Determining Competency for Entry to Nursing Practice: A Grounded Theory Study

<p>Critical Comparative Nursing Assessment (CCNA) is a theory about how the competence of completing Bachelor of Nursing students in New Zealand is determined. Semi-structured, audio-taped interviews and field notes were used to collect data from twenty-seven nurses with experience in undertaking competency assessment. A Glaserian grounded theory approach was used to guide the data collection and analysis. This utilised the processes of constant comparative analysis, theoretical sampling and saturation to generate a middle range substantive grounded theory. This is presented as a model consisting of four emergent categories that explain how nurses formulate professional judgements about competence. These are a) gathering, which describes the processes used to collect evidence of practice to inform decisions; b) weighing up, which explains how evidence is analysed using the processes of benchmarking and comparative analysis; c) judging brings into focus the tensions inherent in making professional judgements about competence and how nurses formulated these, and d) moderating, which describes the processes nurses use to validate decisions and ensure that professional responsibilities and public safety are upheld. The basic social psychological process of comparing integrates these categories to explain how nurses resolve the tensions associated with making decisions about competence. This research presents a new way of viewing and understanding how nurses assess competence. It identifies where the challengers and tensions related to the assessment of competence lie and suggests strategies that if implemented could further enhance the validity and reliability of assessment outcomes.</p>

Determining Competency for Entry to Nursing Practice: A Grounded Theory Study

<p>Critical Comparative Nursing Assessment (CCNA) is a theory about how the competence of completing Bachelor of Nursing students in New Zealand is determined. Semi-structured, audio-taped interviews and field notes were used to collect data from twenty-seven nurses with experience in undertaking competency assessment. A Glaserian grounded theory approach was used to guide the data collection and analysis. This utilised the processes of constant comparative analysis, theoretical sampling and saturation to generate a middle range substantive grounded theory. This is presented as a model consisting of four emergent categories that explain how nurses formulate professional judgements about competence. These are a) gathering, which describes the processes used to collect evidence of practice to inform decisions; b) weighing up, which explains how evidence is analysed using the processes of benchmarking and comparative analysis; c) judging brings into focus the tensions inherent in making professional judgements about competence and how nurses formulated these, and d) moderating, which describes the processes nurses use to validate decisions and ensure that professional responsibilities and public safety are upheld. The basic social psychological process of comparing integrates these categories to explain how nurses resolve the tensions associated with making decisions about competence. This research presents a new way of viewing and understanding how nurses assess competence. It identifies where the challengers and tensions related to the assessment of competence lie and suggests strategies that if implemented could further enhance the validity and reliability of assessment outcomes.</p>

Managing Digital Identities: A Grounded Theory of Mental Health Professionals’ Participation in Online Social Networking

Despite the meteoric rise of social media, little is known about how clinical social workers and other mental health professionals respond to this new form of communication. This study used classic (Glaserian) grounded theory methodology to explore the experiences and concerns of mental health professionals on social networking websites such as Facebook, Twitter, and LinkedIn. The main concern that emerged out of research interviews with 26 mental health professionals was a loss of control over others’ perceptions and the loss of ability to compartmentalize the different parts of identities associated with personal and professional selves. Participants resolved these concerns through the author-identified basic social process of “managing digital identities.” This study highlights practice implications for professionals as they manage online identity.

Diferencias en el análisis de datos desde distintas versiones de la Teoría Fundamentada

La teoría fundamentada (TF) es una metodología de investigación ampliamente conocida y utilizada en las ciencias sociales. Tiene varias versiones (Teoría Fundamentada Glaseriana, Straussiana, Dimensional, Constructivista y Análisis Situacional) que muestran diferencias que tienden a generar cierta confusión en su estudio y uso. Es el caso del proceso de análisis de datos. Para identificar estas diferencias, se realizó una revisión intencionada de la literatura publicada en los últimos 20 años en español, portugués e inglés. Hicimos una búsqueda sistemática en cinco bases de datos científicas y Google Scholar Beta. Fueron seleccionados 72 textos, incluidos libros y artículos de los cuales 31 están escritos por los principales referentes de cada versión y 41 escritos por otros autores y autoras que contribuyen a la comprensión del método. El análisis de estos textos permitió identificar elementos comunes y diferencias significativas. Los resultados encontrados revelan cinco aspectos comunes entre las versiones: comparación constante, muestreo teórico, elaboración de memorandos, sensibilidad teórica y saturación teórica. Asimismo, se encontró diferencias significativas en el proceso de análisis de datos, las corrientes filosóficas de cada versión, la teoría generada, los datos recolectados como entrevistas, entre otros. En particular, el proceso de análisis en las cinco versiones tiene aspectos comunes, pero los procedimientos utilizados son diferentes. Finalmente, se elaboraron representaciones gráficas para facilitar la comprensión del análisis de datos. El artículo facilita a los investigadores, especialmente a los nuevos, reconocer cómo y cuándo encajar en los diversos aspectos utilizados para el análisis de datos, especialmente si los requisitos de la investigación obligan a mezclar o fusionar algunas perspectivas durante el proceso de análisis.Grounded Theory (TF) is a widely known and widely used research methodology in the social sciences. It has various versions (Glaserian Grounded Theory, Straussian, Dimensional, Constructivist and Situational Analysis) show differences that tend to generate some confusion in their study and use. It is the case with the data analysis process. To identify these differences, we carried out an intentional review of the literature published in the last 20 years in Spanish, Portuguese, and English. We did a systematic search in five scientific databases and Google Scholar Beta. We selected 72 texts, included books and articles. They were 31 of them written by the main referents of each version and, 41 were written by other authors who contribute to the understanding of the method. The analysis of these texts allowed us to identify common elements and significant differences. The results that we found reveal five common aspects between the versions: constant comparison, theoretical sampling, elaboration of memoranda, theoretical sensitivity, and theoretical saturation. Also, we found we find significant differences in the data analysis process, the philosophical currents of each version, the theory generated, the data collected as interviews, among others. In particular, the analysis process in the five versions has common aspects, but the procedures used are different. Finally, we elaborate graphical representations to facilitate understanding of data analysis. The article makes it easier for investigators, especially new ones, to recognize how and when to fit in the various aspects used for data analysis, especially if the research requirements force you to mix or merge some perspectives during the analysis process.

Patients’ experiences of the complex trust-building process within digital cardiac rehabilitation

The development of digital solutions is becoming increasingly important in facing global challenges. Therefore, research on this topic is important in taking into account cardiac patients’ experiences of the rehabilitation process for the design of digital counseling solutions. The aim of the present qualitative study was to explore the different meanings that patients give to the rehabilitation process using a Glaserian grounded theory (GT) approach. Qualitative interviews were conducted with 30 participants from a rehabilitation center in Finland. The findings indicated a “complex trust-building process” core category comprising five categories of trust-building in rehabilitation: feeling that one has hit rock bottom, facing and coping in a crosscurrent, understanding together as a peer group, moving toward a healthier lifestyle with technology, and finding self-awareness. The complex process of trust-building involved interactions among emotion, cognition, and acceptance and support processes. Therefore, digital rehabilitation should be incorporated into counseling based on patients’ psychosocial, physical and emotional needs to help patients become aware of their own feelings and thoughts during the rehabilitation process.

Becoming a Channel of God: How Faith Community Nurses Develop Their Spiritual Practice

Purpose: This study explored the underlying process faith community nurses (FCNs) experience in developing their spiritual nursing practice. Design: A qualitative, exploratory design was used. Method: Data from interviews with six FCNs were generated and analyzed using Glaserian grounded theory. Findings: The basic social psychological process, cultivating the soul to become a channel of God, explains the steps these nurses take to achieve stages of presence. Going through these stages of presence, FCNs develop a foundation of God-related beliefs and values, presence with self, presence with God, presence with others, presence with God and others, and become a channel of God. Conclusions: Developing spiritual care competence in assessing and meeting clients’ spiritual needs is necessary to enhance person-centered practice, a vital aspect of holistic care. The model of presence can inform the development of spiritual care competencies and link to other nursing theories including Watson’s theory of caring and Benner’s novice to expert theory. Workplace support is needed for nurses to refine spiritual nursing care practices and integrate spiritual care into practice. Further research regarding the stages of presence could foster deeper understanding of how foundations of God-related values develop.

'Going off track': The consequences of barriers to Ghanaian midwives’ ability to provide quality care.

Despite global efforts to reduce maternal and neonatal mortality rates, the problem continues to persist, especially in Lower- and Middle-Income Countries like Ghana. For years it has been acknowledged that the deployment of well-trained and regulated midwives could provide a cost-efficient way of reducing maternal and neonatal mortality. However, multiple factors including; recently increasing demands made by birthing women, the growing complexity of midwifery work and a shortage of midwives as well as other barriers have affected the ability of midwives to provide quality maternal and neonatal care. This study aims to provide insight into some of the consequences of these barriers that midwives face in their workplaces.MethodsGlaserian Grounded Theory was applied in this study. Semi structured interviews were conducted with twenty-nine (29) midwives and four (4) other workers whose roles impacts on the work of midwives. In accordance with the requirements of grounded theory, data collection and analysis occurred concurrently while building on the data that has already been analyzed. Constant comparison was used throughout the data analysis.ResultsThe analysis of the data indicated that barriers to midwives’ ability to provide quality care have physiological, psychological and socioeconomic consequences on midwives thereby affecting the quality of the care that they offer to women and newborns. ConclusionThe effects of the barriers to midwives’ abilities to provide quality care are intertwined and have consequences on both the midwives as well as on the quality of the care that they provide to patients. By implementing measures to ameliorate or mitigate the effects of the barriers that midwives face in their work, the quality of the care that they provide to women and neonates will be enhanced, which in turn will positively affect the retention of midwives and maximize the benefits of implementing the midwifery model of care.

“Doing Magic With Very Little”: Barriers to Ghanaian Midwives' Ability to Provide Quality Maternal and Neonatal Care

PURPOSEThis study identified barriers that affected Ghanaian midwives' ability to provide quality care to prevent maternal and neonatal mortality.DESIGNGlaserian Grounded Theory was the framework of this study. Interviews were conducted with 33 participants from 10 facilities in seven districts in one region in southern Ghana.FINDINGSMidwives are committed to do their best to provide quality care to women and newborns. Barriers to their care included a lack of resources of care, unsupportive facility management, and client related barriers.CONCLUSIONSMeasures to reduce barriers for midwives to provide quality care must improve health financing at a national and facility level; the encouragement of supportive supervision and management at a facility level; and actions to enhance midwife engagement with clients and communities.