Thesis (M.S.)--University of Michigan, 1990.

Thesis (M.S.)--University of Wisconsin, School of Nursing. / eContent provider-neutral record in process. Description based on print version record.

Thesis (M.S.)--University of Wisconsin, Schoold of Nursing. / eContent provider-neutral record in process. Description based on print version record.

Thesis (Ph. D.)--University of Missouri--Columbia, 1999. / "May 1999." Typescript. Vita. Includes bibliographical references (leaves 127-129). Also available on the Internet.

Thesis (M.S.)--University of Michigan, 2001. / Includes bibliographical references.

Background: There has been wide interest shown in the manner in which ethical dimensions in nursing practice are approached and addressed. As a result a number of ethical decision making models have been developed to tackle these problems. However, in this thesis it has been argued that the ethical dimensions of nursing practice are still not clearly understood and responded in Brunei. Design and method: This thesis describes a qualitative analysis into the Bruneian nurses’ perceptions of ethical dimensions in nursing practice. Drawing on constructivist grounded theory as a method of inquiry, twenty eight practicing and administrative nurses were individually interviewed. The nurses described how ethical dimensions were perceived in their practice, by means of the difficulties they are facing in the real world of nursing practice; how they have responded to these difficulties, and why they make such responses. Findings: The nurses described three ethical dimensions in their practice, namely ‘nurse at work’ which illustrates the ethical dimensions within the work environment; ‘nurse and doctor’ that elucidates the ethical dimensions in the nurse and doctor relationship and ‘nurse and patient’ which further examines ethical aspects in patient care. ‘Taking responsibility’ and ‘shifting responsibility to others’ were identified as approaches that the nurses took in responding to the ethical dimensions with the aim of avoiding the conflict and maintaining ward harmony. These responses provide new insights into how nurses’ response to ethical dimension in the ward settings where it puts strong emphasis on the nurses’ understanding of responsibility placed upon them as a professional nurse. ‘Negotiating ethical responsibility’ emerged as a core category within the data which illustrate that nurses’ responses to the ethical dimensions form a continuous process, involving constant consideration of the two types of responses. The core category described that ethical dimensions in the nurses’ practice were contextualised in the ‘ethical responsibility’ that is placed upon them within the nursing organisation. This thesis has expanded the current theoretical knowledge of ethical dimensions by elaborating on the concerns experienced in nursing practice and the responses individual nurses utilise to negotiate and discharge their ethical responsibilities at work. The study has also extended emphasis to the reasoning and responses that nurses are engaged in, whilst at the same time, negotiating ethical responsibility regarding the context in which they are placed during their working hours. This core category provides a number of possible implications for future research, nursing practice, education and policy, which would facilitate the exploration of ethical understanding for nurses in Brunei, and enable the provision of an ethical environment, so making ethical dimensions more transparent.

The purpose of this study was to compare the perception of the nurse and the perception of the patient in identifying priorities for his learning needs with respect to the hospital environment and to his medical condition. A Q-sort of statements related to these two learning needs was developed and used to test the nurses' perception and the patients' perception of these learning needs. The diabetic patient was selected for study because his learning needs with respect to his condition are well documented, and the general staff nurse was selected because she is responsible for direct patient care. To test the hypotheses, the Q-sort was administered to 50 newly hospitalized diabetic patients, to 50 general staff nurses directly responsible for the care of these patients, and to 50 general staff nurses having no contact with a patient or no direct responsibility for his care. The study was conducted in a large hospital in Vancouver, British Columbia. The hypotheses assumed that the two groups of nurses and the patients would assign different priorities to the patients' learning needs. The .05 level of significance was used in this study. An analysis of selected personal characteristics of the patients provided a description of the patient population. The findings showed that all but one patient had been in hospital before, and that only three patients were newly diagnosed diabetics. An analysis of selected personal characteristics of the nurses indicated that there was no significant difference between the two groups. Thus, any differences in perception could not be attributed to these characteristics. The Q-sort scores of all three groups were examined for differences in perception and the selected personal characteristics were tested with respect to these scores. The results indicated that both groups of nurses and the patients assigned a greater degree of importance to the patient's learning needs related to his diabetic condition than those related to the hospital environment. Although the nurses attached a greater degree of importance to the former needs than did the patients, the difference was not significant. The results also indicated that a majority of nurses and patients, matched as pairs, perceived the patient's learning needs related to the diabetic condition as more important, and yet there was a significant difference in perception. Other results showed a high degree of correlation between both groups of nurses and the patients and the nurses responsible for their care, with respect to priorities assigned to statements within each of the two categories of learning needs. Although the selected personal characteristics of each group were tested with respect to their more important Q-sort scores, only a limited number of relationships were significant for the patients and the nurses directly responsible for their care and none for the other group of nurses. These significant relationships were age, marital status, duration of illness, and education of the patients, and additional education and experience of the nurses. The results of the study have demonstrated the value of the Q-sort technique as a procedure for acquiring data with respect to the learning needs of the patient. The analysis of the data of the nurses and the patients under their care provided a measurement of the quality of patient care. In addition, the analysis of the data of the patients provided a guide for the establishment of a desirable learning sequence for the individual patient. / Education, Faculty of / Graduate

This research evaluates whether nurses working in general hospital settings utilise the counselling skills they are taught during their initial nurse training when they practice as qualified nurses. A narrative enquiry methodology was used to gather stories about everyday nurse patient interactions from eight nurses working in a variety of general hospital settings. The stories were tape recorded and transcribed before being subjected to qualitative descriptive analysis, a variant of content analysis, which yielded a number of themes. The analytical process incorporated the use of a hermeneutic circle to reinforce the reliability of the analysis and three types of skill were identified within the narratives. The narratives suggest that nurses do use counselling skills regularly when interacting with patients and carers, in particular the skills of information giving and empathy. These skills are inter-related in nursing practice and their usage stems from the personal experiences of the nurses involved rather than any training received prior to their qualifying as registered practitioners. While the sample size is relatively small the findings might suggest there could be some worth in further research to determine the relational skills possessed by those wishing to enter nurse training. This type of investigation has a resonance with current calls for reform of nurse education and might allow for training in the area of interpersonal skills to become more personalised. Ethical permissions were obtained from NRES, the Ethics committee of the United Lincolnshire Hospitals Trust and the University of Manchester.

An exploratory study was conducted on 25 male and female patients who were admitted to a 29-bed surgical unit of a 450-bed general hospital, for diagnostic testing. The purpose of the study was to answer the following questions: (1) What situations does the patient perceive as helping him feel comfortable while he is experiencing the diagnostic regime? (2) What situations does the patient perceive as making him feel uncomfortable while he is experiencing the diagnostic regime? (3) What coping responses does the patient utilize in adapting to discomfort promoting situations during the diagnostic regime? The data for the study were collected through the utilization of a structured questionnaire for the initial visit and taped interviews with the selected patients. During the interviews, particular emphasis was placed upon exploring the patients' concerns by the use of Orlando's Open-Ended Interview Technique and a modified version of the Critical Incident Technique. The results were then categorized into themes of patient responses, tabulated, and analyzed. The results of the study revealed that the situations the patient perceived as promoting comfort or discomfort were dependent upon two significant variables: (1) The degree to which the patient's personal value system needs were met during the diagnostic regime; (2) The patient's ability to mobilize adaptive coping responses to deal with the stresses created by the diagnostic regime. The coping responses utilized by the patients in adapting to discomfort promoting experiences in hospital were numerous and highly diversified. It was noted that the patients' ability to cope adaptively was primarily influenced by their evaluation of what was happening to them. In turn, this evaluation was affected by their past experience, their present biopsychosocial state, and the duration of the uncomfortable experience. / Applied Science, Faculty of / Nursing, School of / Graduate

This dissertation is an ethnographic exploration of gossip and rumour around the fear and distrust that surrounds a local hospital in KwaNdebele that has acquired a reputation as a slagpale (an Afrikaans term for slaughterhouse). Using ethnographic data gathered over an 18 month period, I examine how gossip (ukuhleba) and rumour (amahemuhemu) capture patient voices of discontent with hospital service while also being a means by which patients seek to discipline medical professionals and to warn others about possible abuse when visiting the hospital. The focus on gossip and rumour answers an often neglected question in scholarship, which is how patients respond to the widely reported power that medical professionals exercise over them? Furthermore, having broadly traced the uses of gossip and rumour in resistance to biomedical technologies to the 1800s, this dissertation moves beyond a focus on patient responses to examine the logic underpinning this resistance. To do this I compare three categories of traditional healers in KwaNdebele. I found that gossip and rumours also circulated about traditional healers although unequally among the three types. There is particular suspicion around non-initiating healers called amagedla who are thought to practice outside ancestral structures of control. I read the emphasis on ancestral regulation as a metaphor for communal control and accordingly conclude that biomedicine and its practitioners similarly meet with much resistance particularly because they are far removed and disempowering to what are often semi-literate and illiterate residents. Finally, the dissertation focuses on stories of hospital hauntings and deaths said to be connected with a diminishing traditional practice of ‘fetching’ the spirits of those who die at the hospital and shows that discourses around hospital deaths and burial rites are intimately connected to broader considerations that extend beyond the hospital setting to encompass socio-economic changes and resultant anxieties. These considerations are framed through an idiom of a call for a return to tradition and ultimately express a perceived crisis of social reproduction in post-apartheid KwaNdebele. / Dissertation (MSocSci)--University of Pretoria, 2018. / UP Postgraduate Merit Bursary / NRF Scarce Skills Master's Scholarship / Anthropology and Archaeology / MSocSci / Unrestricted