This thesis is about patient/nurse interaction in a community practice. My aim is to advance sociologically informed understandings about patient/nurse interaction. The key areas of inquiry in my grounded theory study are: The meanings and understandings expressed in patient/nurse interaction. The influence of socio-cultural characteristics in patient/nurse interaction. My study was conducted in a community practice setting using the traditional discovery methodology of Glaser and Strauss (1967). The community practice setting is four health centres with social and geographical differences. The participants in the study are patients attending those health centres and practice nurses who work there. Research methods are observations, informal interviews and semi-structured interviews. Constant comparative analysis supports my research process. My substantive theory is constructed from the generation of two categories: Investment and Experience. The category of Investment relates to the social assets and resources brought to patient/nurse interaction. The category of Experience relates to the historically crafted meanings and understandings that individuals bring to patient/nurse interaction. Together, these categories contribute to understandings of patient/nurse interaction in a community practice setting. I argue in this thesis that the meanings and understandings that patients and nurses bring to interaction provide the social dimension that is quintessential and foundational in their relationship. I also argue that the social construction of reality of being a patient or a nurse is related to the socio-cultural characteristics that they bring to their performance in patient/nurse interaction. I show that performance as a patient or a nurse is initiated and achieved via processes of acting and reacting to each other in relation to socio-cultural characteristics. I demonstrate that the meanings and understandings patients and nurses generate from experiences beyond and including their situated need/care interaction are pivotal in the negotiation of their relationship. Empowerment plays a central role in processes of negotiation and is connected to the social construction of reality in patient/nurse interaction. My substantive theory contributes to understanding of patient/nurse interaction and raises the visibility of negotiation, empowerment, and the influential role of socio-cultural characteristics. The implications of my substantive theory relate to the involvement and participation of stakeholders in health care practice and delivery. In nurse education, the standards of proficiency for eligibility to register with the NMC should be revised to include the social dimension of patient/nurse interaction as a domain of practice. I conclude by arguing that sociologically informed understandings need to be expanded and applied in health care and nursing with contemporary social policy and current priorities for health in mind.

Nursing is uniquely demanding work and occupational stress in the nursing profession has been well-documented. Many theories of stress-related disruptions among helping professionals have been proposed. Although these theories differ slightly in their origin of stress, they share similarities in nurses’ response to the patient relationship. Depersonalization, withdrawal, and avoidance all serve to create relational distance between the nurse and the patient. Despite the prevalence of these responses, there are not any theories on the nurses’ process of disengagement from patient relationships. Using Strauss and Corbin’s (1990) grounded theory method, this study explored acute care nurses’ experience of disengagement in patient relationships. The purpose of the study was to develop a mid-range theory of nurses’ process of disengagement from patient relationships as it occurred in acute care. Through purposive and theoretical sampling, 12 acute care nurses participated in open-ended individual interviews. The process of open, axial and selective coding discovered seven categories related to nurses’ experience of disengagement from patient relationships. These categories were emotional experience, behavioural expression, environmental influences, relational distance, professional identity and work spillover. Although these categories were exclusive, conceptual elements were interwoven into more than one category. The categories were interrelated around the core category, ‘Doing and Being’, and the process of nurses’ disengagement from patient relationships was delineated. Participants in the study experienced dissonance when they were unable to act in accordance to their caring beliefs. Conditions in the work environment, such as the lack of time, the culture of productivity and patient characteristics influenced and promoted their process of disengagement. Disengagement was manifested in the nurse-patient relationship by decreased eye contact, increased physical distance and increased task focused behaviour. These behaviours increased relational distance between the nurse and the patient. Nurses’ experience of dissonance had the potential to foster feelings of professional dissatisfaction and alienation from self, leading to increased turnover behaviour and depression. Implications and recommendations for practice and future research are discussed.

Thesis (M Nursing)--University of South Australia, 1998

Thesis (MEd) -- University of South Australia, 1993

The phenomenon of human globalisation has led to the creation of a new social world, one which is characterised by its cultural diversity. Health services constitute one of the most fundamental of social organisations, so with this change, has come a need for nurses to provide relevant and appropriate care to the multiplicity of peoples who now live in contemporary social communities. Providing appropriate nursing care today is demanding new skills of nurses and to ensure that they can meet this demand, new knowledge and understanding is required. To do this well, constitutes one of the greatest contemporary challenges facing nursing. The aim of this study was to identify and analyse the theories and models of nursing that hold authority on and guide cross-cultural care giving in nursing. The thesis underlying this study was to respond to the question - when nurses have had access to cultural care theory and its related literature for some 30 years, why has this not, as yet, had a significant impact on nursing? The intent being to explore the genesis and development of the knowledge used to underpin cross-cultural care in nursing and by doing so assist nurses to better understand, in the fullest sense, the meanings that are being created and conveyed. To achieve this, a qualitative methodology was employed to make possible the description and interpretation of existing theory with a critical approach being taken towards that text. Understanding and unmasking the theory revealed both overt and covert beliefs and ideas intrinsic to the discourse, which have the potential to shape and configure nurses’ attitudes, opinions and perspectives. This research has considered, explored and analysed contemporary theories of cross-cultural nursing to provide clarification and enhance the capacity of nurses to gain a fuller understanding of cross-cultural care. It offers new insights into the viewpoints being advanced and opens up fresh possibilities for the development of a deeper understanding of Western scholarship on culture in nursing. The findings also identify areas for continued inquiry, which if focused upon and developed into the future, could contribute to improvements in nursing and greater understanding of the complex domain of cross-cultural care.

The phenomenon of human globalisation has led to the creation of a new social world, one which is characterised by its cultural diversity. Health services constitute one of the most fundamental of social organisations, so with this change, has come a need for nurses to provide relevant and appropriate care to the multiplicity of peoples who now live in contemporary social communities. Providing appropriate nursing care today is demanding new skills of nurses and to ensure that they can meet this demand, new knowledge and understanding is required. To do this well, constitutes one of the greatest contemporary challenges facing nursing. The aim of this study was to identify and analyse the theories and models of nursing that hold authority on and guide cross-cultural care giving in nursing. The thesis underlying this study was to respond to the question - when nurses have had access to cultural care theory and its related literature for some 30 years, why has this not, as yet, had a significant impact on nursing? The intent being to explore the genesis and development of the knowledge used to underpin cross-cultural care in nursing and by doing so assist nurses to better understand, in the fullest sense, the meanings that are being created and conveyed. To achieve this, a qualitative methodology was employed to make possible the description and interpretation of existing theory with a critical approach being taken towards that text. Understanding and unmasking the theory revealed both overt and covert beliefs and ideas intrinsic to the discourse, which have the potential to shape and configure nurses’ attitudes, opinions and perspectives. This research has considered, explored and analysed contemporary theories of cross-cultural nursing to provide clarification and enhance the capacity of nurses to gain a fuller understanding of cross-cultural care. It offers new insights into the viewpoints being advanced and opens up fresh possibilities for the development of a deeper understanding of Western scholarship on culture in nursing. The findings also identify areas for continued inquiry, which if focused upon and developed into the future, could contribute to improvements in nursing and greater understanding of the complex domain of cross-cultural care.

The purpose of this study was to develop a substantive theory or at least a set of theoretical propositions explaining the process of nurse-patient interaction in the presence of technology. This study was undertaken in Perth, Western Australia. The grounded theory method was chosen to undertake this research.The study's informants consisted of nurses. Theoretical sampling led to the inclusion of patients and patients' relatives. Purposive and theoretical sampling were used to choose the informants. Data were obtained using field observations and formal and informal interviews with nurses and post-discharge patients. Data analysis was conducted using the constant comparative method (Glaser and Strauss, 1967), writing memos and drawing a schema. The Ethnograph software package (Seidel, 1988) was used to organize and manage the data.The findings of the study indicated that nurses were stymied in their person-centered interactions with patients in the presence of technology. Nurses used the process of navigating the course of interaction to deal with this problem. The process of navigating the course of interaction consisted of three phases. These were the phases of embarking, steering and veering and disembarking. The action/interaction of the process occurred during the steering and veering phase and four specific strategies of interaction became evident in this research. These strategies of interaction were steadying, demurring, coasting and maximizing. The strategies of interaction used by nurses did not center on one type. There was rather a movement between strategies during and between interactions with patients in the presence of technology. This movement was termed oscillating connections. Conditions that modified the core process of navigating the course of interaction were also identified. The findings of the study provide an understanding of the problem ++ / encountered by nurses in their interaction with patients in the presence of technology and the process used by the nurses to deal with this problem.

Thesis (M.S.)--University of Nevada, Reno, 2007. / "May 2007." Includes bibliographical references (leaves 38-41). Online version available on the World Wide Web. Library also has microfilm. Ann Arbor, Mich. : ProQuest Information and Learning Company, [2007]. 1 microfilm reel ; 35 mm.

Thesis (Ph. D.)--University of Washington, 1995. / Vita. Includes bibliographical references (leaves [66]-70).

Thesis (M.P.A.)--Kutztown University of Pennsylvania, 1991. / Source: Masters Abstracts International, Volume: 45-06, page: 2948. Abstract precedes thesis as 6 preliminary leaves. Typescript. Includes bibliographical references.