽  
pp. 736-750
Author(s):  
Nisha Laila ◽  
◽  
Linu Sara George ◽  
Shalini G. Nayak ◽  
◽  
...  
Keyword(s):  
Grounded Theory ◽  
Qualitative Study ◽  
Conceptual Model ◽  
Autism Spectrum ◽  
Theory Approach ◽  
Eligibility Criteria ◽  
Training Centre ◽  
Northern India ◽  
Core Category ◽  
Voice Recorder

Objective: The main objective of this study was to explore the experiences of mothers parenting children with Autism Spectrum Disorder (ASD) with a view to formulate a conceptual model of parenting experiences based on the constructs identified. Design &Methods: The study used grounded theory methodology in order to derive a conceptual model for parenting a child with ASD. The participants were mothers between the age group of 24-50 years undergoing parent child training from Autism training Centre, Northern India. The study is based on in depth interviews with twelve mothers who were meeting the eligibility criteria. The interviews were digitally recorded with a voice recorder. The anonymity and confidentiality of the participants were assured. The translated data were coded and categorised using open code software Results: The qualitative data analysis revealed thirteen major categories and forty six sub categories and a core category was derived out of the concepts and formulated a conceptual model of coping with autism, Unique and differential parenting Mothers Journey towards adaptation. Conclusion: This qualitative study provides evidence for parenting experiences of Indian mothers of children with ASD. The findings would provide identification of problems, need based care and guidance for professionals. Practice Implications: The conceptual model formulated could be used as a basis to test the hypothesis in various aspects of the concepts discussed in relation to mothers experiences of a child with ASD and thus a substantive theory of parenting a child with ASD could be developed in future after comparing and concept analysis of the existing parenting theories .

How do hospice nurses prepare to give end-of-life care? A grounded theory study of nurses in one UK hospice

2021 ◽  
Vol 27 (7) ◽  
pp. 334-350
Author(s):  
Sue Griffith ◽  
Leslie Gelling
Keyword(s):  
Grounded Theory ◽  
End Of Life ◽  
End Of Life Care ◽  
Role Models ◽  
Theory Approach ◽  
Life Care ◽  
Core Element ◽  
Hospice Nurses ◽  
Individual Interviews ◽  
Making A Difference

Background: Literature for preparing hospice nurses to deliver end-of-life care is sparse. Aim: To investigate how nurses in one UK hospice prepared to deliver end-of-life care in their role. Methods: A classic grounded theory approach was used to investigate the experiences of 22 registered nurses in one UK hospice, to discover how they prepared for their role. A total of 17 individual interviews and one focus group were conducted. Constant comparison of data and member checking were performed to establish validity. Findings: Findings were synthesised into five categories: the ‘shared ideal’, feeling good at the job, making a difference, experience/exposure to hospice work and the importance of role models. The shared ideal formed the core category, which explained how hospice nurses feel a sense of ‘fit’ with their work. Conclusion: The feeling of a nurse feeling well-suited to the work and that there the work was a good ‘fit’ for them was identified as a core element to nurses' feelings of preparedness to provide end-of-life care.

Equity in nursing care: A grounded theory study

2017 ◽  
Vol 26 (2) ◽  
pp. 598-610 ◽  
Author(s):  
Zahra Rooddehghan ◽  
Zohreh ParsaYekta ◽  
Alireza N Nasrabadi
Keyword(s):  
Grounded Theory ◽  
Health System ◽  
Nursing Care ◽  
Sample Selection ◽  
Main Concern ◽  
Mutual Relationship ◽  
Individual Interviews ◽  
The Core ◽  
Core Category ◽  
Nurses Perceptions

Background: Equity in providing care is also a major value in the nursing profession. Equitable care aims to provide the entire population with safe, efficient, reliable, and quality nursing services at all levels of health. Objectives: This study was conducted to explain the process of the realization of equity in nursing care. Research design: This qualitative study uses Glaser’s approach to grounded theory. Participants and research context: Sample selection began with convenience sampling and continued with purposive sampling. A total of 27 people were ultimately selected as the study subjects. Data were mainly collected through unstructured in-depth individual interviews plus observation and field notes. The data were then analyzed using the “Six C’s” coding family of Glaser. Ethical considerations: The study protocol was approved by the Tehran University of Medical Sciences (91D1302870). Written informed consent was also obtained from all subjects. Findings: According to the findings, participants’ main concern in providing equitable care is the rationing of nursing care. The identification of participants’ main concern led to the emergence of the core category of the study, that is, “nurses’ domination.” The other categories revolving around the core category were conceptualized according to the six C’s coding family: “nurses being dominated,” “nurses’ ineffective power in the health system,” “low attention to equitable care in health system,” “lack of clarity in measuring equitable care,” “the health structure’s inconsistency with equity,” and “the inefficiency of the care system.” Conclusion: There is a mutual relationship between providing fair care and nurses’ perceptions of equity. Nurses who have themselves experienced equity can provide their patients the experience of equity. This mutual relationship is actualized in a context in which fair care is clearly defined and demanded.

scholarly journals Moral Distress in Community and Hospital Settings for the Care of Elderly People. A Grounded Theory Qualitative Study

Healthcare ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1307
Author(s):  
Giulia Villa ◽  
Federico Pennestrì ◽  
Debora Rosa ◽  
Noemi Giannetta ◽  
Roberta Sala ◽  
...  
Keyword(s):  
Grounded Theory ◽  
Protective Factor ◽  
Moral Distress ◽  
The Elderly ◽  
Single Type ◽  
Theory Approach ◽  
Structured Interviews ◽  
Healthcare Settings ◽  
Core Category ◽  
Care Of Elderly

Background: Moral distress has frequently been investigated in single healthcare settings and concerning a single type of professional. This study aimed to describe the experience of moral distress in all the types of professionals providing daily care to elderly patients and residents. Methods: The Grounded Theory approach, developed by Corbin and Strauss, was used. This study included participants from hospital and nursing homes of northern Italy. Purposive and theoretical sampling was used. Between December 2020 and April 2021, semi-structured interviews were conducted. Results: Thirteen participants were included in the study. Four categories were derived from the data: talking and listening, care provider wellbeing, decision making, protective factors, and potential solutions. The core category identified was “sharing daily”. Interviewees confirm how hard it may be to communicate to the elderly, but at the same time, how adequate communication with the leader is a protective factor of moral distress. They also confirm how communication is key to managing or downsizing misunderstandings at all levels. Findings highlight the scarcity of operators as a fundamental trigger of moral distress. Conclusions: Many determinants of this phenomenon lie behind the direct control of professionals, but education can help them learn how to prevent, manage, or downsize the consequences.

scholarly journals Exodus of clergy: Responding to, reinterpreting or relinquishing the call

2017 ◽  
Vol 38 (1) ◽  
Author(s):  
Shaun Joynt
Keyword(s):  
Grounded Theory ◽  
Pastoral Ministry ◽  
Roman Catholic Church ◽  
Future Research ◽  
Theory Approach ◽  
Full Time ◽  
Protestant Church ◽  
The Core ◽  
Core Category ◽  
The Church

�Who will lead the sheep when the shepherds are gone?� Clergy plays an important role in the establishing and sustaining of the church; without them, congregants will not be rooted in the faith nor will the faith be transmitted to the next generation. The shortage of clergy in the Roman Catholic Church and the distribution or displacement challenge facing the Protestant church pose a risk to the future of the church; therefore, the response of clergy to their call to full-time pastoral ministry is crucial for the continued existence of the church. The purpose of this study was to discover the variables involved in responding to the call to full-time pastoral ministry in a church. A grounded theory approach was used to discover the properties of the core category: �calling�. Semi-structured interviews were conducted, and data were coded using Glaser and Strauss� grounded theory methodology. The core category �calling� included properties such as age, defining what a call is or is not; it evolves over time, it has an aspect of timing and it requires �worldly experience� to be effective. Osmer�s descriptive-empirical task was used as a practical theological lens through which to view the core category �calling�. The results indicated three responses by clergy who had left full-time pastoral ministry: not being called in the first place, a dual call (being bi-vocational) and being called but leaving anyway. Further research is needed to assist clergy in accurately identifying and developing their call to full-time pastoral ministry.Intradisciplinary and/or interdisciplinary implications: The research calls for an ongoing dialogue with regard to the concept of clergy calling and initiates this by means of a practical theology perspective of a grounded theory study. Future research recommendations are suggested.

1 Development of the School-Aged Life Impact Burn Recovery Evaluation (SA-LIBRE: 5–12) Profile: A Conceptual Model Framework

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S6-S7
Author(s):  
Camerin A Rencken ◽  
Silvanys L Rodríguez-Mercedes ◽  
Khushbu F Patel ◽  
Gabrielle G Grant ◽  
Erin M Kinney ◽  
...  
Keyword(s):  
Grounded Theory ◽  
Focus Group ◽  
Literature Review ◽  
Conceptual Model ◽  
Burn Injury ◽  
Expert Consensus ◽  
Fine Motor ◽  
Theory Approach ◽  
Model Framework ◽  
Individual Interviews

Abstract Introduction Pediatric burn injuries can alter the trajectory of the survivor’s entire life. Patient-centered outcome measures are helpful to capture and assess their unique physical and psychosocial needs and long-term recovery. This study aimed to develop a conceptual model framework to measure outcomes most important to pediatric burn survivors aged 5 to 12 years as a part of the SA-LIBRE5-12 Computer Adaptive Test (CAT) development. Methods This study used a systematic literature review guided by the WHO International Classification of Functioning – Child and Youth. Previously established domains in the American Burn Association/Shriners Hospitals for Children Burn Outcomes Questionnaire5-18 further guided framework development. Individual interviews with parents and clinicians were conducted to obtain perspectives on domains most important to assess following a burn injury in children aged 5 to 12 years. One clinician focus group was completed to identify gaps in the preliminary framework, and semi-weekly expert consensus meetings were conducted to solidify the framework. Qualitative data were analyzed by grounded theory methodology in NVivo 12 software. Results The literature review identified 82 articles. Eight parents and seven clinicians participated in individual interviews, four clinicians participated in one focus group, and three consultants were included in the expert consensus meetings. The consultants included a burn surgeon, psychiatrist, and health services researcher. Three major domains emerged from the grounded theory approach, including: 1) Physical Functioning: fine motor and upper extremity, gross motor and lower extremity, pain, skin sensitivity, sleep and fatigue, and physical resilience; 2) Psychological Functioning: cognitive, behavioral, emotional, resilience, and body image; and 3) Family and Social Functioning: school, peer relations, community participation, family relationships, and parental satisfaction. Conclusions The comprehensive literature review, clinician and parent individual interviews, clinician focus group, and expert consensus meetings resulted in a conceptual model framework for parent-reported health outcomes after a burn injury in school-aged children aged 5 to 12 years. The framework will be used to develop item banks for a CAT-based assessment of school-aged children’s health and developmental outcomes.

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