The purpose of this study was to describe the lived experience of nurses who care for hospitalized women outside of an addiction treatment setting who have a problem with drugs and/or alcohol. The relational experiences of ten registered nurses who had cared for women with drug and alcohol problems were elicited. Heideggerian hermeneutic phenomenology was the method used to interpret the nurse participant's meaning of their experience. The theoretical framework that was used to explore the nurses' experience o caring for women who abuse or are dependent on alcohol and/or drugs was Boykin and Schoenhofer's Nursing as Caring (1993). The relational themes that emerged were: Caring in the dark; Intentionally knowing the woman with AOD as a unique person; and Experiencing sisterhood. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2015. / FAU Electronic Theses and Dissertations Collection

The number of adults over the age of 65 years living with one of more chronic illness in the United States is an acknowledged health challenge for the 21st century. This qualitative research investigation examined the lived experience for adults living with one or more chronic illnesses in the context of a community of faith with access to a faith community nurse. Interpretative hermeneutic analysis was used for the phenomenological study. Findings indicate that the adults expressed their primary essence is living in abundance while living faith and living caring. The findings from this study describe the relationship between adults living with chronic illness, the community of faith and the faith community nurse. Further, findings from this study contribute to essential knowledge necessary for developing models of health care in the community for adults living with chronic illness and nursing care in the community that are distinct and complex. Findings will also support the development of interventions in contexts of faith communities to support and strengthen adults living with one or more chronic illness. The emerging specialty practice in nursing labeled faith community nursing holds promise to come alongside current models of health care to support living in abundance. / by Susan MacLeod Dyess. / Thesis (Ph.D.)--Florida Atlantic University, 2008. / Includes bibliography. / Electronic reproduction. Boca Raton, FL : 2008 Mode of access: World Wide Web.

With passage of the Patient Protection and Affordable Care Act (PPACA) and the publication of the Institute of Medicine’s report on the future of nursing, nurses are slated to take on an expanded role in primary healthcare delivery in the near future. Nurse practitioners, in particular, will be instrumental in filling the gap in primary care availability engendered by the increasing specialization of physician practice and increased access to healthcare made possible by the provisions of the PPACA. The need for this study was identified through gaps in the literature related to nurse practitioner practice; specifically, the paucity of quantitative research regarding patients’ perspectives of core holistic nursing values in nurse practitioner care, and, since nursing care is by definition and tradition holistic in nature, this inquiry attempted to quantify the degree to which nurse practitioner care upholds and preserves core holistic nursing values. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2014. / FAU Electronic Theses and Dissertations Collection

Patient engagement has become a widely used term, but remains a poorly understood concept in healthcare. Citations for the term during the past two decades have increased markedly throughout the healthcare-related disciplines without a common definition. Patient engagement has been credited for contributing to improved outcomes and experiences of care. Means of identifying and evaluating practices that facilitate patient engagement in care have become an ethical imperative for patient-centered care. This process begins with a definition of the concept. Concept analysis is a means of establishing a common definition of a concept through identification of its attributes, antecedents and consequences within the context of its use. Concept analysis is a methodology that has been used in social science and nursing as a means to resolve conceptual barriers to theory development in an evolving field. The methodological theory was based in the analytic philosophical tradition and sustained during the 20th century by the strength of philosophical positivism in the health sciences. This concept analysis is guided procedurally by Rogers’ evolutionary approach that incorporates postmodern philosophical principles and well-defined techniques. This dissertation is informed by the expanded and updated perspective of the neomodern era in nursing research, which advances the concept analysis methodology further. An analysis of the concept underlying the term patient engagement in the scientific literature revealed four defining attributes: personalization, access, commitment and therapeutic alliance. These defining attributes were derived through thematic analysis of over 100 individual attributes shared among six categories and three domains. The resultant definition revealed that patient engagement is both process and behavior shaped by the relationship between patient and provider and the environment where healthcare delivery takes place. Patient engagement is defined as the desire and capability to actively choose to participate in care in a way uniquely appropriate to the individual, in cooperation with a healthcare provider or institution, for the purposes of maximizing outcomes or improving experiences of care. In addition to the attributes of the concept identified in the literature, themes relevant to patient engagement were identified through inputs from six focus groups of persons living with HIV in New York City. The focus group participants were convened to inform the development of a mobile application designed to support their healthcare needs. Their experiences, insights and expectations were valuable in ascertaining those actions or behaviors that may serve to assist the patient in obtaining and adhering to care. The focus group transcripts were coded twice. The first round occurred prior to the concept analysis of the literature and used emergent coding methodology to capture meanings independent of the findings of the concept analysis. The second round occurred after the concept analysis of the literature and used the resultant attributes to perform a directed concept analysis of the transcripts. The content analyses of the transcripts from the patient perspective supported and reinforced the attributes from the concept analysis. The focus groups also highlighted another important aspect of patient engagement, that of privacy/confidentiality, which had not been specifically addressed in the concept analysis of the literature. The definition and the identified attributes serve as a heuristic in designing patient engagement strategies and as a basis for future development of the engagement concept in healthcare. The supporting concepts for engagement, especially the role of empathy in the therapeutic alliance, require further clarification and debate. While patient engagement may be promoted through face-to-face interactions or through health information technology, the defining attributes are invariable and should guide the design of engagement processes and tools. Finally, the value of understanding and exploring the defining attributes of patient engagement in medical and nursing education becomes clear, as is the need for continuing clinical training to support and encourage patient engagement skills.

This dissertation examines the assessment and documentation of sexual orientation and gender identity in the home healthcare setting, specifically patient and nurse perceptions of such data collection, as well as what is documented in nurses’ narrative notes about patients’ sexual orientation and gender identity. Chapter One describes the problem of health disparities among lesbian, gay, bisexual and transgender (LGBT) patients and how lack of documentation contributes to this problem. In Chapter Two, an integrated review of the literature on patients’ attitudes and perceptions related to the collection of information about sexual orientation and gender identity in the healthcare setting is reported. In Chapter Three, a qualitative study to determine nurses’ experiences, attitudes, and perceptions related to collecting information about sexual orientation and gender identity in the home healthcare setting is reported, and emergent barriers and facilitators discussed. In Chapter Four, a data mining study to examine what is documented about sexual orientation and gender identity in narrative home care nurses’ notes in an electronic health record is described. Finally, in Chapter Five, the findings of the three studies are summarized, overarching conclusions reported and implications for policy, practice and research are discussed.

The purpose of this study was to determine the relationships between the nurses' decision making model, frequency of Rapid Response Team (RRT) activation, and the nurse's skill at the early recognition of clinical deterioration. A descriptive, cross sectional quantitative design was used. The participants in this study were 167 acute care registered nurses who had activated the RRT at least once in the preceding 12 months. The participants first were asked to recall a time when they had made the decision to activate the RRT and then were asked to complete the instruments used in this study. Using the Nurse Decision-Making Instrument, the participant's decision making model then was categorized as analytic, intuitive, or mixed. The skill at early recognition of clinical deterioration was measured with the Manifestations of Early Recognition Instrument. Participant scores on the two instruments were significantly correlated with each other as well as to their frequency of RRT activation over the preceding 12 months. The findings of this study indicated that nurses who used analytical decision making activated the RRT with greater frequency than either the intuitive or mixed decision makers. In addition, registered nurses who used analytical decision making to activate the RRT tended to have higher levels of skill in the early recognition of clinical deterioration, as measured by the MER, than either the intuitive or mixed decision makers. Another finding of this study was that RNs with higher levels of skill in the early recognition of clinical deterioration tended to activate the RRT more frequently than RNs with lower levels of this skill. The implications of this study are that the use of analytical decision making may result in more frequent activation of the RRT. / Increased frequency of RRT activation has been linked in the literature with decreased patient mortality rates. The significance of the findings from this study is that the use of analytic decision making has the potential to reduce the incidence of the number one patient safety indicator, failure to rescue. / by Carlo G. Parker. / Thesis (Ph.D.)--Florida Atlantic University, 2011. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2011. Mode of access: World Wide Web.

This study was designed to describe the attitudes of staff nurses toward patients who have Acquired Immunodeficiency Syndrome (AIDS), and to determine if the 1989 Washington State licensing requirement for seven hours of AIDS education was effective in changing the attitudes of these nurses toward AIDS patients. Health care providers' attitudes toward patients with AIDS have been documented as differing from their attitudes toward patients with other debilitating conditions (cancer, diabetes, heart disease) in that they place more blame for getting the disease on those with AIDS, they tend to have some degree of homophobia, and they are sometimes overly cautions in using protective procedures around these patients. The consequence of these attitudes can be seen in the nursing care received by some of these patients: insensitive comments and avoidance behavior by staff.

"September 2002" Includes bibliographical references (leaves 301-318)

The increasing prevalence and severity of anorexia among the young has led to an increase in the number of paediatric hospital admissions and readmissions over the years. Moreover there has been a significant drop in the age of patients being admitted to hospitals for treatment. Recognising the importance of the nursing role and the therapeutic relationship, this thesis reports specific detailed insights into the daily routine of nurses and adolescents with anorexia on a ward, which bases its re-feeding program on behaviour-modification principles (‘The Level System’), and the impact of this program on nurse-patient relationships. In many ways, life for an adolescent with anorexia on the ward mirrored life for a prison inmate. Within ‘The Level System’ program, nurses and doctors became analogous to prison officers. The subsequent themes reflect these similarities. The study provides positive recommendations for constructive change to improve the lives of both nurses and patients and further enhances lay and professional understandings of the nursing care for adolescents with anorexia within a behaviour-modification treatment program. / Doctor of Philosophy (PhD)

The notion of 'Care' has occupied a central place as foundation in nursing theory, ethics and practice. An examination of critical and authoritative documents reveals that the term is vague and ill defined. The literature on care does not theorise the concept as fully as expected in a profession where the concept is considered central. Moreover, even the best theories of care neglect justice. Applying Wittgenstein's concept of family resemblance allows the debate to move on from definitional issues to assess the applicability of 'care' to the practice of the profession. An examination of a range of assessments of nursing practice shows that although 'care' is frequently used in connection with nursing, it does not appear to be a major consideration in key areas of appraisal. This thesis explores the relationship between care and justice in nursing and proposes that they be integrated within nursing theory. A theory for nursing that does not exclude care, but that has justice as its basis is proposed. Care, when used in the context of justice provides nursing with a theory that is appropriate not only for nursing theory and ethics but also assists the profession meet the demands of modern practice.