Dissertation (Ph.D.)--The University of North Carolina at Greensboro, 2010. / Title from PDF t.p. (viewed Jul. 16, 2010). Directed by Anita Tesh; submitted to the School of Nursing. Includes bibliographical references (p. 90-104).

Thesis (Ph.D.)--Ohio University, November, 2004. / Title from PDF t.p. Includes bibliographical references (p. 145-172)

Construction of a tool to assist nurses to assess the abilities of patients, with chronic conditions, to feed themselves was based upon twenty-one identified feeding behaviors derived from observations of a random sample of fifty such patients from two urban hospitals. Observations were also made of the nurses who cared for these patients. Identifying specific behavior items was concurrent with defining five categories along the dependence-independence continuum during analysis of the data. A 3:1:1 ratio for weighting behavioral components was established arbitrarily. The Kenny Self-care five point numerical rating scale was adapted to provide a method of determining the amount of help a patient would require to feed himself. Experts in the field agreed, with minor modifications, that the tool could determine a measure of independent feeding. A reliability test, using eight pairs of registered nurses to assess thirty-two patients produced a reliability coefficient of .849; evidence that this tool is dependable and consistent in measuring the relative state of feeding dependence-independence of patients with chronic conditions. Rating behaviors provides written evidence of the degree to which the patient is able to feed himself. The difference between what a patient can do and the criteria for independent feeding provides a measure of the help a patient will require to feed himself. Further research is indicated in the areas of usefulness of the tool for registered nurses, identifying psychosocial behaviors more precisely, testing the tool in different feeding situations and expansion of the tool to include the other activities of daily living. / Applied Science, Faculty of / Nursing, School of / Graduate

Fibromyalgia syndrome (FMS) is characterised by chronic widespread pain, tender points and fatigue. A clear biological explanation of FIVIS is lacking, and there is debate regarding the 'legitimacy' of the condition. Often, therefore, people with FIVIS do not obtain a straightforward, clear diagnosis - or any diagnosis at all. This research sought to explore the diagnostic and subsequent experience of people with FIVIS. Semi-structured interviews were conducted with 17 people formally diagnosed with FIVIS. Interviews were tape-recorded, transcribed, and analysed by the inductionabduction method. Findings were triangulated through documentary analysis of lay literature on FMS. Participants referred to their symptoms within a dualistic framework, with symptoms seen as an aggressive force that invades the body. Individuals had high expectations of the medical profession. They expected tests to be done, with a diagnosis and prognosis to follow. The diagnostic process was often reported as complex, ambiguous, and ambivalent. Although individuals were initially relieved following the diagnosis, this was often replaced by shock and uncertainty, as no one appeared to know what FIVIS is, what caused it or how to treat it. Consequently, informants had actively to search for a meaning of FMS through lay networks and literature. Several chose to reject the diagnosis, as it did not represent their own understanding and experience of their symptoms.The meaning attached to FIVISin fluenced participants' coping strategies. They had difficulty finding adequate social support, and while significant others assumed this role, the informants felt uncomfortable. Many expected the medical profession should provide social support, but this was not always forthcoming. People diagnosed with FIVIS expect their illness to be satisfactorily understood and explained by the medical profession. Tensions exist between this expectation and their actual experience.

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

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